Health professionals’ and caregivers’ perspectives on improving paramedics’ provision of palliative care in Australian communities: a qualitative study DOI Creative Commons
Madeleine L Juhrmann, Phyllis Butow, Cara Platts

et al.

BMJ Open, Journal Year: 2024, Volume and Issue: 14(9), P. e086557 - e086557

Published: Sept. 1, 2024

Objectives Paramedics have the potential to make a substantial contribution community-based palliative care provision. However, they are hindered by lack of policy and institutional support, as well targeted education training. This study aimed elicit paramedics’, doctors’ nurses’, general practitioners’, residential aged nurses’ bereaved families carers’ attitudes perspectives on how paramedicine can be improved better suit needs patients, their carers, clinicians involved in delivering care. Design In this qualitative underpinned social constructivist epistemology, semistructured interviews were conducted. Setting participants 50 with experience, from all jurisdictions Australia. Participants interviewed between November 2021 April 2022. Results All suggested paramedics play an important adjunct role provision end-of-life home-based settings. Three levels opportunities for improvement identified: macrolevel (policy frameworks; funding education; accessing medical records widening scope); mesolevel (service-level training; interprofessional understanding communities practice community expectations) microlevel (palliative subspecialty; debriefing self-care partnering families). Conclusion To enhance paramedic capacity provide improvements targeting systems, services, individuals should made. calls stronger inclusion interdisciplinary greater investment both generalist specialist workforce.

Language: Английский

Enhancing end-of-life care in Ghana: nurse strategies and practices in addressing patient needs DOI Creative Commons
Evans Osei Appiah,

Agnes Abena Aquah,

Stella Appiah

et al.

BMC Palliative Care, Journal Year: 2025, Volume and Issue: 24(1)

Published: March 14, 2025

Abstract Background Globally, end-of-life care is vital for individuals in their final months or years, emphasizing comfort and dignity. However, the provision of palliative low-resource countries, such as Ghana, remains inadequately documented poorly understood. This study aimed to identify specific needs patients families explore strategies enhance end life practices among nurses selected settings Accra, Ghana. Methodology qualitative research utilized in-depth, one-on-one interviews using semi-structured a sample N = 32 working two hospitals Thematic content analysis was used analyze data. Participants were purposively selected, with size determined by data saturation. Results The identified three main themes eleven subthemes. were: providing dignity care, respecting ethical values, perceptions care. subthemes included: showing presence, demonstrating compassion, addressing challenges conversations, fostering autonomy respect, managing gratitude discontent, helping accept condition, seeking additional training, building emotional connections, involving families, patients’ cultural, social, religious beliefs. participants had cared currently caring aged 50–75 years cancer, organ failures, Advanced Heart diseases cognitive disorders. described efforts make last days memorable possible. Conclusions Nurses Ghana provide compassionate pain relief, concerns, patient expressions influenced cultural factors. To quality, policymakers should implement structured training develop culturally aligned guidelines meet receiving

Language: Английский

Citations

0
Development of a palliative paramedicine framework to standardise best practice: A Delphi study DOI Creative Commons
Madeleine L Juhrmann, Phyllis Butow, Paul Simpson

et al.

Palliative Medicine, Journal Year: 2024, Volume and Issue: 38(8), P. 853 - 873

Published: March 14, 2024

Background: Growing global demand for palliative care services has prompted generalist clinicians to provide adjunct support specialist teams. Paramedics are uniquely placed respond these patients in the community. However, embedding principles into their core business will require multifactorial interventions at structural, healthcare service and individual clinician consumer levels. Aim: To develop a paramedicine framework suitable national implementation, standardise best practice Australia. Design: Delphi study utilising questionnaire completion; each round informed need for, content of, next round. Free text comments were also sought Round 1. Two rounds of undertaken. Setting/participants: Sixty-eight participants took part 1, representing six countries, 66 2. Participants included paramedics, doctors nurses, general practitioners, researchers carers with lived experience expertise paramedicine. Results: Seventeen original 24 components gained consensus; 6 modified; 9 new arose from All modified consensus Only one component did not gain across both was excluded final 32-component framework. Conclusion: This developed comprehensive addressing macro-, meso- micro-level required Future research ought engage multidisciplinary team create an implementation strategy, any perceived barriers, facilitators challenges applying policy practice.

Language: Английский

Citations

2
South African palliative care provider perspectives on emergency medical services in palliative situations DOI Creative Commons
Caleb Hanson Gage, Liz Gwyther, Willem Stassen

et al.

African Journal of Emergency Medicine, Journal Year: 2024, Volume and Issue: 14(4), P. 231 - 239

Published: Aug. 30, 2024

Due to the frequent intersection of Emergency Medical Services (EMS) with palliative situations and increasing global need for care, there has been increased recognition care integration EMS. However, EMS systems remain segregated in many Low-to-Middle Income Country contexts, as South Africa (SA). The aim this study was gather perspectives providers SA concerning situations.

Language: Английский

Citations

1
Paramedics providing end-of-life care: an online survey of practice and experiences DOI Creative Commons
Natasha Campling, Joanne Turnbull, Alison Richardson

et al.

BMC Palliative Care, Journal Year: 2024, Volume and Issue: 23(1)

Published: Dec. 21, 2024

Abstract Background Global demand for care during the last year of life (end-of-life) is rising and with shortfalls in community healthcare services, paramedics are increasingly called on to deliver this. Despite this growing paramedic workforce, little large-scale or detailed empirical research has evaluated current practice experiences attending patient group. Therefore, as part a wider study evaluating delivery end-of-life care, survey England describing paramedics’ providing was undertaken. Methods A cross-sectional online design. Quantitative data were analysed using descriptive statistics qualitative free text responses Framework Analysis. The link distributed registered employed by all 11 NHS Trusts employing England, United Kingdom. Results Nine hundred twenty received. They reported availability professionals advice and/or referral. Respondents often, always sometimes: lacked medical history (91%, 839), access existing advance planning documentation (98%, 900) specific medicines needed (80%, 737); encountered conflicting views (89%, 819); lack pre-registration training (81%, 743) continuing professional development (77%, 708) influenced their ability meet needs. Conclusions This first national delivering provides new evidence insight into challenges faced potential impact these perceived levels competence confidence. multiple challenges, which potentially provide good quality increase risk hospital conveyance. Paramedic at must be supported via improved to: records; anticipatory authority administer; 24/7 palliative (for shared decision-making); education (including integrative ways working between ambulance services). Action required integrate paramedicine within team, robust support delivery.

Language: Английский

Citations

1
What are the triggers for palliative care referral in burn intensive care units? Results from a qualitative study based on healthcare professionals’ views, clinical experiences and practices DOI
André Filipe Ribeiro, Sandra Martins Pereira, Rui Nunes

et al.

Palliative Medicine, Journal Year: 2024, Volume and Issue: 38(3), P. 297 - 309

Published: Feb. 19, 2024

Background: Burns are a global public health problem, accounting for around 300,000 deaths annually. have significant consequences patients, families, healthcare teams and systems. Evidence suggests that the integration of palliative care in burn intensive units improves patients’ comfort, decision-making processes family care. Research is needed on how to optimise referrals. Aim: To identify triggers referral critically burned patients based professionals’ views, experiences practices. Design: Qualitative study using in-depth interviews. Setting/participants: All five Burn Intensive Care Units reference centres across Portugal were invited; three participated. Inclusion criteria: Professionals with experience/working these settings. A total 15 professionals (12 nurses 3 physicians) Reflexive thematic analysis was performed. Results: Three main identified: (i) severity extension, (ii) Co-morbidities (iii) Multiorgan failure. Other also generated: Rehabilitative related suffering changes body image, Family and/or dysfunctional complex processes, Long stay unit (iv) Uncontrolled pain. Conclusions: This identifies clinical The systematisation use could help streamline pathways strengthen units. practice enhance early high-quality integrated proportionate patient centred

Language: Английский

Citations

0
Health professionals’ and caregivers’ perspectives on improving paramedics’ provision of palliative care in Australian communities: a qualitative study DOI Creative Commons
Madeleine L Juhrmann, Phyllis Butow, Cara Platts

et al.

BMJ Open, Journal Year: 2024, Volume and Issue: 14(9), P. e086557 - e086557

Published: Sept. 1, 2024

Objectives Paramedics have the potential to make a substantial contribution community-based palliative care provision. However, they are hindered by lack of policy and institutional support, as well targeted education training. This study aimed elicit paramedics’, doctors’ nurses’, general practitioners’, residential aged nurses’ bereaved families carers’ attitudes perspectives on how paramedicine can be improved better suit needs patients, their carers, clinicians involved in delivering care. Design In this qualitative underpinned social constructivist epistemology, semistructured interviews were conducted. Setting participants 50 with experience, from all jurisdictions Australia. Participants interviewed between November 2021 April 2022. Results All suggested paramedics play an important adjunct role provision end-of-life home-based settings. Three levels opportunities for improvement identified: macrolevel (policy frameworks; funding education; accessing medical records widening scope); mesolevel (service-level training; interprofessional understanding communities practice community expectations) microlevel (palliative subspecialty; debriefing self-care partnering families). Conclusion To enhance paramedic capacity provide improvements targeting systems, services, individuals should made. calls stronger inclusion interdisciplinary greater investment both generalist specialist workforce.

Language: Английский

Citations

0