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1.
Pflege ; 34(2): 80-91, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33576697

RESUMEN

Working conditions of nurses in general palliative care in Germany - A cross-sectional survey Abstract. Background: Most terminally ill people are treated within general palliative care including outpatient care, nursing homes and hospitals. In contrast, only a small number is treated within specialised palliative care. Nursing research within the framework of palliative care focuses on the latter. AIM: To investigate the working conditions of nurses working in general palliative care and to analyse potential differences between nurses in outpatient care, in nursing homes and in hospitals. METHODS: A cross-sectional survey was conducted among nurses working in outpatient care, in nursing homes and in hospitals. The questionnaire included questions about working conditions, parts of the Copenhagen Psychosocial Questionnaire and self-developed questions. Descriptive and bivariate analyses were conducted. RESULTS: 437 questionnaires entered final analyses (response rate 16.7 %). On average, nurses spend 20 % of their working time with palliative care. Every fourth nurse (n = 104) express the wish for an additional qualification in palliative care. The following demands are reported: confrontation with pain, death and dying, as well as care of relatives. 59 % (n = 249) of the nurses evaluate the quality of palliative care as good / very good. CONCLUSIONS: Nurses are faced with demands, which so far had only been a subject of discussion within the framework of the specialised palliative care. Further steps for action, in particular the additional qualification in palliative care for nurses, should be discussed.


Asunto(s)
Enfermería de Cuidados Paliativos al Final de la Vida , Estudios Transversales , Alemania , Enfermería de Cuidados Paliativos al Final de la Vida/organización & administración , Humanos , Encuestas y Cuestionarios , Carga de Trabajo/estadística & datos numéricos
2.
J Hosp Palliat Nurs ; 23(2): 120-127, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33633091

RESUMEN

Outbreaks of COVID-19 among nursing homes, assisted living facilities, and other long-term care facilities in the United States have had devastating effects on residents. Restrictions such as banning visitors, sequestering residents, and testing health care staff have been implemented to mitigate the spread of the virus. However, consequences include a decline in mental and physical health, decompensation, and a sense of hopelessness among residents. We present and explore a case study at an assisted living facility addressing the ethical issues in balancing the management of the community versus the resident's right to autonomy and self-determination. A team of palliative care experts was brought into assisted living facilities to manage patients, care for well residents, and provide input in advance care planning and symptom management. The principles of self-determination and autonomy, stewardship, and distributive justice were explored. The use of nursing skills in triage and assessment, principles in public health, and the 8 domains of palliative care provided a comprehensive framework for structuring emergency operations. Palliative interventions and the role of palliative care nurses played an integral part in addressing ethical challenges in the containment of the virus and the deleterious effects of social isolation among the elderly.


Asunto(s)
Instituciones de Vida Asistida/ética , Brotes de Enfermedades , Enfermería de Cuidados Paliativos al Final de la Vida/ética , Salud Pública/ética , Anciano , Instituciones de Vida Asistida/organización & administración , Humanos , Cuidados a Largo Plazo/ética , Estudios de Casos Organizacionales , Estados Unidos/epidemiología
3.
J Hosp Palliat Nurs ; 23(2): 128-134, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33633092

RESUMEN

Northern New Jersey was inside one of the worst initial coronavirus disease 2019 pandemic epicenters in the United States. At the peak of the pandemic surge in mid-April 2020, New Jersey saw 8045 hospitalized patients with severe coronavirus disease 2019 symptoms, of which 2002 were in intensive care unit beds (86.3% of statewide capacity), including 1705 requiring mechanical ventilation. Because of the severity of pulmonary dysfunction/hypoxia, the unprecedented numbers of critically ill patients, the national opioid shortage, and transmission prevention measures for standard palliative care treatment protocols in place for refractory and/or end-of-life dyspnea were found to be ineffective in providing adequate symptom relief. The aim of the following Notes From the Field is to provide concise, pragmatic, and experiential reflection by 3 palliative care advanced practice nurses from 3 different hospital systems within the pandemic epicenter. The novel methods and opioid strategies implemented by their respective palliative care teams to ensure continued effective and appropriate treatment for end-of-life dyspnea are described. These accounts include Lessons Learned in order to assist others who may need to quickly implement changes in the future due to pandemic resurgence or second-wave events.


Asunto(s)
/enfermería , Brotes de Enfermedades , Disnea/enfermería , Enfermería de Cuidados Paliativos al Final de la Vida , /epidemiología , Hospitalización , Humanos , New Jersey/epidemiología
5.
Int J Palliat Nurs ; 27(1): 37-45, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33629909

RESUMEN

BACKGROUND: Occupancy is commonly used to measure bed management in hospices. However, the increasing complexity of children and young people and growing dependence on technology mean that this is no longer effective. AIM: To develop a dependency tool that enables the hospice to safely and effectively manage the use of beds for planned short breaks (respite care), preserving capacity for children requiring symptom management and end-of-life care. METHODS: A comprehensive literature review and existing tools were used to inform the development of the Martin House Dependency Tool Framework. Training was provided to staff and the tool was piloted before applying it across the hospice caseload. FINDINGS: The tool has been used on 431 children (93.1% of caseload). The tool enabled consistency of assessment and more effective management of resources, due to a contemporaneous understanding of the clinical needs of those on the caseload. CONCLUSION: The tool has enabled consistent and transparent assessment of children, improving safety, effectiveness and responsiveness, and the management of the workforce and resources.


Asunto(s)
Cuidados Paliativos al Final de la Vida/organización & administración , Enfermería de Cuidados Paliativos al Final de la Vida , Modelos de Enfermería , Cuidados Paliativos/organización & administración , Ocupación de Camas , Inglaterra , Hospitales para Enfermos Terminales , Humanos , Evaluación de Necesidades , Asignación de Recursos , Cuidados Intermitentes/organización & administración
6.
Int J Palliat Nurs ; 27(1): 30-36, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33629911

RESUMEN

BACKGROUND: The demand for hospice-at-home (HH) nurses is increasing due to an ageing global population and many people preferring to die at home. Therefore, the retention of existing HH nurses is vital. AIMS: This paper explores HH nurses' experiences of caring for dying patients to discover the factors that enable them to maintain their enthusiasm for their work, and cope with the challenges of working in a patient's home. METHODS: This qualitative study consisted of multiple unstructured interviews with 16 HH nurses conducted in England. FINDINGS: The interviews show that HH nurses: use a broad range of coping mechanisms; encounter intense, complex, unpredictable and ethically unclear challenges; identify a need for more support; and love their job. CONCLUSION: In order for nurses to continue to enjoy their job, extra support to incorporate protected time for debriefing at the end of an HH nurse's shift is needed. Nurses also need training to develop positive coping skills, external supervision on a one-to-one basis as needed, and have their value demonstrated, by their employers and managers recognising and acknowledging them. These factors are likely to facilitate in the retention of employment of HH nurses.


Asunto(s)
Actitud del Personal de Salud , Servicios de Atención de Salud a Domicilio , Enfermería de Cuidados Paliativos al Final de la Vida , Adaptación Psicológica , Inglaterra , Humanos , Entrevistas como Asunto , Satisfacción en el Trabajo , Evaluación de Necesidades , Estrés Laboral , Muestreo
7.
Int J Palliat Nurs ; 27(1): 20-29, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33629912

RESUMEN

BACKGROUND: An 8-month rotation programme was implemented for five nurses employed in two kinds of children's palliative care environments: hospital wards and hospices. This study reports the views of the nurses completing the rotation. The research drew on appreciative inquiry and involved a pre- and post-rotation interview and questionnaire. Thematic analysis of the interviews revealed seven themes: adjusting to the rotation programme; support mechanisms; being safe; new knowledge and skills; knowledge exchange; misconceptions; future plans. These were supported by the questionnaire findings. Although the nurses identified some frustration at having to undertake competency assessments relating to previously acquired skills, as well as being out of their 'comfort zone', all the participants highly recommended the programme. They commented very positively on the support they received and the overall learning experience as well as the new insight into different aspects of care. In addition, they were able to share their newfound knowledge and expertise with others.


Asunto(s)
Actitud del Personal de Salud , Enfermería de Cuidados Paliativos al Final de la Vida/educación , Personal de Enfermería/educación , Enfermería Pediátrica/educación , Competencia Clínica , Humanos , Satisfacción en el Trabajo , Londres , Evaluación de Programas y Proyectos de Salud
8.
J Contin Educ Nurs ; 52(3): 130-135, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33631023

RESUMEN

BACKGROUND: COVID-19 has highlighted the need for universal palliative care access. Nurses require palliative care education throughout the trajectory of professional training to effectively achieve this vision. METHOD: Review of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care and use of educational exemplars highlight opportunities for improving palliative nursing education in academic and clinical settings. RESULTS: Consistently applying palliative care principles affects nursing outcomes across myriad domains of person-centered services. All nurses are responsible for delivering primary palliative care, but they cannot practice what they do not know. The End-of-Life Nursing Education Consortium Project offers evidence-based education for nursing students and practicing nurses nationally and globally. CONCLUSION: Equipping both nurses and nursing students with palliative care education is critical to improve the overall quality of health care throughout the continuum during COVID-19 and in the face of future health crises. [J Contin Educ Nurs. 2021;52(3):130-135.].


Asunto(s)
/epidemiología , Educación Continua en Enfermería/organización & administración , Salud Global , Enfermería de Cuidados Paliativos al Final de la Vida/educación , Cuidados Paliativos/normas , Curriculum , Humanos , Pandemias , Guías de Práctica Clínica como Asunto , Estados Unidos/epidemiología
9.
Am J Nurs ; 121(3): 60-63, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33625014

RESUMEN

This series on palliative care is developed in collaboration with the Hospice and Palliative Nurses Association (HPNA; https://advancingexpertcare.org). The HPNA aims to guide nurses in preventing and relieving suffering and in giving the best possible care to patients and families, regardless of the stage of disease or the need for other therapies. The HPNA offers education, certification, advocacy, leadership, and research.


Asunto(s)
Administración Oral , Analgésicos Opioides/uso terapéutico , Infusiones Parenterales , Morfina/uso terapéutico , Oxicodona/uso terapéutico , Dimensión del Dolor , Relación Dosis-Respuesta a Droga , Enfermería de Cuidados Paliativos al Final de la Vida , Humanos , Rol de la Enfermera , Cuidados Paliativos
11.
Nursing (Säo Paulo) ; 24(272): 5108-5114, jan.2021.
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1148441

RESUMEN

Objetivo: identificar os conceitos e cuidados de enfermagem relacionados a Lesão Terminal de Kennedy disponíveis na literatura. Método: Trata-se de uma revisão integrativa que utilizou como base de dados BVS e Portal de Periódicos CAPES, usando os referenciais MEDLINE, LILACS, BDENF e SciELO. Foram considerados estudos que avaliavam a Lesão Terminal de Kennedy e cuidados de enfermagem. Resultados: Foram incluídos um total de 05 publicações no formato de textos e resumos completos, sendo 04 estudos e 01 editorial. Os estudos são de língua estrangeira (inglês e espanhol), reforçando assim a alerta para a necessidade da comunidade científica nacional. Os dados foram categorizados, sendo agrupados em duas categorias: Úlcera Terminal de Kennedy e suas peculiaridades e Implementações de Enfermagem no fim da vida. Conclusão: Percebe-se ainda uma escassez nos estudos científicos principalmente pela comunidade científica nacional em particular os enfermeiros demonstrando o déficit de conhecimentos produzidos relacionados ao cuidar de pacientes acometidos pela Lesão Terminal de Kennedy.(AU)


Objective: to identify the nursing concepts and care related to Kennedy's Terminal Injury available in the literature. Method: This is an integrative review that used the BVS and CAPES Journals Portal Database, using the MEDLINE, LILACS, BDENF and SciELO. Studies that evaluated Kennedy's Terminal Injury and nursing care were considered. Results: A total of 05 publications in the form of texts and full abstracts were included, 04 studies and 01 editorial. The studies are in a foreign language (English and Spanish), thus reinforcing the alert to the need of the national scientific community. The data were categorized, being grouped into two categories: Kennedy's Terminal Ulcer and its peculiarities and the strategies of Nursing actions at the end of life. Conclusion: There is still a shortage in scientific studies mainly by the national scientific community, in particular nurses demonstrating the lack of knowledge produced related to caring for patients affected by Kennedy's Terminal Injury.(AU)


Objetivo: identificar los conceptos y cuidados de enfermería relacionados con la Lesión Terminal Kennedy disponibles en la literatura. Método: Se trata de una revisión integradora que utilizó la base de datos del Portal de Revistas de la BVS y CAPES, utilizando las referencias MEDLINE, LILACS, BDENF y SciELO. Se consideraron los estudios que evaluaron la lesión terminal de Kennedy y la atención de enfermería. Resultados: Se incluyeron un total de 05 publicaciones en forma de textos y resúmenes completos, 04 estudios y 01 editorial. Los estudios son en lengua extranjera (inglés y español), reforzando así la alerta a la necesidad de la comunidad científica nacional. Los datos fueron categorizados, agrupándose en dos categorías: Úlcera Terminal Kennedy y sus peculiaridades y las estrategias de actuación de Enfermería al final de la vida. Conclusión: Aún existe una escasez de estudios científicos principalmente de la comunidad científica nacional, en particular enfermeras que demuestren la falta de conocimiento producido relacionado con el cuidado de los pacientes afectados por la Lesión Terminal Kennedy.(AU)


Asunto(s)
Humanos , Cuidados Paliativos , Cuidado Terminal , Úlcera , Heridas y Traumatismos , Enfermería de Cuidados Paliativos al Final de la Vida
12.
Clin J Oncol Nurs ; 25(1): 17-22, 2021 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-33480883

RESUMEN

Palliative care was once believed to be too high-touch to be delivered via telehealth. However, numerous studies have demonstrated the positive effects of palliative care delivered through telehealth. Because the COVID-19 pandemic has quickly shifted how health care is delivered to patients with cancer, particularly because of their immunocompromised status and the risks associated with unnecessary exposures in the clinic, previous lessons from palliative care research studies can be used to inform practice. This article presents a case study that illustrates evidence and best practices for continuing to deliver palliative care via telehealth after COVID-19 restrictions are lifted.


Asunto(s)
/mortalidad , /prevención & control , Comunicación , Enfermería de Cuidados Paliativos al Final de la Vida/normas , Enfermería Oncológica/normas , Telemedicina/normas , Adulto , Anciano , Prestación de Atención de Salud/normas , Resultado Fatal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Guías de Práctica Clínica como Asunto , Estados Unidos
13.
J Pain Symptom Manage ; 61(3): e1-e5, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33359217

RESUMEN

CONTEXT: In spring 2020, New York experienced a surge of patients hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) disease, as part of a global pandemic. There are limited data on populations of COVID-19-infected patients seen by palliative care services. OBJECTIVE: To describe a palliative care population at one New York hospital system during the initial pandemic surge. METHODS: This repeated cross-sectional, observational study collected data on palliative care patients in a large health system seen during the COVID-19 outbreak and compared it with pre-COVID data. RESULTS: Palliative service volume surged from 678 (4% of total admissions) before COVID-19 to 1071 (10% of total admissions) during the COVID-19 outbreak. During the outbreak, 695 (64.9%) of the total palliative patients tested positive for the virus. Compared with a preoutbreak group, this COVID-19-positive group had higher rates of male (60.7% vs. 48.6%, P < 0.01) and Latino (21.3% vs. 13.3%; P < 0.01) patients and less white patients (21.3% vs. 13.3%; P < 0.01). Our patients with COVID-19 also had greater prevalence of obesity and diabetes and lower rates of end-stage organ disease and cancers. The COVID-19-positive group had a higher rate of intensive care unit admissions (58.9% vs. 33.9%; P < 0.01) and in-hospital mortality rate (57.4% vs. 13.1%; P < 0.01) than the preoutbreak group. There was increased odds of mortality in palliative care patients who were COVID-19 positive (odds ratio = 3.21; 95% confidence interval = 2.43-4.24) and those admitted to the intensive care unit (odds ratio = 1.45; 95% confidence interval = 1.11-1.9). CONCLUSION: During the initial surge of the COVID-19 pandemic in New York, palliative care services experienced a large surge of patients who tended to be healthier at baseline and more acutely ill at the time of admission than pre-COVID-19 palliative patients.


Asunto(s)
/mortalidad , Enfermería de Cuidados Paliativos al Final de la Vida , Hospitalización , Cuidados Paliativos , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Mortalidad Hospitalaria , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , New York , Pandemias
15.
Enferm. intensiva (Ed. impr.) ; 31(4): 170-183, oct.-dic. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-197685

RESUMEN

OBJETIVO: Comprender el sentido otorgado por los profesionales de la salud de la Unidad de Cuidado Intensivo (UCI), respecto a los cuidados del paciente al final de la vida, y de sus familiares. MÉTODOS: Estudio cualitativo con un diseño Investigación-Acción (IA), en dos UCIs de la ciudad de Bogotá. Se formó un grupo en cada unidad, cada uno incluyó mínimo seis trabajadores de la salud. Las técnicas de recogida de datos fueron: 4 Asambleas participativas y 6 narrativas clínicas. El análisis de datos incluyó la preparación de los datos, descubrimiento de temas, codificación e interpretación de datos, relativización y rigor de los datos. RESULTADOS: Participaron 20 trabajadores de UCI, del análisis de los datos emergieron cuatro categorías: Equipo multidisciplinario de UCI frente al proceso de fin de vida, Manejo del paciente crítico y de su familia, al final de la vida en UCI, Proceso de Comunicación entre el paciente, familia y equipo multidisciplinario al final de la vida, Aspectos éticos al final de la vida en la UCI. CONCLUSIONES: Los profesionales conciben como un objetivo terapéutico, preservar la calidad de vida durante la estancia del paciente en UCI. Para los profesionales de la salud, es fundamental desarrollar guías basadas en la evidencia que faciliten el manejo multidisciplinar al final de la vida, la personalización de la atención, la comunicación efectiva, la satisfacción de las necesidades físicas, emocionales y espirituales de la persona y su familiar y favorecer el derecho de autonomía del paciente en la toma de decisiones


OBJECTIVE: To understand for what care of the patient at the end of life and their relatives means to ICU health professionals. METHODS: Qualitative study with a Research-Action (AI) design, in two intensive care units of the city of Bogotá. Groups were formed in each unit and each group included at least six health professionals, the data collection techniques were: 4 participative assemblies and 6 clinical narratives, the data analysis was done through the preparation of the data, discovery of topics, coding and interpretation of data, relativisation and rigour of the data. RESULTS: 20 ICU workers participated, the analysis of the data revealed four thematic categories: Multidisciplinary team of the ICU facing the end-of-life process, Management of critical patients and their families at the end of life in the ICU, Communication process between the patient, family and multidisciplinary team at the end of life, Ethical aspects at the end of life in the ICU. CONCLUSIONS: The professionals consider preserving quality of life during the patient's stay in the ICU a therapeutic objective. The development of evidence-based guidelines that facilitate multidisciplinary management at the end of life, customisation of care, effective communication, fulfilling the physical, emotional and spiritual needs of the person and their family and favouring the patient's right of autonomy in decision making


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Personal de Salud/organización & administración , Cuidados Paliativos al Final de la Vida/métodos , Unidades de Cuidados Intensivos , Personal de Salud/psicología , Enfermería de Cuidados Paliativos al Final de la Vida/métodos , Familia/psicología , Toma de Decisiones , Investigación Cualitativa
17.
Rev. enferm. UERJ ; 28: e49901, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1123419

RESUMEN

Objetivo: identificar elementos da Síndrome de terminalidade a partir do cruzamento de termos registrados pelos enfermeiros no cuidado ao fim de vida em idosos com demência avançada. Método: estudo observacional, retrospectivo, da ferramenta metodológica mapeamento cruzado. Foram coletados registros dos últimos 10 dias de vida de 38 prontuários de pessoas com demência avançada. Resultados: foram identificados 97 termos de respostas humanas, e através do mapeamento cruzado, foram elencados 22 diagnósticos de enfermagem, desses 11 diagnósticos de enfermagem apresentaram relevância estatística em 50% ou mais dos pacientes e oito diagnósticos de enfermagem apresentaram-se relevantes estatisticamente quando avaliados de acordo com a prevalência nas 380 observações. A Síndrome de terminalidade foi verificada em todas 380 avaliações, em média 7,5 diagnósticos da síndrome foram observados. Conclusão: a alta prevalência da Síndrome de terminalidade sustenta a inclusão do diagnóstico de enfermagem na Taxonomia II da NANDA-I, dado que os enfermeiros já a observam e a registram em sua prática(AU)


Objective: to identify elements of Terminal Syndrome by cross-referencing terms recorded by nurses providing end-of-life care for elderly people with advanced dementia. Method: in this retrospective, observational study, using a cross-mapping methodological tool, records of the last 10 days of life were collected from 38 medical records of people with advanced dementia. Results: 97 human-response terms were identified, and by cross-mapping, 22 nursing diagnoses were listed; of these, 11 nursing diagnoses displayed statistical importance in 50% or more of the patients, while eight nursing diagnoses were statistically important when assessed by prevalence in the 380 observations. Terminal Syndrome was found in all 380 evaluations, averaging 7.5 diagnoses of the syndrome. Cases were observed Conclusion: the high prevalence of Terminal Syndrome supports the inclusion of this nursing diagnosis in the NANDA-I Taxonomy II, as nurses already observe and record in practice(AU)


Objetivo: identificar elementos del síndrome terminal mediante términos de referencia cruzada registrados por enfermeras que brindan atención al final de la vida a personas mayores con demencia avanzada. Método: en este estudio observacional retrospectivo, utilizando una herramienta metodológica de mapeo cruzado, se recolectaron registros de los últimos 10 días de vida de 38 historias clínicas de personas con demencia avanzada. Resultados: Se identificaron 97 términos de respuesta humana y, mediante mapeo cruzado, se enumeraron 22 diagnósticos de enfermería; de estos, 11 diagnósticos de enfermería mostraron importancia estadística en el 50% o más de los pacientes, mientras que ocho diagnósticos de enfermería fueron estadísticamente importantes cuando se evaluaron por prevalencia en las 380 observaciones. El síndrome terminal se encontró en las 380 evaluaciones, con un promedio de 7,5 diagnósticos del síndrome. Se observaron casos Conclusión: la alta prevalencia de Síndrome Terminal apoya la inclusión de este diagnóstico de enfermería en la Taxonomía II de NANDA-I, ya que las enfermeras ya observan y registran en la práctica(AU)


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Diagnóstico de Enfermería , Cuidados Paliativos al Final de la Vida , Demencia , Enfermería de Cuidados Paliativos al Final de la Vida , Brasil , Registros de Enfermería/clasificación , Estudios Retrospectivos , Terminología Normalizada de Enfermería , Hospitales para Enfermos Terminales
18.
Artículo en Alemán | MEDLINE | ID: mdl-33185710

RESUMEN

BACKGROUND: Palliative care supply increased in Germany in recent years. But how many people use which forms of palliative care and how does this differ between regions? METHOD: Retrospective cohort study with claims data from insured persons who died in 2016: Based on services billed at least once in the last six months of life, we determined the use of primary palliative care (PPC), specialized palliative homecare (SPHC), as well as inpatient palliative and hospice care, using regional billing codes for PPC and SPHC services for the first time. RESULTS: Of the 95,962 deceased in the study population, 32.7% received palliative care nationwide, with variations from 26.4% in Bremen to 40.8% in Bavaria. PPC services were billed at 24.4% (16.9% in Brandenburg to 34.1% in Bavaria). SPHC services received 13.1% (6.3% in Rhineland-Palatinate to 18.9% in Brandenburg and 22.9% in Westphalia-Lippe with different SPHC practices). Inpatient palliative care was received by 8.1% (6.7% in Schleswig-Holstein/Hesse to 13.0% in Thuringia); 3.3% (1.6% in Bremen to 5.6% in Berlin) with hospice services. CONCLUSION: SPHC is used more frequently than previously reported, while PPC is declining. Utilization seems to be based less on objective needs than on region-specific framework conditions. Besides needs criteria, further development of palliative care should be oriented more towards outcomes and relevant framework conditions.


Asunto(s)
Enfermería de Cuidados Paliativos al Final de la Vida , Cuidado Terminal , Berlin , Alemania , Humanos , Cuidados Paliativos , Estudios Retrospectivos
20.
Rech Soins Infirm ; (141): 60-69, 2020 06.
Artículo en Francés | MEDLINE | ID: mdl-32988191

RESUMEN

Nurses in Lebanon are poorly prepared to provide palliative care (PC), and practice in this area is poorly documented. This qualitative descriptive study aimed to understand the reality of nursing practice in PC, with terminally ill cancer patients, within an interdisciplinary team. A simple case study was conducted with eleven nurses, three families, an interdisciplinary team, and national experts in PC. Data analysis, carried out with triangulation of both methods and sources, highlighted a humanist relationship characterized by caring, transcending the five central emerging themes : the perception of PC as a means of offering a better quality of life, comprehensive patient care, interdisciplinarity, spirituality, and family support during PC. The results could provide empirical foundations to guide the development of PC nursing practice in the country.


Asunto(s)
Enfermería de Cuidados Paliativos al Final de la Vida , Neoplasias/enfermería , Grupo de Atención al Paciente/organización & administración , Humanos , Líbano , Estudios de Casos Organizacionales , Investigación Cualitativa
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