The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Jul 2018
Bridging the Cultural Divide Between Oncology and Palliative Care Subspecialties: Clinicians' Perceptions on Team Integration.
Palliative care improves symptom burden, distress, patient and family satisfaction, and survival for patients with cancer. Oncology professional societies endorse the integration of palliative care into routine care for patients with advanced cancers. Despite this, cultural differences between medical subspecialties and the limited number of clinicians trained in palliative care lower the adoption of integrated care models. We assessed oncologists' and palliative care clinicians' perceptions about integrating oncology and palliative care using a nurse delivering palliative care to patients newly diagnosed with lung cancer. ⋯ Integration between oncology and palliative care among the 6 VA medical centers varies considerably. Nurses delivering palliative care embedded in oncology teams may facilitate the integration of these subspecialties.
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Am J Hosp Palliat Care · Jun 2018
Patient and Provider Perspectives on a Mind-Body Program for Grieving Older Adults.
Spousal bereavement in older age is a major stressor associated with an increase in both mental and physical problems. The Stress Management and Resiliency Training: Relaxation Response Resiliency Program (SMART-3RP) is an 8-week multimodal mind-body program that targets stress and has been found efficacious in decreasing the mental and physical manifestations of stress in varied populations. This qualitative study sought to investigate the relevance, credibility, and feasibility of the SMART-3RP in the community. ⋯ Our findings suggest that the SMART-3RP may be helpful in decreasing somatic and psychological distress in older adults who have lost a spouse.
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Am J Hosp Palliat Care · Jun 2018
When and Why Do Neonatal and Pediatric Critical Care Physicians Consult Palliative Care?
Parents of children admitted to neonatal and pediatric intensive care units (ICUs) are at increased risk of experiencing acute and post-traumatic stress disorder. The integration of palliative care may improve child and family outcomes, yet there remains a lack of information about indicators for specialty-level palliative care involvement in this setting. ⋯ Palliative care was most beneficial for families at risk of experiencing communication problems that resulted from organizational factors, including those with long lengths of stay and medical complexity. The ability of palliative care consultants to bridge communication was limited by some of these same organizational factors. Physicians valued the involvement of palliative care consultants when they improved efficiency and promoted harmony. Given the increasing number of children with complex chronic conditions, it is important to support the capacity of ICU clinical teams to provide primary palliative care. We suggest comprehensive system changes and critical care physician training to include topics related to chronic illness and disability.
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Am J Hosp Palliat Care · Jun 2018
Clinical TrialQuality of Life and Compassion Satisfaction in Clinicians: A Pilot Intervention Study for Reducing Compassion Fatigue.
Compassion fatigue (CF) is prevalent in healthcare professionals, particularly in those caring for chronic, acutely ill, and/or those patients who might be moving toward comfort care. Over time, CF can lead to burnout (BO) and secondary traumatic stress and an overall decrease in professional quality of life. In this pilot study, participants completed a resiliency program focused on education about CF and self-awareness of its individualized impact and were expected to develop ongoing self-care practices to prevent/address the untoward effects. ⋯ While the small sample size of this pilot study limits the generalizability of the findings, there were positive effects for CS and BO in participants over time, indicating possible benefits of providing self-care education to healthcare providers. Additional research with a larger sample size is needed to address how healthcare providers might further benefit from resiliency education and interventions to improve professional quality of life.
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Am J Hosp Palliat Care · Jun 2018
Randomized Controlled Trial Multicenter StudyA Randomized Controlled Trial of Strategies to Improve Family Members' Preparedness for Surrogate Decision-Making.
To evaluate 2 strategies for preparing family members for surrogate decision-making. ⋯ The disconnect between confidence and performance raises questions about how to prepare family members to be surrogate decision-makers.