Primary Care Physician Knowledge, Utilization, and Attitude Regarding Advance Care Planning, Hospice, and Palliative Care: Much Work Remains (757)

Snyder, Sara; Allen, Kyle R.; Hazelett, Susan; Radwany, Steven

doi:10.1016/j.jpainsymman.2010.10.236

Cited by 3 publications

(2 citation statements)

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“…This clearly affects the end-of-life care provided in different care places. It has earlier been suggested that staff in nursing homes and GPs have less education and training in end-of-life conversations and circumstances are not optimal for end-of-life care, resulting in poorer communication and less likelihood that the person will be treated with respect and dignity by staff (Snyder et al, 2011; Malik et al, 2017; Smets et al, 2018). Previous studies have also shown a lack of end-of-life communication in nursing homes (Bollig et al, 2016; Smedback et al, 2017), which may also partly account for a higher likelihood of decisions being made about the care that the deceased person would not have wanted in nursing homes.…”

Section: Discussionmentioning

confidence: 99%

The influence of care place and diagnosis on care communication at the end of life: bereaved family members’ perspective

et al. 2021

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Objective To investigate the influence of care place and diagnosis on care communication during the last 3 months of life for people with advanced illness, from the bereaved family members’ perspective. Method A retrospective survey design using the VOICES(SF) questionnaire with a sample of 485 bereaved family members (aged: 20−90 years old, 70% women) of people who died in hospital was employed to meet the study aim. Results Of the deceased people, 79.2% had at some point received care at home, provided by general practitioners (GPs) (52%), district nurses (36.7%), or specialized palliative home care (17.9%), 27.4% were cared for in a nursing home and 15.7% in a specialized palliative care unit. The likelihood of bereaved family members reporting that the deceased person was treated with dignity and respect by the staff was lowest in nursing homes (OR: 0.21) and for GPs (OR: 0.37). A cancer diagnosis (OR: 2.36) or if cared for at home (OR: 2.17) increased the likelihood of bereaved family members reporting that the deceased person had been involved in decision making regarding care and less likely if cared for in a specialized palliative care unit (OR: 0.41). The likelihood of reports of unwanted decisions about the care was higher if cared for in a nursing home (OR: 1.85) or if the deceased person had a higher education (OR: 2.40). Significance of results This study confirms previous research about potential inequalities in care at the end of life. The place of care and diagnosis influenced the bereaved family members’ reports on whether the deceased person was treated with respect and dignity and how involved the deceased person was in decision making regarding care.

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Section: Discussionmentioning

confidence: 99%

The influence of care place and diagnosis on care communication at the end of life: bereaved family members’ perspective

et al. 2021

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“…They consider that this discussion is not beneficial to the patient, as it is exhausting and uncomfortable 13 . In turn, nurses recognise the importance of talking about death with patients who have no chance of a cure, although they only have this kind of conversation when they are willing to or when there is an opportunity 14 .…”

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confidence: 99%

Cuidados paliativos e a atenção primária à saúde: scoping review

Saito

Zóboli

2015

Rev. Bioét.

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The ageing population has increased the incidence of chronic health conditions, requiring the inclusion of different levels of palliative care (PC) in different parts of the health system, including the Primary Health Care (PHC). This new reality might interfere with the ethical issues of PHC. This research aimed to identify, from the point of view of health professionals, the ethical problems which arise from the palliative care in PHC. We carried out a systematic review in PubMed, EMBASE, LILACS, CINAHL, using the descriptors 'ethics', 'bioethic's, 'Primary Health Care' and 'Palliative Care'. We found 3,915 articles of which 16 remained after analyses. The ethical problems found were: lack of resources; lack of knowledge about palliative care; lack of communication skills; difficulty in establishing limits in clinical relationship; work overload; lack of support from referral services. These problems, in general are similar to those experienced in the PHC but with differences in specific situations. The incorporation of palliative care to the Primary Health Care specific guidelines and training as well as the custom of shared and co-responsible care. Keywords: Palliative Care. Chronic Disease. Primary Health Care. End-of-life. Bioethics. Ethics. ResumoCuidados paliativos e a atenção primária à saúde: scoping review O envelhecimento da população aumentou a incidência de doenças crônicas, demandando a inserção dos cuidados paliativos (CP) em diferentes níveis da rede, incluindo a atenção primária à saúde (APS). Isso poderá interferir nas questões éticas da APS. A presente pesquisa teve como objetivo identificar, na visão dos profissionais de saúde, os problemas éticos decorrentes da prática dos CP na APS. Fez-se revisão sistemática nas bases PubMed, Embase, Lilacs, CINAHL, com os descritores "ética", "bioética", "atenção primária à saú-de" e "cuidados paliativos". Localizaram-se 3.915 artigos, restando 16, após a análise. Os problemas éticos detectados foram: escassez de recursos; desconhecimento sobre CP; falta de habilidades comunicacionais; dificuldade de estabelecer limites na relação clínica; sobrecarga de trabalho; falta de apoio dos serviços de referência. Na abrangência, esses problemas assemelham-se aos vividos na APS, com diferenças nas situações específicas. Para incorporar os CP na APS, são necessárias normatizações e formação específicas, além da cultura do cuidado compartilhado e corresponsável. Palavras-chave: Cuidados paliativos. Doença crônica. Atenção primária à saúde. Terminalidade de vida. Bioética. Ética. ResumenLos cuidados paliativos y la atención primaria de salud: scoping review El envejecimiento poblacional aumentó las enfermedades crónicas, planteando la inclusión de diferentes niveles de cuidados paliativos (CP) en la red sanitaria, incluyendo la Atención Primaria de Salud (APS). Esto puede interferir con la ética de la APS. Nuestra investigación objetivó identificar, según los profesionales, cuales son los problemas éticos de los CP en la APS. La revisión sistemática en PubMe...

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Challenges in Using Insurance Claims Data to Identify Palliative Care Patients for a Research Trial

Enguídanos

Rahman

Fields

et al. 2020

Journal of Pain and Symptom Management

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Primary Care Physician Knowledge, Utilization, and Attitude Regarding Advance Care Planning, Hospice, and Palliative Care: Much Work Remains (757)

Cited by 3 publications

References 0 publications

The influence of care place and diagnosis on care communication at the end of life: bereaved family members’ perspective

The influence of care place and diagnosis on care communication at the end of life: bereaved family members’ perspective

Cuidados paliativos e a atenção primária à saúde: scoping review

Challenges in Using Insurance Claims Data to Identify Palliative Care Patients for a Research Trial

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