Care Seminar Research Articles

Overcoming Geographical Barriers: A Distance Mediated Interdisciplinary Palliative Care Seminar

Overcoming Geographical Barriers: A Distance Mediated Interdisciplinary Palliative Care Seminar

Palliative Care Knowledge Following an Interdisciplinary Palliative Care Seminar.

The COVID-19 pandemic created a unique opportunity to evolve an interdisciplinary palliative care seminar (IPC) into a virtual platform. This seminar provides foundational palliative and hospice concepts, introductions into palliative care disciplines, integration of teamwork, and incorporates interdisciplinary student led patient encounters. Traditionally, this experience had been in person, however during the COVID-19 pandemic, healthcare restrictions transitioned the educational delivery to a virtual platform. To assess the knowledge gained from this novel experience, the Palliative Care Knowledge Test (PCKT) was administered before and after the IPC Seminar. A 1-year follow up survey was also administered to evaluate how the IPC Seminar was applicable to the students' clinical experiences and practice. The virtual didactics and virtual student led patient encounters significantly improved learners understanding of palliative and hospice care. This gain of knowledge was noted across undergraduate and graduate programs, which highlights the need for and benefit from foundational concepts. Furthermore, a 1-year follow up survey noted the IPC seminar was applicable to their practices and suggests that this experience will impact future patients. Many of the students practice in rural areas where access to palliative care services is limited or non-existent. This experience exponentially impacts the growth of palliative and hospice care understanding and access to care across the region. Evolving our IPC Seminar has shown to significantly improve knowledge, foster collaboration of student led interdisciplinary teams, and increases capacity to meet the needs of more learners.

General Ward Nurses' Self-Efficacy, Ethical Behavior, and Practice of Discharge Planning for End-Stage Cancer Patients: Path Analysis.

General ward nurses play a key role in discharge planning for end-stage cancer patients. It is necessary to assess the factors regarding their practice to promote discharge planning in accordance with end-stage cancer patients’ wishes. This study aimed to investigate the relationships between general ward nurses’ practice of discharge planning for end-stage cancer patients, self-efficacy, ethical behavior, attitude, knowledge and experience, perceived skills, and perceived barriers. A total of 288 general ward nurses from nine hospitals in a city in Japan completed the questionnaire. Path analysis was conducted to test the hypotheses. The results showed that nurses’ self-efficacy, ethical behavior (do-no-harm, do-good), knowledge (experience of attending home care seminars), and perceived skills (assertiveness) were positively and directly related to the practice of discharge planning. Nursing experience and perceived skills (assertiveness) were positively associated with discharge planning practice, while perceived barriers (death discussion) and attitude (degree of leaving it to discharge planning nurses (DPNs)) were negatively associated, with self-efficacy acting as a mediator. Thus, our findings show that it is important to enhance self-efficacy and nursing ethical behavior to improve the practice of discharge planning. Accordingly, education regarding home care, assertive communication skills, death discussion, and ethics is needed for general ward nurses.

Nursing Experience of a Patient with End Stage Renal Disease and Lung Adenocarcinoma Received Initial Hemodialysis

<p>本文為一位罹患肺腺癌的末期腎病變病人，面臨雙重重大疾病治療的壓力下，接受初次化學及血液透析治療的護理經驗。護理期間於2018年7月31日至9月30日，運用Gordon十一項健康功能型態為評估工具，透過直接照護及觀察等方式蒐集資料，確認病人有體液容積過量、營養失衡及無望感等健康問題，透過回覆示教及教導病人水分控制技巧，改善因體液容積過量所致呼吸喘的症狀；經偕同營養師制定飲食治療計劃，改善因化學治療副作用導致的營養失衡；藉由跨團隊照護、家人及病友支持，成功地使病人適時表達因雙重重大疾病所產生的經濟壓力困境與對未來生活價值的無望感。冀望將此照護經驗分享，讓同性質病人能坦然面對生命逆境，順利進入化學及血液透析治療，早日回歸職場。</p> <p> </p><p>This article was about a patient with end-stage renal disease and lung adenocarcinoma and then she received nursing experience of initial chemical and hemodialysis . The author cared for such a patient from July 31, 2018 to september 30, 2018, Using Gordon’s 11 functional appraisals and both observation and discussion, the following patient’s care issues were identified ,including fluid overload , malnutrition, hopelessness .With these,we can teach the patient skills to control water,and improve the symptoms of asthma caused by fluid overload.Also,we can formulate a diet therapy plan with a dietitian to improve the nutritional imbalance caused by the side effects of chemotherapy. With cross-team care, family and patient support,we can successfully make the patient talk about their difficulties cause by double major diseases in a timely manner,and hopeless economical pressure . I hope to share this care experience and recommend it to the case care seminars of related units.With this, patients of the same nature can face life’s adversity calmly and smoothly.Then,patients will be willing to choose the chemical and hemodialysis treatments, and return to the workplace as soon as possible.</p> <p> </p>

Parenteral Nutrition in Advanced Cancer: The Healthcare Providers' Perspective.

IntroductionThe evidence base for parenteral nutrition (PN) in advanced cancer patients is limited. We studied healthcare providers’ (HCPs’) experiences with PN in cancer patients, focusing on perceived treatment benefits and challenges.MethodsAn 18-item online survey was emailed to HCPs attending one of three regional palliative care seminars held within a 6-month period. The survey included single-response items, multiple-response items, and free text boxes concerning PN. Descriptive statistics and qualitative thematic content analysis were applied.ResultsOne hundred and two seminar participants completed the survey. Ninety-three percent were female, 86% were nurses/oncological nurses, and 80% worked in primary care. Respondents reported a well-functioning collaboration across levels of care. They perceived that PN may increase the patients’ level of energy, improve the general condition, and reduce eating-related distress. On the downside, HCPs observed burdensome side effects, that the treatment was resource-demanding, and that decisions on PN withdrawal were difficult.ConclusionThe study results are based on the perspectives of more than 100 HCPs with comprehensive clinical experience with PN. Their knowledge represents an important experience base for improvement of healthcare services and advanced care planning. Supplementary InformationThe online version contains supplementary material available at 10.1007/s40487-022-00189-1.

Comparison of Japanese Nurses' and Care Workers' Scores on the Dialogue Preference Scales for Elderly (DPSE)

This study compared nurses’ and care workers’ scores on the Dialogue Preference Scales for Elderly (DPSE) created from data from nursing students in Japan. For this forward-looking, quantitative, questionnairebased study, data collection was conducted from 2010 to 2012 with care seminar participants in Japan. Participants were nurses (n = 277; 36.96 ± 10.33 years old, males; 4.33% females; 95.66%) and care workers (n = 83; 40.52 ± 11.68 years old, males; 25.30% females; 74.69). The samples varied significantly in mean age (p < 0.05) and gender (p < 0.001). The number of years of experience was 139.94 for nurses with SD = 10.99 and 90.99 for care workers with SD = 45.44 (p < 0.001).

Teaming up for patient care seminars: Using Microsoft Teams private channels to facilitate HIPAA-compliant small group educational sessions.

Teaming up for patient care seminars: Using Microsoft Teams private channels to facilitate HIPAA-compliant small group educational sessions.

Students Practicing Interprofessional Collaboration in the Context of Hospice and Palliative Care.

Interprofessional education allows students to collaborate with students and professionals of multiple disciplines. An Interdisciplinary Palliative Care (IPC) Seminar, held in the Midwest, involves students from disciplines of medicine, nursing, pharmacy, social work, and chaplaincy. The curriculum of the seminar incorporates asynchronous and synchronous didactic presentations, experiential learning through group exercises and discussion, along with home visits by students in interdisciplinary dyads. The purpose of this study was to determine whether students' participation in a 3-week IPC seminar would positively influence their socialization and value of interprofessional collaboration with the ultimate goal of developing skilled professionals who engage in interprofessional practice in hospice and palliative care settings. This descriptive study invited participants to take a pre- and postseminar online survey using the Interprofessional Socialization and Valuing Scale-21 (ISVS-21) to assess shifts in students' perceptions of interprofessional socialization and the value of collaborative health-care practice. In their pre-and postseminar scores, 71 participants reported they more strongly agreed with all items on the ISVS-21 after completing the seminar. The results from this study suggest the IPC Seminar is an effective educational model for advancing the value of interprofessional socialization and collaborative practice in hospice and palliative health-care.

Impact of community lifestyle intervention on anthropometric parameters and body composition among overweight and obese women: findings from the MyBFF@home study

BackgroundThe prevalence of overweight and obesity among Malaysian women remained high over the past three decades. Collaboration with existing community at-risk may be feasible for wide-scale prevention of overweight and obesity in the country. The aims of this study were to examine the impact of community-based lifestyle intervention among overweight and obese women on their anthropometric and body composition changes as compared to the usual care group.MethodsThis was a quasi-experimental study conducted in low-cost flats in Kuala Lumpur, Malaysia. A total of 255 overweight and obesity individuals aged between 18 to 59 years old were assigned to either the lifestyle intervention group (n = 169) or the usual care group (n = 146) over a period of 6 months. Individuals in the intervention group received 6 individual lifestyle counselling comprised of physical activity, diet counselling and self-monitoring components aimed to achieve at least 5% weight loss while individuals in the usual care group obtained six sessions of health care seminars from health care providers. These individuals were then followed-up for another 6 months without any intervention as part of maintenance period.ResultsAn intention-to-treat analysis of between-groups at 6-month of intervention (β, 95% CI) revealed greater changes in weight among intervention individuals’ (− 1.09 kg vs. -0.99; p < 0.018) as compared to the control group. These changes were not sustained during the maintenance phase (between 6 and 12 months). Overall significant improvement at 12th month was found for visceral fat (− 0.78 vs. -0.64; p-value = 0.017), although no significant changes between groups were detected either during intervention or maintenance phase (p > 0.05). Individuals in the intervention group showed a significant increase for skeletal muscle mass (0.13 kg) than those individuals in the control group (− 0.37 kg), p = 0.033, throughout the study period.ConclusionThis study provides evidence that an overweight and obesity prevention program can be implemented in a community setting, with some reduction of several anthropometric and body composition parameters.

Session 301 - Challenging Behaviors in Dementia Care: Recognizing Unmet Needs—a Positive Approach to Care (TM) Seminar

Session 301 - Challenging Behaviors in Dementia Care: Recognizing Unmet Needs—a Positive Approach to Care (TM) Seminar

Report from the 15th Japanese Society for Foot Care Seminar in Hakodate

Report from the 15th Japanese Society for Foot Care Seminar in Hakodate

Advancing the Measurement of Dental Students' Professionalism.

In dental education, professionalism has been viewed as a requirement in order to achieve and maintain competence in the practice of dentistry. The Professionalism Mini-Evaluation Exercise (P-MEX), a 21-item instrument validated in medicine, is often used to measure the following observable professionalism behaviors: doctor-patient relationship, reflective skills, time management skills, and interprofessional relationship skills. Emotional intelligence (EI) is defined as the ability to accurately perceive emotions in oneself and in others in order to improve performance and personal growth. The primary aim of this study was to elucidate for dental education the relationship of professionalism as measured by the P-MEX to EI as measured by the Emotional Quotient Inventory (EQ-i) 2.0, and the secondary aim was to explore relationships between EQ-i 2.0 subscales and the P-MEX. A correlational cohort study was conducted in 2015-16 in which the EQ-i 2.0 was administered to dental students at one U.S. dental school at the end of their second year as they began their clinical education experience. Out of a total class of 66 students, 49 (74%) were chosen to participate through randomized selection in order to have about 12 students per team clinic group. The P-MEX evaluations were collected eight months later in three settings: the comprehensive care clinic, community outreach clinics, and clinical care seminars. The students' EQ-i 2.0 mean scores and P-MEX mean scores resulted in a non-significant correlation. However, the EQ-i 2.0 subscales self-actualization and happiness were significantly correlated with the P-MEX mean scores. These results suggest that there was a relationship between these students' EI and professionalism, which supports the use of both for the evaluation and development of professionalism through a multiple triangulated effort.

Teaching medical professionalism: a lesson in perspective from Plato's Protagoras.

Medical professionalism is difficult to define and is poorly understood.1 The Royal College of Physicians (RCP) defines medical professionalism as: ‘A set of values, behaviours, and relationships that underpins the trust the public has in doctors’ , which includes ‘integrity, compassion, altruism, continuous improvement, excellence and working in partnership with members of the wider healthcare team’. 2 A QMUL primary care seminar in 2015 about educating clinicians for medical professionalism gave the example of dedicating appropriate time to the parents of children undergoing major surgery. There is evidence that professionalism can be developed via role modelling and personal reflections.3 Traditionally, doctors have taught their trainees professionalism by role modelling — but might we learn anything new from older models of professionalism? The RCP’s concept of medical professionalism and its relation with public trust has similarities with the concept of ‘virtue’, debated in Socrates’ dialogue with Protagoras, as recorded by Plato in 380 bce Protagoras, a Greek philosopher, claims to be able to teach virtue (the Greek …

"The Use of Protective Gloves in Occupational Skin Disease Prevention: Feasibility and Customeracceptance in Physiotherapy"

Background: Physiotherapists have an occupationally elevated risk of dermatoses. One aim of skin care seminars for specific professional groupsin individual prevention programme in Germany is to ensure appropriate use of safety measures during patient treatment. Initially physiotherapists often think skeptically about the use of gloves and patients’ acceptance of this protective measure. So the objective of this study was to assess the practicality of glove use during physiotherapy (qualitative investigation) and customer acceptance of them during massage (quantitative investigation).Methods: Structured problem-focused interviews about glove usage were held with 20 skin diseased physiotherapists and masseurs after skin care seminars. The data was evaluated inductively using Mayring’s qualitative content analysis. The clients’ acceptance was tested in a controlled randomized three setting study with 120 subjects who received a back massage and evaluated quality aspects of their massage in a questionnaire. The physiotherapist was wearing either gloves of PVC, gloves made of nitrile rubber or no gloves at all. A non-inferiority test was used to test group differences.Result: The majority of participating physiotherapists considered the use of protective gloves a practical and useful measure. However, occasional problems in everyday practice and in special therapy methods were reported. The analysis of 120 questionnaires (100% response rate) for quality aspects and the willingness to pay regarding client acceptancein a massage - with or without gloves -showed a non-inferiority result for massages with gloves.Conclusion: Convincing individual physiotherapists of the benefits of wearing gloves is crucial for implementation of this preventive measure. It is improbable that patients would refuse services because therapists wear gloves during treatments. Consequently, the usage of gloves is unlikely to result in a loss of practice custom.

End-of-Life Educational Seminar in a Prelicensure Bachelor of Science in Nursing Program

Nurses today are caring for patients with higher acuity in acute inpatient settings and subsequently experience more patient deaths. Since 2011, prelicensure baccalaureate students in their final semester at a nursing school in Northeast Ohio have been required to participate in a half-day end-of-life care seminar modeled after the End-of-Life Nursing Education Consortium program. This seminar incorporates content on symptom management, communication, final hours of life, care of the patient and family experiencing loss, and self-care. This article describes the teaching methods and seminar content and reports the student evaluations and reflective comments. Student evaluations and reflections were very positive. Participants identified learning the most about communication skills, holistic care, and knowing what to expect in the final hours of life.

Attendance at end-of-life care seminars and related factors among home visiting nurses

Aims: The aim of this study was to identify the factors associated with the opportunities that home visiting nurses attended seminars about end-of-life care. Method: This was a cross-sectional correlation study. Data were gathered from 343 home visiting nurses working in 62 agencies across Chiba prefecture in eastern Japan. The authors asked participants: (i) questions on socio-demographic data; (ii) questions on opportunities for attending end-of-life care seminars; and (iii) questions on agency characteristics. Opportunities for attending end-of-life care seminars were classified into two categories as either having an opportunity to attend end-of-life care seminars “0 times” or “once or more”. Multivariate logistic regression analysis was performed to identify the relationship between attendance at end-of-life care seminars and related socio-demographic and agency characteristics. Results: Data from 224 home visiting nurses working in 53 agencies were included in the analysis. Overall, 66 nurses (29.5%) had no opportunity to attend end-of-life care seminars. Multivariate logistic regression analysis showed that autonomy in providing end-of-life care (OR=2.82, 95% CI: 1.07–7.40) was associated with attendance at end-of-life care seminars. Conclusion: Nursing managers should provide autonomy to staff in order to ensure quality of end-of-life care among nursing staff.

Development, implementation and evaluation of a pain management and palliative care educational seminar for medical students.

Despite calls for the development and evaluation of pain education programs during early medical student training, little research has been dedicated to this initiative. To develop a pain management and palliative care seminar for medical students during their surgical clerkship and evaluate its impact on knowledge over time. A multidisciplinary team of palliative care and pain experts worked collaboratively and developed the seminar over one year. Teaching methods included didactic and case-based instruction, as well as small and large group discussions. A total of 292 medical students attended a seminar during their third- or fourth-year surgical rotation. A 10-item test on knowledge regarding pain and palliative care topics was administered before the seminar, immediately following the seminar and up to one year following the seminar. Ninety-five percent (n=277) of students completed the post-test and 31% (n=90) completed the follow-up test. The mean pretest, post-test and one-year follow-up test scores were 51%, 75% and 73%, respectively. Mean test scores at post-test and follow-up were significantly higher than pretest scores (all P<0.001). No significant difference was observed in mean test scores between follow-up and post-test (P=0.559), indicating that students retained knowledge gained from the seminar. A high-quality educational seminar using interactive and case-based instruction can enhance students' knowledge of pain management and palliative care. These findings highlight the feasibility of developing and implementing pain education material for medical students during their training.

Home visiting nurses' attitudes toward caring for dying patients, and related workplace factors

To identify workplace factors related to home visiting nurses (HVNs) positive attitudes toward caring for dying patients. In this cross-sectional study, 343 HVNs working in 62 agencies across Chiba prefecture, eastern Japan, received an anonymous self-administered questionnaire from July to August 2012. 304 questionnaires (88.6%) were returned, and the data of 206 HVNs (60.1%) in 54 different agencies was analysed. Multiple regression analysis showed that attendance at terminal care seminars, agency support of schedule organisation enabling attendance at terminal care seminars, and positive feedback from patients and families were significantly positively associated with HVNs' attitudes toward terminal care. These results may give useful interventional methods for nursing managers to enhance HVNs terminal care practices.

Integrating Medical Humanities into a Pharmaceutical Care Seminar on Dementia

Objective. To design, integrate, and assess the effectiveness of a medical humanities teaching module that focuses on pharmaceutical care for dementia patients.Design. Visual and textual dementia narratives were presented using a combination of teacher and learner-centered approaches with the aim being to highlight patients' and caregivers' needs for empathy and counselling.Assessment. As gauged from pre- and post-experience questionnaires, students highly rated this approach to teaching medical humanities. In-class presentations demonstrated students' increased sensitivity to patient and caregiver needs, while objective learning outcomes demonstrated students' increased knowledge and awareness.Conclusions. Pharmacy students were open to and successfully learned from reading and discussing patient and caregiver narratives, which furthers the discussion on the value of integrating the medical humanities into the curricula of pharmacy and other health sciences.

A regional model of interprofessional education

This paper describes the innovative features of the first regional model of interprofessional education (IPE) in the US, developed by The Commonwealth Medical College, Scranton, PA, USA, as a new, independent, community-based medical school in northeastern Pennsylvania. Essential educational components include collaborative care seminars, interprofessional sessions, simulations, live web-based seminars and newly innovative virtual environment interactive exercises. All of these elements are being integrated into the curricula of 14 undergraduate and allied professional schools, and three graduate medical education programs located in the region. Activities incorporate simulation, standardized patients, student leadership, and faculty and student facilitation. As this new regional model of interprofessional education is fully implemented, its impact will be assessed using both quantitative and qualitative outcomes measurements. Appropriate ongoing modifications to the model will be made to ensure improvement and further applicability to collaborative learning.