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Article

Oncology nurse managers' perceptions of palliative care and end-of-life communication

SAWIN, Kathleen J. ; MONTGOMERY, Kathleen E. ; DUPREE, Claretta Yvonne ; HAASE, Joan E. ; PHILLIPS, Celeste R. ; HENDRICKS-FERGUSON, Verna L.
Journal of pediatric oncology nursing, 06/2019, vol.36, n°3, p. 178-190

Thème : Soins.

COMMUNICATION ; FIN VIE ; DEMARCHE PALLIATIVE ; INFIRMIERE ; CANCEROLOGIE ; PEDIATRIE ; CADRE SANTE
; RESSENTI

The purpose of this study was to describe pediatric oncology nurse managers' (NMs) perspectives of palliative care/end-of-life (PC/EOL) communication. The study, guided by group-as-a-whole theory and empirical phenomenology, was part of a larger, multisite study aimed at understanding pediatric oncology nurses' experiences of PC/EOL communication. Nurses were assigned to focus groups based on length or type of experience (i.e., nurses with <1, 2-5, or >5 years' work experience and NMs). Eleven NMs from three Midwestern pediatric hospitals with large oncology programs participated in one focus group. The participants' mean years of experience was 15.8 in nursing and 12 in pediatric oncology; 90% had a BSN or higher degree; all had supervisory responsibilities. The authors identified 2,912 meaning statements, which were then analyzed using Colaizzi's method. Findings include NMs' overall experience of "Fostering a Caring Climate," which includes three core themes: (1) Imprint of Initial Grief Experiences and Emotions; (2) Constant Vigilance: Assessing and Optimizing Family-Centered Care; and (3) Promoting a Competent, Thoughtful, and Caring Workforce. Findings indicate that pediatric oncology NMs draw on their own PC/EOL experiences and their nursing management knowledge to address the PC/EOL care learning needs of nursing staff and patient/family needs. NMs need additional resources to support nursing staff's PC/EOL communication training, including specific training in undergraduate and graduate nursing programs and national and hospital-based training programs.

Origine : PubMed

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Article

Au domicile, oser l’impertinence dans l’accompagnement de fin de vie

LECOINTRE, Brigitte
REVUE DE L INFIRMIERE, 02/2019, vol.68, n°248, p. 35-37

Thème : Soins.

DOMICILE ; ACCOMPAGNEMENT ; FIN VIE ; TEMOIGNAGE ; INFIRMIERE ; COMMUNICATION ; RELATION PERSONNEL SOIGNANT FAMILLE ; RELATION PERSONNEL SOIGNANT PATIENT

L’approche des soins palliatifs centrée sur la personne malade oblige à établir des partenariats entre cette dernière, les soignants, la famille, les professionnels sociaux et les bénévoles d’accompagnement. La communication qui se décline dans le dialogue, l’écoute, l’instauration d’une relation de confiance, l’observation des comportements et du langage corporel est essentielle face à l’incertitude et à un questionnement existentiel du malade et de ses proches. À domicile, comme en témoigne cette infirmière expérimentée, ces questionnements convoquent les soignants dans leur professionnalisme et leur humanité.

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Article

Enhancing advance care planning conversations by nurses in a bone marrow transplantation unit

IZUMI, Shigeko ; BURT, Malinda ; SMITH, Jennifer C. ; MCCORD, Keren ; FROMME, Erik K.
Oncology nursing forum, 01/05/2019, vol.46, n°3, p. 288-297

Thème : Formation.

PLANIFICATION ; ANTICIPATION ; SOIN ; COMMUNICATION ; RELATION PERSONNEL SOIGNANT PATIENT ; INFIRMIERE ; GREFFE ; MOELLE OSSEUSE ; ETATS-UNIS ; EVALUATION ; FORMATION

OBJECTIVES: To describe the impact of advance care planning (ACP) education on nurses' confidence in ACP knowledge and practice and to identify barriers to facilitate ACP conversation in a bone marrow transplantation unit.
SAMPLE & SETTING: 60 nurses working in the bone marrow transplant unit at Oregon Health and Science University, an academic medical center.
METHODS & VARIABLES: The aim of this quality improvement project was to increase ACP conversations by nurses. The authors used a single-group pre-/post-test design to assess the effectiveness of a 30-minute educational intervention in changing nurses' confidence and practice. Group interviews were conducted to identify barriers to ACP.
RESULTS: The educational intervention increased nurses' confidence in knowledge about ACP. The number of nurses who discussed ACP with patients also increased, but it was not statistically significant. Lack of time, inefficient workflow, and concerns about questioning providers' understanding of patient preferences were identified as barriers for nurses engaging in and documenting ACP conversations.
IMPLICATIONS FOR NURSING: In addition to appropriate education, strategies that help tailor ACP practice to fit into nurse workflow and promote collaboration with other healthcare team members are needed to change nurses' ACP practice.

Origine : PubMed

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Article

Moral distress and attitudes about timing related to comfort care for hospitalized patients - a survey of inpatient providers and nurses

BENDER, Melissa A. ; ANDRILLA, C. Holly A. ; SHARMA, Rashmi K. ; HURD, Caroline ; SOLVANG, Nicole ; MAE-BALDWIN, Laura
The American journal of hospice and palliative care, 09/04/2019, Pagination inconnue

Thème : Soins.

DETRESSE PSYCHOLOGIQUE ; HOPITAL ; PERSONNEL MEDICAL ; INFIRMIERE ; SOIN CONFORT ; TRAJECTOIRE MALADIE

CONTEXT: Providing nonbeneficial care at the end of life and delays in initiating comfort care have been associated with provider and nurse moral distress.
OBJECTIVE: Evaluate provider and nurse moral distress when using a comfort care order set and attitudes about timing of initiating comfort care for hospitalized patients.
METHODS: Cross-sectional survey of providers (physicians, nurse practitioners, and physician assistants) and nurses at 2 large academic hospitals in 2015. Providers and nurses were surveyed about their experiences providing comfort care in an inpatient setting.
RESULTS: Two hundred five nurse and 124 provider surveys were analyzed. A greater proportion of nurses compared to providers reported experiencing moral distress "some, most, or all of the time" when using the comfort care order set (40.5% and 19.4%, respectively, P = .002). Over 60% of nurses and providers reported comfort care was generally started too late in a patient's course, with physician trainees (81.4%), as well as providers (80.9%) and nurses (84.0%) < 5 years from graduating professional school most likely to report that comfort care is generally started too late.
CONCLUSIONS: The majority of providers and nurses reported that comfort care was started too late in a patient's course. Nurses experienced higher levels of moral distress than providers when caring for patients using a comfort care order set. Further research is needed to determine what is driving this moral distress in order to tailor interventions for nurses and providers.

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Article

The support, education, and advocacy (SEA) program of care for women with metastatic breast cancer - a nurse-led palliative care demonstration program

REISER, Victoria ; ROSENZWEIG, Margaret ; WELSH, Ann ; REN, Dianxu ; USHER, Barbara
The American journal of hospice and palliative care, 11/04/2019, Pagination inconnue

Thème : Soins.

CANCER SEIN ; DEMARCHE PALLIATIVE ; ACCOMPAGNEMENT ; INFIRMIERE ; ACCOMPAGNEMENT SOCIAL ; QUALITE SOIN ; HOSPITALISATION JOUR

BACKGROUND: Women with metastatic breast cancer (MBC) experience unique symptom management and psychosocial needs due to aggressive, yet palliative treatment with a progressive, chronic illness.
OBJECTIVE: This article describes the effect of a quality improvement project for coordination of supportive care in MBC. Program evaluations included referral rates for supportive services, patient-reported outcomes of symptom distress, generalized anxiety, and overall well-being.
DESIGN: An interdisciplinary Support, Education and Advocacy Program (MBC-SEA) was developed. The 1-hour, weekly, patient review included collaborative assessments to determine needs for social service, psychological counseling, and palliative care. A prospective pre- and postexperimental cohort design with convenience sampling was used. Analysis was conducted with paired t test analysis of pre- and postimplementation outcomes.
SETTING/PARTICIPANTS: Program outcomes of 118 women with MBC visiting an urban outpatient breast cancer clinic during September 2016 to November 2016 (pre) and January 2017 to March 2017 (post) were evaluated.
MEASUREMENTS: Referral rates to social work and palliative care, symptom, anxiety, and overall well-being scores.
RESULTS: Following program implementation, referrals to palliative care and social work supportive services increased significantly including patient-reported outcomes symptom distress scores mean difference 1.4 (95% confidence interval [CI]: 0.4306-2.6428), P = .004; generalized anxiety scores mean difference 1.5 (95% CI: 0.5406-2.5781), P = .003; and overall well-being mean difference of -0.7 (95% CI: -1.3498 to -0.0570), P = .03.
CONCLUSIONS: Purposeful nurse-led assessment for social service and palliative care needs increases referrals with improvement in patient-reported outcomes.

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Article

Evaluation of health-care providers' perception of spiritual care and the obstacles to its implementation

FARAHANI, Azam Shirinabadi ; RASSOULI, Maryam ; SALMANI, Nayereh ; MOJEN, Leila Khanali ; SAJJADI, Moosa ; HEIDARZADEH, Mehdi ; MASOUDIFAR, Zeynab ; KHADEMI, Fateme
Asia-Pacific journal of oncology nursing, 06/2019, vol.6, n°2, p. 122-129

Thème : Soins. Cote : eD02.03.02

DEMARCHE PALLIATIVE ; SPIRITUALITE ; MEDECIN ; INFIRMIERE ; PATIENT ; CANCER ; IRAN

Objective: Cancer patients face many health challenges, including spiritual issues. Therefore, an awareness of health-care providers' perspective on spiritual care provision is important. This study aimed to determine health-care providers' perception of spiritual care and to examine the individual barriers to its implementation in cancer patients.
Methods: The present descriptive study included 136 physicians and nurses. The Spiritual Care Survey was used as a research tool. Data were analyzed through descriptive statistics using IBM SPSS Statistics for Windows, version 20.0.
Results: In this study, 70.6% of the participants considered spiritual care to be influential in the patients' quality of life. However, 64.7% had received no spiritual care training, while 82.4% indicated a willingness to attend these courses. Regarding the obstacles to providing spiritual care, the highest and lowest scores, respectively, belonged to the lack of time and the person's reluctance to talk about spiritual issues.
Conclusions: Spiritual care has not yet found its proper place in the care setting of Iran, and health-care team members do not have sufficient training to provide this kind of care despite their belief in its positive impact on patients' quality of life.

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Article

Are district nurses well placed to provide equitable end-of-life care to individuals who are homeless?

TRAYNOR, Rebecca
British journal of community nursing, 02/04/2019, vol.24, n°4, p. 165-172

Thème : Soins.

FIN VIE ; SOIN ; REVUE LITTERATURE ; INFIRMIERE ; PRECARITE ; SANS DOMICILE FIXE ; RECHERCHE

This literature review aimed to answer the focus question: are district nurses well placed to provide equitable end of life care (EOL) for homeless individuals? It focused on 10 primary research studies, from which two themes emerged and subsequently formed the basis of the discussion: (1) the difficulty in predicting disease trajectory in people who are homeless and (2) the gaps in existing systems. The main findings from these themes were a lack of education on the recognition of the dying and a general lack of knowledge of the complex challenges faced by and health needs of homeless people, which cause stigma from both the general public and health professionals towards these marginalised individuals. Further, there is certainly a lack of suitable places to deliver palliative and EOL care for people who are homeless. Available services are inflexible and have no tolerance for substance misuse, which creates an access barrier for homeless people in need of EOL care.

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Article

"Beyond the boundaries of care dependence" - a phenomenological study of the experiences of palliative care nurses

PIREDDA, Michela ; CANDELA, Maria L. ; MASTROIANNI, Chiara ; MARCHETTI, Anna ; D'ANGELO, Daniela ; LUSIGNANI, Maura ; DE MARINIS, Maria G. ; MATARESE, Maria
Cancer nursing, 03/04/2019, Pagination inconnue

Thème : Soins.

DEPENDANCE ; INFIRMIERE ; DEMARCHE PALLIATIVE ; PHENOMENOLOGIE ; ITALIE ; RESSENTI

BACKGROUND: Dependence is a common life experience and innate condition for human beings due to their bodily and relational essence, but in contemporary society, it has become a stressful condition. Care dependence is central to nursing, and patients with advanced cancer are often dependent on care. Understanding nurses' perceptions of care dependence can contribute to awareness of the impact it has on nurses.
OBJECTIVE: The aim of this study was to explore palliative care nurses' experiences and perceptions regarding patient dependence.
METHODS: Sixteen nurses taking care of dependent patients in a palliative care center in Rome were interviewed. Giorgi's descriptive phenomenological method was used.
RESULTS: Nurses caring for dependent patients transcend the boundaries of dependence. Care dependence is an experience of powerlessness and regression. A patient's life in dependence is precarious, as they have to overcome the daily limits of life. Taking care of dependent patients requires nurses to manage the unmanageable and to know and to embrace change from within in order to build positive relations of personal closeness and reciprocal self-giving.
CONCLUSIONS: Nurses should be aware that self-transcendence and the consequent positive relations could make the difference in the experience of care dependence and promote personal growth for both patient and nurse. Positive and transcending relationships can transform care dependence into the opportunity to find meaning and purpose in life.
IMPLICATIONS FOR PRACTICE: The study highlights what nurses feel in caring for dependent patients. Understanding nurses' perceptions is important to delineate a proper caring for dependent patients.

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Article

Multidimensional emotion regulation strategies among hospice nurses

BARNETT, Michael D. ; CANTU, Christina ; CLARK, Kametrice A.
DEATH STUDIES, 02/04/2019, 6 p.

Thème : Soins. Cote : e00.07DEA

EMOTION ; ETATS-UNIS ; INFIRMIERE ; DEMARCHE PALLIATIVE ; UNITE SOINS PALLIATIFS ; COPING

The purpose of this study was to investigate relationships between four emotion regulation strategies (intrinsic affect-improving, intrinsic affect-worsening, extrinsic affect-improving, and extrinsic affect-worsening) and compassion fatigue, job satisfaction, and life satisfaction among 90 hospice nurses who completed an online survey. Intrinsic affect-improving was associated with higher life satisfaction. Intrinsic affect-worsening was associated with higher compassion fatigue and lower life satisfaction. Extrinsic affect-worsening was associated with lower job satisfaction. Overall, these findings support a multidimensional approach to understanding emotion regulation among hospice nurses.

Origine : Taylor and Francis+NEJM

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Article

Development of student competencies for palliative care

CARRILLO, Gloria Mabel ; GOMEZ, Olga Janeth ; DIAZ, Lorena Chaparro ; CARRENO, Sonia Patricia
International Journal of Palliative Nursing, 02/04/2019, vol.25, n°4, p. 177-184

Thème : Formation. Cote : 00.07INT

DEMARCHE PALLIATIVE ; UNITE SOINS PALLIATIFS ; SOIN ; MOURANT ; PRATIQUE PROFESSIONNELLE ; INFIRMIERE ; ETUDIANT ; COMPETENCE PROFESSIONNELLE ; QUESTIONNAIRE ; COLOMBIE

AIM: Identify the palliative care learning needs of healthcare students and determine the acceptability of an innovative learning strategy for palliative care named competencia para cuidar en el hogar-paliar (CUIDAR-PALIAR) aimed to increase students' competencies.
METHODS: A single-group mixed methods design was used. A questionnaire was designed and semi-structured interviews were used to determine the palliative care competencies of undergraduate students; 90 students participated in the strategy.
FINDINGS: The learning needs of students are: approaches to death and loss, how to intervene with the patient's family, understanding of the palliative care context, management of the patient's pain and symptoms and the development of therapeutic communication skills.
CONCLUSION: The strategy is highly accepted by students, and statistically significant increases in palliative care were observed before and after the intervention. These preliminary results justify future interventions due to the potential effect of the strategy CUIDAR-PALIAR in the development of competencies for palliative care in undergraduate students.

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Article

Meaningful experiences and end-of-life care in the intensive care unit - a qualitative study

STOKES, Heather ; VANDERSPANK-WRIGHT, Brandi ; FOTHERGILL BOURBONNAIS, Frances ; WRIGHT, David Kenneth
Intensive and critical care nursing, 06/04/2019, Pagination inconnue

Thème : Soins.

RESSENTI ; SOIN ; FIN VIE ; CANADA ; SOIN INTENSIF ; RECHERCHE QUALITATIVE ; SENS ; INFIRMIERE

OBJECTIVES: The purpose of this study was to provide a comprehensive exploration of nurses' meaningful experiences of providing end-of-life care to patients and families in the intensive care unit (ICU). The objectives of this research were: (1) To explore what is meaningful practice for nurses regarding end-of-life care; (2) To describe how nurses create a good death in the intensive care unit and (3) To identify the challenges that nurses face that affect their meaningful experiences and ultimately the creation of a good death.
RESEARCH DESIGN: This study utilised an interpretive phenomenological approach using Van Manen's (1997) method.
SETTING: In-depth, face-to-face interviews were conducted with six intensive care nurses employed in a 32-bed medical/surgical intensive care unit of an academic tertiary care centre in Canada.
FINDINGS: The overarching theme from the analysis of this experience was "being able to make a difference" which was intricately woven around contributing to a good death. Three main themes were identified and included: creating a good death, navigating the challenges and making it work.
CONCLUSION: The findings reveal how intensive care nurses provide good end-of-life care and create good deaths for patients and families.

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Article

The role and function of the palliative care nurse practitioner in Israel

HARON, Yafa ; ROMEM, Anat ; GREENBERGER, Chaya
International Journal of Palliative Nursing, 02/04/2019, vol.25, n°4, p. 186-192

Thème : Soins. Cote : 00.07INT

DEMARCHE PALLIATIVE ; ISRAEL ; INFIRMIERE ; SOIN INFIRMIER ; PRATIQUE PROFESSIONNELLE

BACKGROUND: Research studies emphasise the importance of the nurse practitioner (NP) role in the continuum of care, patient health outcomes, and the formation of a positive work environment. There are different reports about the extent of care delivered by the nurse practitioner in different fields of expertise and in different countries.
AIM: To present the characteristics of nurse practitioners in Israel, the extent of the role and practice, activities, role responsibilities, and job satisfaction.
METHODS: A descriptive computerised survey targeted palliative care nurse practitioners (PCNP). The study included nurses from all regions and districts in Israel, regardless of the nurses' health maintenance organisation or hospital affiliations.
RESULTS: NPs reported performing fewer frequent physical assessments, medication prescriptions issued, and lab and imaging referrals.
CONCLUSION: The complexity of the implementation of the NP role requires prior planning for role introduction, mentorship for the NP, and understanding of the interface between the NP and other professional staff.

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Article

End-of-life nursing and education consortium communication curriculum for nurses

BULLER, Haley ; VIRANI, Rose ; MALLOY, Pamela ; PAICE, Judith A.
JOURNAL OF HOSPICE AND PALLIATIVE NURSING, 04/2019, vol.21, n°2, p. E5-E12

Thème : Soins. Cote : 00.07JHP

FIN VIE ; SOIN INFIRMIER ; FORMATION ; COMMUNICATION ; INFIRMIERE ; ETATS-UNIS

Nurses have unique clinical responsibilities and opportunities with patients that require strong communication skills. However, many nurses lack effective communication skills and often receive inadequate palliative care communication training and education. To promote communication education for palliative care nurses, the End-of-Life Nursing and Education Consortium created a Communication Curriculum for nurses and developed an in-person train-the-trainer course. Organized by the 8 domains of the National Consensus Project Guidelines for Quality Palliative Care, a 1-day course was provided in August 2018 to 46 nurses representing 38 institutions. Completion of precourse surveys demonstrated participants’ institutional resources for palliative care communication education and their greatest communication challenges. Immediate postcourse evaluations demonstrated that the course improved nurses’ knowledge and confidence in communication and their ability to educate others. Palliative care nurses can incorporate communication skills into their practice and provide communication skills training to their institution.

Origine : journals.lww.com

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Physicians and nurses' knowledge and attitudes towards advance directives for cancer patients in Saudi Arabia

ALFAYYAD, Isamme N. ; AL-TANNIR, Mohamad A. ; ALESSA, Waleed A. ; HEENA, Humariya M. ; ABU-SHAHEEN, Amani K.
Plos one, 2019, vol.14, n°4, 13 p.

Thème : Soins. Cote : eD02.03.02

ATTITUDE ; CONNAISSANCE ; MEDECIN ; INFIRMIERE ; DIRECTIVE ANTICIPEE ; CANCER ; PATIENT ; ARABIE SAOUDITE

This study aimed to investigate physicians' and nurses' knowledge and attitudes toward advance directives (ADs) for cancer patients, which empower patients to take decisions on end-of-life needs if they lose their capacity to make medical decisions. A cross-sectional study was conducted using convenience sampling. The outcomes were responses to the knowledge and attitude questions, and the main outcome variables were the total scores for knowledge and attitudes toward ADs. This study included 281 physicians and nurses (60.5%). Most physicians were men (95, 80.5%), whereas most nurses were women (147, 86.5%). The mean (standard deviation; SD) total knowledge score was 6.8 (4.0) for physicians and 9.1 (3.0) for nurses (p < 0.001). There was a significant difference in the total knowledge score between nurses and physicians, with an adjusted mean difference of 1.54 (95% confidence interval [CI]; 0.08-2.97). Other significant independent predictors of knowledge of ADs were female sex (1.60, 95% CI; 0.27-3.13) and education level (master's versus bachelor's: 1.26, 95% CI; 0.30-2.33 and Ph.D. versus bachelor's: 2.22, 95% CI; 0.16-4.52). Nurses' attitudes appeared to be significantly more positive than those of physicians, and the mean total attitude score (SD) was 19.5 for nurses (6.2) and 15.1 (8.1) for physicians (p < 0.001). The adjusted mean difference (95% CI) for nurses versus physicians was 3.71 (0.57-6.98). All participants showed a high level of knowledge of ADs; however, nurses showed considerably more positive attitudes than physicians.

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The experience of the nurse caring for families of patients at the end of life in the intensive care unit

RIVERA-ROMERO, Nathaly ; OSPINA GARZÓN, Heidi Paola ; HENAO-CASTAÑO, Angela Maria
Scandinavian journal of caring sciences, 13/03/2019, Pagination inconnue

Thème : Soins.

INFIRMIERE ; FAMILLE ; ACCOMPAGNEMENT ; FIN VIE ; SERVICE URGENCES ; SENS ; RECHERCHE QUALITATIVE ; PHENOMENOLOGIE ; EMOTION ; IMPACT PSYCHOLOGIQUE

The patient who enters at the intensive care unit (ICU) usually does because of health conditions that are sometimes irreversible and lead to death, and the care at the end of life becomes the main factor of this situation; therefore, the aim of this article was to understand the meaning of the experience of giving care to families at the end of life in an ICU. For this reason, a qualitative, hermeneutic phenomenological research was carried out. For the data collection, a semi-structured interview was conducted to 18 participants, and the results were returned to each of the participants in order to validate each of the categories and interpretations. Among these results, two main categories were identified: emotional response of the nurse to the family and nursing care to the family of patients at the end of life. It was concluded that the nurses working at the ICU are facing aspects related to the end of life that generates emotional and psychological burden; additionally, they do not have specific training in this subject, especially in relation to the care of the families in this situation, for which they provide this care based on empiricism.

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Article

Addressing educational needs in managing complex pain in cancer populations - evaluation of APAM: an online educational intervention for nurses

LEUNG, Yvonne W. ; WONG, Jiahui ; KITELEY, Cathy ; ELLIS, Jerusha ; ESPLEN, Mary Jane
The American journal of hospice and palliative care, 27/02/2019, Pagination inconnue

Thème : Formation.

CANCER ; INFIRMIERE ; CONTROLE DOULEUR ; FORMATION PROFESSIONNELLE ; CANADA

CONTEXT: Cancer-related pain is associated with significant suffering and is one of the most challenging symptoms to manage. Studies indicate that front-line clinicians often lack the knowledge on best practices in cancer pain management.
OBJECTIVES: The current project, a quality improvement (QI) initiative, evaluated the outcome of an online educational intervention for nurses on complex cancer pain management.
METHODS: An online 7-module educational intervention, Advanced Pain Assessment and Management, was offered from 2012 to 2017. Pre-post course evaluations included self-reported knowledge and confidence across cancer pain management domains. In-course competency assessments included knowledge examination, online discussion forum participation, opioid dosage calculation assignment, and small-group-based case study. A mixed-model statistical analysis was used to assess pre-post course change in pain management confidence level.
RESULTS: In all, 306 nurses from 89 hospitals in Ontario, Canada, were enrolled in the course; 81.4% returned the precourse survey and 71.9% successfully completed the course. The average confidence level on pain management was low at baseline (57.5%) but improved significantly post-course. In-course competency assessments ranged from 81% to 89%. Mixed-model results showed post-course improvements in confidence levels, independent of sociodemographic background, clinical role, and professional educational level. Nurses with longer years of practice and more cancer cases reported greater confidence.
CONCLUSION: A facilitator-led online educational intervention focusing on complex cancer pain management can significantly improve nurses' knowledge, confidence, and skills. Low baseline knowledge among nurses highlights the pressing need for health-care organizations to implement cancer pain management training as an integral part of health-care QI initiative.

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End-of-life nursing and education consortium communication curriculum for nurses

BULLER, Haley ; VIRANI, Rose ; MALLOY, Pamela ; PAICE, Judith A.
JOURNAL OF HOSPICE AND PALLIATIVE NURSING, 01/04/2019, vol.21, n°2, p. E5–E12

Thème : Formation.

FIN VIE ; COMMUNICATION ; INFIRMIERE ; DEMARCHE PALLIATIVE ; FORMATION PROFESSIONNELLE

Nurses have unique clinical responsibilities and opportunities with patients that require strong communication skills. However, many nurses lack effective communication skills and often receive inadequate palliative care communication training and education. To promote communication education for palliative care nurses, the End-of-Life Nursing and Education Consortium created a Communication Curriculum for nurses and developed an in-person train-the-trainer course. Organized by the 8 domains of the National Consensus Project Guidelines for Quality Palliative Care, a 1-day course was provided in August 2018 to 46 nurses representing 38 institutions. Completion of precourse surveys demonstrated participants’ institutional resources for palliative care communication education and their greatest communication challenges. Immediate postcourse evaluations demonstrated that the course improved nurses’ knowledge and confidence in communication and their ability to educate others. Palliative care nurses can incorporate communication skills into their practice and provide communication skills training to their institution.

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Evaluation of the pronouncement of death policy implementation and outcomes - implications for advanced practice nursing

JACKSON, Hazel Anita ; OLIVER, JoAnn ; HOUSE, Kim
JOURNAL OF HOSPICE AND PALLIATIVE NURSING, 04/2019, vol.21, n°2, p. 139-143

Thème : Mort. Cote : 00.07JHP

MORT ; INFIRMIERE ; CERTIFICAT DECES ; TEMPS

In 2011, the Veterans Health Administration mandated that Veterans Affairs (VA) Medical Centers develop and implement a policy that allowed registered nurses (RNs) and advanced practice registered nurses (APRNs) to pronounce the death of residents who die in Veterans Affairs community living centers, previously known as nursing homes, provided that there is a written do-not-resuscitate order in their medical record. The purpose of this quality improvement project was to determine the extent to which the implementation of the RN/APRN death pronouncement policy affected death pronouncement time for residents who die after 5 PM and before 7:30 AM, on weekends and holidays. This project is significant because the previous physician-only death pronouncement policy was found to cause unnecessary delays in death pronouncement. A chart review of the medical records of all veterans' deaths pronounced by physicians 3 years before the implementation of the policy and 4 years after the RN/APRN policy was reviewed and implemented. The data analysis was conducted using descriptive analysis. A significant difference was found in the results (P < .05). The maximum for prepolicy deaths was 125 minutes. The maximum for postpolicy deaths was 7 minutes. The results supported the assumption that RN/APRN pronounced death without delay.

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Article

Resilience in inpatient palliative care nursing - a qualitative systematic review

POWELL, Martin J. ; FROGGATT, Katherine ; GIGA, Sabir
BMJ supportive and palliative care, 26/02/2019, Pagination inconnue

Thème : Soins.

RESILIENCE ; DEMARCHE PALLIATIVE ; RECHERCHE QUALITATIVE ; REVUE LITTERATURE ; INFIRMIERE ; HOPITAL ; STRESS ; COPING

BACKGROUND: Nurses in inpatient palliative care are frequently exposed to death and dying in addition to common stressors found in other nursing practice. Resilience may mitigate against stress but remains ill-defined and under-researched in the specialist palliative care setting.
OBJECTIVE: The aim of this systematic review was to understand resilience from the perspectives of inpatient palliative care nurses.
DESIGN: A thematic synthesis of qualitative studies was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
DATA SOURCES: Academic Search Ultimate, Cumulative Index to Nursing and Allied Health Literature, Medline Complete, PsycINFO and Scopus.
REVIEW METHODS: The review stages were searching for relevant literature, selecting relevant papers, data extraction, critical appraisal and thematic synthesis.
RESULTS: Eight studies revealed 10 subthemes, 3 descriptive themes and 1 analytical theme: resilience occurs when nurses incorporate stressful aspects of their personal or professional lives into a coherent narrative that enhances their ability to cope with the demands of their role.
CONCLUSION: Palliative care nursing is more stressful if patients or situations remind nurses of personal experiences. Nurses cope better with adequate support; however, coping does not necessarily imply increased resilience. Resilience occurs when nurses cognitively process their experiences, articulate their thoughts and feelings into a coherent narrative, and construct a sense of meaning or purpose. Future research could explore how nurses understand resilience and how it could be enhanced in the palliative care inpatient setting. With resilience, nurses may remain in the profession longer and improve the quality of care when they do.

Origine : PubMed

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Soins palliatifs pédiatriques et rôle infirmier

EDDA-MESSI, Barbara
REVUE DE L'INFIRMIERE, 01/2018, vol.68, n°247, p. 30-31

Thème : Age de la vie, situations spécifiques liées à la fin de vie.

DEMARCHE PALLIATIVE ; PEDIATRIE ; ROLE ; INFIRMIERE ; INTERDISCIPLINARITE ; COORDINATION

Ce n’est que depuis 2008 que les soins palliatifs pédiatriques sont clairement évoqués en France. Ils sont définis comme des soins allant de la période anténatale jusqu’à 19 ans, dès que l’enfant est atteint d’une maladie qui limite ou menace sa durée de vie. De nombreuses infirmières peuvent, au cours de leur carrière, y être confrontées en établissement sanitaire ou médico-social. Ils nécessitent une prise en charge pluridisciplinaire et une coordination de tous les professionnels de santé concernés par la prise en charge.

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ACCOMPAGNEMENT DEMARCHE PALLIATIVE EVALUATION FAMILLE FIN VIE FORMATION INFIRMIERE MEDECIN MORT PATIENT PERSONNEL SANTE RELATION PERSONNEL SOIGNANT PATIENT ROLE SOIN SOIN INFIRMIER

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