Palliative care for patients with heart failure: a cross-sectional study among nursing healthcare professionals

Brendan McCormack - ORCID: 0000-0001-8525-8905 https://orcid.org/0000-0001-8525-8905Background: Acute heart failure is a problem that the public healthcare system faces worldwide. Despite improving healthcare systems and the resulting treatment, the disease's incidence and frequency has increased annually. Therefore, patients with acute heart failure often seek help in the emergency room, where nursing health professionals encounter the condition early or late. In the final stages, they need to focus on providing palliative care to such patients. The chapter aims to determine the nursing healthcare professionals' knowledge, perceptions, and attitudes towards palliative care in patients with heart failure in the emergency and cardiology departments. Methods: A cross-sectional study was carried out. The survey took place in August 2019 involving nursing healthcare professionals. Results: Of 104 nurses, 50% (n = 52) had received training in palliative care throughout their education and 7.7% (n = 8) had received additional training. Nursing healthcare professionals in both the emergency and the cardiology departments have similar knowledge about palliative care. With regard to the perception of implementing palliative care, the data shows a statistically significant difference between both departments. Furthermore, statistically significant differences between the emergency and cardiology departments have been found in some statements regarding their attitudes, namely that there remains a need for palliative care in treating patients with heart failure. Discussion and conclusion: We believe that the knowledge of palliative care in the cardiology and emergency departments is good, and that there are no major differences between the knowledge and departments. However, further training is required to improve the healthcare staff's knowledge, perceptions, and attitudes towards palliative care in patients with heart failure. ©2023 the author(s), published by De Gruyter. All rights reserved.https://doi.org/10.1515/9783110786088-010pubpu

Aktivnosti za preprečevanje osamljenosti starejših odraslih v domovih za starejše

Uvod: Osamljenost je mednarodni problem javnega zdravja. Povzroča boleč in skrb vzbujajoč občutek čustvene ali socialne izolacije in je vzrok težavam, povezanim z duševnim zdravjem. Osamljenost je pogosto prisotna pri starejših odraslih, tudi pri tistih, ki bivajo v domovih za starejše. S pregledom literature želimo predstaviti aktivnosti in njihovo učinkovitost pri zmanjševanju osamljenosti pri starejših odraslih v domovihza starejše. Metode: Izvedli smo sistematični pregled znanstvene literature. Iskanje s ključnimi besedami v angleškem jeziku je potekalo v mednarodnih bazah podatkov: PubMed, CINAHL in SAGE. Za prikaz pregleda ter izbire vključenih člankov smo uporabili diagram poteka. Vključene članke smo kritično ocenili z orodjem Joanna Briggs Institutes in zbrane podatke analizirali po metodi tematske analize. Rezultati: V končno analizo je bilo vključenih 20 člankov. Oblikovali smo dve glavni temi. Prva tema »aktivnosti za preprečevanje osamljenosti« odraža dve podtemi: gibalne in družabne aktivnosti. Druga tema »vpliv aktivnosti na preprečevanje osamljenosti« prikazuje fizične, psihološke in socialne vplive aktivnosti na preprečevanje osamljenosti. Diskusija in zaključek: Pri zmanjševanju osamljenosti so najučinkovitejše vodene in usmerjene aktivnosti: telesne vadbe, umetniško ustvarjanje, vrtnarjenje, pogovorne skupine, pa tudi terapija smeha in obujanje spominov

Symptoms experienced by patients with acute myocardial infarction that the triage nurses should know in the emergency department: a systematic review

Brendan McCormack - ORCID: 0000-0001-8525-8905 https://orcid.org/0000-0001-8525-8905Background: Vascular and heart disease present a big problem in public health society. Acute myocardial infarction (AMI), which belongs under acute coronary syndromes, is one of the most common diseases and biggest causes of early death in developed countries. Symptoms in patients with myocardial infarction vary between typical and atypical symptoms. This review aims to identify different AMI symptoms of patients who seek medical attention in the emergency department (ED). Methods: A systematic review of the literature in CINAHL, MEDLINE, ScienceDirect, and SAGE was conducted to identify studies on detected symptoms in patients with myocardial infarction over 18 years in the ED. The search was limited to studies on this topic published up to December 2021. The data analysis was based on thematic analysis. Results: Out of 2,814 studies retrieved, 11 studies were included. The data analysis identified one main theme: clinical symptoms and three subcategories. Conclusion: The triage nurses need to pay attention to cardiovascular symptoms, such as chest pain, the most common symptom. Their focus also needs to be redirected to epigastric pain and cold sweating, which are abdominal and systemic symptoms, and anxiety and nausea/vomiting in patients with diabetes. Impact: AMI is one of the most common diseases and causes of early death in developed countries. The literature lacks knowledge about the different symptoms of AMI, which the triage nurses must be careful about. The knowledge and rapid identification of myocardial infarction helps triage nurses provide the best outcomes. ©2023 the author(s), published by De Gruyter. All rights reserved.https://doi.org/10.1515/9783110786088-002pubpu

A qualitative study of family members' experiences of their loved one developing dementia and their subsequent placement in a nursing home

From PubMed via Jisc Publications RouterBrendan McCormack - ORCID: 0000-0001-8525-8905 https://orcid.org/0000-0001-8525-8905Aim: To investigate the family members' experiences with receiving help and support while their loved one develops dementia and their subsequent placement in nursing homes.Background: As the dementia disease progresses, some family members will struggle with the option of nursing home placement. This situation can precipitate feelings of anger, disappointment and guilt, all of which can be overwhelming.Methods: A qualitative descriptive study with in‐depth interviews (n = 19) was carried out in several nursing homes of Slovenia's North Eastern Region.Results: Inductive thematic analysis identified two main themes: (i) developing the diagnosis and (ii) accommodation process. Family members noticed the progressive behavioural changes in their loved ones. While they were searching for help at the primary health care level, they experienced a lack of help and support.Conclusions: When family members detect behavioural changes in their loved ones, the primary health care team should establish an early diagnosis of dementia and provide adequate decision‐making support.Implications for Nursing Management: The findings are useful to prepare guidance for a family member to inform them of the types of support available and from which associations and organisations. To achieve adequate management support, primary health care teams need to be aware of family member experiences.29pubpub

Elements of person-centred care of older people in primary healthcare: A systematic literature review with thematic analysis

Brendan McCormack - ORCID: 0000-0001-8525-8905 https://orcid.org/0000-0001-8525-8905Background: Higher life expectancy in the ageing population and, consequently, an increase in the older population bring additional challenges for healthcare providers, especially in primary healthcare. The person-centred care of older people is defined as an approach that puts older people at the centre of care and recognizes the importance of their needs. The chapter aims to identify the key elements of person-centred care for older people, in primary healthcare. Methods: A systematic review of relevant literature was carried out. Literature searches were conducted in international databases, with keywords and their synonyms with Boolean operators. The search was limited to articles published until December 2021. Results: The literature review identified two main themes: (1) personal and communication determinants like the interaction of all participants, the experience of illness and the needs of the older people, the attitude of the primary healthcare team, the wishes of the older people and (2) managerial characteristics that include qualification, leadership, organization, and operationalization. Conclusion: The person-centred care of older people should be caring, compassionate, empathetic, confident, supportive, autonomous, and respectful. All these identified elements need to be heard and respected by all primary healthcare teams. It is important to recognize the needs of older people and, at the same time, have a positive experience with professional healthcare. The person-centred care of older people should focus on the patient's needs, family, and the wider local community. ©2023 the author(s), published by De Gruyter. All rights reserved.https://doi.org/10.1515/9783110786088-008pubpu

Triage of patients with acute coronary syndrome at the emergency department: A retrospective study

Brendan McCormack - ORCID: 0000-0001-8525-8905 https://orcid.org/0000-0001-8525-8905Background: Acute coronary syndrome represents a considerable challenge worldwide as one of the causes of death; its diagnosis is often very complex. It includes acute myocardial infarction with ST-segment elevation, acute myocardial infarction without ST-segment elevation, unstable angina pectoris, and sudden cardiac arrest. Methods: This retrospective cohort study included 678 patients who were admitted to the emergency department between 2015 and 2019 with acute coronary syndrome. Triage data were reviewed for vital signs, baseline characteristics, chief complaints, demographic variables, mode and time of arrival, triage, diagnosis, and treatment. Regression was used to identify key symptoms and patient characteristics at triage encounter to predict acute coronary syndrome. Results: A total of 678 triage records were identified. The average age of the sample was 67 years old, 58.6% male, and 31.8% came by themselves to the emergency department. The most common diagnosis was acute myocardial infarctions without ST elevation (38.2%). Chest pain and difficulty in breathing were the two most common symptoms. Most patients were not assigned to the appropriate triage category, i.e., were diagnosed as less urgent. Discussion and conclusion: This study presents the triage of patients with acute coronary syndrome at the emergency department to provide a comprehensive insight into their care. By identifying patient symptoms at the emergency department, nurse triage recognizes patients with acute coronary syndrome on time, thus increasing the accuracy of determining the triage category, which will impact the treatment outcome of patients. ©2023 the author(s), published by De Gruyter. All rights reserved.https://doi.org/10.1515/9783110786088-009pubpu

Family members’ experiences with the spiritual care of older people living with dementia in nursing homes: A phenomenological hermeneutical study

Aim To illuminate family members experiences with the spiritual care provided to their family members living with dementia in nursing homes. Design A qualitative research design utilizing phenomenological hermeneutical approach. Methods Data were gathered by conducting twelve in-depth interviews with family members of older people living with dementia in nursing homes and analysed using the phenomenological hermeneutical analysis. The COREQ guidance was used for reporting of this study. Results Finding revealed that family members were worried and fearful when nursing care was routinely provided with little consideration given to spiritual needs and lacking compassion. Findings affirm that “riendliness” is an essential aspect of respectful caring from the family members' perspective. Family members want compassionate, loving, caring and dignified nursing care for their relative living with dementia in the nursing homes

Developing philosophical and pedagogical principles for a pan-European person-centred curriculum framework

Brendan McCormack - ORCID: 0000-0001-8525-8905 https://orcid.org/0000-0001-8525-8905Background: In the associated article in this special issue of the International Practice Development Journal, Phelan et al. (2020) offer an analysis of the global positioning of person-centredness from a strategic policy perspective. This second article, an international person-centred education curriculum development initiative, builds on that foundational work. It outlines the systematic, rigorous processes adopted by academics from five European countries to analyse stakeholder data, theoretically frame the data, and thereby identify philosophical and pedagogical principles to inform the development of person-centred curriculum frameworks.Aim: To identify key principles that have the potential to create an international curriculum framework for the education of person-centred healthcare practitioners.Methods: A hermeneutic praxis methodological approach was used, where multiple rounds of data analyses were conducted. These were initially undertaken in each country, then collaboratively with partners, while engaging with other forms of evidence.Findings: The project group generated a set of principles embedded in four philosophical dimensions: (i) transformative; (ii) co-constructed; (iii) relational; and (iv) pragmatic. The purpose of the curriculum was identified as being transformative, facilitating journeying through knowing, doing, being and becoming a competent and committed person-centred practitioner. A person-centred curriculum is built on a philosophy of pragmatism, adopts a co-constructionist approach to curriculum design and implementation, and encourages connectivity with self, other persons and contexts. Pedagogical principles, aligned to the four philosophical dimensions, identified the required learning environment, and the learning, teaching and assessment approaches required to educate person-centred healthcare practitioners.Conclusion: This article represents steps to foster a more focused and engaging way of implicitly and explicitly embedding person-centred care in curricula. Our theoretical framework has enabled us to consider the different layers of practice while staying true to the purpose of curriculum design. The presentation of the framework in this article makes it available for wider critique to those with an interest in this area of study.Implications for practice: The draft framework provides an opportunity for curriculum teams to critically reflect on and have dialogue around current curricula Person-centred curricula have the potential to improve service-user experiences of care Prepared person-centred practitioners will contribute to person-centred cultures Students and practitioners will experience person-centredness Practitioners will be bold and innovativehttps://doi.org/10.19043/ipdj.10Suppl2.00410pubpubSuppl

Review of developments in person-centred healthcare

Brendan McCormack - ORCID: 0000-0001-8525-8905 https://orcid.org/0000-0001-8525-8905Tanya McCance - ORCID: 0000-0002-9787-2627 https://orcid.org/0000-0002-9787-2627In recent years, there has been a shift in orientation towards person-centredness as part of a global move towards humanising and centralising the person within healthcare. Person-centredness, underpinned by robust philosophical and theoretical concepts, has an increasingly solid footprint in policy and practice, but research and education lag behind. This article considers the emergence of person-centredness, including person-centred care, and how it is positioned in healthcare policy around the world, while recognising a dominant philosophical positioning in Western philosophy, concepts and theories. Second, the evolution of person-centred healthcare over the past five years is reviewed. Published evidence of person-centred healthcare developments is drawn on, as well as information gathered from key stakeholders who engaged with the partner organisations in an Erasmus+ project to develop a European person-centred healthcare curriculum framework. Five themes are identified, which underpin the literature and stakeholder perspectives: Policy development for transformation Participatory strategies for public engagement Healthcare integration and coordination strategies Frameworks for practice Process and outcome measurement These themes reflect the World Health Organization’s global perspective on people-centred and integrated healthcare, and give some indication of development priorities as person-centred healthcare systems continue to be developed.https://doi.org/10.19043/ipdj.10Suppl2.00310pubpubSuppl