How can we ensure the success of specialised palliative home-care? A qualitative study (ELSAH) identifying key issues from the perspective of patients, relatives and health professionals

Seipp, Hannah; Haasenritter, Jörg; Hach, Michaela; Becker, Dorothée; Ulrich, Lisa-R.; Schütze, Dania; Engler, Jennifer; Michel, Cathrin; Bösner, Stefan; Kuss, Katrin

doi:10.1177/02692163211026516

Cited by 12 publications

(19 citation statements)

References 57 publications

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“…Nurses in palliative care should be given the opportunity to identify those individuals who have an increased risk of suicide attempts. Involving close relatives with knowledge about the individual's thoughts and feelings can be valuable (Seipp et al 2021).…”

Section: Discussionmentioning

confidence: 99%

Nurses’ experiences of suicide attempts in palliative care

Hultsjö

Persdotter

Jakobsson³

et al. 2023

Pall Supp Care

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Objectives To describe nurses’ experiences of caring for individuals who have attempted suicide in specialized palliative care and to describe if the care of these individuals changed after the suicide attempt. Methods A qualitative, descriptive study was conducted. Nine nurses working in specialized palliative care units were interviewed following a semi-structured interview guide. Conventional content analysis was used in the analysis process. Results The results are presented in 3 categories: “A suicide attempt evokes strong emotions,” “Health-care efforts changed after the suicide attempt,” and “Experiences for the rest of working life.” Suicide attempts aroused emotions in nurses such as frustration, compassion, and feelings of being manipulated. The relationship between the nurse and the individual was strengthened after the suicide attempt, and their conversations became deeper and changed in nature. Health-care efforts relating to the individual increased after the suicide attempt. Significance of results The results of the study can create an awareness that the palliative process also includes the risk of suicide and can be used to create conditions for nurses to be able to handle questions about suicide without fear. The results of the study can be used as an “eye opener” to the fact that suicidality occurs in palliative care. In summary, there is a critical need for nursing education in suicide risk assessment and continued follow-up care for patients at risk of suicide within palliative care.

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Section: Discussionmentioning

confidence: 99%

Nurses’ experiences of suicide attempts in palliative care

Hultsjö

Persdotter

Jakobsson³

et al. 2023

Pall Supp Care

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“…Furthermore, by demonstrating empathy when broaching sensitive topics, health professionals can reduce burden and scepticism. A predefined framework ensures comparability and orientation, but a successful SOPC approach requires flexibility and the ability to adapt to individual needs and situations [ 12 ]. Health professionals in other studies also feared that the use of PROMs may reduce the quality of relationships, but they also found that PROMs can result in open conversations and help patients raise topics of personal relevance [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

“…We purposively sampled the SOPC teams for team location (rural and urban locations), and the use of differing EDS, to address software-related issues with regard to the expansion in all hessian teams. The SOPC teams knew the research team from a previous phase of the study [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

“…We are striving to integrate tools into existing documentation and analysis structures to ensure their sustainable implementation and use. The study has already enabled us to identify topics that contribute to providing successful care from the perspectives of those involved [ 12 ]. Based on these findings and an overview of the literature on outcome measures used in palliative care, we have put together validated tools to a set of measures [ 10 ] that are designed for use in a palliative care setting and that can help support the team in their work [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Integrating patient- and caregiver-reported outcome measures into the daily care routines of specialised outpatient palliative care: a qualitative study (ELSAH) on feasibility, acceptability and appropriateness

Seipp

Haasenritter

Hach³

et al. 2022

BMC Palliat Care

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Background The use of patient-reported outcome measures (PROM) and caregiver-reported outcome measures can raise the patient centeredness of treatment and improve the quality of palliative care. Nevertheless, the everyday implementation of self-report in patients and caregivers is complex, and should be adapted for use in specific settings. We aimed to implement a set of outcome measures that included patient and caregiver self- and proxy-reported outcome measures in specialised outpatient palliative care (SOPC). In this study, we explore how the Integrated Palliative Outcome Scale (IPOS), IPOS Views on Care (IPOS VoC) and the Short-form Zarit Caregiver Burden Interview (ZBI-7) can be feasibly, acceptably and appropriately implemented in the daily care routines of SOPC. Methods Five SOPC teams were trained, and used the outcome measures in daily practice. Team members were mainly nurses and physicians. To investigate their feedback, we used a multi-method qualitative design consisting of focus groups with SOPC-team members (n = 14), field notes of meetings and conversations with the SOPC teams. In an iterative process, we analysed the findings using qualitative content analysis and refined use of the outcome measures. Results We found that integrating patient and caregiver outcome measures into daily care routines in SOPC is feasible. To improve feasibility, acceptability and appropriateness, the resulting burden on patients and relatives should be kept to a minimum, the usefulness of the measures must be understood, they should be used considerately, and administration must be manageable. We removed ZBI-7 from the set of measures as a result of feedback on its content and wording. Conclusions SOPC-team members have reservations about the implementation of PROM in SOPC, but with appropriate adjustments, its application in daily care is feasible, accepted and perceived as appropriate. Previous to use, SOPC-team members should be trained in how to apply the measures, in the design of manageable processes that include integration into electronic documentation systems, and in ongoing evaluation and support. They should also be taught how useful the measures can be. Trial registration May 19th, 2017, German Clinical Trials Register DRKS-ID: DRKS00012421.

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“…In a first step, we examined key features of successful care from the perspective of patients, relatives and health professionals. We found that 'treatment of complex symptoms, comprehensive care and a sense of security, as well as a focus on the quality of relationships, respect for individuality and the facilitation of self-determination' [22] are relevant topics that need to be covered. On this basis, we assembled a set of validated outcome measures, which is based on the Outcome Assessment and Complexity Collaborative (OACC) suite of measures [6].…”

Section: Introductionmentioning

confidence: 99%

State-wide implementation of patient-reported outcome measures (PROMs) in specialized outpatient palliative care teams (ELSAH): A mixed-methods evaluation and implications for their sustainable use

Seipp

Haasenritter

Hach³

et al. 2022

BMC Palliat Care

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Background Such patient-reported outcome measures (PROMs) and patient-centered outcome measures as the Integrated Palliative Care Outcome Scale (IPOS), Phase of Illness, and IPOS Views on Care (IPOS VoC), facilitate patient-centered care and help improve quality. To ensure sustainability, implementation and usage should be adapted according to setting. When settings involve several distinct teams that differ in terms of views and working practices, it is more difficult to integrate outcome measures into daily care. The ELSAH study aimed to learn how health professionals working in specialized outpatient palliative care (SOPC) viewed the use of these outcome measures in daily care, and what they express is needed for successful sustainable, state-wide application. Methods We used a parallel mixed-methods design involving three focus groups (n = 14) and an online-survey based on normalization process theory (n = 76). Most participants were nurses and physicians from 19 SOPC-teams in Hesse, Germany. We used a triangulation protocol including convergence coding matrices to triangulate findings. Results The majority of health professionals were able to integrate the outcome measures into their working lives and said that it had become a normal part of their day-to-day work. To ensure their sustainable integration into daily care, the motivation and concerns of health professionals should be taken into consideration. Health professionals must clearly recognize how the measures help improve daily care and quality evaluation. Conclusions To implement the outcome measures in a number of teams, it will be necessary to take individual team characteristics into account, because they influence motivation and concerncs. Further, it will be necessary to offer opportunities for them to engage in peer support and share information with other teams. The sustainable use of outcome measures in SOPC will require continuous support within each team as well as across teams. When several distinct teams are working in the same setting, a cross-team coordination unit can help to coordinate their work efficiently. Trial registration German Clinical Trials Register DRKS-ID: DRKS00012421; www.germanctr.de/DRKS00012421

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How can we ensure the success of specialised palliative home-care? A qualitative study (ELSAH) identifying key issues from the perspective of patients, relatives and health professionals

Cited by 12 publications

References 57 publications

Nurses’ experiences of suicide attempts in palliative care

Nurses’ experiences of suicide attempts in palliative care

Integrating patient- and caregiver-reported outcome measures into the daily care routines of specialised outpatient palliative care: a qualitative study (ELSAH) on feasibility, acceptability and appropriateness

State-wide implementation of patient-reported outcome measures (PROMs) in specialized outpatient palliative care teams (ELSAH): A mixed-methods evaluation and implications for their sustainable use

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How can we ensure the success of specialised palliative home-care? A qualitative study (ELSAH) identifying key issues from the perspective of patients, relatives and health professionals

Cited by 12 publications

References 57 publications

Nurses’ experiences of suicide attempts in palliative care

Nurses’ experiences of suicide attempts in palliative care

Integrating patient- and caregiver-reported outcome measures into the daily care routines of specialised outpatient palliative care: a qualitative study (ELSAH) on feasibility, acceptability and appropriateness

State-wide implementation of patient-reported outcome measures (PROMs) in specialized outpatient palliative care teams (ELSAH): A mixed-methods evaluation and implications for their sustainable ﻿use

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Product

Resources

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State-wide implementation of patient-reported outcome measures (PROMs) in specialized outpatient palliative care teams (ELSAH): A mixed-methods evaluation and implications for their sustainable use