1,720,990 research outputs found
Encounter
No full textIn this poem, a palliative care provider describes an encounter with a patient. She answers simple heavy questions from a patient about who she is, what she does, what she knows, and what she has. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Resilience in palliative healthcare professionals: a systematic review
No full textPurpose: Exposure to end-of-life and chronic illness on a daily basis may put palliative healthcare professionals’ well-being at risk. Resilience may represent a protective factor against stressful and demanding challenges. Therefore, the aim is to systematically review the quantitative studies on resilience in healthcare professionals providing palliative care to adult patients. Methods: A literature search on PubMed, Scopus, Web of Science and PsycINFO databases was performed. The review process has followed the international PRISMA statement guidelines. Results: At the initial search, a total of 381 records were identified. Twelve articles were assessed for eligibility and, finally, 6 studies met all the inclusion criteria. Of these, four researches were observational and two interventional pilot studies. From the systematic synthesis, palliative care providers’ resilience revealed to be related to other psychological constructs, including secondary traumatic stress, vicarious posttraumatic growth, death anxiety, burnout, compassion satisfaction, hope and perspective taking. Conclusions: The current systematic review reported informative data leading to consider resilience as a process modulator and facilitator among palliative care professionals. A model on palliative healthcare providers’ experience and the role of resilience was proposed. Further studies may lead to its validation and implementation in assessment and intervention contributing to foster palliative healthcare professionals’ well-being
It's all a matter of time
No full textOne of the most precious values of the modern age is time. Despite the increasing life expectancy achieved by medicine and by the time-saving automation technologies, for most of us, time is never enough. Beside manifold upheavals and psychological consequences (1), the COVID-19 pandemic and the consequent quarantine have impacted on our subjective perception of “time”, opening a frightening Pandora’s box. The healthcare emergency has thrown the population into a surreal novel where the time perception may be shrunk and, simultaneously, expanded or suddenly frozen without control and full awareness. Individuals are waved by events like leaves lashed out by an unexpected wind which brings unpredictable changes. Thus, our existence is no more like before: the rhythm of our days has changed, and nothing could be the same in our next future as the pandemic has left indelible marks in habits and perspectives
Healthcare professionals’ perceptions about the Italian law on advance directives
No full textBackground: In the variegated legislative framework on advance directives, the first specific regulation in Italy on this issue came into force only in 2018. Research objective: This qualitative study aimed to investigate the implications of the new Italian law on advance directives in clinical practice from the perspective of those who deal with this delicate ethical issue on an everyday basis, that is, Italian healthcare professionals. Research design: A qualitative research design using semi-structured audio-recorded interviews was adopted. The data collection and analysis were performed according to the Grounded Theory approach. Participants: Nineteen healthcare professionals (16 nurses, 3 physicians) working in a palliative care unit of a research and clinical institute in Italy. Ethical considerations: The study is part of the WeDistress HELL Project (WEllness and DISTRESS in HEalth care professionals dealing with end of Life and bioethicaL issues) approved by the Ethical Committee of ICS Maugeri - Institute of Pavia (Italy). Findings: The authors identified a main overall category, ‘Pros and Cons of the Italian law on advance directives’, composed of six constituent categories: Positive welcome, Self-determination and protection, Prompts for future betterment, Uncertainties, Lack of knowledge, and Neutrality and no suggestions. Discussion: The Italian law n. 219/2017 on advance directives was seen as a legal instrument possessing both strengths and weaknesses, but able to guarantee the patient’s self-determination and support healthcare professionals in providing care according to patients’ wishes. Conclusion: An understanding of the healthcare providers’ perspective may support the discussion on advance directives and bridge the gaps that currently persist in handling ethical issues
Underneath the White Coat: Risk and Protective Factors for Palliative Care Providers in Their Daily Work
No full textPalliative care practice is associated with risk factors linked to end-of-life, chronicity, personal, interpersonal, and work characteristics, as well as with protective factors, but how these are perceived by the health care providers themselves is not clear. This article aims to elaborate a theoretical framework explaining the risk and protective factors for palliative care providers in their daily practice. Nineteen providers (16 nurses, 3 physicians) working in a palliative care unit of a clinical-research institute in Northern Italy were interviewed. A Grounded Theory qualitative approach guided the data collection and analysis. From the interviews, 28 codes, subsequently organized into 11 interconnected categories, emerged. They described both stressors (emotion management regarding death/dying, conflicts, communication and relationship with patients/caregivers, discrepancies between patients' and caregivers' needs, communication of poor diagnosis/prognosis, decision making about treatment, and real-life and work interference) and protective factors (social support, positive approach and value of past experience, recognized value of/passion toward professional work, work-family balance). Experiencing these elements as positive or negative depends on the professionals' point of view, as well as their past and present experience. Understanding what dealing with life-limiting illnesses means may suggest tailored interventions to improve professionals' well-being by fostering the protective elements and combatting the risk factors
A cornerstone of healthy aging: do we need to rethink the concept of adherence in the elderly?
No full textAnna Giardini,1 Marina Maffoni,2 Przemyslaw Kardas,3 Elisio Costa4 1Psychology Unit, Istituti Clinici Scientifici Maugeri Spa SB, IRCSS Montescano, Montescano (PV), Italy; 2Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy; 3Department of Family Medicine, Medical University of Lodz, Lodz, Poland; 4Elísio Costa, UCIBIO-REQUIMTE, Faculty of Pharmacy and Porto4Ageing EIP-AHA Reference Site, University of Porto, Porto, Portugal Abstract: Worldwide, the population is aging and this trend will increase in the future due to medical, technological and scientific advancements. To take care of the elderly is highly demanding and challenging for the health care system due to their frequent condition of chronicity, multimorbidity and the consequent complex management of polypharmacy. Nonadherence to medications and to medical plans is a well-recognized public health problem and a very urgent issue in this population. For this reason, some considerations to identify a new shared approach to integrated care of older people are described. The concept of adherence should be considered as a complex and continuous process where family, caregivers and patients’ beliefs come into play. Moreover, a new culture of adherence should contemplate the complexity of multimorbidity, as well as the necessity to renegotiate the medication regimen on the basis of each patient’s needs. Keywords: population aging, chronicity, multimorbidity, polypharmacy, nonadherenc
The italian version of the hospital ethical climate survey: First psychometric evaluations in a sample of healthcare professionals employed in neurorehabilitation medicine and palliative care specialties
No full textThis study aims to assess, through psychometric evaluations, a preliminary Italian version of the Hospital Ethical Climate Survey (HECS), checking its factor structure through exploratory factor analysis (EFA) and confirming the resulting factor structure in a second sample using confirmatory factor analysis (CFA). This research included a total of 315 Italian healthcare professionals working in neuro-rehabilitation medicine and palliative care units from six hospitals. EFA revealed a two-factor structure, including ethical vision of patient care and managerial support. CFA on the second sample confirmed the factor structure extracted from EFA, displaying good internal consistencies. Correlations showed that both dimensions were positively associated with well-being and social support, while negatively related to burnout and moral distress, supporting construct validity. The Italian version of HECS repre-sents a user-friendly instrument to evaluate the ethical climate perceptions of healthcare professionals who are increasingly at risk of facing ethical dilemmas due to the growing complexity of patient care
Healthcare professionals' moral distress in adult palliative care: A systematic review
No full textObjectives Palliative care providers may be exposed to numerous detrimental psychological and existential challenges. Ethical issues in the healthcare arena are subject to continual debate, being fuelled with ongoing medical, technological and legal advancements. This work aims to systematically review studies addressing the moral distress experienced by healthcare professionals who provide adult palliative care. Methods A literature search was performed on PubMed, Scopus, Web of Science and PsycINFO databases, searching for the terms 'moral distress' AND 'palliative care'. The review process has followed the international PRISMA statement guidelines. Results The initial search identified 248 papers and 10 of them were considered eligible. Four main areas were identified: (1) personal factors, (2) patients and caregivers, (3) colleagues and superiors and (4) environment and organisation. Managing emotions of self and others, witnessing sufferance and disability, caring for highly demanding patients and caregivers, as well as poor communication were identified as distressing. Moreover, the relationship with colleagues and superiors, and organisational constraints often led to actions which contravened personal values invoking moral distress. The authors also summarised some supportive and preventive recommendations including self-empowerment, communication improvement, management of emotions and specific educational programmes for palliative care providers. A holistic model of moral distress in adult palliative care (integrating emotional, cognitive, behavioural and organisational factors) was also proposed. Conclusions Cognisance of risk and protective factors associated with the moral distress phenomenon may help reframe palliative healthcare systems, enabling effective and tailored actions that safeguard the well-being of providers, and consequently enhance patient care
Stigma Experienced by Parkinson's Disease Patients: A Descriptive Review of Qualitative Studies
No full textParkinson's disease (PD) is a neurodegenerative disease characterized by motor and nonmotor symptoms. Both of them imply a negative impact on Health-Related Quality of Life. A significant one is the stigma experienced by the parkinsonian patients and their caregivers. Moreover, stigma may affect everyday life and patient's subjective and relational perception and it may lead to frustration and isolation. Aim of the present work is to qualitatively describe the stigma of PD patients stemming from literature review, in order to catch the subjective experience and the meaning of the stigma construct. Literature review was performed on PubMed database and Google Scholar (keywords: Parkinson Disease, qualitative, stigma, social problem, isolation, discrimination) and was restricted to qualitative data: 14 articles were identified to be suitable to the aim of the present overview. Results are divided into four core constructs: stigma arising from symptoms, stigma linked to relational and communication problems, social stigma arising from sharing perceptions, and caregiver's stigma. The principal relations to these constructs are deeply analyzed and described subjectively through patients' and caregiver's point of view. The qualitative research may allow a better understanding of a subjective symptom such as stigma in parkinsonian patients from an intercultural and a social point of view
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