• Title/Summary/Keyword: Palliative care

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The Use of Antibiotics in Hospice and Palliative Care Settings

  • Shekhar, Aditya C.
    • Journal of Hospice and Palliative Care
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    • v.25 no.1
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    • pp.50-54
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    • 2022
  • Antibiotics are commonly prescribed medications in the hospice and palliative care setting, as well as in many other healthcare settings. The overuse or negligent use of antibiotics is associated with the harmful consequence of fostering the development of antibiotic-resistant pathogens. Thus, there is an urgent need to critically examine and audit antibiotic use in all aspects of healthcare. In the status quo, there is a lack of consistent standards and guidelines surrounding the use of antibiotics in hospice and palliative care settings, leading to significant variations in how antibiotics are prescribed and administered in end-of-life care. It is apparent that greater thought needs to go into antibiotic decisions for patients receiving hospice or palliative care, especially considering the harmful consequences of the overprescription of antibiotics. The literature suggests that many clinicians prescribe antibiotics inappropriately for patients who would not benefit from their use or prescribe them without adequate documentation. Clinicians should be deliberate about when they prescribe antibiotics and adhere to the appropriate documentation standards and procedures within their institution or community. Future research should seek to generate generalizable knowledge about which patients will benefit most from antibiotic therapy during end-of-life care.

Effect of palliative care practical training on nursing students' attitudes toward death, end-of-life care nursing attitude, and spiritual nursing competency (말기 환자간호 실습교육이 간호대학생의 죽음에 대한 태도, 임종간호 태도, 영적간호역량에 미치는 효과)

  • Kim, Kyung Ah
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.30 no.3
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    • pp.276-286
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    • 2023
  • Purpose: This study aimed to assess the effect of palliative care practical training for nursing students. Methods: This quasi-experimental study included 38 third-grade nursing students form one university. Practical training, develooed by experts, was provided for 2 weeks (90 h) in a palliative care hospital. Participants received education on palliative care but no clinical practical experience. Collected data were analyzed using independent t-test, χ2 test and paired t-test using the WIN SPSS 23.0 program. Results: Students showed significant pretest-posttest differences in attitude toward death (t=-2.43, p=.021), end-of-life nursing attitude (t=3.90, p=<.001) and spiritual nursing competency (t=3.82, p=.001). Conclusion: The study results revealed that palliative care practical training was an effective learning method to improve nursing attitude, toward death, end-of-life nursing attitude and spiritual nursing competency. Further studied are needed to assess the effects of various education programs of palliative care.

Screening and Assessment Tools for Measuring Delirium in Patients with Cancer in Hospice and Palliative Care: A Systematic Review

  • Yang, Eun Jung;Hahm, Bong-Jin;Shim, Eun-Jung
    • Journal of Hospice and Palliative Care
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    • v.24 no.4
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    • pp.214-225
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    • 2021
  • Purpose: This study reviewed screening and assessment tools that are used to measure delirium in patients with cancer in hospice and palliative care settings and examined their psychometric properties. Methods: Four databases were searched for studies using related search terms (delirium, tools, palliative care, cancer, and others). The inclusion criteria were a) studies that included screening/assessment tools for measuring delirium in cancer patients receiving hospice/palliative care, and b) studies published in English or Korean. The exclusion criteria were a) studies that were conducted in an intensive care setting, and b) case studies, qualitative studies, systematic reviews, or meta-analyses. Results: Out of the 81 studies identified, only 10 examined the psychometric properties of tools for measuring delirium, and 8 tools were ultimately identified. The psychometric properties of the Memorial Delirium Assessment Scale (MDAS) were the most frequently examined (n=5), and the MDAS showed good reliability, concurrent validity, and diagnostic accuracy. The Delirium Rating Scale had good reliability and diagnostic accuracy. The Delirium Rating Scale-Revised 98 also showed good reliability and structural validity, but its diagnostic performance was not examined in hospice/palliative care settings. The Nursing Delirium Screening Scale showed relatively low diagnostic accuracy. Conclusion: The MDAS showed evidence of being a valid assessment tool for assessing delirium in patients with cancer in palliative care. Few studies examined the diagnostic performance of delirium tools. Therefore, further studies are needed to examine the diagnostic performance of screening/assessment tools for the optimal detection of delirium in patients with cancer in hospice/palliative care.

Development of Audio-visual Aids of Death Education for Hospice Patients and Their Families (호스피스 환자와 가족을 위한 임종교육 시청각 자료 개발)

  • Seo, Mi-Suk;Kang, Yu Jung;Yoon, Ji Yoon;Kim, Tae Yeon;Cho, Hye Jun;Park, So Yeon;Lee, Si Yeon;Jang, Ji Hye;Kim, Yu Jin;Kang, Mi Teum
    • Journal of Hospice and Palliative Care
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    • v.19 no.3
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    • pp.240-248
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    • 2016
  • Purpose: Patients and their caretakers need to understand various problems and requirements in the dying process so that they may prepare for death for the rest of their remaining life. Accordingly, a systematic audio-visual resource was developed to educate hospice patients and their families at the palliative care ward about the process of dying. Methods: For the development of an audio-visual resource, a initial education material was produced in the form of simple and accessible Power Point handouts based on literature study. Then, the program was completed through five rounds of a process, including expert advice, revision, update and evaluation. Results: The final version of the program was filmed with cooperation of the medical literature information division. Using the program, patients and families were educated through five phases over three sessions for a total 26 minutes and 34 seconds. Conclusion: The significance of this study lies in the fact that it was conducted after the establishment of the palliative care ward, which made it easier for nurses provide the education. It is expected that the program may be used by hospice specialists as well as nurses as an education resource for hospice patients and their families.

Development and Validation of the Hospice Palliative Care Performance Scale (호스피스완화의료서비스 성과평가 도구개발)

  • Kwon, So-Hi
    • Journal of Korean Academy of Nursing
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    • v.41 no.3
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    • pp.374-381
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    • 2011
  • Purpose: The purpose of this study was to develop and validate a hospice palliative care performance measure which would cover more than just physical symptoms or quality of life. Methods: Through an intensive literature review, the author chose questions that measured aspects of physical, emotional, spiritual, social, or practical domains pertinent to hospice palliative care for inclusion in the scale. Content validation of the questions was established by 15 hospice palliative care professionals. A preliminary Hospice Palliative Care Performance Scale (HPCPS) of 20 questions was administered to 134 pairs of terminal cancer patients from 5 hospice palliative care units and their main family caregiver. A validation study was conducted to evaluate construct validity and internal consistency. Results: Factor analysis showed 14 significant questions in five subscales; Physical, Emotional, Spiritual, Social, and Patient' rights. There were no significant differences between the ratings by patients and family members except for three out of the 14 questions. The measure demonstrated construct validity, and Cronbach's ${\alpha}$ of the subscales ranged from .73 to .79. Conclusion: The HPCOS demonstrated acceptable validity and reliability. It can be used to assess effectiveness of hospice palliative care for terminal cancer patients in practice and research.