Objective: This study examined rural community-based nurses' self-reported knowledge and skills in the provision of psychosocial care to rural residing palliative and end-of-life clients and carers. We further sought to determine correlates of knowledge gaps to inform workforce education and planning.
Method: Nurses from a rural area of Victoria, Australia, were invited to complete an electronic questionnaire rating their knowledge against 6 national palliative care standards and 10 screening and assessment tools. A 5-point scale of (1) No experience to (5) Can teach others was used to rate knowledge. Results were classified into three categories: practice gaps, areas of consolidation, and strengths. Descriptive and logistical regression was used to analyze data.
Results: A total of 122 of 165 nurses (response rate = 74%) completed the survey. Of these nurses, 87% were Registered Nurses, 43% had ≥10 years' experience in palliative care, and 40% had palliative care training. The majority of practices across the standards and screening and assessment tools were rated as knowledge strengths ( = 55/67, 82%). Gaps and areas of consolidation were in the use of client and carer assessment tools, the care of specific populations such as children, supporting carers with appropriate referrals, resources, and grief, and facilitating the processes of reporting a death to the coroner. Lack of formal training and lower years of experience were found to be associated with practice gaps.
Significance Of Results: Our study found rural nurses were confident in their knowledge and skills in the majority of psychosocial care. As generalist nurses make up the majority of the rural nursing workforce, further research should be undertaken on what educational strategies are needed to support and upskill rural community-based nurses to undertake formal training in palliative care.
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http://dx.doi.org/10.1017/S1478951521001644 | DOI Listing |
J Palliat Med
January 2025
Pain and Palliative Care, Medical Superspeciality Hospital, Kolkata, India.
Acute leukemia (AL) affects patients' well-being and inflicts substantial symptom burden. We evaluated palliative care needs and symptom burden in adult patients with AL from diagnosis through fourth week of induction chemotherapy. Newly diagnosed adult patients with AL scheduled for curative-intent treatments, prospectively completed Functional Assessment of Cancer Therapy-Leukemia questionnaire at diagnosis and postinduction therapy.
View Article and Find Full Text PDFJMIR Res Protoc
January 2025
Orthopedics and Trauma Surgery, University Hospital Düsseldorf, Düsseldorf, Germany.
Background: An aging population in combination with more gentle and less stressful surgical procedures leads to an increased number of operations on older patients. This collectively raises novel challenges due to higher age heavily impacting treatment. A major problem, emerging in up to 50% of cases, is perioperative delirium.
View Article and Find Full Text PDFJ Palliat Med
January 2025
Department of Medicine, Division of Geriatrics and Palliative Care, Duke University School of Medicine, Durham, North Carolina, USA.
Systemic autoimmune rheumatic diseases (SARDs) consist of a broad range of immune-mediated multisystem diseases. They are chronic, incurable illnesses that often present in early to mid-life and can be associated with a high symptom burden, disability, and early mortality. Treatment guidelines for similar chronic, life-limiting conditions with uncertain disease courses now recommend palliative care (PC) assessment at the time of diagnosis.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Division of Geriatrics, School of Medicine, University of California San Francisco.
Importance: The Walter Index is a widely used prognostic tool for assessing 12-month mortality risk among hospitalized older adults. Developed in the US in 2001, its accuracy in contemporary non-US contexts is unclear.
Objective: To evaluate the external validity of the Walter Index in predicting posthospitalization mortality risk in Brazilian older adult inpatients.
J Palliat Med
January 2025
Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Psychiatric and existential distress are common and difficult-to-treat symptoms that are frequently encountered in the palliative care setting; current treatment options are limited in efficacy and tolerability. Psychedelic-assisted therapies (PAT) have gained public and scientific interest in their potential to induce rapid and effective reductions in psychiatric and existential distress in patients with serious medical illness, but remain available only in the research setting. Ketamine as a pharmacologic agent has a large body of evidence in the treatment of refractory depression.
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