The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Aug 2018
ReviewProvider Tools for Advance Care Planning and Goals of Care Discussions: A Systematic Review.
Advance care planning and goals of care discussions involve the exploration of what is most important to a person, including their values and beliefs in preparation for health-care decision-making. Advance care planning conversations focus on planning for future health care, ensuring that an incapable person's wishes are known and can guide the person's substitute decision maker for future decision-making. Goals of care discussions focus on preparing for current decision-making by ensuring the person's goals guide this process. ⋯ Although several studies report positive findings, there is a lack of consistent patient outcome evidence to support any one clinical tool for use in advance care planning or goals of care discussions. Effective advance care planning conversations at both the population and the individual level require provider education and communication skill development, standardized and accessible documentation, quality improvement initiatives, and system-wide coordination to impact the population level. There is a need for research focused on goals of care discussions, to clarify the purpose and expected outcomes of these discussions, and to clearly differentiate goals of care from advance care planning.
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Am J Hosp Palliat Care · Aug 2018
ReviewThe Use of Simulation to Teach Nursing Students and Clinicians Palliative Care and End-of-Life Communication: A Systematic Review.
To present the findings of a systematic review on the use of simulation-based learning experiences (SBLEs) to teach communication skills to nursing students and clinicians who provide palliative and end-of-life care to patients and their families. ⋯ While the need for further research is acknowledged, we recommend this evidence be augmented by training programs that utilize SBLEs through (1) applying standards, (2) clearly specifying goals and objectives, (3) integrating externally validated scenarios, and (4) employing rigorous evaluation methods and measures that link the SBLE to the training objectives and desired clinician practice behaviors and patient outcomes.
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Am J Hosp Palliat Care · Aug 2018
Quality of Life in a Hospice: A Validation of the Croatian Version of the EORTC QLQ-C15-PAL.
Quality of life is the cornerstone of palliative care, and assessing it requires validated and standardized questionnaires. However, the majority of questionnaires are not tested in a hospice setting. The purpose of this study is to evaluate the quality of life in a hospice using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 for Palliative Care (PAL) (EORTC QLQ-C15-PAL) questionnaire and validating it in Croatian language. ⋯ The EORTC QLQ-C15-PAL can be used successfully in Croatian palliative care. However, inevitable issues such as low retest percentage due to short survival and low physical functioning scores need to be acknowledged in further formulations of quality of life questionnaires specific to hospice care.
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Am J Hosp Palliat Care · Aug 2018
Five-Year Experience of an Inpatient Palliative Care Unit at an Academic Referral Center.
Palliative care units (PCUs) staffed by specialty-trained physicians and nurses have been established in a number of medical centers. The purpose of this study is to review the 5-year experience of a PCU at a large, urban academic referral center. ⋯ These data show that a successful PCU is enabled by buy in from a wide variety of referring specialists and by a multidisciplinary palliative care team focused on care of the actively dying patient as well as pain and symptom management, advance care planning, and hospice referral since a large proportion of referred patients do not die in house.
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Am J Hosp Palliat Care · Aug 2018
Mindful Self-Care and Secondary Traumatic Stress Mediate a Relationship Between Compassion Satisfaction and Burnout Risk Among Hospice Care Professionals.
Effective self-care in hospice is anecdotally proclaimed to reduce burnout risk. Yet, the topic has received little empirical attention. ⋯ Hospice care professional had higher self-care, CS, lower STS, and Burnout compared to published norms. Those who engaged in multiple and frequent self-care strategies experienced higher professional quality of life. Implications for hospice providers and suggestions for future research are discussed.