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3.
Trials ; 21(1): 1019, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33308290

RESUMO

BACKGROUND: Burnout is an occupational syndrome that leads to mental health problems, job turnover, and patient safety events. Those caring for critically ill patients are especially susceptible due to high patient mortality, long hours, and regular encounters with trauma and ethical issues. Interventions to prevent burnout in this population are needed. Preliminary studies suggest debriefing sessions may reduce burnout. This study aims to assess whether participation in regular debriefing can prevent burnout in intensive care unit (ICU) clinicians. METHODS: A randomized controlled trial will be conducted in two large academic medical centers. Two hundred ICU clinicians will be recruited with target enrollment of 100 physicians and 100 non-physicians (nurses, pharmacists, therapists). Participants must have worked in the ICU for the equivalent of at least 1 full time work week in the preceding 4 weeks. Enrolled subjects will be randomized to virtually attend biweekly debriefing sessions facilitated by a psychotherapist for 3 months or to a control arm without sessions. Our debriefs are modeled after Death Cafés, which are informal discussions focusing on death, dying, loss, grief, and illness. These sessions allow for reflection on distressing events and offer community and collaboration among hospital employees outside of work. The primary outcome is clinician burnout as measured by the Maslach Burnout Inventory (MBI) Score. Secondary outcomes include depression and anxiety, as measured by the Patient Health Questionnaire 8 (PHQ-8) and Generalized Anxiety Disorder 7-item scale (GAD-7), respectively. Questionnaires will be administered prior to the intervention, at 1 month, at 3 months, and at 6 months after enrollment. These values will be compared between groups temporally. Qualitative feedback will also be collected and analyzed. DISCUSSION: With ICU clinician burnout rates exceeding 50%, Death Café debriefing sessions may prove to be an effective tool to avert this debilitating syndrome. With COVID-19 limiting social interactions and overloading ICUs worldwide, the virtual administration of the Death Café for ICU clinicians provides an innovative strategy to potentially mitigate burnout in this vulnerable population. TRIAL REGISTRATION: ClinicalTrials.gov NCT04347811 . Registered on 15 April 2020.


Assuntos
Esgotamento Profissional/prevenção & controle , Unidades de Terapia Intensiva/estatística & dados numéricos , Estresse Ocupacional/psicologia , Assistência Terminal/psicologia , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Conscientização/fisiologia , Esgotamento Profissional/epidemiologia , /virologia , Estudos de Casos e Controles , Comunicação , Estado Terminal/mortalidade , Estado Terminal/psicologia , Depressão/diagnóstico , Depressão/epidemiologia , Humanos , Estresse Ocupacional/epidemiologia , Questionário de Saúde do Paciente/estatística & dados numéricos , Segurança do Paciente/estatística & dados numéricos , Reorganização de Recursos Humanos/estatística & dados numéricos , Inquéritos e Questionários , Interface Usuário-Computador
4.
Pan Afr Med J ; 35(Suppl 2): 130, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33193945

RESUMO

The COVID-19 pandemic has strained health care systems beyond capacity resulting in many people not having access to life-sustaining measures even in well-resourced countries. Palliative and end-of-life care are therefore essential to alleviate suffering and ensure a continuum of care for patients unlikely to survive. This is challenging in sub-Saharan Africa where lack of trained teams on basic palliative care and reduced access to opioids limit implementation of palliative and end-of-life care. At the same time, health care providers have to cope with local cultural conceptions of death and absence of advance care directives.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Cuidados Paliativos/organização & administração , Pandemias , Pneumonia Viral/terapia , Assistência Terminal/organização & administração , Diretivas Antecipadas , África ao Sul do Saara/epidemiologia , Analgésicos Opioides/provisão & distribução , Analgésicos Opioides/uso terapêutico , Atitude Frente a Morte , Barreiras de Comunicação , Continuidade da Assistência ao Paciente , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Cultura , Acesso aos Serviços de Saúde , Humanos , Cuidados Paliativos/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Relações Profissional-Paciente , Insuficiência Respiratória/tratamento farmacológico , Insuficiência Respiratória/etiologia , Insuficiência Respiratória/mortalidade , Estigma Social , Assistência Terminal/psicologia
5.
Medicine (Baltimore) ; 99(44): e22743, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126312

RESUMO

Strategies to increase appropriateness of EoL care, such as shared decision making (SDM), and advance care planning (ACP) are internationally embraced, especially since the COVID-19 pandemic. However, individuals preferences regarding EoL care may differ internationally. Current literature lacks insight in how preferences in EoL care differ between countries and continents. This study's aim is to compare Dutch and Japanese general publics attitudes and preferences toward EoL care, and EoL decisions. Methods: a cross-sectional survey design was chosen. The survey was held among samples of the Dutch and Japanese general public, using a Nationwide social research panel of 220.000 registrants in the Netherlands and 1.200.000 in Japan. A quota sampling was done (age, gender, and living area). N = 1.040 in each country.More Japanese than Dutch citizens tend to avoid thinking in advance about future situations of dependence (26.0% vs 9.4%; P = .000); say they would feel themselves a burden for relatives if they would become dependent in their last phase of life (79.3% vs 47.8%; P = .000); and choose the hospital as their preferred place of death (19.4% vs 3.6% P = .000). More Dutch than Japanese people say they would be happy with a proactive approach of their doctor regarding EoL issues (78.0% vs 65.1% JPN; P = .000).Preferences in EoL care substantially differ between the Netherlands and Japan. These differences should be taken into account a) when interpreting geographical variation in EoL care, and b) if strategies such as SDM or ACP - are considered. Such strategies will fail if an international "one size fits all" approach would be followed.


Assuntos
Comparação Transcultural , Assistência Terminal/psicologia , Adulto , Planejamento Antecipado de Cuidados , Idoso , Estudos Transversais , Feminino , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Países Baixos , Adulto Jovem
6.
PLoS One ; 15(10): e0238357, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027265

RESUMO

BACKGROUND: Palliative care is nowadays essential in nursing care, due to the increasing number of patients who require attention in the final stages of their life. Lack of knowledge of and negative attitude palliative care among nurses is one of the most common barriers to quality palliative care. This study, therefore, aimed to assess nurses' knowledge about palliative care and attitude toward end-of-life care in public hospitals in Wollega zones, Ethiopia. METHODS: A multicenter institutional-based cross-sectional study design was employed to collect data from 372 nurses working in public hospitals in Wollega zones from October 02-22, 2019. A self-administered questionnaire with three different parts: Demographic characteristics of nurses, the Palliative Care Quiz for Nursing (PCQN), and the Frommelt Attitudes Towards Care of the Dying (FATCOD). SPSS version 21 was used for analysis used for data analysis. The binary logistic regression test was used for analysis at p < 0.05. FINDINGS: Our final sample size was 422 nurses (response rate = 88%). With the mean total PCQN scores (9.34), the majority of them showed an inadequate level of knowledge about palliative care. The mean total FATCOD scores (79.58) displayed a positive attitude toward end-of-life care, with 52% of respondents eager to care for a dying person and their family. Nurses who had PC service experience [AOR = 1.94 CI (1.10-3.42), p = 0.02] and had ever attended training/lecture on PC [AOR = 1.87 CI (1.01-3.46), p = 0.04] were independently associated with nurses' knowledge about PC. Similarly, nurses who had no PC service experience [AOR = 0.41, CI (0.21-0.79), p = 0.008], who read articles/brochures about PC [AOR = 1.94, CI (1.11-3.39), p = 0.01] and had provided care for a smaller number of terminally ill patients [AOR = 1.74, CI (1.01-2.97), p = 0.04] were significantly associated with nurses' attitude towards end-of-life care. CONCLUSION: The study highlighted that nurses' knowledge about palliative care is inadequate, and showed a less favorable attitude toward end-of-life care. The findings also provide evidence for greater attentions and resources should be directed towards educating and supporting nurses caring for patients with palliative care needs in Wollega Zones.


Assuntos
Atitude do Pessoal de Saúde , Papel do Profissional de Enfermagem , Cuidados Paliativos , Assistência Terminal , Adulto , Estudos Transversais , Educação em Enfermagem , Etiópia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Hospitais Públicos , Humanos , Masculino , Pessoa de Meia-Idade , Papel do Profissional de Enfermagem/psicologia , Cuidados Paliativos/psicologia , Inquéritos e Questionários , Assistência Terminal/psicologia , Adulto Jovem
7.
PLoS One ; 15(9): e0239423, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32977327

RESUMO

OBJECTIVES: We examined how caregivers who had cared for a relative at end of life (EoL) wished to be cared for in the event that they experienced advanced dementia or physical disability in the future, and what factors influenced their preferences for EoL care. METHODS: In this mixed-methods study, 83 participants, recruited from multiple sources in Israel, were interviewed concerning socio-demographic factors, health status, past experience with EoL, preference for extension of life vs. quality of life (QoL), willingness to be dependent on others, and preferences for EoL care. RESULTS: In case of advanced dementia, 58% preferred euthanasia or suicide; around a third chose those for physical disability. Care by family members was the least desired form of care in the advanced dementia scenario, although more desirable than institutional care in the physical disability scenario. QoL was rated as the highest factor impacting preferences for EoL care. Men demonstrated a higher preference than women for extension of life over QoL. CONCLUSION: Our study points to the need for society to consider solutions to the request of participants to reject the type of EoL experienced by their relatives. Those solutions include investing in improving the quality of life at the end of life, and offering alternatives such as euthanasia, which a large proportion of our participants found ethically and medically appropriate within the current system of care in the event of severe physical disability, and more so in the event of advanced dementia.


Assuntos
Cuidadores/psicologia , Família , Preferência do Paciente/estatística & dados numéricos , Assistência Terminal/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
8.
Cuad Bioet ; 31(102): 203-222, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32910672

RESUMO

The crisis in the health system caused by COVID-19 has left some important humanitarian deficits on how to care for the sick in their last days of life. The humanization of the dying process has been affected in three fundamental aspects, each of which constitutes a medical and ethical duty necessary. In this study, I analyze why dying accompanied, with the possibility of saying goodbye and receiving spiritual assistance, constitutes a specific triad of care and natural obligations that should not be overlooked - even in times of health crisis - if we do not want to see human dignity violated and violated some fundamental rights derived from it.


Assuntos
Atitude Frente a Morte , Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Espiritualidade , Assistência Terminal/ética , Desumanização , Emoções , Humanos , Relações Interpessoais , Obrigações Morais , Cuidados Paliativos , Conforto do Paciente , Isolamento de Pacientes/ética , Direitos do Paciente , Pessoalidade , Papel do Médico , Religião , Assistência Terminal/métodos , Assistência Terminal/psicologia , Visitas a Pacientes
10.
S Afr Fam Pract (2004) ; 62(1): e1-e4, 2020 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-32787389

RESUMO

Medical practitioners are confronted daily with decisions about patients' capacity to consent to interventions. To address some of the pertinent issues with these assessments, the end-of-life decision-making capacity of a 72-year-old female with treatment-resistant schizophrenia and terminal cancer is discussed, as are the role of the treating clinician and the importance of health-related values. There is a recommendation that the focus of these assessments can rather be on practical outcomes, especially when capacity issues arise. This implies that the decision-making capacity of the patient is only practically important when the treatment team is willing to proceed against the patient's wishes. This shifts the focus from a potentially difficult assessment to the simpler question of whether the patient's capacity will change the treatment approach. Clinicians should attend to any possible underlying issues, instead of focusing strictly on capacity. Compared to the general populations people with serious mental illness (SMI) have higher rates of physical illness and die at a younger age, but they do not commonly access palliative care services. Conversations about end-of-life care can occur without fear that a person's psychiatric symptoms or related vulnerabilities will undermine the process. More research about palliative care and advance care planning for people with SMI is needed. This is even more urgent in light of the coronavirus disease-2019 (COVID-19) pandemic, and South African health services should consider recommendations that advanced care planning should be routinely implemented. These recommendations should not only focus on the general population and should include patients with SMI.


Assuntos
Tomada de Decisões , Competência Mental/psicologia , Neoplasias/psicologia , Psicologia do Esquizofrênico , Assistência Terminal/psicologia , Idoso , Betacoronavirus , Infecções por Coronavirus/psicologia , Feminino , Humanos , Consentimento Livre e Esclarecido/psicologia , Pandemias , Pneumonia Viral/psicologia , Esquizofrenia
11.
N Z Med J ; 133(1518): 64-72, 2020 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-32683433

RESUMO

AIMS: To test the feasibility of surveying bereaved next-of-kin in the South Island about their perceptions of end-of-life care for people over 18 years of age; to report results; and to identify issues for future research. METHOD: The study used the VOICES (Views of Informal Carers Evaluation of Services) questionnaire from the UK, adapted for use in Aotearoa New Zealand. Identification of next-of-kin for all South Island deaths September-November 2017 was undertaken by a commercial firm specialising in such work. Addresses of next-of-kin were sought from the Electoral Roll, with 1,813 eligible people identified and 272 (15.0%) next-of-kin unable to be traced. Surveys were posted out once only, with options to complete by mail, online, by telephone or with a face-to-face interview. RESULTS: Of the 1,541 surveys distributed, 514 (33.4%) were completed. Results confirmed the suitability of the locally modified VOICES instrument and research process. The quality of care overall was rated most highly in hospice or own home, but only a minority were able to die in these settings. Nevertheless, relatives indicated that most people died 'in the best place'. CONCLUSIONS: The VOICES questionnaire is acceptable to respondents and there are viable methods for seeking a population sample. Aspects of the questionnaire require modification before wider use. The information obtained can help district health boards, hospices other healthcare providers, and consumers in planning for end-of-life care.


Assuntos
Luto , Doença de Crohn/epidemiologia , Hospitais/estatística & dados numéricos , Assistência Terminal/psicologia , Adolescente , Adulto , Idoso , Doença de Crohn/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia/epidemiologia , Projetos Piloto , Estudos Retrospectivos , Adulto Jovem
12.
PLoS One ; 15(7): e0233494, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32649715

RESUMO

IMPORTANCE: In the Kilimanjaro region of Tanzania, there are no advance care planning (ACP) protocols being used to document patient preferences for end-of-life (EoL) care. There is a general avoidance of the topic and contemplating ACP in healthcare-limited regions can be an ethically complex subject. Nonetheless, evidence from similar settings indicate that an appropriate quality of life is valued, even as one is dying. What differs amongst cultures is the definition of a 'good death'. OBJECTIVE: Evaluate perceptions of quality of death and advance EoL preparation in Moshi, Tanzania. DESIGN: 13 focus group discussions (FGDs) were conducted in Swahili using a semi-structured guide. These discussions were audio-recorded, transcribed, translated, and coded using an inductive approach. SETTING: Kilimanjaro Christian Medical Centre (KCMC), referral hospital for northern Tanzania. PARTICIPANTS: A total of 122 participants, including patients with life-threatening illnesses (34), their relatives/friends (29), healthcare professionals (29; HCPs; doctors and nurses), and allied HCPs (30; community health workers, religious leaders, and social workers) from KCMC, or nearby within Moshi, participated in this study. FINDINGS: In characterizing Good Death, 7 first-order themes emerged, and, of these themes, Religious & Spiritual Wellness, Family & Interpersonal Wellness, Grief Coping & Emotional Wellness, and Optimal Timing comprised the second-order theme, EoL Preparation and Life Completion. The other first-order themes for Good Death were Minimal Suffering & Burden, Quality of Care by Formal Caregivers, and Quality of Care by Informal Caregivers. INTERPRETATION: The results of this study provide a robust thematic description of Good Death in northern Tanzania and they lay the groundwork for future clinical and research endeavors to improve the quality of EoL care at KCMC.


Assuntos
Família/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Assistência Terminal/psicologia , Adulto , Feminino , Humanos , Masculino , Qualidade da Assistência à Saúde , Religião , Assistentes Sociais/psicologia , Tanzânia
13.
Metas enferm ; 23(6): 59-66, jul. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194598

RESUMO

OBJETIVO: describir las creencias actitudinales sobre el comportamiento suicida en profesionales sanitarios de Atención Primaria. MÉTODO: se realizó un estudio descriptivo transversal a través de un muestreo no probabilístico de conveniencia. Se diseñó un formulario online con la escala creencias actitudinales sobre el comportamiento suicida (CCCS-18), que se distribuyó por correo electrónico a médicos y enfermeras dependientes de las siete direcciones Asistenciales de Atención Primaria de la Comunidad de Madrid. Asimismo se podía acceder al cuestionario desde tres sociedades científicas de Atención Primaria. Se llevó a cabo un análisis univariante y bivariante comparando los cuatro factores incluidos en el CCCS-18 por categoría profesional, edad y años de experiencia. RESULTADOS: participaron 169 sujetos, 86 (50,89%) enfermeras y 83 (49,11%) médicos. Se detectaron diferencias estadísticamente significativas entre ambos en la dimensión moral del suicidio (los médicos 1,45 puntos más de media), y en la dimensión de legitimación del suicido (2,59 puntos más de media para las enfermeras). El 10,6% de los profesionales sanitarios no está de acuerdo con la importancia de la intervención ante una situación de suicidio y la mitad de los profesionales no descarta suicidarse bajo una circunstancia extrema. CONCLUSIONES: hay una tendencia grupal a no legitimar el suicidio. Los profesionales no apoyan la creación de clínicas de apoyo al suicidio, ni la idea de llegar a considerar el suicidio algo normal en una sociedad ideal. Existen altos grados de acuerdo en la aceptación del suicidio en personas mayores y en pacientes con enfermedad terminal. Los profesionales creen de forma mayoritaria que el suicidio no es un acto inmoral, un asesinato o un atentado contra la sociedad


OBJECTIVE: to describe the attitudinal beliefs about suicidal behaviour among Primary Care professionals. METHOD: a descriptive cross-sectional study was conducted through non-probability sampling of convenience. An online form was designed with the Attitudinal Beliefs Questionnaire about Suicidal Behavior (CCCS-18), which was sent by email to physicians and nurses from the seven Primary Healthcare Managements of the Autonomous Comunity of Madrid. Likewise, the questionnaire could be accessed from three Primary Care scientific societies. Univariate and bivariate analysis were conducted, comparing the four factors included in the CCCS-18 by professional category, age, and years of experience. RESULTS: the study included 169 subjects: 86 (50.89%) nurses and 83 (49.11%) physicians. Statistically significant differences were detected between both groups regarding the moral dimension of suicide (1.45 more points as mean score for physicians), and in the legitimization of suicide dimension (2.59 more points as mean score for nurses). A 10.6% of healthcare professionals don't agree with the importance of intervention when faced with a suicide scenario, and half of the professionals don't rule out committing suicide under extreme circumstances. CONCLUSIONS: there is a group trend to not legitimize suicide. Professionals don't support the creation of support clinics for suicide, or the idea of considering suicide as something normal in an ideal society. There are high levels of agreement in terms of accepting suicide in elderly patients and in patients with terminal diseases. The majority of professionals believe that suicide is not an immoral act, a murder, or an attempt against society


Assuntos
Humanos , Conhecimentos, Atitudes e Prática em Saúde , Suicídio/psicologia , Pessoal de Saúde/psicologia , Atenção Primária à Saúde , Pessoal de Saúde/estatística & dados numéricos , Estudos Transversais , Inquéritos e Questionários , Médicos/psicologia , Assistência Terminal/psicologia
15.
Rev Mal Respir ; 37(6): 451-461, 2020 Jun.
Artigo em Francês | MEDLINE | ID: mdl-32505369

RESUMO

INTRODUCTION: Numerous studies about poor communication and altered quality of life of patients with chronic obstuctive pulmonary disease (COPD) lead to the conclusion that overall palliative management of COPD remains to be improved. The aim of this study was to describe pulmonologists' practice of palliative care for COPD patients in order to identify obstacles to it. MATERIAL AND METHOD: A survey was sent to all pulmonologists whose email appeared in the 2017 French-language Respiratory Medicine Society's directory. RESULTS: A total of 294 responses were obtained, among which 287 were analysed. Overall, 81.6% of the pulmonologists said that they identify a distinct palliative phase from "sometimes to often" in the care of COPD patients. When not identified, the most common reason given (68.8%) was the difficulty of defining when to start palliative care. Aspects of the palliative approach, which were considered the most problematic for pulmonologists, were the discussion of end of life care, and the impression that COPD patients have a low demand for information. 31% of pulmonologists reported that they gathered information about patients' wishes to undergo resuscitation and endotracheal intubation in 61 % to 100% of patients who they judged to have the most severe disease. CONCLUSION: Uncertainty as to when to begin a palliative approach for COPD patients and perceptions around communication in chronic diseases appear to be the main obstacles to a palliative approach.


Assuntos
Cuidados Paliativos/psicologia , Cuidados Paliativos/estatística & dados numéricos , Percepção , Padrões de Prática Médica/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/terapia , Pneumologistas , Adulto , Diretivas Antecipadas/psicologia , Diretivas Antecipadas/estatística & dados numéricos , Idoso , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos/normas , Relações Médico-Paciente , Padrões de Prática Médica/normas , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Pneumologia/normas , Pneumologia/estatística & dados numéricos , Pneumologistas/psicologia , Pneumologistas/estatística & dados numéricos , Qualidade de Vida , Assistência Terminal/métodos , Assistência Terminal/psicologia , Assistência Terminal/estatística & dados numéricos
17.
Psychol Trauma ; 12(S1): S146-S147, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32538660

RESUMO

The COVID-19 pandemic has changed the way doctors approach palliative and end-of-life care, which has undoubtedly affected the mental health of patients, families, and health care professionals. Given these circumstances, doctors working on the front line are vulnerable to moral injury and compassion fatigue. This is a reflection of 2 junior doctors experiencing firsthand demands of caring for patients during the outbreak. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Fadiga por Compaixão , Infecções por Coronavirus/terapia , Corpo Clínico Hospitalar , Cuidados Paliativos , Pandemias , Pneumonia Viral/terapia , Relações Profissional-Família , Trauma Psicológico , Assistência Terminal , Adulto , Fadiga por Compaixão/etiologia , Fadiga por Compaixão/psicologia , Inglaterra , Humanos , Corpo Clínico Hospitalar/ética , Corpo Clínico Hospitalar/psicologia , Princípios Morais , Cuidados Paliativos/ética , Cuidados Paliativos/psicologia , Relações Profissional-Família/ética , Trauma Psicológico/etiologia , Trauma Psicológico/psicologia , Assistência Terminal/ética , Assistência Terminal/psicologia
19.
J Pain Symptom Manage ; 60(2): e70-e74, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32387574

RESUMO

Bereavement care is considered an integral component of quality end-of-life care endorsed by the palliative care movement. However, few hospitals and health care institutions offer universal bereavement care to all families of patients who die. The current coronavirus disease 2019 pandemic has highlighted this gap and created a sense of urgency, from a public health perspective, for institutions to provide support to bereaved family members. In this article, drawing on the palliative care and bereavement literature, we offer suggestions about how to incorporate palliative care tools and psychological strategies into bereavement care for families during this pandemic.


Assuntos
Luto , Infecções por Coronavirus , Família/psicologia , Pandemias , Pneumonia Viral , Terapia Cognitivo-Comportamental , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/terapia , Humanos , Cuidados Paliativos/métodos , Cuidados Paliativos/psicologia , Pneumonia Viral/psicologia , Pneumonia Viral/terapia , Assistência Terminal/métodos , Assistência Terminal/psicologia
20.
Curr Opin Anaesthesiol ; 33(3): 354-360, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32371634

RESUMO

PURPOSE OF REVIEW: To familiarize pediatric anesthesiologists with primary palliative care procedural communication skills and recommendations for discussions involving complex medical decision-making or advance care planning, such as discussions about resuscitation status. RECENT FINDINGS: Recent publications highlight the benefits of pediatric palliative care (PPC) for seriously ill patients and their families, and how PPC principles might be applied to perioperative communication and decision-making. Both prospective and retrospective reports reveal improved quality of life, symptom management, and avoidance of unnecessary interventions when PPC is introduced early for a child with serious illness. SUMMARY: Pediatric anesthesiologists will, at some point, care for a child with serious illness who would benefit from PPC. It is important that all members of the perioperative care team are familiar with primary PPC procedural communication skills and models for approaching discussions about goals of care, shared decision-making, and advance care planning. Pediatric anesthesiologists should be incorporated as early as possible in team discussions about potential procedures requiring sedation for seriously ill children.


Assuntos
Anestesia , Cuidados Paliativos/psicologia , Qualidade de Vida , Assistência Terminal/psicologia , Planejamento Antecipado de Cuidados , Anestesiologistas , Criança , Humanos , Pediatria , Ordens quanto à Conduta (Ética Médica)
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