Guided imagery (GI) is a nonpharmacological intervention that is increasingly implemented in different clinical contexts. However, there have been no studies on the effect of GI on the comfort of inpatients of palliative care (PC) units. Therefore, the aim of this study was to evaluate the effects of GI on the comfort of patients in PC. A 1-group, pretest-posttest, pre-experimental design was used to measure differences in heart rate, respiratory rate, pain, and comfort in patients (n = 26) before and after a 2-session GI program. The intervention featuring GI increased comfort, measured by an Abbreviated Holistic Comfort Scale and the visual analog comfort scale (P < .001), and decreased heart rate (P < .001), respiratory rate (P < .001), and pain, as measured by the (numerical) visual analog pain scale (P < .001). This study demonstrates that the use of an intervention featuring GI increases the comfort of oncology patients admitted to a PC unit. The use of GI by nurses is inexpensive, straightforward to implement, and readily available and may result in the provision of comfort care.
Providing palliative care involves serious challenges for nurses, such as end-of-life decisions, contact with people's suffering and dying, and increased risk of burnout. However, studies have revealed that the burnout level of health professionals working in palliative care is lower than that of health professionals working in other settings. This study aimed to describe the lived experiences of nurses caring in a palliative care unit. A phenomenological descriptive study was undertaken. Nine nurses were recruited from a palliative care unit in Portugal. Data were collected using individual interviews and analyzed following the method of Giorgi. Five themes reflect the essence of the lived experience: (1) experience centered on the relationship with the other (ie, the patient and the family), (2) experience centered on the relationship with one's own self, (3) exhausting experience, (4) rewarding experience, and (5) the team as a pillar. These findings can be valuable for understanding the challenges and strategies experienced by nurses caring in palliative care and for designing interventions that focus on reducing the risk of burnout among nurses-not only those working in palliative care but also those working in other contexts who experience regular contact with suffering and death.
Background: Travelbee's theoretical model has significantly influenced the palliative care movement. According to Travelbee, the Human-to-Human Relationship is the means through which the purpose of nursing is fulfilled. Thus, nurses are challenged to implement a more reflective practice based on compassion and sympathy. Objective: To describe Travelbee's Human-to-Human Relationship Model and provide an adequate conceptual framework for palliative nursing care. Main topics under analysis: To frame Travelbee's theory. To describe the suitability of the theory for palliative care. To reflect on Travelbee's view of nursing. To analyze its relevance in the nursing context. Conclusion: Travelbee's Human-to-Human Relationship Model is in line with the philosophy of palliative care, being an interpersonal process in which nurses intervene in the suffering process but also in its prevention.
Constipation is a health condition that presents a significant problem to the people suffering from it, generally defined as fewer than three bowel movements per week, and with great prevalence and impact on quality of life in adults and elderly people (Bub, Brinckmann, Cicconetti, & Valentine, 2006;Rao et al., 2015). It affects the overall well-being of individuals, has a multifactorial character, and can be influenced by physical, psychological, physiological, emotional, and environmental factors. Studies have reported an incidence of constipation among ambulatory adult patients over 65 old of 26% in men and 34% in women. Incidence is considerably higher in people living in nursing homes and hospitals than in those people living in the community (Lim & Childs, 2013). Dementia and acute stroke and palliative cancer patients are particular clinical conditions cited by researchers for constipation (Bub et al.Abstract Purpose: To identify nonpharmacological clinically effective interventions for constipation in adults. Methods: A systematic review of experimental studies of nonpharmacological interventions addressing participants' management of constipation using samples of adults over 18 years of age was conducted. In evaluating the methodological quality of the eligible studies, we used the assumptions of the Cochrane Collaboration, and for the reporting of items in the systematic review we used the Model of Preferential Reporting Items for Systematic Reviews and Meta-Analyses. The protocol of this review was recorded in the International Prospective Register of Systematic Reviews of the University of York under number 43693. Results: This review included 12 randomized controlled trials. Nonpharmacological effective interventions for the resolution of constipation were identified: individualized intervention based on the participant's modifiable risk factors of constipation promoting literacy in health; educational measures in dietary modification and lifestyle; and abdominal massage. Conclusions: Specific nonpharmacological interventions are crucial for nurses' clinical practice and of major importance for clients and families.Evidence on these interventions in resolving constipation is still scarce and fails to provide evidence-based data to support nursing clinical practice. Clinical Relevance: Personal lifestyles, comorbidities, medication, and sedentary habits are likely to be risk factors in constipation. Thus, it is important to invest in nonpharmacological interventions that promote changes in behavior regarding prevention or resolution of constipation. Moreover, nursing researchers worldwide should conduct research for clinical practice regarding the fundamentals of care.
Background: Guided imagery (GI) is being increasingly used as a non-pharmacological intervention in different clinical settings. However, GI intervention programs have not yet been developed and adapted to patients admitted to palliative care units, which impedes their implementation. Thus, the need emerges to develop and validate a GI program. Objective: To develop and validate a GI program. Methodology: A descriptive study was conducted following the guidelines of the Medical Research Council for the development of complex interventions in 3 phases: identifying the evidence base, identifying/developing appropriate theory, modelling process and outcomes. Results: The development process resulted in a program consisting of 2 GI sessions to be implemented in the same week. Preliminary results on the implementation of a GI session suggest that the intervention is effective in increasing comfort. Conclusion: The characteristics of the GI program proved to be adjusted to the context and target population. The effectiveness of the GI program will be tested in a quasi-experimental study.
Background: Satisfaction with care is an important outcome measure in end-of-life care. Validated instruments are necessary to evaluate and disseminate interventions that improve satisfaction with care at the end of life, contributing to improving the quality of care offered at the end of life to the Portuguese population. The purpose of this study was to perform a cross-cultural adaptation and psychometric analysis of the Portuguese version of the CANHELP Lite Bereavement Questionnaire. Methods: Methodological research with an analytical approach that includes translation, semantic, and cultural adaptation. Results: The Portuguese version comprised 24 items. A panel of experts and bereaved family members found it acceptable and that it had face and content validity. A total of 269 caregivers across several care settings in the northern region of Portugal were recruited for further testing. The internal consistency analysis of the adapted instrument resulted in a global alpha value of 0.950. The correlation between the adapted CANHELP questionnaire and a global rating of satisfaction was of 0.886 (p < 0.001). Conclusions: The instrument has good psychometric properties. It was reliable and valid in assessing caregivers’ satisfaction with end-of-life care and can be used in both clinical and research settings.
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