Medicine and Health Sciences Commons^™

Stakeholder Perspectives Of A Pilot Multicomponent Delirium Prevention Intervention For Adult Patients With Advanced Cancer In Palliative Care Units: A Behaviour Change Theory-Based Qualitative Study, Anna Green, Annmarie Hosie, Jane L. Phillips, Slavica Kochovska, Beverly Noble, Meg Brassil, Anne Cumming, Peter G. Lawlor, Shirley H. Bush, Jan M. Davis, Layla Edwards, Jane Hunt, Julie Wilcock, Carl Phillipson, Eugene Wesley Ely, Cynthia Parr, Melanie Lovell, Meera Agar

Nursing Papers and Journal Articles

Background: Theory-based and qualitative evaluations in pilot trials of complex clinical interventions help to understand quantitative results, as well as inform the feasibility and design of subsequent effectiveness and implementation trials.

Aim: To explore patient, family, clinician and volunteer (‘stakeholder’) perspectives of the feasibility and acceptability of a multicomponent non-pharmacological delirium prevention intervention for adult patients with advanced cancer in four Australian palliative care units that participated in a phase II trial, the ‘PRESERVE pilot study’.

Design: A trial-embedded qualitative study via semi-structured interviews and directed content analysis using Michie’s Behaviour Change Wheel and the Theoretical Domains Framework.

Setting/participants: Thirty-nine …

Clinicians' Delirium Treatment Practice, Practice Change, And Influences: A National Online Survey, Annmarie Hosie, Meera Agar, Gideon A. Caplan, Brian Draper, Stephen Hedger, Debra Rowett, Penny Tuffin, Seong Leang Cheah, Jane L. Phillips, Linda Brown, Manraaj Sidhu, David C. Currow

Nursing Papers and Journal Articles

Background: Recent studies cast doubt on the net effect of antipsychotics for delirium.

Aim: To investigate the influence of these studies and other factors on clinicians’ delirium treatment practice and practice change in palliative care and other specialties using the Theoretical Domains Framework.

Design: Australia-wide online survey of relevant clinicians.

Setting/participants: Registered nurses (72%), doctors (16%), nurse practitioners (6%) and pharmacists (5%) who cared for patients with delirium in diverse settings, recruited through health professionals’ organisations.

Results: Most of the sample (n=475): worked in geriatrics/aged (31%) or palliative care (30%); in hospitals (64%); and saw a new patient with delirium …

Effectiveness Of Online Communication Skills Training For Cancer And Palliative Care Health Professionals: A Systematic Review, Melissa N. Berg, Irene Ngune, Penelope Schofield, Lisa Grech, Ilona Juraskova, Michelle Strasser, Zoe Butt, Georgia K.B Halkett

Nursing Papers and Journal Articles

Objective: To determine the reported effect of online communication skills training (CST) on health professional (HP) communication skills and patient care outcomes in cancer and palliative care.

Methods: Primary research published in English between January 2003 and April 2019 was identified in bibliographic databases including Medline, Embase and Proquest (Prospero: CRD42018088681). An integrated mixed-method approach included studies describing a CST intervention and its effect, for cancer or palliative care HPs, delivered online or blended with an online component. Included studies' outcomes were categorised then findings were stratified by an evaluation framework and synthesised in an effect direction plot. Risk of …

Clinically Significant Depressive Symptoms Are Prevalent In People With Extremely Short Prognoses - A Systematic Review, Wei Lee, Marley Pulbrook, Caitlin Sheehan, Slavica Kochovska, Sungwon Chang, Annmarie Hosie, Elizabeth Lobb, Deborah Parker, Brian Draper, Meera R. Agar, David Currow

Nursing Papers and Journal Articles

Context: Currently, systematic evidence of prevalence of clinically significant depressive symptoms in people with extremely short prognoses is not available to inform its global burden, assessment, and management.

Objectives: To determine the prevalence of clinically significant depressive symptoms in people with advanced life-limiting illnesses and extremely short prognoses (range of days to weeks).

Methods: A systematic review and meta-analysis (random effects model) were performed (PROSPERO: CRD42019125119). MEDLINE, Embase, PsycINFO, CINAHL, and CareSearch were searched for studies (1994-2019). Data were screened for prevalence of clinically significant depressive symptoms (assessed using validated depression-specific screening tools or diagnostic criteria) of adults with advanced …

General Practice Physicians' And Nurses' Self- Reported Multidisciplinary End-Of-Life Care: A Systematic Review, Hugh Senior, Matthew Grant, Joel J. Rhee, Michèle Aubin, Peta Mcvey, Claire Johnson, Leanne Monterosso, Harriet Nwachukwu, Julia Fallon-Ferguson, Patsy Yates, Briony Williams, Geoffrey Mitchell

Nursing Papers and Journal Articles

Background: General practitioners (GPs) and general practice nurses (GPNs) face increasing demands to provide end-of-life care (EoLC) as the population ages. To enhance primary palliative care (PC), the care they provide needs to be understood to inform best practice models of care.

Objective: To provide a comprehensive description of the self-reported role and performance of GPs and GPNs in (1) specific medical/nursing roles, (2) communication, (3) care co-ordination, (4) access and out-of-hours care, and (5) multidisciplinary care.

Method: Systematic literature review. Data included papers (2000 to 2017) sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases. …

General Practice Palliative Care: Patient And Carer Expectations, Advance Care Plans And Place Of Death-A Systematic Review, Claire E. Johnson, Peta Mcvey, Joel J. Rhee, Hugh Senior, Leanne Monterosso, Briony Williams, Julia Fallon-Ferguson, Matthew Grant, Harriet Nwachukwu, Michele Aubin, Patsy Yates, Geoffrey Mitchell

Nursing Papers and Journal Articles

Background: With an increasing ageing population in most countries, the role of general practitioners (GPs) and general practice nurses (GPNs) in providing optimal end of life (EoL) care is increasingly important.

Objective: To explore: (1) patient and carer expectations of the role of GPs and GPNs at EoL; (2) GPs’ and GPNs’ contribution to advance care planning (ACP) and (3) if primary care involvement allows people to die in the place of preference.

Method: Systematic literature review. Data sources: Papers from 2000 to 2017 were sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases.

Results: From 6209 journal …

Identifying The Barriers And Enablers To Pallative Care Nurses' Recognition And Assessment Of Delirium Symptoms: A Qualitative Study, Annmarie Hosie, M Agar, Elizabeth A. Lobb, P M. Davidson, Jane Phillips

Nursing Papers and Journal Articles

Context: Delirium is under-recognised by nurses, including those working in palliative care settings where the syndrome occurs frequently. Identifying contextual factors that support and/or hinder palliative care nurses’ delirium recognition and assessment capabilities is crucial, to inform development of clinical practice and systems aimed at improving patients’ delirium outcomes.

Objective: To identify nurses’ perceptions of the barriers and enablers to recognising and assessing delirium symptoms in palliative care inpatient settings.

Methods: A series of semi-structured interviews, guided by critical incident technique, were conducted with nurses working in Australian palliative care inpatient settings. A hypoactive delirium vignette prompted participants’ recall of …

End-Of-Life Delirium: Issues Regarding Recognition, Optimal Management And The Role Of Sedation In The Dying Phase., S H. Bush, M M. Leonard, M Agar, J A. Spiller, Annmarie Hosie, D Wright, D J. Meagher, D C. Currow, E Bruera, P G. Lawlor

Nursing Papers and Journal Articles

CONTEXT:

In end-of-life care, delirium is often not recognized and poses unique management challenges, especially in the case of refractory delirium in the terminal phase.

OBJECTIVES:

To review: delirium in the terminal phase context, specifically in relation to recognition issues; the decision-making processes and management strategies regarding its reversibility; the potential refractoriness of delirium to symptomatic treatment; and the role of sedation in refractory delirium.

METHODS:

We combined multidisciplinary input from delirium researchers and knowledge users at an international delirium study planning meeting and relevant electronic database literature searches (Ovid Medline, Embase, PsycINFO and CINAHL) to inform this narrative review. …

Do Palliative Care Health Professionals Settle For Low Level Evidence?, R J. Chan, Jane Phillips, D C. Currow

Nursing Papers and Journal Articles

No abstract provided.

The Clinical And Social Dimensions Of Prescribing Palliative Home Oxygen For Refractory Dyspnea, Katrina Breaden, Jane Phillips, Meera Agar, Carol Grbich, Amy P. Abernethy, David C. Currow

Nursing Papers and Journal Articles

Background: Chronic breathlessness is a significant problem in palliative care and oxygen is often prescribed in an attempt to ameliorate it. Often, this prescription falls outside the current funding guidelines for long-term home oxygen use. The aim of this qualitative study was to understand the factors that most influence Australian specialist palliative care nurses' initiation of home oxygen for their patients. Methods: A series of focus groups were held across three states in Australia in 2011 involving specialist palliative care nurses. The invitation to the nurses was sent by e-mail through their national association. Recorded and transcribed data were coded …