Agency Problem and Health Care Expenditure: Evidence from Terminally-Ill Patients in Taiwan

Knowledge and comfort related to palliative care among Indonesian primary health care providers

Australian Journal of Primary Health ◽

10.1071/py20111 ◽

2020 ◽

Vol 26 (6) ◽

pp. 472

Author(s):

Nuzul Sri Hertanti ◽

Mei-Chih Huang ◽

Chia-Ming Chang ◽

Susan Jane Fetzer ◽

Chi-Yin Kao

Keyword(s):

Health Care ◽

Palliative Care ◽

Primary Health Care ◽

Health Care Providers ◽

Primary Healthcare ◽

Terminally Ill ◽

Care Providers ◽

Terminally Ill Patients ◽

Primary Health ◽

Primary Health Care Providers

This study investigated Indonesian primary health care providers’ knowledge and comfort towards palliative care. A descriptive cross-sectional design was used. From August 2017 to February 2018, the research team approached 70 primary care centres in the Yogyakarta province of Indonesia and invited health care providers to complete the Palliative Care Quiz for Nursing – Indonesia and describe their comfort in caring for terminally ill patients. Data were obtained from 516 health care providers. The mean (±s.d.) score of palliative care knowledge was low (7.8±3.3 of a possible score of 20). Current comfort level in providing palliative care was also low (1.6±2.7 of a possible score of 10). Only 11.3% of palliative care knowledge was explained by respondents understanding of palliative care definition, their education levels and experience in providing palliative care in hospital. However, 82.9% of provider comfort was explained by their experiences for caring for terminally ill patients in primary healthcare centres, palliative care training and years of work experience in primary healthcare centres. Indonesian evidence-based palliative care standards and guidelines must be established with education offered to all providers.

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Perspectives of relatives and health care workers on care of terminally ill patients in the UK

American Journal of Hospice and Palliative Medicine® ◽

10.1177/104990910201900211 ◽

2002 ◽

Vol 19 (2) ◽

pp. 121-128 ◽

Cited By ~ 2

Author(s):

Peter Ferry ◽

Richard Hancock ◽

Cindy Newton ◽

John Taylor ◽

Kim Horton

Keyword(s):

Health Care ◽

Health Care Workers ◽

Terminally Ill ◽

Terminally Ill Patients ◽

Care Workers ◽

The Uk

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The needs of terminally ill patients at home: directing one's life, health and things related to beloved others

Palliative Medicine ◽

10.1191/0269216304pm818oa ◽

2004 ◽

Vol 18 (1) ◽

pp. 53-61

Author(s):

Ireen M Proot ◽

Huda Huijer Abu-Saad ◽

Ruud HJ ter Meulen ◽

Minke Goldsteen ◽

Cor Spreeuwenberg ◽

...

Keyword(s):

Health Care ◽

Grounded Theory ◽

Life Expectancy ◽

Family Members ◽

Terminally Ill ◽

Terminal Phase ◽

Grounded Theory Study ◽

Terminally Ill Patients ◽

Taking Care ◽

At Home

This article describes the results of a grounded theory study among terminally ill patients (with a life expectancy of less than three months) at home ( n = 13, aged 39-83). The most commonly recurring theme identified in the analysis is ‘directing’, in the sense of directing a play. From the perspectives of patients in our study, ‘directing’ concerns three domains: 1) directing one's own life; 2) directing one's own health and health care; and 3) directing things related to beloved others (in the meaning of taking care of beloved ones). The patient's directing is affected by impeding and facilitating circumstances: the patient's needs and problems in the physical, psychological and existential/spiritual domain, and the support by family members and providers. Supporting patients and families, stimulating the patients' directing, giving attention to all domains of needs and counselling patients' families in the terminal phase are issues that need attention and warrant further investigation.

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Comparison of Patient Self-Reported Quality of Life and Health Care Professional-Assessed Symptoms in Terminally ill Patients With Cancer

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909120944157 ◽

2020 ◽

pp. 104990912094415

Author(s):

Chikako Matsumura ◽

Nanako Koyama ◽

Morito Sako ◽

Hideo Kurosawa ◽

Takehisa Nomura ◽

...

Keyword(s):

Quality Of Life ◽

Health Care ◽

Palliative Care ◽

Health Care Professionals ◽

Terminally Ill ◽

Patients With Cancer ◽

Terminally Ill Patients ◽

Patient Reported ◽

Exact Agreement

Background: Few studies evaluated whether health care professionals accurately assess several symptoms for patients with cancer in palliative care units. We determined the agreement level for several symptoms related to quality of life (QOL) between patient-reported QOL assessment and health care professional-assessed symptoms based on the Support Team Assessment Schedule (STAS). Method: An observational study was performed with terminally ill patients with cancer hospitalized in the palliative care unit between June 2018 and December 2019. Patients and health care professionals independently assessed 7 symptoms at the time of hospitalization and after 1 week. Patients completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C15-PAL). In examining the proportions of exact agreement, “exact agreement” referred to the pairs of the scores (QLQ-C15-PAL vs STAS) being (1 vs 0), (2 vs 1), (3 vs 2 or 3), or (4 vs 4). The relationships of physical functioning between QLQ-C15-PAL and Palliative Performance Scale (PPS) were examined. Results: Of 130 patients, approximately 60% had PPS scores from 40 to 60. The highest mean score on QLQ-C15-PAL was for fatigue (63.8). The exact agreement on symptoms between patients and health care professionals ranged from 15.4% (fatigue) to 57.7% (nausea and vomiting). The mean of the transformed QLQ-C15-PAL and proportions of exact agreement were negatively correlated ( R 2 = 0.949, P < .05). The physical function scores in QLQ-C15-PAL for each PPS group showed no differences. Conclusion: We expect patient-reported outcomes including QLQ-C15-PAL to be added to health care professionals’ assessment of serious symptoms such as fatigue in terminally ill patients with cancer.

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Attitudes to Euthanasia in Icus and Other Hospital Departments

Nursing Ethics ◽

10.1177/0969733009102693 ◽

2009 ◽

Vol 16 (3) ◽

pp. 319-327 ◽

Cited By ~ 13

Author(s):

Selma Tepehan ◽

Erdem Özkara ◽

M. Fatih Yavuz

Keyword(s):

Internal Medicine ◽

Health Care ◽

Intensive Care ◽

Intensive Care Units ◽

Terminally Ill ◽

Patient Rights ◽

Care Staff ◽

Health Care Staff ◽

Terminally Ill Patients ◽

Doctors And Nurses

The aim of this study was to reveal doctors' and nurses' attitudes to euthanasia in intensive care units and surgical, internal medicine and paediatric units in Turkey. A total of 205 doctors and 206 nurses working in several hospitals in Istanbul participated. Data were collected by questionnaire and analysed using SPSS v. 12.0. Significantly higher percentages of doctors (35.3%) and nurses (26.6%) working in intensive care units encountered euthanasia requests than those working in other units. Doctors and nurses caring for terminally ill patients in intensive care units differed considerably in their attitudes to euthanasia and patient rights from other health care staff. Euthanasia should be investigated and put on the agenda for discussion in Turkey.

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