Patients' Sense of Security During Palliative Care—What Are the Influencing Factors?

Milberg, Anna; Friedrichsen, Maria; Jakobsson, Maria; Nilsson, Eva Carin; Niskala, Birgitta; Olsson, Maria; Wåhlberg, Rakel; Krevers, Barbro

doi:10.1016/j.jpainsymman.2013.08.021

Cited by 41 publications

(48 citation statements)

References 22 publications

(25 reference statements)

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“…Meeting different persons and having to repeat information or not having a trusted person to discuss care options with results in frustration (Klarare et al, ). Experiencing inclusion in care planning and being in a partnership helped patients and family caregivers continue with everyday life, as reported by patients with advanced cancer and family caregivers in this study and other studies (Melin‐Johansson et al, ; Milberg et al, ; Sarmento et al, ). Palliative care provision is complex, and appreciation of the highlighted nuances in this study may develop care further to better meet expressed or anticipated needs in patients with advanced cancer and their family caregivers.…”

Section: Discussionsupporting

confidence: 74%

Actions helping expressed or anticipated needs: Patients with advanced cancer and their family caregivers’ experiences of specialist palliative home care teams

et al. 2018

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Patients with advanced cancer and family caregivers in palliative care face physical, psychological, social and existential challenges, much of the time home alone. Specialist palliative home care team services can be instrumental for sense of security in an uncertain situation. The aim of this study was to describe patients’ and family caregivers’ experiences of specialist palliative home care team actions that are identified by the participants as helping or hindering interventions. Six patients and seven family caregivers were interviewed using the enhanced critical incident technique. Ninety‐five critical incidents and wish list items were identified. Providing adequate resources, keeping promises and being reliable, and creating partnerships are actions by specialist palliative care teams that patients and family caregivers experienced as helping in meeting expressed or anticipated needs in patients and family caregivers. Being reliable and including patients and family caregivers in partnerships help to continue with daily life, even though death may be close. Unmet needs resulted in experiences of disrespect or violation of personal space/integrity.

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Section: Discussionsupporting

confidence: 74%

Actions helping expressed or anticipated needs: Patients with advanced cancer and their family caregivers’ experiences of specialist palliative home care teams

et al. 2018

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“…In a multivariable analysis, Milberg et al 27 found that a sense of mastery over the situation was positively related to a higher sense of security.…”

Section: Discussionmentioning

confidence: 99%

Home palliative care works: but how? A meta-ethnography of the experiences of patients and family caregivers

Sarmento

Gysels

Higginson

et al. 2017

BMJ Support Palliat Care

110

103

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“…A sense of security is reported to be an aspect of quality care [17] and a key component of palliative homecare [18][19][20][21]. Studies have revealed that patients and relatives' perceptions of security in homecare were fairly similar and encompassed a trusting relationship with the nurse, feeling respected, recognized, informed and being involved in the treatment and care [19,21]. It was also important to live as normal an everyday life as possible and that the healthcare professionals were reliable, competent and available when needed.…”

Section: Introductionmentioning

confidence: 99%

A sense of security in palliative homecare in a Norwegian municipality; dyadic comparisons of the perceptions of patients and relatives - a quantitative study

Hov

Bjørsland

Kjøs³

et al. 2020

BMC Palliat Care

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Background: As palliative care increasingly takes place in patients' homes, perceptions of security among patients in the late palliative phase and their relatives are important. Aim: To describe and compare patient-relative dyads regarding their perceptions of security in palliative homecare, including the perceived security of the actual care given to the patients, as well as the subjective importance of that care. Methods: A cross sectional questionnaire study including 32 patient-relative dyads was conducted in an urban municipality in Norway. Patients were in a late palliative phase and received palliative homecare. Each patient proposed one relative. Data were collected using a modified version of the Quality from the Patients' Perspective instrument (QPP), which focuses on security and comprises three dimensions: medical-technical competence, identity-orientation approach and physical-technical conditions. Context-specific scales containing four aspects (competence, continuity, coordination/ cooperation, availability) were added. The instrument contains two response scales; perceived reality (PR) and subjective importance (SI). Data were analysed by descriptive statistics, Chi-squared test, T-test and Wilcoxon's signed rank test. Results: Patients had high mean scores on the PR-scale for the sense of security in palliative homecare in the dimensions of medical-technical competence and physical-technical conditions. There were three low mean scores on the PR-scale: the aspect of continuity from patients and the aspects of continuity and coordination/cooperation from relatives. The patients scored the SI scale statistically significantly higher than the PR scale in the identity-orientation approach dimension and in the aspect of continuity, while relatives did so in all dimensions and aspects. The intra-dyadic patient-relative comparisons show statistically significant lower scores from relatives on the PR-scale in the dimensions of medical-technical competence, physical-technical conditions, identity-orientation approach and the aspect coordination/cooperation. Conclusions: There are several statistically significant differences between patients and relatives' perceptions of security in the palliative homecare received (PR) compared with the subjective importance of the care (SI) and statistically significant differences in the patient-relative dyads in PR. A relatively mutual sense of security in palliative homecare is important for patient-relative dyads, as relatives often provide care and act as patients' spokespersons. What they assess as important can guide the development of palliative homecare.

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Patients' Sense of Security During Palliative Care—What Are the Influencing Factors?

Cited by 41 publications

References 22 publications

Actions helping expressed or anticipated needs: Patients with advanced cancer and their family caregivers’ experiences of specialist palliative home care teams

Actions helping expressed or anticipated needs: Patients with advanced cancer and their family caregivers’ experiences of specialist palliative home care teams

Home palliative care works: but how? A meta-ethnography of the experiences of patients and family caregivers

A sense of security in palliative homecare in a Norwegian municipality; dyadic comparisons of the perceptions of patients and relatives - a quantitative study

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