Development of an intervention (PICASO) to optimise the palliative care capacity of social workers in Flanders: a study protocol based on phase I of the Medical Research Council framework

Taels, Brent; Audenhove, Chantal Van; Cohen, Joachim; Hermans, Koen; Declercq, Anja

doi:10.1136/bmjopen-2021-060167

Cited by 3 publications

(3 citation statements)

References 69 publications

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“…Palliative care, based on the biopsychosocial model of disease (1), enlarged by the spiritual dimension (2), aims to provide holistic care (3)(4)(5)(6)(7). Since cure is no longer possible (7,8), palliative care patients evolve towards death (9,10), often affected by both somatic (11)(12)(13)(14)(15) and psychiatric morbidities (16-18), as well as by social problems (19)(20)(21)(22). The vast majority of palliative care patients suffer from cancer (10) and the therapeutic objective is often limited to a temporary stabilization of their condition and relief of symptoms (23).…”

Section: Introductionmentioning

confidence: 99%

Complexity in palliative care inpatients: prevalence and relationship with provision of care, a retrospective study

Schutzbach,

Corminboeuf,

Wild

et al. 2024

Preprint

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Context: Palliative car aims to provide comprehensive care, since end of life can be marked by somatic, psycho-social and spiritual distress, requiring interdisciplinary care. However, interdiscoplinary care is costly, and palliative care services, as all other medical services, get under pressure to be as cost-effective as possible. Objectives To describe the case complexity of palliative care inpatients, to evaluate possible correlations between complexity and provision of care and to identifycomplexity subgroups. Methods Patients (N = 222) hospitalized in a specialized palliative care unit (Switzerland) were assessed regarding their biopsychosocial case complexity by means of the INTERMED. Based on a chart review, INTERMED scores were determined at admission and the end of hospitalization/death. Descriptive statistics and Pearson correlation coefficients were estimated for the association between biopsychosocial case complexity and amount and type of care provided. A principal component analysis (PCA) was conducted to explain variance and to identify patient subgroups. Results Almost all patients (98.7 %) qualified as complex as indicated by the INTERMED. Provision of care correlated positively (r=0.23, p=0.0008) with the INTERMED scores upon admission. The change of INTERMED score during stay correlated negatively with provided care (r=-0.27, p=0.0001). PCA performed with two factors explained 49% of the total variance and identified two subgroups which differed regarding the psychosocial item scores of the INTERMED. Conclusion Specialized palliative care inpatients show the highest complexity score of all populations assessed up to now with the INTERMED. Correlations between biopsychosocial complexity and care provided, and between care and decrease of complexity scores, can be considered as an indicator for care efficiency. Patient subgroups with specific needs (psychosocial burden) suggest that palliative care teams need specialized staff. Trial registration The study was accepted August 24, 2023 by the ethics committee of the Canton of Vaud (CER-VD 2023-01200).

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Section: Introductionmentioning

confidence: 99%

Complexity in palliative care inpatients: prevalence and relationship with provision of care, a retrospective study

Schutzbach,

Corminboeuf,

Wild

et al. 2024

Preprint

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“…The advantage of this framework was used to help researchers work with stakeholders (physicians, nurses, and patients) to identify the core components of complex interventions, and to conduct research from different perspectives and appropriate approaches ( 22 ). Currently, the MRC framework has been widely used in health care, as well as other social and economic areas that affect people’s health ( 29 , 30 ). Therefore, the aim of this study was to identify evidence-based strategies guided by the MRC framework to prevent pressure injuries in prone position patients with mechanically ventilated in ICU and to provide theoretical basis for the future application in clinical nursing work.…”

Section: Introductionmentioning

confidence: 99%

Strategies to preventing pressure injuries among intensive care unit patients mechanically ventilated in prone position: a systematic review and a Delphi study

Wang,

Fan,

Chen

et al. 2023

Front. Med.

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BackgroundAlthough the incidence of pressure injury in the prone position is high for the mechanically ventilated patients in the intensive care unit, evidence-based strategies are still lacking.ProposeTo conduct a systematic review of current evidence, and to propose a series of strategies to prevent pressure injuries among mechanically ventilated patients with prone position in the intensive care unit.MethodsThe study was guided by the Medical Research Council framework. After a systematic review of current evidence of original articles, guidelines, expert consensus and theories, a strategy draft was developed. Then we invited 20 experts to modify and refine these strategies through two rounds of Delphi consensus method.ResultsAfter two rounds of Delphi process, the importance of coefficient of variation (Cv) and Kendall’s coefficient of concordance in the strategies repository were 0.067 and 0.311, respectively. And the operability of Cv and Kendall’s coefficient of concordance in the strategy draft was 0.055 and 0.294, respectively. Ultimately, we established 31 strategies for including 7 themes (assess risk factors, assess skin and tissue, body position management, skin care, nutrition, preventing medical device-related pressure injuries, education and supervision). In addition, we also developed a strategy framework to clarify our strategies.ConclusionAccording to the Medical Research Council framework, we developed 7 themes and 31 strategies to prevention prone-position pressure injuries among the intensive care unit mechanically ventilated patients. This study was considered to improve the clinical management of pressure injuries among prone position patients in the intensive care unit settings.

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“…The advantages of this framework is used to help researchers work with stakeholders (physicians, nurses, and patients) to identify the core components of complex interventions and to design and conduct research from different perspectives and appropriate approaches [22]. Currently, the MRC framework has been widely used in health care, as well as other social and economic areas that affect people's health [29,30]. Therefore, the aim of this study was to identify evidence-based strategies guided by the MRC framework to prevent pressure injuries in prone position patients with mechanically ventilated in ICU and to provide a theoretical basis for the future application in clinical nursing work.…”

Section: Introductionmentioning

confidence: 99%

Strategies to Preventing pressure injuries among intensive care unit patients mechanically ventilated in prone position: a systematic review and a Delphi study

Wang,

Fan,

Chen

et al. 2023

Preprint

View full text Add to dashboard Cite

Background Although the incidence of pressure injury in the prone position is high for the mechanically ventilated patients in the intensive care unit, evidence-based strategies are still lacking. Propose To conduct a systematic review of current evidence, and to propose a series of strategies to prevent pressure injuries among mechanically ventilated patients with prone position in the intensive care unit. Method The study was guided by the Medical Research Council framework. After a systematic review of current evidence of original articles, guidelines, expert consensus and theories, a strategy draft was developed. Then we invited 20 experts to modify and refine these strategies through two rounds of Delphi consensus method. Result After two rounds of Delphi process, the importance of coefficient of variation (Cv) and Kendall’s coefficient of concordance in the strategies repository were 0.067 and 0.311, respectively. And the operability of Cv and Kendall’s coefficient of concordance in the strategy draft was 0.055 and 0.294, respectively. Ultimately, we established 31 strategies for including 7 themes (assess risk factors, assess skin and tissue, body position management, skin care, nutrition, preventing medical device-related pressure injuries, education and supervision).In addition, we also developed a strategy framework to clarify our strategies. Conclusion According to the Medical Research Council framework, we developed 7 themes and 31 strategies to prevention prone-position pressure injuries among the intensive care unit mechanically ventilated patients. This study was considered to improve the clinical management of pressure injuries among prone position patients in the intensive care unit settings.

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Development of an intervention (PICASO) to optimise the palliative care capacity of social workers in Flanders: a study protocol based on phase I of the Medical Research Council framework

Cited by 3 publications

References 69 publications

Complexity in palliative care inpatients: prevalence and relationship with provision of care, a retrospective study

Complexity in palliative care inpatients: prevalence and relationship with provision of care, a retrospective study

Strategies to preventing pressure injuries among intensive care unit patients mechanically ventilated in prone position: a systematic review and a Delphi study

Strategies to Preventing pressure injuries among intensive care unit patients mechanically ventilated in prone position: a systematic review and a Delphi study

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