Fostering timely integrated palliative care in nursing homes through critical companionship: experiences from a Padi-Palli interventional study in France.

Background: One of the fundamental pillars of integrating a palliative approach in nursing home care is increasing professional competencies and institutional capacity. However, conventional training designs have been proven to fall short of supporting this integration. This paper details the results of a practice development intervention that used critical companionship as a learning design to facilitate the integration of a palliative approach in the care of nursing home residents in France.

"You close the door, wipe your sadness and put on a smiling face": a qualitative study of the emotional labour of healthcare professionals providing palliative care in nursing homes in France.

Background: Palliative care provided to frail and dying older persons in nursing homes results in intense emotions for residents and their relatives as well as for healthcare professionals. In France, scant attention has been given to how nursing home professionals manage their emotions when providing palliative care. This study analysed the emotional demands of providing palliative care in the nursing home context, the emotional strategies used by healthcare professionals to navigate such demands, and how these demands affect their emotional wellbeing.

[From comprehensive geriatric assessment to an integrated multidimensional assessment system : interRAI tools and their applications].

The multidimensional assessment carried out with interRAI tools constitutes an operationalization of the International Classification of Functioning, Disability and Health (ICF) and is adapted to the specificities of each place of care. From a single assessment, the interRAI approach makes it possible to conduct a multidimensional assessment of functional autonomy and to produce a series of indicators (health, areas of intervention, quality of care and consumption of resources). It helps to identify clinical needs to be the subject of a personalized care plan and the strengths and weaknesses of health organizations to modify the professional practices.

Assessing the implementation and effectiveness of early integrated palliative care in long-term care facilities in France: an interventional mixed-methods study protocol.

Background: Majority of residents in long-term care facilities (LTCF) have limited and delayed access to palliative care even though many suffer from incurable chronic illnesses that will likely require the provision of palliative care. We present the study protocol of "PADI-Palli", an intervention aims to advance early integrated palliative care into standard care delivered in LTCF. This study will assess the effectiveness of early integrated palliative care on palliative care accessibility for older persons in LTCF, and identify the key factors for the successful implementation of early integrated palliative care and its sustainability in the LTCF context.

Building a telepalliative care strategy in nursing homes: a qualitative study with mobile palliative care teams.

Background: Despite increasing use of telemedicine in the field of palliative care, studies about the best circumstances and processes where it could replace face-to-face interaction are lacking. This study aimed to: (1) identify situations that are most amenable to the use of telemedicine for the provision of palliative care to patients in nursing homes; and (2) understand how telemedicine could best be integrated into the routine practice of mobile palliative care teams.

Methods: A qualitative study based on semi-structured focus groups (n = 7) with professionals (n = 33) working in mobile palliative care teams in France.

[Not Available].

Aim: This article aims to set some theoretical and practical milestones to better understand the challenges of interdisciplinary research in palliative care.

Method: A theoretical perspective of the main challenges of interdisciplinary research is provided through a review of existing literature, supported by practical experiences learnt from the implementation of two research projects on the improvement of the organization of healthcare services in palliative care in France.

Results: Palliative care is historically and philosophically grounded in interdisciplinary culture.

Impacts on health outcomes and on resources utilization for anticancer drugs injection at home, a complex intervention: a systematic review.

Background: As hospital-based home care is a complex intervention, we critically appraised the key elements that could ensure the completeness of assessment and explain the heterogeneity of the literature results about the comparison between home and hospital setting for the anticancer drugs injection within the same standards of clinical care.

Methods: Systematic review was conducted. Medline, Embase, Cochrane Library, Web of Sciences, and Cumulative Index of Nursing and Allied Health (Cinahl) searched to February 1, 2019, and combined with grey literature.

Implementation of a Standardized Comprehensive Assessment Tool in France: A Case Using the InterRAI Instruments.

Background: The improvement of quality of care requires a standardized and comprehensive assessment tool but implementation is challenging.

Purpose: We have reported on the development of the interRAI instruments in France from the onset to the mandatory use at the national level. We also have identified in the literature and in practices, incentives and barriers for the implementation of this integrated clinical information system in long term care.

Impacts on health outcomes and on resource utilisation of home-based parenteral chemotherapy administration: a systematic review protocol.

Introduction: Despite the demonstrated feasibility and policies to enable more to receive chemotherapy at home, in a few countries, parenteral chemotherapy administration at home remains currently marginal. Of note, findings of different studies on health outcomes and resources utilisation vary, leading to conflicting results. This protocol outlines a systematic review that seeks to synthesise and critically appraise the current state of evidence on the comparison between home setting and hospital setting for parenteral chemotherapy administration within the same high standards of clinical care.

Evaluation de la culture de sécurité en Etablissement d'Hébergement pour Personnes Agées Dépendantes (EHPAD): adaptation française du questionnaire Nursing Home Survey on Patient Safety Culture.

The objective was to translate into French the American questionnaire "Nursing Home Survey on Patient Safety Culture" and to test the feasibility of its use in a sample of nursing homes. The questionnaire was translated by a multidisciplinary group of six experts and tested on a sample of people working in nursing homes. The questionnaire was then administered in five nursing homes.

Diagnostic study, design and implementation of an integrated model of care in France: a bottom-up process with continuous leadership.

Background: Sustaining integrated care is difficult, in large part because of problems encountered securing the participation of health care and social service professionals and, in particular, general practitioners (GPs).

Purpose: To present an innovative bottom-up and pragmatic strategy used to implement a new integrated care model in France for community-dwelling elderly people with complex needs.

Results: In the first step, a diagnostic study was conducted with face-to-face interviews to gather data on current practices from a sample of health and social stakeholders working with elderly people.

A novel model of integrated care for the elderly: COPA, Coordination of Professional Care for the Elderly.

Despite strong evidence for the efficacy of integrated systems, securing the participation of health professionals, particularly primary care physicians (PCPs), has proven difficult. Novel approaches are needed to resolve these problems. We developed a model - COPA - that is based on scientific evidence and an original design process in which health professionals, including PCPs, and managers participated actively.