Reading and reflecting on experiential accounts of hospital patients to foster a person-centered care approach: A novel educational method

Background Innovative teaching methods are needed to ensure end-of-life care is provided by nurses through a person-centered approach. Aims This study was designed to (a) explore the self-identified impact of reading dying patient experiential narrative accounts on undergraduate nursing students; and (b) explore the teaching usefulness of patient experiential narrative accounts for enhanced undergraduate nursing student awareness of the need to provide person-centered end-of-life care. Methods Qualitative descriptive study, with 31 undergraduate nursing students reading experiential narrative accounts of dying patients and reflecting on them. A thematic analysis was carried out on the written student reflections. Descriptive statistics were used to summarize student socio-demographic data and their answers to questions on a reaction response sheet designed to assess how useful this activity had been from their perspective. Findings Three main themes were identified: (1) gaining an insightful understanding of the relationship between the nurse and the person with advanced-terminal illness; (2) gaining awareness of themselves as nurses in their clinical practice; (3) pointing out how nurses should behave and what they should do to place the person living with advanced-terminal illness at the center of nursing practice. Among all respondents, 87.09% of students thought this was a useful learning activity. Conclusions Reflecting on patient experiential accounts is an innovative teaching method, which help with nursing students value and gain insight into person-centered end-of-life care

Barriers and facilitators perceived by registered nurses to providing person-centred care at the end of life. A scoping review

Background: Registered nurses are increasingly expected to provide person-centred end-of-life care. However, there is a gap between patients’ needs and the capacity of nurses to meet the existing recommendations on provision of this care. Identifying the relevant barriers and facilitators can inform the development of strategies to support person-centred nursing.Aim: To identify registered nurses’ perceived barriers and facilitators in terms of providing person-centred end-of-life care.Method: A scoping review was conducted according to the 2005 guidelines proposed by Arksey and O‘Malley. The databases Medline, CINAHL, PsycINFO, Cochrane, Web of Science and Embase were searched using the period 2000 to 2018. Empirical studies, literature reviews and studies focusing on the experiences of generalist nurses providing end-of-life care were included. The selected articles were independently reviewed by two researchers.Results: A total of 2,126 publications were identified, with 26 retained after applying the eligibility criteria. Four barriers to providing person-centred care were identified: knowledge of end-of-life care; communication skills; coping strategies; and teamwork. Three main facilitators were identified: knowing the person in a holistic way; nurses’ self-knowledge; and the development of a good nurse-person relationship. Organisational and managerial support also emerged to be important. These findings are reflected in the construct of McCormack and McCance’s (2017) Person-centred Practice Framework.Conclusions and implications for practice: This review provides an overview and an understanding of the key elements that influence the provision of person-centred end-of-life care by registered nurses. These barriers and facilitators point to professional competencies that could improve nurses’ ability to provide this care. This scoping review highlights registered nurses’ need for more specific education, and the elements identified could be a starting point to design an innovative educational programme for registered nurses focused on person-centred end-of-life care to improve person-centred care-related outcomes.https://doi.org/10.19043/ipdj.92.0089pubpub

The location of death and dying across Canada: a study illustrating the socio-political context of death and dying

Background: Concern has existed for many years about the extensive use of hospitals by dying persons. In recent years, however, a potential shift out of hospital has been noticed in a number of developed countries, including Canada. In Canada, where high hospital occupancy rates and corresponding long waits and waitlists for hospital care are major socio-political issues, it is important to know if this shift has continued or if hospitalized death and dying remains predominant across Canada. Methods: Recent individual-anonymous population-level inpatient Canadian hospital data were analyzed to answer two questions: (1) what proportion of deaths in provinces and territories across Canada are occurring in hospital now? and (2) who is dying in hospital now? Results: In 2014–2015, 43.9% of all deaths in Canada (excluding Quebec) occurred in hospital. However, considerable cross-Canada differences in end-of-life hospital utilization were found. Some cross-Canada differences in hospital decedents were also noted, although most were older, male, and they died during a relatively short hospital stay after being admitted from their homes and through the emergency department after arriving by ambulance. Conclusion: Over half of all deaths in Canada are occurring outside of hospital now. Cross-Canada hospital utilization and inpatient decedent differences highlight opportunities for enhanced end-of-life care service planning and policy advancements

What is the “right” number of hospital beds for palliative population health needs?

Healthcare services are one of the twelve determinants of population health. While all types of healthcare services are important, timely access to hospital-based care when needed is critical. For three decades, long waits and wait lists for hospital admission and inpatient care have been a concern in Canada. Undersupply of hospital beds to meet population needs may be the cause of this as hospitals were downsized due to government funding cutbacks and hospital expansion has not occurred since despite population growth and aging. The availability of hospital beds for palliative population health needs may therefore be an issue, particularly as longstanding concern exists about terminally-ill and dying people being frequently admitted to hospital and having long hospital stays. A decline in hospital deaths in many developed countries, including Canada, could indicate that palliative population needs for hospital-based care are not being met. This paper compares the number of hospitals and hospital beds that exist in 9 Canadian provinces and 15 developed countries in relation to population and spatial considerations in an attempt to determine an optimal number of hospital beds for the general public and thus also palliative population health needs. Methods: Document analysis. Publicly-available hospital, population, and geographic information was sought for 9 Canadian provinces and 15 developed countries and compared. Results: Major differences in citizen to hospital bed ratios and citizen to hospital ratios across provinces and countries were found. The availability of hospitals and hospital beds clearly varies. Conclusion: Some regions may have too few hospitals and hospital beds to meet the palliative and other care needs of their citizens. Sufficient beds should exist so necessary admissions to hospital can occur without harmful delay

Dignity models in healthcare.A review of the literature

Errasti-Ibarrondo, M.B., Carvajal-Valcarcel, A., Martinez-Garcia, M., Arantzamendi-Solabarrieta, M., "Dignity models in healthcare.A review of the literature", Tipo de participación: Póster del congreso: 8th World research congress of the european association for palliative care, celebrado en Lérida, del 5 al 7 de junio de 2014

The image of nursing in the media: A scoping review

Aim: To systematically review the available evidence from research exploring the image of nurses in the media. Background: Nurses have historically faced many challenges and have received media attention for such efforts. However, the image of nursing traditionally conveyed by media has failed to represent the real character and a positive image of the nursing profession. Review methods: For this scoping literature review, a search was conducted in PubMed, CINAHL, Scopus, PsycINFO, Web of Science and Dialnet to identify studies written in English, Spanish or Portuguese from the earliest date in the databases until February 2022. Four authors were involved in a two-stage screening process. Data were subjected to quantitative content analysis. A decade-by-decade analysis was performed to track the evolution of the research. Results: Sixty studies were included. The analysis shows (1) an increasing interest in analysing the portrayal of nurses and nursing in media over time, especially from 2000 onwards; (2) a prevailing trend of focusing on one form of media when analysing the portrayal of nurses; (3) qualitative designs as the most frequent method for exploring the image of nursing; and (4) a predominantly negative image conveyed by media. Conclusions: There is a notable body of scientific evidence about the image of nurses and nursing portrayed in media. The interest in analysing media depictions of nursing has a long history. The included studies' samples showed heterogeneity, as they were obtained from different media, periods and countries. Implications for nursing: This scoping review is the first systematic review to provide a comprehensive map of what has been studied thus far regarding media depictions of nursing. It confirms the imperative need for nurses in different settings (academic, assistance or management fields) to maintain a proactive attitude towards addressing images of nursing and ensuring accurate representations

Barriers and facilitators perceived by registered nurses to providing person-centred care at the end of life. A scoping review

Background: Registered nurses are increasingly expected to provide person-centred end-of-life care. However, there is a gap between patients's needs and the capacity of nurses to meet the existing recommendations on provision of this care. Identifying the relevant barriers and facilitators can inform the development of strategies to support person-centred nursing. Aim: To identify registered nurses perceived barriers and facilitators in terms of providing person-centred end-of-life care. Method: A scoping review was conducted according to the 2005 guidelines proposed by Arksey and O`Malley. The databases Medline, CINAHL, PsycINFO, Cochrane, Web of Science and Embase were searched using the period 2000 to 2018. Empirical studies, literature reviews and studies focusing on the experiences of generalist nurses providing end-of-life care were included. The selected articles were independently reviewed by two researchers. Results: A total of 2,126 publications were identified, with 26 retained after applying the eligibility criteria. Four barriers to providing person-centred care were identified: knowledge of end-of-life care; communication skills; coping strategies; and teamwork. Three main facilitators were identified: knowing the person in a holistic way; nurses¿ self-knowledge; and the development of a good nurse-person relationship. Organisational and managerial support also emerged to be important. These findings are reflected in the construct of McCormack and McCance¿

Conducting phenomenological research: Rationalizing the methods and rigour of the phenomenology of practice

Aims To offer a complete outlook in a readable easy way of van Manen's hermeneutic¿phenomenological method to nurses interested in undertaking phenomenological research. Background Phenomenology, as research methodology, involves a certain degree of complexity. It is difficult to identify a single article or author which sets out the didactic guidelines that specifically guide research of this kind. In this context, the theoretical¿practical view of Max van Manen's Phenomenology of Practice may be seen as a rigorous guide and directive on which researchers may find support to undertake phenomenological research. Design Discussion paper. Data sources This discussion paper is based on our own experiences and supported by literature and theory. Our central sources of data have been the books and writings of Max van Manen and his website ¿Phenomenologyonline¿. Implications for nursing The principal methods of the hermeneutic¿phenomenological method are addressed and explained providing an enriching overview of phenomenology of practice. A proposal is made for the way the suggestions made by van Manen might be organized for use with the methods involved in Phenomenology of Practice: Social sciences, philosophical and philological methods. Thereby, nurse researchers interested in conducting phenomenological research may find a global outlook and support to understand and conduct this type of inquiry which draws on the art

The importance of nurses' way of caring: the experience of patients' with advanced and terminal cancer

Errasti-Ibarrondo, B., Pérez, M., Arantzamendi, M., et al. “The importance of nurses' way of caring: the experience of patients' with advanced and terminal cancer” en 14th Congress of the European Association for Palliative Care, celebrado en Copenhague (Dinamarca) del 8 al 10 de mayo de 201