The Evolution of End-of-Life Care

Fink-Samnick, Ellen

doi:10.1097/ncm.0000000000000159

Cited by 9 publications

(12 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Yet, palliative care conversations are intimate, multifaceted, and obviously challenging for healthcare providers to navigate with patients. These challenges are amplified when considering the spectrum of diverse cultural perspectives about end-of-life processes, perspectives, and attitudes (33). Barriers to learning about palliative care may mirror the barriers to accessing palliative care, including patient and family reluctance, lack of awareness of resources, and worry about inferior survival (3).…”

Section: Discussionmentioning

confidence: 99%

Predictors of Palliative Care Knowledge: Findings from the Health Information National Trends Survey

Ogunsanya

Goetzinger

Owopetu

et al. 2021

Cancer Epidemiology, Biomarkers &Amp; Prevention

View full text Add to dashboard Cite

Background: Palliative care plays an important role in improving the quality of life for patients with cancer and their caregivers and has been associated with increased patient satisfaction. However, palliative care knowledge in the general population is limited, and often physician referral occurs late in prognosis. The objective of this analysis was to examine factors associated with palliative care knowledge. Method: Using data from the 2018 NCI's Health Information National Trends Survey (HINTS) 5 Cycle 2, descriptive statistics, bivariate analyses, and multivariable logistic regressions were used to assess factors associated with respondents' palliative care knowledge using ORs and 95% confidence intervals as measures of association. The outcome of interest was measured with the item “How would you describe your level of knowledge about palliative care?” Possible response selections were “I've never heard of it,” “I know a little bit about palliative care,” and “I know what palliative care is and could explain it to someone else.” To reduce the risk of type 1 error, jackknife variance estimations with repeated replications were used. All analyses were conducted with the SURVEYLOGISTIC command using SAS 9.4 (SAS Institute Inc.), and the statistical significance level was set at P < 0.05. Results: A total of 3,450 respondents (weighted sample size: 249,489,772) met the inclusion criteria. About 89% (n = 3,000) of all respondents had inadequate knowledge of palliative care. Multivariable analyses indicated that frequent health care utilization as defined as ≥ 2 times per year [OR, 3.01; 95% confidence interval (CI), 2.65–3.58], female gender (OR, 2.15; 95% CI, 1.31–3.59), being married (OR, 2.02; 95% CI, 1.14–3.59), having a college degree or higher (OR, 13.83; 95% CI, 1.71–12.04), and having a regular source of care (OR, 2.67; 95% CI, 1.37–1.90) had greater odds of adequate palliative care knowledge. Those without a cancer diagnosis were less likely to have adequate knowledge of palliative care (OR, 0.49; 95% CI, 0.41–0.89). Conclusions: Knowledge of palliative care in the United States is low, particularly for those not already actively using their available healthcare system. Public health education efforts are needed to target subgroups of the U.S. population identified by this analysis to increase palliative care knowledge. Impact: Healthcare providers have a major role to play in improving palliative care knowledge.

show abstract

Section: Discussionmentioning

confidence: 99%

Predictors of Palliative Care Knowledge: Findings from the Health Information National Trends Survey

Ogunsanya

Goetzinger

Owopetu

et al. 2021

Cancer Epidemiology, Biomarkers &Amp; Prevention

View full text Add to dashboard Cite

show abstract

“…The term is an all-encompassing dynamic in which practitioners, professionals, and providers experience the same reality as their patients, families, and support systems. The practitioner's traditionally steadfast professional boundaries become blurred, leading to heightened levels of emotional vulnerability that can prompt the development of more pervasive wholistic health issues (e.g., psychopathology, pathophysiology, psychosocial circumstances) ( Fink-Samnick, 2020 ).…”

Section: Collective To Collective Occupational Traumamentioning

confidence: 99%

“…Prepandemic and pandemic-related studies yield contextual considerations on workforce burnout incidence and risk of COT across disciplines, as well as racial, ethnic, socioeconomic, and cultural groups. Rising rates of workforce trauma across the industry translate to significant consequences for workforce wholistic health and wellness such as burnout, pervasive mental health exacerbation, onset, and chronic illness emergence (ANF, 2021;Bryant-Genevier et al, 2021;Fink-Samnick, 2020;Denning et al, 2021;Kelly et al, 2021;McFadden et al, 2021;Moitra et al, 2021;Prasad et al, 2021;Rossi et al, 2021). Kelly et al (2021) explored burnout for nurses prepandemic, characterized by emotional exhaustion, depersonalization, and disengagement from work.…”

Section: Examining the Evidencementioning

confidence: 99%

Collective Occupational Trauma, Health Care Quality, and Trauma-Informed Leadership

Fink-Samnick

2022

Professional Case Management

Self Cite

View full text Add to dashboard Cite

Managing stress, burnout, and vicarious trauma is a long-standing issue for the health and behavioral health workforce, including those in case management. Yet, the recent novel coronavirus pandemic has amplified routine burnout to record levels. Practitioners and patients are amid a new dynamic of collective occupational trauma (COT). In this realm, health and behavioral health workers (HBWs) experience the same reality as their patients, families, and support systems; professional boundaries become blurred, leading to heightened levels of emotional vulnerability that can prompt the development of more pervasive psychopathology. This reality has put the Quadruple Aim in peril, with increased workforce turnover, staff shortages, costs, and quality challenges. Purpose/Objectives: This article: Identifies the incidence and costs associated with COT for HBWs; Distinguishes among terms associated with HBW burnout; Describes the occupational stress–trauma continuum; Defines COT; Explains the connection between COT and health care quality; Identifies why trauma-informed care (TIC) is relevant to address COT; Applies TIC to leadership and supervision strategies Identifies how established resources of guidance address workforce health, mental health, and professional self-care. Primary Practice Setting(s): Applicable to all health and behavioral health settings where case management is practiced. Findings/Conclusions: Organizational cultures must shift from a “process and roll” mindset to one that is trauma-informed. Implementation of TIC has yielded successful outcomes for the workforce via enhanced patient engagement, treatment adherence, and successful outcomes. In tandem, TIC leadership and supervision models have had promising results and should be more readily utilized; they acknowledge and address workforce trauma while prioritizing staff health, mental health, and wellness. Failure to shift the culture will result in an ongoing exodus of practitioners, leaving insufficient numbers to render safe, cost-effective, efficient, and patient-centered care. Implications for Case Management Practice: The case management workforce comprises professional disciplines across health and behavioral health, employed in every setting. The expanding workforce presence has put them at risk of COT. Leadership strategies must shift to acknowledge workforce exposure to occupational trauma, address mental health and wellness, and address professional self-care. This shift is key to mitigating retention, sustainability, and quality challenges.

show abstract

“…Cracks and other liabilities in that vital base emerge, grow, and ultimately weaken the structure's stability. The building collapses from a faulty foundation system that should have maintained it for a lifetime (Fink-Samnick, 2020).…”

Section: Foundational Concepts and Historical Contextmentioning

confidence: 99%

The Social Determinants of Mental Health

Fink-Samnick¹

2021

Professional Case Management

Self Cite

View full text Add to dashboard Cite

he health care industry remains fixated on the social determinants of health (SDoH), the nonclinical psychosocial and socioeconomic circumstances that contribute to health outcomes. The five long-standing SDoH domains were updated for Healthy People 2030 (U.S. Department of Health & Human Services, 2020a) at the end of 2020 and continue to top the priority list for every organization:1. Economic stability 2. Education access and quality 3. Health care access and quality 4. Neighborhood and built environment 5.

show abstract

The Evolution of End-of-Life Care

Cited by 9 publications

References 9 publications

Predictors of Palliative Care Knowledge: Findings from the Health Information National Trends Survey

Predictors of Palliative Care Knowledge: Findings from the Health Information National Trends Survey

Collective Occupational Trauma, Health Care Quality, and Trauma-Informed Leadership

The Social Determinants of Mental Health

Contact Info

Product

Resources

About