1,721,000 research outputs found
Patienten mit Migrationshintergrund - Herausforderungen einer transkulturellen Palliativmedizin
No full textPalliative care for patients with Turkish or Arabic migration background in Lower Saxony. A survey from palliative care professionals' perspective
No full textPeople with a migration background (MB) are an important part of German society. If and how they use specialised palliative care (SPC) has not been studied. We aimed to assess the current SPC for patients with Turkish or Arabic MB (the largest group of immigrants in Germany with a shared ascribed culture) from the point of view of healthcare professionals (HCP) in Lower Saxony. All HCPs in institutions providing SPC (n = 90) were invited to participate in an anonymous online survey which contained closed and open questions about care for this patient group, characteristics of the last patient with Turkish or Arabic MB they cared for, and resources and strategies to care for these patients. The survey was analysed using descriptive statistics and qualitative content analysis. Fifty-five HCPs in SPC participated, mostly nurses aged between 40 and 60 years. One fifth had not cared for a patient with Turkish or Arabic MB during the last 12 months. Given their local population, 84.6% estimated that they cared for a lower number of patients than would be representative. In care, problems with communication as well as difficulties to interact with and manage families, and in organising and planning care were most prevalent. Only 21% of participants had access to interpreters. Patients with Turkish or Arabic MB seem to be underrepresented in SPC. The high rate of communication problems highlights the necessity of reliable and accessible interpreter services. Most difficulties were of psychosocial nature, showing how important the holistic approach of SPC is in caring for terminally ill patients with Turkish or Arabic MB
Spezialisierte Ambulante Palliativ-Versorgung
No full textAbstractSince 2007, patients with severe advanced life-limiting illnesses and high, complex symptom burdens have a right to receive specialized outpatient palliative care (SAPV). Multi-professional teams with heterogeneous organizational structures provide care in cooperation with primary care givers, not limited to cancer patients. The aim of SAPV is to foster patient’s autonomy and quality of life. SAPV can be provided as counseling of patient and care givers, coordination of care, additional supportive and full care provision. While the basis of SAPV provision is regulated by a SAPV directive, different contracts between care providers and health care insurances regulate organization, cooperation, definition of care levels, service provision and compensation. Some regions have model contracts that are binding for all SAPV teams in the area; in other regions teams negotiate e. g. compensation, individually with insurances. The article gives an overview of the regulations regarding SAPV.</jats:p
Attitudes and experiences regarding physician assisted suicide. A survey among members of the German Association for Palliative Medicine
No full textThe need to regulate physician-assisted suicide (PAS) and organizations offering assisted suicide has been controversially debated in Germany. Before the German parliament voted on various drafts in November 2015, the German Association for Palliative Medicine surveyed its members on their attitudes and experiences regarding PAS. Items for the survey were derived from the literature and consented in a focus group. Literature search: 2005-2015 - PubMed: PAS [Title/Abstract] UND survey (all countries), grey literature. We invited 5152 members of the DGP to participate in the online/paper survey. Descriptive quantitative and content analytic qualitative analysis of data using SPSS and MaxQDA. We obtained 1811 valid data sets (response rate 36.9%). 33.7% of the participants were male, 43.6% were female, and 0.4% identifed as other. Physicians accounted for 48.5% of the respondents, 17.8% nurses, other professions 14.3%, and about 20% of the data was missing socio-demographic information. More than 90% agreed that "wishes for PAS may be ambivalent" and "are rather a wish to end an unbearable situation". Of the 833 participating physicians, 56% refused participating in PAS and 74.2% had been asked to perform PAS. PAS was actually performed by 3%. Of all participating members, 56% approved of a legal ban of organizations offering assisted suicide. More than 60% of all professions agreed that PAS is not a part of palliative care. The respondents show a broad spectrum of attitudes, only partly supporting statements of relevant bodies, such as DGP. Because many are confronted with the issue, PAS is relevant to professionals in palliative care
Palliative Versorgung von Menschen mit Migrationshintergrund - Forschungsergebnisse und Handlungsempfehlungen
No full textIs digitalization still an uncharted territory for palliative care? Use of electronic patient records and assessment instruments in German specialist palliative care: results of an online survey
No full textAbstract Background The use of routinely collected clinical data from electronic patient records (EPR) offers substantial potential for quality management and health services research, particularly in specialised palliative care (SPC). This study investigates the degree of standardization, outcome assessment practices, and EPR implementation in palliative care units (PCU), palliative care advisory teams (PCA) and specialised palliative home care (SPHC) in Germany. Methods Cross-sectional online survey among community and inpatient SPC services in Germany using setting-specific questionnaires with closed and open-ended questions. Descriptive analyses were performed. Results 209 teams participated (PCU: 71; PCA: 31; SPHC: 107). Of the PCUs, 29.6% document exclusively digitally (PCA: 38.7%; SPHC: 57.9%), 15.5% exclusively paper-based (PCA: 6.5%; SPHC: 0.9%) and 52.1% both digital and paper-based (PCA: 48.4%; SPHC: 24.3%) (missing: PCU: 2.8%; PCA: 6.5%; SPHC: 16.8%). In PCU and PCA various EPR systems are used (PCU at least 10, PCA at least 7); in SPHC, two systems are employed by 96% of the teams. More than one EPR is used in 13.0% (PCU) and 27.0% (PCA). The majority of teams employ at least one standardised assessment to record functional status (PCU: 95.7%, PCA: 90.3%, SPHC: 66.4%) and symptom burden (PCU: 85.9%, PCA: 87.1%, SPHC: 64.5%). Assessments during care processes were limited: 25.4% of PCUs, 16.1% of PCAs, and 30.8% of SPHC teams documented symptom burden, and 8.5% of PCUs; 0% of PCA; and 17.8% of SPHC documented functional status daily or during visits. Conclusion The use of routine health care data in SPC is limited by fragmented documentation practices, lack of standardization, poor interoperability, and the insufficient relevance of many health information systems for capturing patient-centred outcomes. To improve both care quality and research, there is a need for consensus on assessment instruments, as well as the development of interoperable digital infrastructures
Beyond Barriers: Reconsidering Cultural Sensitivity in Hospice and Palliative Care Services by Applying the Empathy Map
No full textAbstract Culturally sensitive palliative care for patients with a migration background (PwM) remains a critical but underexplored field, especially in the German healthcare context. Our study employs Dave Gray’s empathy map to capture healthcare providers’ perspectives on the challenges, needs, and experiences of PwM in hospice and palliative care. We investigated palliative care challenges through open-ended questions in an online survey conducted across various hospice and palliative care settings. Based on 332 completed responses, our analysis revealed significant barriers to delivering culturally sensitive care. Using qualitative content analysis, we applied an empathy map to identify categories. Findings showed that language barriers and cultural insensitivity notably hindered communication, access, and trust-building. PwM often relied on family networks, which caused delayed care-seeking and logistical difficulties. Despite these challenges, PwM strived for dignity, trust, and care aligned with their cultural background. Our study highlights the importance of empathy-based approaches in hospice and palliative care and the effectiveness of the empathy map as an instrument for identifying challenges and gaps. By addressing the specific needs of PwM, the findings contribute meaningful insights for healthcare providers, policymakers, and researchers
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