Building trust and facilitating goals of care conversations: A qualitative study in people with heart failure receiving home hospice care

Baik, Dawon; Russell, David; Jordan, Lizeyka; Matlock, Daniel D.; Dooley, Frances; Creber, Ruth Masterson

doi:10.1177/0269216320917873

Cited by 15 publications

(5 citation statements)

References 26 publications

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“…While patients on homecare might be reasonably presumed to prefer remaining at home, it was the patient's preference for home as a place of death that cognitively prepared the patient, proved to unveil perceived control over symptoms, and differentiated healthcare utilization. This finding has implications for improving documented clarity on a place of death and dying for more tailored interventions (Baik et al 2020). Studies showed that patient's endof-life wishes were often not discussed during hospitalization or at the time of referral to homecare, partly due to the lack of unwillingness among patients and caregivers (Hemsley et al 2019;Simon et al 2015).…”

Section: Discussionmentioning

confidence: 99%

Comparing situational influences on differential healthcare utilization trajectories in patients on home palliative care: A qualitative study

Yoon,

Goh,

Yeo

et al. 2024

Pall Supp Care

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Objectives Patients with terminal cancer receiving home palliative care present differential healthcare utilization trajectories before death. It remains unclear which situational elements influence these trajectories among disparate patient groups. The aim of this study was to compare situational influences on “persistently high” and “low stable” trajectories of healthcare utilization in patients who received palliative care support at home. Methods Bereaved family caregivers were recruited from our prior quantitative study investigating healthcare utilization trajectories in oncology patients on home-based palliative care. In-depth interviews were conducted with 30 family caregivers. Data were analyzed using thematic analysis. Results Analysis of data uncovered how the 2 utilization trajectories were influenced by the interplay of 1 or more of 4 situational elements. Perceived symptom control in patients, influenced by their determination to die at home, shapes the susceptibility to situational contingencies, resulting in differential utilization trajectories. Caregivers’ mental readiness in dealing with unexpected circumstances has a significant impact on the overall manageability of care, ultimately affecting decisions related to healthcare utilization. The concordance between symptom needs and scope of homecare services in a given situation proves to be an important determinant. Lastly, perceived accessibility to informal support in times of need acts as a contextual reinforcement, either preventing or precipitating decisions regarding healthcare utilizations. Significance of results Our findings hold important implications for the provision of homecare services, in particular, the need for comprehensive assessment of end-of-life wishes during homecare enrolment and strengthening psychological preparedness of caregivers. Expansion of home-based clinical interventions tailored to high utilizers, and funding for temporary in-home respite should be considered to optimally manage potentially preventable acute healthcare utilization.

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Section: Discussionmentioning

confidence: 99%

Comparing situational influences on differential healthcare utilization trajectories in patients on home palliative care: A qualitative study

Yoon,

Goh,

Yeo

et al. 2024

Pall Supp Care

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“…In the vast majority of articles that referenced care partners, the intent was not to examine or measure their inclusion in the health care team, but instead to better understand aspects of the care partner experience (burden, Bristol et al, 2020; improved preparedness, Aboumatar et al, 2017; prognostic awareness, Applebaum et al, 2018; etc.). In those few studies that examined caregiving behaviors—though not explicitly stated as contributing to the care team’s responsibilities—there was a focus on communication functions such as effective communication with clinicians (Aboumatar et al, 2017) or inclusion in care conversations (Baik et al, 2020). Accordingly, there are little to no studies examining interventions that seek to enhance care partner involvement in the care team, or to make them formal members of care teams (i.e., no boundaries being set, lack of communication processes).…”

Section: Discussionmentioning

confidence: 99%

Conceptual Framework for Integrating Family Caregivers Into the Health Care Team: A Scoping Review

et al. 2022

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More than 80% of family care partners of older adults are responsible for coordinating care between and among providers; yet, their inclusion in the health care delivery process lacks recognition, coordination, and standardization. Despite efforts to include care partners (e.g., through informal or formal proxy access to their care recipient’s patient portal), policies and procedures around care partner inclusion are complex and inconsistently implemented. We conducted a scoping review of peer-reviewed articles published from 2015 to 2021 and reviewed a final sample of 45 U.S.-based studies. Few articles specifically examine the inclusion of care partners in health care teams; those that do, do not define or measure care partner inclusion in a standardized way. Efforts to consider care partners as “partners” rather than “visitors” require further consideration of how to build health care teams inclusive of care partners. Incentives for health care organizations and providers to practice inclusive team-building may be required.

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“…Trust building activities should be planned accordingly. Such efforts could focus on participatory approaches to ensure sustainability such as longitudinal stepwise interventions or simple interventions where the focus is improving communication and the goals of care [60].…”

Section: Plos Onementioning

confidence: 99%

Understanding COVID-19 vaccination behaviors and intentions in Ghana: A Behavioral Insights (BI) study

Vepachedu,

Nurzenska,

Lohiniva

et al. 2024

PLoS ONE

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Introduction Vaccine uptake is influenced by a variety of factors. Behavioral Insights (BI) can be used to address vaccine hesitancy to understand the factors that influence the decision to take or refuse a vaccine. Methodology This two-part study consisted of a survey designed to identify the influence of various drivers of people’s COVID-19 vaccination status and their intention to take the vaccine in Ghana, as well as an experiment to test which of several behaviorally informed message frames had the greatest effect on vaccine acceptance. Data was collected from a total of 1494 participants; 1089 respondents (73%) reported already being vaccinated and 405 respondents (27%) reported not being vaccinated yet. The mobile phone-based surveys were conducted between December 2021 and January 2022 using Random Digit Dialing (RDD) to recruit study participants. Data analysis included regression models, relative weights analyses, and ANOVAs. Results The findings indicated that vaccine uptake in Ghana is influenced more by social factors (what others think) than by practical factors such as ease of vaccination. Respondents’ perceptions of their family’s and religious leaders’ attitudes towards the vaccine were among the most influential drivers. Unexpectedly, healthcare providers’ positive attitudes about the COVID-19 vaccine had a significant negative relationship with respondents’ vaccination behavior. Vaccine intention was positively predicted by risk perception, ease of vaccination, and the degree to which respondents considered the vaccine effective. Perceptions of religious leaders’ attitudes also significantly and positively predicted respondents’ intention to get vaccinated. Although perceptions of religious leaders’ views about the vaccine are an important driver of vaccine acceptance, results asking respondents to rank-order who influences them suggest that people may not be consciously aware—or do not want to admit—the degree to which they are affected by what religious leaders think. Message frames that included fear, altruism, social norms were all followed by positive responses toward the vaccine, as were messages with three distinct messengers: Ghana Health Services, a doctor, and religious leaders. Conclusions What drives COVID-19 vaccine intentions does not necessarily drive behaviors. The results of this study can be used to develop appropriate COVID-19 vaccine uptake strategies targeting the most important drivers of COVID-19 vaccine acceptance, using effective message frames.

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Building trust and facilitating goals of care conversations: A qualitative study in people with heart failure receiving home hospice care

Cited by 15 publications

References 26 publications

Comparing situational influences on differential healthcare utilization trajectories in patients on home palliative care: A qualitative study

Comparing situational influences on differential healthcare utilization trajectories in patients on home palliative care: A qualitative study

Conceptual Framework for Integrating Family Caregivers Into the Health Care Team: A Scoping Review

Understanding COVID-19 vaccination behaviors and intentions in Ghana: A Behavioral Insights (BI) study

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