Impact of a Six-Year Project to Enhance the Awareness of Community-Based Palliative Care on the Place of Death

Murakami, Nozomu; Tanabe, Kouichi; Morita, Tatsuya; Fujikawa, Yasunaga; Koseki, Shiro; Kajiura, Shinya; Nakajima, Kazunori; Hayashi, Ryuji

doi:10.1089/jpm.2017.0696

Cited by 14 publications

(23 citation statements)

References 19 publications

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“…Community home health care nurses are on the frontline and provide comprehensive patient/family-centered care, contributing to patient comfort, fewer hospitalizations, and higher home death rates, which are often desired by patients and serve as a clinical outcome in the community. 40 The majority of patients who need home-based PC live in lowincome and middle-income settings. These services should be a major health priority in those countries.…”

Section: Discussionmentioning

confidence: 99%

Global Survey of the Roles, Satisfaction, and Barriers of Home Health Care Nurses on the Provision of Palliative Care

Brant

Fink

Thompson

et al. 2019

Journal of Palliative Medicine

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Background: The World Health Assembly urges members to build palliative care (PC) capacity as an ethical imperative. Nurses provide PC services in a variety of settings, including the home and may be the only health care professional able to access some disparate populations. Identifying current nursing services, resources, and satisfaction and barriers to nursing practice are essential to build global PC capacity. Objective: To globally examine home health care nurses' practice, satisfaction, and barriers, regarding existing palliative home care provision. Design: Needs assessment survey. Setting/Subjects: Five hundred thirty-two home health care nurses in 29 countries. Measurements: A needs assessment, developed through literature review and cognitive interviewing. Results: Nurses from developing countries performed more duties compared with those from high-income countries, suggesting a lack of resources in developing countries. Significant barriers to providing home care exist: personnel shortages, lack of funding and policies, poor access to end-of-life or hospice services, and decreased community awareness of services provided. Respondents identified lack of time, funding, and coverages as primary educational barriers. In-person local meetings and online courses were suggested as strategies to promote learning. Conclusions: It is imperative that home health care nurses have adequate resources to build PC capacity globally, which is so desperately needed. Nurses must be up to date on current evidence and practice within an evidence-based PC framework. Health care policy to increase necessary resources and the development of a multifaceted intervention to facilitate education about PC is indicated to build global capacity.

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Section: Discussionmentioning

confidence: 99%

Global Survey of the Roles, Satisfaction, and Barriers of Home Health Care Nurses on the Provision of Palliative Care

Brant

Fink

Thompson

et al. 2019

Journal of Palliative Medicine

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“…Enhancing awareness of community-based palliative care has shown to impact on place of death. 20 A recent study suggested that the cost of provision of specialist community palliative care services may offset the cost of hospital-based end-of-life care by reduced acute hospital admissions and bed days to the public. 21 This suggests the need for further exploration of the relationship between local hospital resources especially in areas of low deprivation and the impact on place of death for various causes.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Sociodemographic Factors and Emergency Admissions on the Place of Death of Gynecological Cancer Patients in England: An Analysis of a National Mortality–Hospital Episode Statistics–Linked Data Set

Kaushik

Hounsome

Blinman

et al. 2018

Int J Gynecol Cancer

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ObjectiveThe aim of this study was to develop a predictive model for risk of death in hospital for gynecological cancer patients specifically examining the impact of sociodemographic factors and emergency admissions to inform patient choice in place of death.MethodsThe model was based on data from 71,269 women with gynecological cancer as underlying cause of death in England, January 1, 2000, to July 1, 2012, in a national Hospital Episode Statistics–Office for National Statistics database. Two thousand eight hundred eight deaths were used for validation of the model. Logistic regression identified independent predictors of a hospital death: adjusting for year of death, age group, income deprivation quintile, Strategic Health Authority, gynecological cancer site, and number of elective and emergency hospital admissions and respective total durations of stay.ResultsForty-three percent of deaths from gynecological cancer occurred in hospital. The variables significantly predicting death in hospital were less recent year of death (odds ratio [OR], 0.93; P < 0.001), increasing age (OR, 1.17; P < 0.001), increasing deprivation (OR, 1.06; P < 0. 001), increasing frequency and length of elective and emergency admissions (P < 0.001). The model correctly identified 73% of hospital deaths with a sensitivity of 75% and a specificity of 72%. The areas under the receiver operating curve were 0.78 for the predictive model and 0.71 for the validation data set. Each subsequent emergency admission in the last month of life increased the odds of death in hospital by 2.4 times (OR, 2.38; P < 0.001). Hospital deaths were significantly lower in all other regions compared with London. The model predicted a 16% reduction of deaths in hospital if 50% of emergency hospital admissions in the last month of life could be avoided by better community care.ConclusionsOur findings could enable identification of patients at risk of dying in hospital to ensure greater patient choice for place of death.

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“…Av de inkluderte studiene var det en med randomisert kontrollert (RCT) (35) design, og en pilotstudie med to ulike studiefaser (36). Ellers inkluderte vi ni retrospektive tverrsnittstudier (4,8,13,(37)(38)(39)(40)(41)(42), og åtte kohortstudier (43)(44)(45)(46)(47)(48)(49)51). Alle studiene ble publisert mellom 2010 og 2020.…”

Section: Studieegenskaperunclassified

Faktorer som påvirker kreftpasientens muligheter for å dø hjemme – en systematisk oversiktsartikkel

Nordsveen¹,

Larsen

2022

iNSPIRA

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Bakgrunn: Det er skrevet mye om palliativ omsorg og hjemmedød. Allikevel er det mindre litteratur om hjemmedød relatert til pasienter med kreft, spesielt relatert til behov for tverrfaglig kompetanse og avansert behandling i hjemmet. Hensikt: Å frambringe oppsummerende kunnskap om faktorer som er av betydning for mulighet for å dø hjemme for palliative pasienter med kreft. Metode: Det ble gjennomført et systematisk litteratursøk i følgende databaser AMED, CINAHL, EMBASE, MEDLINE og SweMed+. Søket var begrenset til studier med kvantitativt design publisert fra januar 2010 til desember 2020. To forfattere screenet uavhengig av hverandre artiklenes titler og sammendrag. Fulltekst til inkluderte referanser ble innhentet, før endelig inklusjon eller eksklusjon ble vurdert, og relevant informasjon fra inkluderte studier innhentet. Metodisk kvalitet og evaluering av risiko for systematiske skjevheter ble uavhengig vurdert av to forfattere, før uenighet ble løst i felleskap. Det ble gjort en tematisk innholdsanalyse ved hjelp av det elektroniske verktøyet NVivo, og funnene presenteres i en narrativ syntese. Resultat: 19 artikler ble inkludert. Det var generelt stor heterogenitet i fokus, metodevalg og utfallsmål som ble benyttet i studiene. Grunnet denne heterogeniteten ble metaanalyse eller andre metoder for å summere resultater statistisk vurdert som uegnet. Kontinuerlig palliativ omsorg hjemme fra helsepersonell med kompetanse om palliasjon og avansert behandling i hjemmet, tillit til omsorgspersoner, samt tverrfaglige palliative team er fremmende faktorer for hjemmedød. En annen fremmende forutsetning er pasientens og pårørendes ønske om å gjennomføre dette. Pårørende og deres omsorgsstøtte virker også å være en viktig fremmende faktor, mens det å bo alene er en sentral hemmende faktor. Konklusjon: Funnene i denne studien synliggjør viktigheten av kompetanse og tverrfaglige palliative team for å kunne tilby pasienter hjemmedød.

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Impact of a Six-Year Project to Enhance the Awareness of Community-Based Palliative Care on the Place of Death

Cited by 14 publications

References 19 publications

Global Survey of the Roles, Satisfaction, and Barriers of Home Health Care Nurses on the Provision of Palliative Care

Global Survey of the Roles, Satisfaction, and Barriers of Home Health Care Nurses on the Provision of Palliative Care

The Impact of Sociodemographic Factors and Emergency Admissions on the Place of Death of Gynecological Cancer Patients in England: An Analysis of a National Mortality–Hospital Episode Statistics–Linked Data Set

Faktorer som påvirker kreftpasientens muligheter for å dø hjemme – en systematisk oversiktsartikkel

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