Communication in oncology pharmacy

2017 ◽  
Author(s):  
Bethan Tranter ◽  
Simon Noble
Keyword(s):  
Palliative Care ◽  
Treatment Adherence ◽  
Drug Safety ◽  
Medication Compliance ◽  
Healthcare Providers ◽  
Optimal Drug ◽  
Treatment Medication ◽  
Hospice And Palliative Care ◽  
Timely Treatment

Pharmacists are considered to have a pivotal role in the provision of information in oncology, and in hospice and palliative care. Effective communication is essential for optimal drug safety, timely treatment, medication compliance, and education. The role of the pharmacist has expanded to offer enhanced pharmaceutical care, which serves to improve the communication between healthcare providers and the function of the multidisciplinary team. Furthermore, through optimal communication with patients there will be increased treatment adherence and improved overall care. This chapter focuses on the breadth of communication issues faced by pharmacists involved in cancer care through the full length of the cancer journey, be it curative or palliative.

The Second Domain of Palliative Care

2018 ◽  
Author(s):  
E. Alessandra Strada
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Treatment Adherence ◽  
Psychological Factors ◽  
Physical Symptoms ◽  
Team Work ◽  
Advanced Illness ◽  
Interdisciplinary Work ◽  
Physical Suffering

This chapter proposes palliative psychology competencies in the second domain of palliative care: physical aspects of care. It discusses the importance of interdisciplinary work in assessment and management of pain and other physical symptoms. Palliative psychologists with the necessary knowledge, skills, and attitudes can contribute greatly to team work by identifying and managing psychological factors that can contribute to the patient’s physical suffering. This chapter also briefly describes relevant approaches to dyspnea and constipation. Clinical examples of pain assessment and intervention are provided based on real case scenarios. The basics of pharmacological approaches to pain management in advanced illness are discussed, in order to facilitate the role of palliative psychologists in promoting communication and treatment adherence. The use of integrative medicine modalities to improve physical symptoms is highlighted.

The Role of Hospice and Palliative Care Nurses in Quality Improvement

2017 ◽  
Vol 19 (2) ◽  
pp. 160-165 ◽  
Author(s):  
Lisa C. Lindley ◽  
Keela A. Herr ◽  
Sally A. Norton
Keyword(s):  
Palliative Care ◽  
Quality Improvement ◽  
Hospice And Palliative Care

scholarly journals The function and role of hospice and palliative care facilities in the community

2003 ◽  
Vol 49 (2) ◽  
pp. 194-207
Author(s):  
JUNKO TAKAISHI ◽  
MASAKO SUGIMOTO ◽  
NAOKO ARAGA ◽  
MASAKO AKIYAMA ◽  
YOSHIKO, S. LEIBOWITZ ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Facilities ◽  
Hospice And Palliative Care

What does 'palliative care' mean? Diverse definitions from cancer care providers.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 40-40
Author(s):  
Erin E. Kent ◽  
Rebecca A. Ferrer ◽  
Michelle Mollica ◽  
Grace Huang ◽  
Angela Falisi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Provider ◽  
Healthcare Providers ◽  
Physician Assistants ◽  
Models Of Care ◽  
Care Providers ◽  
Clinical Nurses ◽  
Curative Care ◽  
Wide Range ◽  
Hospice And Palliative Care

40 Background: Existing literature on the epistemology of palliative care has mostly centered on patient/family perspectives. Understanding how multi-disciplinary healthcare providers themselves define palliative care is a critical step towards addressing barriers and harnessing facilitators that affect optimal delivery. Methods: Semi-structured key informant interviews (N = 19) were conducted with members of healthcare provider teams as part of a qualitative study on goals of care for cancer patients enrolled in clinical trials. Purposive sampling included diverse roles: attending physicians/principal investigators, oncology fellows, physician assistants, research and clinical nurses, patient care coordinators, palliative care physicians, social workers, chaplains, and pharmacists. One probe asked participants, “What does palliative care mean to you in your work?” Responses were transcribed and independently coded by two raters using interview-derived deductive and emergent inductive codes. Themes were then identified and analyzed using NVivo. Results: Informants included different elements in their definitions: attributes of palliative care (“Palliative care is helpful”); structure (“We have a pain and palliative team”); patient outcomes “(comfort”), and relation to other services (“adjunct to necessary medical care”). Additional themes also included (1) the charge of palliative care to alleviate suffering; (2) the recognition that palliative care should be holistic; (3) the centrality of symptom management, in particular pain; (4) the conflation of end-of-life, hospice, and palliative care; (5) tensions between palliative and curative care. Provider role and specific team membership appear to influence perspectives on definitions of palliative care. Conclusions: Providers share a wide range of perspectives on the operationalization of palliative care in their work. In addition to soliciting input from patients and family members, the viewpoints of a diverse set of providers should be ascertained often to inform models of care, alleviate tensions between palliative and curative care provider teams, and increase optimal usage of palliative care.

Abstract 13221: Family Caregivers’ Perceptions of Illness Severity in Heart Failure Patients with Limited Life Expectancy

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Lisa Kitko ◽  
Judith Hupcey ◽  
Maureen Palese
Keyword(s):  
Heart Failure ◽  
Palliative Care ◽  
Quality Care ◽  
Healthcare Providers ◽  
Illness Severity ◽  
Patient Death ◽  
Disease Trajectory ◽  
Advance Care ◽  
Hospice And Palliative Care ◽  
Perceived Illness

Introduction: End-of-life (EOL) services, such as hospice and palliative care are often lacking even for the sickest heart failure (HF) patients. Use of these services have been hampered by the lack of availability, lack of referrals due to the unpredictable course in HF, and refusal of services by patients and caregivers due to a lack of understanding of the terminality of HF. The purpose of this study was to determine whether caregivers of HF patients with a predicted survival of less than 2 years, understood disease terminality prior to and after the patient’s death. Methods: As part of a longitudinal study of 100 patient-caregiver dyads, caregivers were interviewed monthly until the patient’s death and then twice post-death. Caregiver interviews immediately preceding and post-patient death were analyzed to determine caregivers’ perceptions of the terminality of heart failure. Results: There were 49 caregivers of patients who died. Patients died an average of 8 months after study enrollment. Most caregivers did not understand the severity of the patient’s disease and 51% (25/49) viewed the death as unexpected. When caregivers retrospectively reflected on the patient’s illness trajectory, they recounted downward trends in patient’s health, but were not aware of the terminality of the patient until after death occurred. Those few caregivers who perceived the illness severity prior to death came to this realization late in the disease trajectory. At the point of recognition, advanced treatments were limited or withdrawn and the short-term use of EOL services such as palliative care or hospice was instituted. Conclusions: The lack of perceived illness severity/terminality has profound implications for patients, caregivers, and healthcare providers. Patients and caregivers who do not understand the seriousness of the illness are less likely to accept EOL services, if offered. Clinicians need to understand the HF EOL trajectory and that EOL discussions and advance care planning help patients and caregivers make informed choices and receive quality care at EOL. We also need to educate all healthcare providers about having these discussions, so palliative care becomes a philosophy of care not merely a referral service immediately preceding death.

The Role of Physical Therapists Within Hospice and Palliative Care in the United States and Canada

2016 ◽  
Vol 34 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Christopher M. Wilson ◽  
Christine H. Stiller ◽  
Deborah J. Doherty ◽  
Kristine A. Thompson
Keyword(s):  
United States ◽  
Palliative Care ◽  
Data Analysis ◽  
Physical Therapy ◽  
Physical Therapists ◽  
The United States ◽  
Direct Patient Care ◽  
Life Threatening ◽  
Hospice And Palliative Care

Purpose: Little is known regarding the extent to which physical therapy is integrated into Hospice and Palliative Care (HPC). The purpose of this study was to describe perceptions of physical therapists (PTs) regarding their role within HPC or working with patients having life-threatening illnesses and to develop a conceptual framework depicting a PTs role within HPC and factors affecting it. Participants: Ten PTs, 5 from the United States and 5 from Canada, with at least 5 years of physical therapy experience and 5 years working experience with patients having life-threatening illnesses or in HPC. Methods: Demographic data were collected by electronic questionnaire. A semistructured interview was conducted with each participant to investigate their perceptions about the role of PTs in HPC. Data Analysis: Interview results were analyzed for trends between participants, practice settings, regions, and other sociocultural aspects. The constant comparative method of qualitative data analysis was used to identify similarities and differences and to develop themes and concepts relative to the role of PT in HPC. Results: Participants identified their 3 primary roles in HPC: providing patient/family care, serving as an interdisciplinary team member, and fulfilling professional responsibilities outside of direct patient care. They described factors within and outside direct patient care which influenced their roles. Concepts included shifting priorities, care across the continuum, and changing perceptions of PTs within HPC. Clinical Relevance: This study described perceptions of the role of PTs within HPC that may be utilized when coordinating future strategies to appropriately promote and expand the role.

scholarly journals Experiences of LGBT Patients and Families With Hospice and Palliative Care: Perspectives of the Palliative Care Team

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 67-67
Author(s):  
Cathy Berkman ◽  
Gary Stein
Keyword(s):  
Palliative Care ◽  
Social Services ◽  
Online Survey ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Term Care ◽  
Lgbt Community ◽  
Hospice And Palliative Care

Abstract The lesbian, gay, bisexual, and transgender (LGBT) community experiences discrimination and stigma in accessing health care and social services – including palliative, hospice, and long-term care. Healthcare providers not recognize or address disparities in care. Providers and institutions may be uncomfortable with sexual orientation and gender identity and expression issues, and often don’t inquire about these. LGBT patients fear being open about their identities, not receiving equal or safe treatment, and having their family of choice and designated surrogates disrespected or ignored by healthcare staff. This study examines the degree to which hospice and palliative care providers report inadequate, disrespectful, or abusive care to LGBT patients and family members. A cross-sectional study using an online survey was completed by 865 providers, including social workers, physicians, nurses, and chaplains. Among respondents, 55% reported that LGB patients were more likely than non-LGB patients to experience discrimination at their institution; 24% observed discriminatory care; 65% reported that transgender patients were more likely than non-transgender patients to experience discrimination; 20% observed discrimination to transgender patients; 14% observed the spouse/partner of LGBT patients having their treatment decisions disregarded or minimized; and 13% observed the spouse/partner being treated disrespectfully. Qualitative data are presented to illustrate discomfort with LGBT patients and spouses/partners, disrespectful care, gossip and ridicule, inadequate care, and denial of care. Implications and suggestions for implementing non-discriminatory and respectful institutional and public policy, and for staff education and training to provide competent and respectiful care to this population are presented.

scholarly journals The role of hospice and palliative care in supporting and fostering trust among the LGBTQ+ population

2021 ◽  
Vol 15 ◽  
pp. 263235242110426
Author(s):  
Natasha Dhawan ◽  
Anais A. Ovalle ◽  
Jonathan C. Yeh
Keyword(s):  
Palliative Care ◽  
Hospice And Palliative Care

scholarly journals Response and role of palliative care during the COVID-19 pandemic: a national telephone survey of hospices in Italy

2020 ◽  
Author(s):  
Massimo Costantini ◽  
Katherine E Sleeman ◽  
Carlo Peruselli ◽  
Irene J Higginson
Keyword(s):  
Palliative Care ◽  
Personal Protective Equipment ◽  
System Response ◽  
Protective Equipment ◽  
List Type ◽  
Telephone Support ◽  
Community Settings ◽  
Policy Changes ◽  
Hospice And Palliative Care

AbstractBackgroundPalliative care is an important component of healthcare in pandemics, contributing to symptom control, psychological support, and supporting triage and complex decision making.AimTo examine preparedness for, and impact of, the COVID-19 pandemic on hospices in Italy to inform the response in other countries.DesignCross-sectional telephone survey, carried out in March 2020.SettingSixteen Italian hospices, purposively sampled according to COVID-19 risk into high (more than 25 COVID-19 cases per 100,000 inhabitants), medium (15-25 cases per 100,000), and low risk (fewer than 15 cases per 100,000) regions. A brief questionnaire was developed to guide the interviews. Descriptive analysis was undertaken.ResultsSeven high risk, five medium risk and four low risk hospices provided data. Two high risk hospices had experienced COVID-19 cases among both patients and staff. All hospices had implemented policy changes, and several had rapidly implemented changes in practice including transfer of staff from inpatient to community settings, change in admission criteria, and daily telephone support for families. Concerns included scarcity of personal protective equipment, a lack of hospice-specific guidance on COVID-19, anxiety about needing to care for children and other relatives, and poor integration of palliative care in the acute setting.ConclusionThe hospice sector is capable of responding flexibly and rapidly to the COVID-19 pandemic. Governments must urgently recognise the essential contribution of hospice and palliative care to the COVID-19 pandemic, and ensure these services are integrated into the health care system response. Availability of personal protective equipment and setting-specific guidance is essential.What is already knownThe Coronavirus disease 2019 (COVID-19) has estimated global mortality of 3.4%, and numbers of cases are rapidly escalating worldwide.Hospice services face unprecedented pressure, with resources rapidly stretched beyond normal bounds.No data exist on the response and role of hospice and palliative care teams to COVID-19.Within Europe, Italy has been most affected by COVID-19.What this paper addsWe surveyed 16 Italian hospices in March 2020, all of which had implemented rapid policy changes in response to COVID-19.Changes to practice included moving to more support in community settings, change in admission criteria, and daily telephone support for families.Personal protective equipment and guidance were lacking.Assessments of risk and potential impact on staff varied greatly.Implications for policy and practiceGovernments must recognise the hospice and palliative care sector as an essential component of the health care system response to COVID-19.The hospice sector is capable of responding rapidly to the COVID-19 pandemic, but the potential of this response will be undermined unless hospices can access personal protective equipment.Considerations for hospice services during the COVID-19 pandemic are changes to visitor policies, interruption of volunteering, shifting roles and responsibilities such as greater community working and telephone support for relatives.

Palliative care in Canada

2015 ◽  
pp. 1058-1071
Author(s):  
Doris Howell ◽  
Ann Syme
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Healthcare Delivery ◽  
Palliative Care Service ◽  
Population Diversity ◽  
Life Care ◽  
Hospice And Palliative Care ◽  
Advocacy Role ◽  
Hospice Palliative Care

This chapter describes palliative and end-of-life care from the national and provincial perspectives and trends and innovations in hospice and palliative care service delivery in Canada and specifically the developments in nursing. To provide a context within Canada, factors that have influenced the development of hospice palliative care in Canada inclusive of geographic and population diversity; the three levels of government accountable for healthcare delivery at the federal, provincial, and regional levels; and the advocacy role of the Canadian Hospice Palliative Care Association are also described.

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