- Email: [email protected]
Development of core indicators of non-specialist palliative care in hospitals: An international modified Delphi study
Annals of Oncology 30 (Supplement 5): v822–v824, 2019 doi:10.1093/annonc/mdz273
CANCER NURSING: PALLIATIVE AND END-OF-LIFE CARE CN20
Opinions of palliative care patients and nurses regarding dignified care
1
CN22 Background: Dignity is an important issue for delivering high quality palliative care. This descriptive, methodological study was conducted to evaluate Turkish validity and reliability of The Patient Dignity Inventory (PDI) among palliative care patients and to explore the views of palliative care patients and nurses about dignified care. Methods: This study was approved by Baskent University Institutional Review Board (Project No: KA17/280). Patient demographic form, Palliative Performance Scale and, Hospital Anxiety and Depression Scale (HADS) were used for data collection.Ten palliative care patients and 10 nurses were interviewed. The semi-structured, face to face interviews were recorded digitally, transcribed verbatim and analyzed. Turkish validity and reliability study of the PDI was conducted with 127 palliative care patients with advanced cancer. Face validity, factor structure, concurrent validity, internal consistency and test-retest reliability analysis were performed. Results: Cronbach’s coefficient alpha for the PDI was 0.94 and test-retest reliability was r ¼ 0.75. Concurrent validity tests demonstrated positive significant correlations between factors of PDI and HADS. Factor analysis demonstrated 5 factors accounting for 68.7% of the overall variance. The factors were labeled as symptom distress, existential distress, self-confidence, dependency and, support and care requirements. Three themes emerged through data obtained from palliative care patients: respectability, caring practices, and usefulness. Three themes emerged through data obtained from palliative care nurses: maintaining one’s respectability; barriers and recommendations; benefits of care. Conclusions: Turkish version of the PDI is a valid and reliable instrument among palliative care patients. Education may be useful for raising awareness of healthcare professionals about dignified care. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
CN21
Development of core indicators of non-specialist palliative care in hospitals: An international modified Delphi study
M. Nevin1, G. Hynes1, S. Payne2, V. Smith1 School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland, 2International Observatory on End of Life Care, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
1
Background: Healthcare providers working in acute care hospitals have significant exposure to cancer patients with palliative care needs, and for the majority of patients these reflect non-specialist rather than specialist palliative care needs. Embedding nonspecialist palliative care in acute hospital-based care is challenging. The aim of this paper is to present a core set of indicators for the provision of non-specialist palliative care in hospitals which was determined using a Delphi consensus process. Methods: Preliminary indicators derived from a concept analysis and systematic review were subjected to a three round modified Delphi study, whereby a multidisciplinary expert panel of key stakeholders appraised (rated) each preliminary indicator on its ‘importance’ to non-specialist palliative care provision in hospitals. Stakeholders were also offered an opportunity to add ‘new’ indicators as they considered relevant. Consensus was defined whereby 70%, or more, of the participants across stakeholder groups agreed that an indicator was ‘core’ to non-specialist palliative care provision in the hospital setting. Results: A total of 92 experts (74% response rate) representing the views of patients, clinicians and researchers, from twelve countries participated in the final round. This study resulted in 32 core indicators of hospital based non-specialist palliative care, categorised into 5 structural indicators (relating to infrastructure and governance), 21 organisational indicators (relating to clinical care processes) and 6 staff indicators (relating to training and support for healthcare providers). Conclusions: This study presents the first guidance for clinical practice, policy and research related to non-specialist palliative care provision in hospitals, based on evidence and International consensus from all key stakeholder groups. These indicators provide a means to assess, review, and communicate the core elements of non-specialist palliative care in hospitals, thereby setting a benchmark for changes in policy and practice.
Psychological distress among patients with advanced cancer: A concept analysis
N. Huda Nursing, Taipei Medical University, Taipei, Taiwan Background: Psychological distress is common problem happened in advanced cancer patient. Issued of distress are often faced by health care professional when they are dealing with advanced cancer since many of unmet psychological need was identified. Unfortunately description of psychological distress in advanced cancer is not clearly mention since we know that psychological distress concept in advanced cancer is totally different with the psychological distress in the patient of early stage of cancer. Failure to acknowledge it earlier may have a great impact to patient’s quality of life. Although many articles referred and describing about psychological distress, this term is still poorly defined in the literature and has not been clearly yet. There are no articles were found about concept analysis of psychological distress among advanced cancer patients. The Purpose of this concept analysis is to clearly define psychological distress in terms of advanced cancer patients. This concept analysis could bring clarity meaning by examining various ways it is used in nursing area. Clarifying what is meant by psychological distress will help oncology nurse able to communicate among their colleagues, patients and care giver. Methods: A literature search was conducted using CINAHL, Clinical Key, and Psych Info data base for the past 30 years (1988-2018). Results: Cancer related psychological distress as a concept has limited research substation. Psychological distress in terms of advanced cancer has five defining attributes: 1) Anxiety, 2) Depression, 3) Demoralization, 4) Death anxiety and 5) Perceived in ability to cope effectively. The Primary antecedent is treatment complexity. The consequences can be negatively or positively related to concept. The most positive consequences is much appreciation of life. In another side, a negative psychological distress outcome are hopelessness, low quality of life, and reduced performance status. Conclusions: Concept analysis of psychological distress could clearly defined the meaning of psychological distress and being as a guidance for nurses to give their nursing care appropriately. Intervention should address the antecedents and consequences of the concept and considered individual as a person who has unique characteristic. Legal entity responsible for the study: The author. Funding: Has not received any funding. Disclosure: The author has declared no conflicts of interest.
CN23
Palliative care requirements of cancer patients and investigation of knowledge and expectations related to palliative care of the patients and their families
O. Topkaya Radiation Oncology, Anadolu Medical Center, Kocaeli, Turkey Background: The aim of this study is to determine the palliative care needs of cancer patients and to examine the knowledge and expectations of the patients and their families about palliative care. Methods: The research was conducted as a descriptive study.The sampling has formed 110 patients and 110 patients families who received a treatment between the dates of June- August 2017. The datas were collected for using socio-demographic and palliative care survey and questionnaire form, Palliative Performance Scale and Edmonton Symptom Scale. Results: 80.9% of the patients have received information about the disease. 76.4% of the patients and 60% their families weren’t aware of palliative/supportive care, and 49.1% of the patient/55.5% of the family have been seen worries and expectations for treatment and care. These anxieties of in the patients 46.4% can’t be like former ones and 31.8% have got a pain, while the anxieties of in the patients families 43.6% were losing their patients life and 33.6% is the extension of the treatments period. 63.6% of the families had problems with maintaining their daily work. 25% of the patients defined palliative care as end-of-life care, while others patients defined it as a symptom management and supportive treatment. Expectations of 99.1% the patients and 97.3% of their families were to learn the treatment and care plan; 97.3% of the patients and 80% of the
C European Society for Medical Oncology 2019. Published by Oxford University Press on behalf of the European Society for Medical Oncology. V
All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz273.001/5578154 by guest on 24 October 2019
Y. Eskigulek1, S. Kav2 Gynecologic Oncology, Gazi University - Faculty of Medicine, Ankara, Turkey, 2Faculty of Health Sciences Nursing Department, Baskent University, Ankara, Turkey
Legal entity responsible for the study: The authors. Funding: Health Research Board. Disclosure: All authors have declared no conflicts of interest.
CANCER NURSING: PALLIATIVE AND END-OF-LIFE CARE CN20
Opinions of palliative care patients and nurses regarding dignified care
1
CN22 Background: Dignity is an important issue for delivering high quality palliative care. This descriptive, methodological study was conducted to evaluate Turkish validity and reliability of The Patient Dignity Inventory (PDI) among palliative care patients and to explore the views of palliative care patients and nurses about dignified care. Methods: This study was approved by Baskent University Institutional Review Board (Project No: KA17/280). Patient demographic form, Palliative Performance Scale and, Hospital Anxiety and Depression Scale (HADS) were used for data collection.Ten palliative care patients and 10 nurses were interviewed. The semi-structured, face to face interviews were recorded digitally, transcribed verbatim and analyzed. Turkish validity and reliability study of the PDI was conducted with 127 palliative care patients with advanced cancer. Face validity, factor structure, concurrent validity, internal consistency and test-retest reliability analysis were performed. Results: Cronbach’s coefficient alpha for the PDI was 0.94 and test-retest reliability was r ¼ 0.75. Concurrent validity tests demonstrated positive significant correlations between factors of PDI and HADS. Factor analysis demonstrated 5 factors accounting for 68.7% of the overall variance. The factors were labeled as symptom distress, existential distress, self-confidence, dependency and, support and care requirements. Three themes emerged through data obtained from palliative care patients: respectability, caring practices, and usefulness. Three themes emerged through data obtained from palliative care nurses: maintaining one’s respectability; barriers and recommendations; benefits of care. Conclusions: Turkish version of the PDI is a valid and reliable instrument among palliative care patients. Education may be useful for raising awareness of healthcare professionals about dignified care. Legal entity responsible for the study: The authors. Funding: Has not received any funding. Disclosure: All authors have declared no conflicts of interest.
CN21
Development of core indicators of non-specialist palliative care in hospitals: An international modified Delphi study
M. Nevin1, G. Hynes1, S. Payne2, V. Smith1 School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland, 2International Observatory on End of Life Care, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
1
Background: Healthcare providers working in acute care hospitals have significant exposure to cancer patients with palliative care needs, and for the majority of patients these reflect non-specialist rather than specialist palliative care needs. Embedding nonspecialist palliative care in acute hospital-based care is challenging. The aim of this paper is to present a core set of indicators for the provision of non-specialist palliative care in hospitals which was determined using a Delphi consensus process. Methods: Preliminary indicators derived from a concept analysis and systematic review were subjected to a three round modified Delphi study, whereby a multidisciplinary expert panel of key stakeholders appraised (rated) each preliminary indicator on its ‘importance’ to non-specialist palliative care provision in hospitals. Stakeholders were also offered an opportunity to add ‘new’ indicators as they considered relevant. Consensus was defined whereby 70%, or more, of the participants across stakeholder groups agreed that an indicator was ‘core’ to non-specialist palliative care provision in the hospital setting. Results: A total of 92 experts (74% response rate) representing the views of patients, clinicians and researchers, from twelve countries participated in the final round. This study resulted in 32 core indicators of hospital based non-specialist palliative care, categorised into 5 structural indicators (relating to infrastructure and governance), 21 organisational indicators (relating to clinical care processes) and 6 staff indicators (relating to training and support for healthcare providers). Conclusions: This study presents the first guidance for clinical practice, policy and research related to non-specialist palliative care provision in hospitals, based on evidence and International consensus from all key stakeholder groups. These indicators provide a means to assess, review, and communicate the core elements of non-specialist palliative care in hospitals, thereby setting a benchmark for changes in policy and practice.
Psychological distress among patients with advanced cancer: A concept analysis
N. Huda Nursing, Taipei Medical University, Taipei, Taiwan Background: Psychological distress is common problem happened in advanced cancer patient. Issued of distress are often faced by health care professional when they are dealing with advanced cancer since many of unmet psychological need was identified. Unfortunately description of psychological distress in advanced cancer is not clearly mention since we know that psychological distress concept in advanced cancer is totally different with the psychological distress in the patient of early stage of cancer. Failure to acknowledge it earlier may have a great impact to patient’s quality of life. Although many articles referred and describing about psychological distress, this term is still poorly defined in the literature and has not been clearly yet. There are no articles were found about concept analysis of psychological distress among advanced cancer patients. The Purpose of this concept analysis is to clearly define psychological distress in terms of advanced cancer patients. This concept analysis could bring clarity meaning by examining various ways it is used in nursing area. Clarifying what is meant by psychological distress will help oncology nurse able to communicate among their colleagues, patients and care giver. Methods: A literature search was conducted using CINAHL, Clinical Key, and Psych Info data base for the past 30 years (1988-2018). Results: Cancer related psychological distress as a concept has limited research substation. Psychological distress in terms of advanced cancer has five defining attributes: 1) Anxiety, 2) Depression, 3) Demoralization, 4) Death anxiety and 5) Perceived in ability to cope effectively. The Primary antecedent is treatment complexity. The consequences can be negatively or positively related to concept. The most positive consequences is much appreciation of life. In another side, a negative psychological distress outcome are hopelessness, low quality of life, and reduced performance status. Conclusions: Concept analysis of psychological distress could clearly defined the meaning of psychological distress and being as a guidance for nurses to give their nursing care appropriately. Intervention should address the antecedents and consequences of the concept and considered individual as a person who has unique characteristic. Legal entity responsible for the study: The author. Funding: Has not received any funding. Disclosure: The author has declared no conflicts of interest.
CN23
Palliative care requirements of cancer patients and investigation of knowledge and expectations related to palliative care of the patients and their families
O. Topkaya Radiation Oncology, Anadolu Medical Center, Kocaeli, Turkey Background: The aim of this study is to determine the palliative care needs of cancer patients and to examine the knowledge and expectations of the patients and their families about palliative care. Methods: The research was conducted as a descriptive study.The sampling has formed 110 patients and 110 patients families who received a treatment between the dates of June- August 2017. The datas were collected for using socio-demographic and palliative care survey and questionnaire form, Palliative Performance Scale and Edmonton Symptom Scale. Results: 80.9% of the patients have received information about the disease. 76.4% of the patients and 60% their families weren’t aware of palliative/supportive care, and 49.1% of the patient/55.5% of the family have been seen worries and expectations for treatment and care. These anxieties of in the patients 46.4% can’t be like former ones and 31.8% have got a pain, while the anxieties of in the patients families 43.6% were losing their patients life and 33.6% is the extension of the treatments period. 63.6% of the families had problems with maintaining their daily work. 25% of the patients defined palliative care as end-of-life care, while others patients defined it as a symptom management and supportive treatment. Expectations of 99.1% the patients and 97.3% of their families were to learn the treatment and care plan; 97.3% of the patients and 80% of the
C European Society for Medical Oncology 2019. Published by Oxford University Press on behalf of the European Society for Medical Oncology. V
All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz273.001/5578154 by guest on 24 October 2019
Y. Eskigulek1, S. Kav2 Gynecologic Oncology, Gazi University - Faculty of Medicine, Ankara, Turkey, 2Faculty of Health Sciences Nursing Department, Baskent University, Ankara, Turkey
Legal entity responsible for the study: The authors. Funding: Health Research Board. Disclosure: All authors have declared no conflicts of interest.