Caring for the Terminally Ill: An Interpretation of Time, Existence, and Mortality

In this paper, the first author explores the complexity of caring for palliative care patients approaching end of life in response to the statement nursing is an interpretive practice. A real-life scenario is used to unravel the exploration of time, existence, and mortality. The author proclaims that the question of death remains unanswered, and the call to palliative care nursing requires an extensive examination of one’s own temporality to cultivate an understanding of patients experiences of grief, legacy, and meaning making in the context of terminal illness

Single Room Maternity Care Model: Unit Culture and Healthcare Team Practices

The evidence regarding the effects of a Single Room Maternity Care (SRMC) model on women’s childbirth experiences, healthcare providers’ workplace satisfaction, and cost outcomes remains equivocal. The research questions for this focused ethnographic study are: how is culture experienced by nurses and other healthcare providers on the SRMC unit, and how do the values, beliefs, and norms of nurses and other healthcare providers on the SRMC unit influence their day-to-day practices of caring for women and their families. The aim of this qualitative focused ethnography was to explore the culture and practices of the healthcare team in a SRMC unit. Twelve healthcare providers were recruited from a Single Room Maternity Care unit located in a Western Canadian hospital. Semi-structured interviews, participant observations, and examination of unit-related documents were conducted between October 2014 and January 2015. Data were analyzed using an approach by Roper and Shapira (2000). Two main themes emerged from the data: creating and maintaining culture and the work family. The participants considered themselves a family, and made collective and conscious efforts to create a unit culture where everyone could feel supported and valued. Unit culture determined the ways members of the healthcare team functioned in their day-to-day practice. Further research is required to explore the relationship between the maternity unit and quality of patient care, as well as the impact of collaborative practices on both providers and recipients of maternal care

The Hidden Nature of Death and Grief

Western culture can be described as death-denying and youth-obsessed. Yet this has not always been the case. Only a few generations ago, death was very much part of life where people died at home with their families members caring for them. A shift occurred, in part, because of the unprecedented advances in medical science that the western world has seen over the past 40 years. Health care professionals now have the knowledge and the technology to prolong life in ways that were previously not only unattainable, but inconceivable. Regardless, the reality that death will eventually come for each of us has not changed; merely our perception of it has. This perception is influenced by the hidden nature of death in our society. This begs the questions: if death in our culture is something to hide, to conceal, and to keep secret, then what does that say about our ability to express grief? What does this mean for those who face it as part of their chosen profession? How might we understand the nature of suffering for those who turn toward the suffering of others? This paper interpretively examines the nature of hidden death and hidden grief in our society.Keywords: death, grief, hermeneutics, hidden, pediatric care nursin

Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understandings, experiences, and preferences

Background: Compassion is considered an essential element in quality patient care. One of the conceptual challenges in healthcare literature is that compassion is often confused with sympathy and empathy. Studies comparing and contrasting patients’ perspectives of sympathy, empathy, and compassion are largely absent. Aim: The aim of this study was to investigate advanced cancer patients’ understandings, experiences, and preferences of “sympathy,” “empathy,” and “compassion” in order to develop conceptual clarity for future research and to inform clinical practice. Design: Data were collected via semi-structured interviews and then independently analyzed by the research team using the three stages and principles of Straussian grounded theory. Setting/participants: Data were collected from 53 advanced cancer inpatients in a large urban hospital. Results: Constructs of sympathy, empathy, and compassion contain distinct themes and sub-themes. Sympathy was described as an unwanted, pity-based response to a distressing situation, characterized by a lack of understanding and self-preservation of the observer. Empathy was experienced as an affective response that acknowledges and attempts to understand individual’s suffering through emotional resonance. Compassion enhanced the key facets of empathy while adding distinct features of being motivated by love, the altruistic role of the responder, action, and small, supererogatory acts of kindness. Patients reported that unlike sympathy, empathy and compassion were beneficial, with compassion being the most preferred and impactful. Conclusion: Although sympathy, empathy, and compassion are used interchangeably and frequently conflated in healthcare literature, patients distinguish and experience them uniquely. Understanding patients’ perspectives is important and can guide practice, policy reform, and future research

How are health research partnerships assessed? A systematic review of outcomes, impacts, terminology and the use of theories, models and frameworks

BACKGROUND: Accurate, consistent assessment of outcomes and impacts is challenging in the health research partnerships domain. Increased focus on tool quality, including conceptual, psychometric and pragmatic characteristics, could improve the quantification, measurement and reporting partnership outcomes and impacts. This cascading review was undertaken as part of a coordinated, multicentre effort to identify, synthesize and assess a vast body of health research partnership literature. OBJECTIVE: To systematically assess the outcomes and impacts of health research partnerships, relevant terminology and the type/use of theories, models and frameworks (TMF) arising from studies using partnership assessment tools with known conceptual, psychometric and pragmatic characteristics. METHODS: Four electronic databases were searched (MEDLINE, Embase, CINAHL Plus and PsycINFO) from inception to 2 June 2021. We retained studies containing partnership evaluation tools with (1) conceptual foundations (reference to TMF), (2) empirical, quantitative psychometric evidence (evidence of validity and reliability, at minimum) and (3) one or more pragmatic characteristics. Outcomes, impacts, terminology, definitions and TMF type/use were abstracted verbatim from eligible studies using a hybrid (independent abstraction–validation) approach and synthesized using summary statistics (quantitative), inductive thematic analysis and deductive categories (qualitative). Methodological quality was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). RESULTS: Application of inclusion criteria yielded 37 eligible studies. Study quality scores were high (mean 80%, standard deviation 0.11%) but revealed needed improvements (i.e. methodological, reporting, user involvement in research design). Only 14 (38%) studies reported 48 partnership outcomes and 55 impacts; most were positive effects (43, 90% and 47, 89%, respectively). Most outcomes were positive personal, functional, structural and contextual effects; most impacts were personal, functional and contextual in nature. Most terms described outcomes (39, 89%), and 30 of 44 outcomes/impacts terms were unique, but few were explicitly defined (9, 20%). Terms were complex and mixed on one or more dimensions (e.g. type, temporality, stage, perspective). Most studies made explicit use of study-related TMF (34, 92%). There were 138 unique TMF sources, and these informed tool construct type/choice and hypothesis testing in almost all cases (36, 97%). CONCLUSION: This study synthesized partnership outcomes and impacts, deconstructed term complexities and evolved our understanding of TMF use in tool development, testing and refinement studies. Renewed attention to basic concepts is necessary to advance partnership measurement and research innovation in the field. Systematic review protocol registration: PROSPERO protocol registration: CRD42021137932 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=137932. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12961-022-00938-8

Compassion: a scoping review of the healthcare literature

BACKGROUND: Recent concerns about suboptimal patient care and a lack of compassion have prompted policymakers to question the preparedness of clinicians for the challenging environment in which they practice. Compassionate care is expected by patients and is a professional obligation of clinicians; however, little is known about the state of research on clinical compassion. The purpose of this scoping review was to map the literature on compassion in clinical healthcare. METHODS: Searches of eight electronic databases and the grey literature were conducted to identify empirical studies published over the last 25 years. Eligible studies explored perceptions or interventions of compassionate care in clinical populations, healthcare professionals, and healthcare students. Following the title and abstract review, two reviewers independently screened full-texts articles, and extracted study data. A narrative approach to synthesizing and mapping the literature was used. RESULTS AND DISCUSSION: Of 36,637 records, 648 studies were retrieved and 44 studies were included in the review. Less than one third of studies included patients. Six themes emerged from studies that explored perceptions of compassionate care: nature of compassion, development of compassion, interpersonal factors related to compassion, action and practical compassion, barriers and enablers of compassion, and outcomes of compassion. Intervention studies included two compassionate care trials with patients and eight educational programs that aimed to improve compassionate care in clinicians and students. CONCLUSIONS: This review identifies the limited empirical understanding of compassion in healthcare, highlighting the lack of patient and family voices in compassion research. A deeper understanding of the key behaviors and attitudes that lead to improved patient-reported outcomes through compassionate care is necessary

Collective soul: The spirituality of an interdisciplinary palliative care team

Although spirituality as it relates to patients is gaining increasing attention, less is known about how health care professionals ~HCP! experience spirituality personally or collectively in the workplace. This study explores the collective spirituality of an interdisciplinary palliative care team, by studying how individuals felt about their own spirituality, whether there was a shared sense of a team spirituality, how spirituality related to the care the team provided to patients and whether they felt that they provided spiritual care. A qualitative autoethnographic approach was used. The study was conducted in a 10-bed Tertiary Palliative Care Unit ~TPCU! in a large acute-care referral hospital and cancer center. Interdisciplinary team members of the TPCU were invited to participate in one-to-one interviews and0or focus groups. Five interviews and three focus groups were conducted with a total of 20 participants.Ye

What Influences Use of Nonpharmacological Treatments for Seniors with Mild or Moderate Dementia: An Integrative Review Protocol

An integrative review protocolAim: The aim of this integrative review is to explore the extent and nature of evidence concerning factors that influence use of nonpharmacological treatment interventions for community-dwelling seniors with mild-to-moderate dementia. Background: Despite the significance of nonpharmacological interventions in optimal management of mild-to-moderate dementia, it is unclear in the literature how seniors with mild or moderate dementia view, understand, and access nonpharmacological interventions. To our knowledge, no review has been conducted on factors influencing the use of nonpharmacological interventions for seniors with mild-to-moderate dementia. Design: An integrative review method will be used to meet the review objective. Review method: We will perform a systematic literature search from five electronic databases to locate relevant empirical and theoretical research evidence on the topic. Eligible studies include empirical research, both qualitative and quantitative methods, and theoretical studies published since 2000 in English, that explored factors influencing use of community-based nonpharmacological interventions for seniors with mild or moderate dementia. Eligibility criteria are studies that included community-dwelling seniors (≥ 65) with mild-to-moderate dementia, their care partners, or health care practitioners and that explored the use of community-based nonpharmacological dementia treatments. We will extract the data by creating matrices on quality appraisal, key methodological features, and key findings. Data analysis will include constant comparison of extracted data, examining relationships between concepts, overall strengths and weaknesses of the literature, and gaps in knowledge. Findings will be visually categorized and narratively summarized. Discussion: This integrative review will identify and synthesize enablers and barriers that influence use of nonpharmacological interventions by seniors with mild-to-moderate dementia, identify knowledge gaps, and inform future research studies and literature reviews