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Evaluation of Managerial Needs for Palliative Care Centers: Perspectives of Medical Directors

  • Kafadar, Didem (Department of Family Medicine, Bagcilar Training and Research Hospital) ;
  • Ince, Nurhan (Department of Public Health, Istanbul School of Medicine, Istanbul University) ;
  • Akcakaya, Adem (Department of Surgery, Bezmialem Vakif University) ;
  • Gumus, Mahmut (Department of Medical Oncology, Bezmialem Vakif University)
  • Published : 2015.06.26

Abstract

Background: Palliative therapies have an important role in increasing the quality of healthcare and in dealing with physical and psychosocial problems due to cancer. We here aimed to evaluate the managerial perspectives and opinions of the hospital managers and clinical directors about specialized palliative care centers. Materials and Methods: This study was conducted in two large-scale hospitals in which oncology care is given with medical directors (n:70). A questionnaire developed by the researchers asking about demographic characteristics and professional experience, opinions and suggestions of medical directors about providing and integrating palliative care into healthcare was used and responses were analyzed. Results: Potential barriers in providing palliative care (PC) and integrating PC into health systems were perceived as institutional by most of the doctors (97%) and nurses (96%). Social barriers were reported by 54% of doctors and 82% of nurses. Barriers due to interest and knowledge of health professionals about PC were reported by 76% of doctors and 75% of nurses. Among encouragement ideas to provide PC were dealing with staff educational needs (72%), improved working conditions (77%) and establishing a special PC unit (49)%. An independent PC unit was suggested by 27.7% of participants and there was no difference between the hospitals. To overcome the barriers for integration of PC into health systems, providing education for health professionals and patient relatives, raising awareness in society, financial arrangements and providing infrastructure were suggested. The necessity for planning and programming were emphasized. Conclusions: In our study, the opinions and perspectives of hospital managers and clinical directors were similar to current approaches. Managerial needs for treating cancer in efficient cancer centers, increasing the capacity of health professionals to provide care in every stage of cancer, effective education planning and patient care management were emphasized.

Keywords

Palliative care;questionnaire;delivery of healthcare;patient care management

References

  1. Abernethy AP, Currow DC, Fazekas BS, et al (2008). Specialized palliative care services are associated with improved shortand long-term caregiver outcomes. Support Care Cancer, 16, 585-97. https://doi.org/10.1007/s00520-007-0342-8
  2. Brazil K, Vohra JU (2005). Identifying educational needs in end-of-life care for staff and families of residents in care facilities. Int J Palliat Nurs, 11, 475-80. https://doi.org/10.12968/ijpn.2005.11.9.19782
  3. Brazil K, Bedard M, Krueger P, et al (2006). Barriers to providing palliative care in long-term care facilities. Can Fam Physician, 52, 472-3.
  4. Budkaew J1, Chumworathayi B (2013). Knowledge and attitudes toward palliative terminal cancer care among Thai generalists. Asian Pac J Cancer Prev, 14, 6173-80. https://doi.org/10.7314/APJCP.2013.14.10.6173
  5. Demiglio L, Williams AM (2013). A qualitative study examining the sustainability of shared care in the delivery of palliative care services in the community. BMC Palliat Care, 12, 1-10. https://doi.org/10.1186/1472-684X-12-1
  6. Edens PS, Harvey CD, Gilden KM (2008). Developing and financing a palliative care program. Am J Hosp Palliat Care, 25, 379-84. https://doi.org/10.1177/1049909108319269
  7. Elcigil A (2011). The current status of palliative care in Turkey: a nurse's perspective. J Pediatr Hematol Oncol, 33, 70-2. https://doi.org/10.1097/MPH.0b013e318212244a
  8. Ferris FD, Bruera E, Cherny N, et al (2009). Palliative cancer care a decade later: accomplishments, the need, next steps -- from the American society of clinical oncology. J Clin Oncol, 27, 3052-8. https://doi.org/10.1200/JCO.2008.20.1558
  9. Gaertner J, Frechen S, Sladek M, Ostgathe C, Voltz R (2012). Palliative care consultation service and palliative care unit: why do we need both? Oncologist, 17, 428-35. https://doi.org/10.1634/theoncologist.2011-0326
  10. Gultekin Z, Pinar G, Pinar T, et al (2008). Health-related quality of life and health care services expectations of the patients with lung cancer. Int J Hematology and Oncology, 18, 99-106.
  11. Gultekin M, Ozgul N, Olcayto E, Tuncer AM (2010).(In English). Turkish J Gynecol Oncol, 13, 1-6.
  12. Hearn J, Higginson IJ (1998). Do specialist palliative care teams improve outcomes for cancer patients? A systematic literature review. Palliat Med, 12, 317-32. https://doi.org/10.1191/026921698676226729
  13. Hirai K, Kudo T, Akiyama M, et al (2011). Public awareness, knowledge of availability, and readiness for cancer palliative care services: a population-based survey across four regions in Japan. J Palliat Med, 14, 918-22. https://doi.org/10.1089/jpm.2010.0529
  14. Kamal AH, Swetz KM, Carey EC, et al (2011). Palliative care consultations in patients with cancer: A Mayo Clinic 5-year review. J Oncol Pract, 7, 48-53. https://doi.org/10.1200/JOP.2010.000067
  15. Komurcu S (2011). Current status of palliative care in Turkey. J Pediatr Hematol Oncol, 33, 78-80. https://doi.org/10.1097/MPH.0b013e3182019968
  16. Luckett T, Phillips J, Agar M, et al (2014). Elements of effective palliative care models: a rapid review. BMC Health Serv Res, 14, 1-22. https://doi.org/10.1186/1472-6963-14-1
  17. Lupu D, Deneszczuk C, Leystra T, McKinnon R, Seng V (2013). Few U.S. public health schools offer courses on palliative and end-of-life care policy. J Palliat Med, 16, 1582-7. https://doi.org/10.1089/jpm.2013.0161
  18. Morita T, Akechi T, Ikenaga M, et al (2005). Late referrals to specialized palliative care service in Japan. J Clin Oncol, 23, 2637-44. https://doi.org/10.1200/JCO.2005.12.107
  19. Nagamatsu Y, Nakayama Y, Clayson H, et al (2014). Caring for patients with malignant pleural mesothelioma in Japan: evaluation of a palliative care educational program. Asian Pac J Cancer Prev, 15, 9165-70. https://doi.org/10.7314/APJCP.2014.15.21.9165
  20. Otsuka M, Koyama A, Matsuoka H, et al (2013). Early palliative intervention for patients with advanced cancer. Jpn J Clin Oncol, 43, 788-94. https://doi.org/10.1093/jjco/hyt074
  21. Ozgul N, Gultekin M, Koc O, et al (2012). Turkish community-based palliative care model: a unique design. Ann Oncol, 23, 76-8. https://doi.org/10.1093/annonc/mds093
  22. Schenker Y, Crowley-Matoka M, Dohan D, et al (2014). Oncologist factors that influence referrals to subspecialty palliative care clinics. J Oncol Pract, 10, 37-44. https://doi.org/10.1200/JOP.2013.001130
  23. Smith TJ, Coyne P, Cassel B, et al (2003). A high-volume specialist palliative care unit and team may reduce in-hospital end-of-life care costs. J Palliat Med, 6, 699-705. https://doi.org/10.1089/109662103322515202
  24. Smith S, Brick A, O'Hara S, Normand C (2014). Evidence on the cost and cost-effectiveness of palliative care: a literature review. Palliat Med, 28, 130-50. https://doi.org/10.1177/0269216313493466
  25. Temel JS, Greer JA, Muzikansky A, et al (2010). Early palliative care for patients with metastatic non-small cell lung cancer. N Engl J Med, 363, 733-42. https://doi.org/10.1056/NEJMoa1000678
  26. Turgay G, Kav S (2012). Turkish healthcare professionals' views on palliative care. J Palliat Care, 28, 267-73.
  27. Wiebe LA, Von Roenn JH (2010). Working with a palliative care team. Cancer J, 16, 488-92. https://doi.org/10.1097/PPO.0b013e3181f28ae6
  28. Yildirim B, Tanriverdi O (2014). Evaluation of cancer patients admitted to the emergency department within one month before death in Turkey: What are the problems needing attention? Asian Pac J Cancer Prev, 15, 349-53. https://doi.org/10.7314/APJCP.2014.15.1.349