Journal of palliative medicine
-
Racial and ethnic disparities in health care access and quality are well documented for some minority groups. However, compared to other areas of health care, such as disease prevention, early detection, and curative care, research in disparities in palliative care is limited. Given the rapidly growing population of minority older adults, many of whom will face advanced serious illness, the availability of high-quality palliative care that meets the varied needs of older adults of all races and ethnicities is a priority. This paper reviews existing data on racial and ethnic disparities in use of and quality of palliative care and outlines priorities for future research.
-
Cancer pain continues to be undertreated, despite the availability of evidence-based guidelines. The Australian National Pain Strategy identified establishment of systems and guidelines to adequately manage cancer pain as a high priority. ⋯ Barriers to evidence-based practice identified by our survey might be addressed via strategies to support decision making and coordination of care (e.g., a clinical pathway). Particular attention should be paid to promoting access to nonpharmacologic interventions and patient education, and improving referral and care coordination.
-
There are few studies specifically focused on the job satisfaction of hospice and palliative nursing assistants (NAs). The goal of this study was to ascertain factors contributing to NAs' job satisfaction and intent to remain with their current employer, garner suggestions for improving NA jobs, and inform hospice and palliative care providers concerned about retaining qualified, satisfied NAs. ⋯ This study found hospice and palliative NAs to be satisfied and committed to their jobs, which most viewed as long-term careers. However, organizations committed to recruitment and retention of committed and satisfied NAs would do well to ensure high-quality NA supervision, include NAs as valued team members, encourage positive work relationships, work to reduce problems identified by NAs as interfering with their work, and continue efforts to increase NA compensation.
-
The query, "Isn't there anything more you can do?" represents a classic informational question with an emotional subtext. In our previous work we have emphasized the value of noticing the emotional cue implicit in this question, and responding with an empathic statement. Yet responding explicitly to patients' emotions is not the best initial communication strategy for all patients. In this paper we discuss four different opening communication strategies--verbalize empathy, exchange information, contain chaos, respect searching--for patients who ask, "Isn't there anything more you can do?"