Hospice assist at home: does the integration of hospice care in primary healthcare support patients to die in their preferred location – A retrospective cross-sectional evaluation study

Graaf, Everlien de; Zweers, Daniëlle; Valkenburg, Anna Ch; Uyttewaal, Allegonda; Teunissen, Saskia

doi:10.1177/0269216315626353

Cited by 28 publications

(30 citation statements)

References 22 publications

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“…Two quantitative non experimental studies using a retrospective cross -sectional design evaluated hospice palliative care programmes at home or at a community level in both Netherlands and Singapore. [12,13] The final two studies were mixed methods. One of which Downing et al [14] evaluated three hospice palliative care models in Kenya and Malawi while Jack et al [15] study examined hospice at home services model based on the experience of health care professional in their delivery of services.…”

Section: Resultsmentioning

confidence: 99%

“…[8][9][10] Nine of the reviewed articles showed that models of hospice at home care utilizes a holistic approach to providing end of life care for patients with terminal illness and their significant others. [7][8][9][10][11][12][13][14][15] These articles also revealed that healthcare providers provide multidimensional care, such as physical, psychological, social, and bereavement support for patients and families in order to decrease suffering. They also went on to say that the models of hospice at home care provided physical support through managing disease symptoms such as pain.…”

Section: Multidimensional Carementioning

confidence: 99%

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Exploring various models of hospice care worldwide that can be used and adapted to the context of Qatar: A review of the literature

Khan

Johnson

Bulushi

2020

IJH

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Background: Hospice care is an alternative for those patients who wish to die at home. Most clients who have a terminal illness would rather choose the services provided by healthcare workers who deliver hospice care in the client’s home. For some, it is important to have the ability to spend time with friends, family and to die with dignity and respect at their preferable place of death. Qatar has established end of life care services for patients with advanced stages of cancer, however these services are delivered on palliative care units housed within the National Center for Cancer Care and Research (NCCCR). Having the ability to provide at home hospice care is a necessity in order to carry out the wish of clients who wish to die at home, fulfil the gap in these facilities, and achieve the goal of Qatar’s national health strategy, which is to improve cancer services.Aim: To explore the literature for different models of at-home hospice care worldwide then find a model that can be adapted to the context of Qatar.Methods: A literature review approach was used. Nine scholarly articles were found that focused on and evaluated different at-home hospice models of care worldwide published between 2007 and 2018. Articles were critically appraised using the Mixed Method Appraisal Tool. The data were analysed by categorizing the included articles in a spreadsheet based on study design.Results: The most significant components of at-home models of hospice care were multidimensional care, staff competent in delivering end of life care services, and the ability to provide twenty-four-hour care in the home. These components had a positive impact on providing safe effective end of life care services at home.Conclusions: Taken together, all the necessary components identified in this literature review will go a long way in the successful development of hospice care in Qatar.

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Section: Resultsmentioning

confidence: 99%

Section: Multidimensional Carementioning

confidence: 99%

Exploring various models of hospice care worldwide that can be used and adapted to the context of Qatar: A review of the literature

Khan

Johnson

Bulushi

2020

IJH

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“…The hospice centred-group is the exception, as GPs are not the driving force of this group and join only incidentally when invited by the hospice team, and the group meets fortnightly. This group runs by a different model, hospice care at home (HaHo), which incorporated the element of recurrent meetings from the PaTz-model as the second of four components [23]. The first component is a GP requested home visit to a patient from a hospice nurse consultant (HNC), who performs a multidimensional assessment, develops a care plan and provides specialist support to patients and relatives.…”

Section: Reflections On the Application Of The Basic Principles Of Patzmentioning

confidence: 99%

“…The first component is a GP requested home visit to a patient from a hospice nurse consultant (HNC), who performs a multidimensional assessment, develops a care plan and provides specialist support to patients and relatives. The third and fourth component are telephone backup provided by the hospice and the assignment of one coordinator of care respectively [23]. As a lack of time is considered the most important barrier to participate in a regular PaTz-group [18], the higher meeting frequency may explain the practical absence of GPs in this group.…”

Section: Reflections On the Application Of The Basic Principles Of Patzmentioning

confidence: 99%

Variation in the implementation of PaTz: a method to improve palliative care in general practice - a prospective observational study

et al. 2020

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Background: PaTz (palliative care at home) is a method to improve palliative care in the primary care setting in the Netherlands. PaTz has three basic principles: (1) local GPs and DNs meet at least six times per year to identify and discuss their patients with a life-threatening illness; (2) these meetings are supervised by a specialist palliative care professional; (3) groups use a palliative care register on which all identified patients are listed. Since the start in 2010, the number of PaTz-groups in the Netherlands has been growing consistently. Although the theory of all PaTz-groups is the same, the practical functioning of PaTz-groups may vary substantially, which may complicate further implementation of PaTz as well as interpretation of effect studies. This study aims to describe the variation in practice of PaTz-groups in the Netherlands.Method: In this prospective observational study, ten PaTz-groups logged and described the activities in their meetings as well as the registered and discussed patients and topics of discussions in registration forms for a 1 year follow-up period. In addition, non-participatory observations were performed in all participating groups. Meeting and patient characteristics were analysed using descriptive statistics. Conventional content analysis was performed in the analysis of topic discussions. Results: While the basic principles of PaTz are found in almost every PaTz-group, there is considerable variation in the practice and content of the meetings of different PaTz-groups. Most groups spend little time on other topics than their patients, although the number of patients discussed in a single meeting varies considerably, as well as the time spent on an individual patient. Most registered patients were diagnosed with cancer and patient discussions mainly concerned current affairs and rarely concerned future issues. Conclusion:The basic principles are the cornerstone of any PaTz-group. At the same time, the observed variation between PaTz-groups indicates that tailoring a PaTz-group to the needs of its participants is important and may enhance its sustainability. The flexibility of PaTz-groups may also provide opportunity to modify the content and tools used, and improve identification of palliative patients and advance care planning.

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“…They include pharmacological treatment, treatment of somatic symptoms and pain treatment, as well as psychological care, rehabilitation, free rental of medical and auxiliary equipment [1]. An important goal of hospice care is to improve the quality of life of patients and their families [2,3]. A decrease in functional efficiency is considered to be an important indicator of quality of life [4].…”

mentioning

confidence: 99%

Assessment of the effects of a multi-component individualized physiotherapy program in patients in a home hospice

Ćwirlej-Sozańska¹,

Wójcicka²,

Kluska³

et al. 2020

Preprint

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Background: Hospice care is aimed at chronically and terminally ill patients. It includes symptomatic treatment as standard, but the interest in physiotherapy programs for hospice patients is increasing in order to improve their functioning and quality of life. Aim: The aim of the study is to assess the impact of a multi-component individualized physiotherapy program on the functional and mental condition and quality of life of patients in a home hospice. Material and method:The study included 60 patients (mean 66.3 years) in a home hospice living in southern Poland. Functional status was assessed twice: before and after intervention. The program was performed for 6 weeks (12 trainings) and was managed on the basis of WHO Rehab-Cycle ICF. The program was individually tailored to the patient, but structured according to the same scheme, i.e. breathing, strengthening, transfer, balance and functional exercisesas well as functional ergonomics. Patients participated in setting particular objectives of the program. The study used: Katz (ADL) and Lawton (IADL) scales, Tinetti test, Visual Analogue Scale (VAS) pain scale, WHOQOL – BREF, Yesavage Geriatric Depression Scale (GDS). A set of ICF categories in terms of function, activity and participation was selected for the studied areas. Results: The average functional level of ADL (mean 2.87) and IADL (mean 11.92) as well as quality of life (WHOQL mean 46.43) of researched patients before the intervention were low, whereas the intensity of pain (VAS mean 5.82), the risk of falling (Tinetti mean 8.20) and depression (GDS mean 16.65) were recorded high. After the completion of the intervention program, a significant improvement was found in all assessed areas, in particular in the scope of performing basic everyday activities(ADL mean 3.95), risk of falling (Tinetti mean 12.25) and QOL (mean 52.58). Conclusions: The physiotherapeutic intervention presented here has a significant impact on improving the performance of basic and complex activities of everyday life as well as the emotional state and quality of life of patients in a home hospice. The results of our research confirm the great need for physiotherapy in hospice patients and for comprehensive assessment by means of ICF. Registration number: researchregistry5264

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Hospice assist at home: does the integration of hospice care in primary healthcare support patients to die in their preferred location – A retrospective cross-sectional evaluation study

Cited by 28 publications

References 22 publications

Exploring various models of hospice care worldwide that can be used and adapted to the context of Qatar: A review of the literature

Exploring various models of hospice care worldwide that can be used and adapted to the context of Qatar: A review of the literature

Variation in the implementation of PaTz: a method to improve palliative care in general practice - a prospective observational study

Assessment of the effects of a multi-component individualized physiotherapy program in patients in a home hospice

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