Palliative care in mental health facilities from the perspective of nurses: a mixed‐methods study

Abstract

Introduction Recent empirical research on palliative care for psychiatric patients is lacking. Aim The aim of this study was to explore nurses' experiences with and identify barriers to providing palliative care to psychiatric patients in Dutch mental health facilities. Methods Mixed-methods; 137 nurses working in Dutch mental health facilities completed a survey. Nine participated in in-depth interviews. Results Thirty-six percent of nurses had experience with providing palliative care to psychiatric patients with physical co-morbidity in the past 2 years. Of all patients, 63% received physical care before death, 46% psychosocial care and 33% spiritual care. In 91% of all cases, care was provided by multidisciplinary teams. Patient characteristics and little attention to palliative care were barriers for timely and adequate palliative care. Discussion In palliative care for psychiatric patients, there is more attention for psychosocial and spiritual care compared to palliative care for patients without psychiatric disorders. Yet there are barriers to adequate palliative care provision. Implications for practice Educating psychiatric nurses about palliative care and close collaboration between physical and mental health care are crucial to address the palliative care needs of psychiatric patients. Since mental health care is increasingly provided ambulatory, palliative care for psychiatric patients outside mental health facilities should be closely monitored.

Spiritual Care in Palliative Care: A Systematic Review of the Recent European Literature

“…Fifty-three articles were included [33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85]. Seventeen were quantitative studies [33,34,36,37,40,43,50,51,54,61,66,67,69,71,74,81,82], of which the majority ( n = 11) were survey studies, 27 qualitative studies […”

“…Seventeen were quantitative studies [33,34,36,37,40,43,50,51,54,61,66,67,69,71,74,81,82], of which the majority ( n = 11) were survey studies, 27 qualitative studies [38,39,41,42,44,45,46,48,49,53,55,56,57,58,59,60,63,64,68,73,76,78,79,80,83,84,85], most of which were interview studies ( n = 13), and nine mixed-methods studies [35,47,52,62,65,70,72,75,77]. Most studies were conducted in Western Europe ( n = 37), especially in the UK ( n = 10), Germany ( n = 8), and the Netherlands ( n = 13).…”

“…A survey among 6263 physicians found that spiritual care was most commonly provided to females, older patients, patients with dementia and patients who died in a nursing home [33]. Another study, examining the experiences of 137 nurses in mental health care, found that only 33% of patients with a life-threatening disease received spiritual care [52]. Furthermore, findings from a qualitative study with sixteen patients with end-stage heart failure living at home in the UK suggest that hospitals did not fully address spiritual concerns of these patients, many of whom struggled with isolation and loneliness [42].…”

Spiritual well-being promotion for older adults: Implication for healthcare policy makers' decision making on cost savings

“…However, we nurses, as front-line gatekeepers for patients’ omnidirectional well-being, should not overlook the potential value of such a spiritual well-being-based nursing intervention while still “think (ing) within the box.“[1617] The possibility that a spiritual well-being-based nursing intervention may boost older adults’ resilience-based recovery[1314] suggests its potential contribution to controlling skyrocketing healthcare costs, which also may create ripple effects that could reduce the productive population's social burden of supporting the older adults and could alleviate a generational conflict. It is time for nurse scientists to escape from the “old fellows’ continuous marching in their former direction and get into a new field to get new viewpoints,”[1718] namely by actively addressing first the feasibility, then the direct and indirect effects on actual patient outcomes, and finally the cost efficiency of a spiritual well-being-based nursing intervention for the added benefit of easing the decision-making of healthcare policy-makers.…”

A relação entre saúde mental e cuidados paliativos: percepções de terapeutas ocupacionais da rede psicossocial

“…Um estudo 16 sobre as taxas de mortalidade em pacientes psiquiátricos teve como resultado a existência de uma alta mortalidade, apontando que na maioria dos estudos revisados, apesar das diferentes abordagens e correlações verificadas, essa mortalidade foi maior do que na população geral. As pesquisas realizadas nos períodos de mudança nas políticas de saúde mental de diversos países sugerem a necessidade de cuidados específicos e a criação de serviços de suporte adequado para os clientes desinstitucionalizados 5,6,15,17 . Isso indica a necessidade de políticas de saúde direcionadas aos cuidados de saúde geral do indivíduo com transtornos mentais e, consequentemente, melhoria de sua qualidade de vida.…”