Risultati per: Guida clinica per le cure palliative

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Circulation, Volume 146, Issue Suppl_1, Page A10081-A10081, November 8, 2022. Introduction:Provision of palliative care to patients with advanced chronic diseases or old populations is suboptimal, which results in unnecessary suffering of and burden to patients, caregivers, and society. Low self-efficacy in palliative care among nurses is a factor affecting suboptimal utilization of palliative care. Poor knowledge is a factor affecting low self-efficacy in nurses. Attitudes may contribute to the relationship between knowledge and self-efficacy, but these relationships have been rarely examined in nurses.Hypothesis:Attitudes moderate the relationship between knowledge and self-efficacy in palliative care among nurses, controlling for covariates.Methods:Data were collected from 282 nurses (Median age: 29 years) regarding self-efficacy, knowledge, attitudes, and covariates (i.e., age, marital status, work experience, experience of advance directive [AD] education, experience of AD with relatives, experience of AD education for patients, and experience of AD counseling). Process v4.1 for SPSS was used to test the hypothesis.Results:The levels of self-efficacy (5.9 out of 10), knowledge (14.6 out of 21), and attitudes (48.0 out of 64) among nurses were moderate. Higher levels of knowledge (p = .026) and attitudes (p < .001), the interaction term of knowledge and attitudes (p = .041), and experience of AD counseling (p = .008) were significantly associated with higher levels of self-efficacy in palliative care (F = 5.643, p < .001, R2= .172), indicating the moderating effect of attitudes. The relationships between higher levels of knowledge and higher levels of self-efficacy were significant only in nurses with highly (p = .005) and moderately positive attitudes (p = .026), but not in nurses with lack of positive attitudes (Figure 1).Conclusions:The findings of this study supported the hypothesis. To improve self-efficacy in palliative care among nurses, improvement in knowledge and facilitation of positive attitudes are needed.

Circulation, Volume 146, Issue Suppl_1, Page A182-A182, November 8, 2022. Introduction:The indications for palliative care consultation are varied and integration of palliative care is often left to physician discretion. We sought to describe the population of post-arrest patients who receive a palliative care consultation and identify common indications for the consultation.Methods:Our study is a single center retrospective chart review from the Colorado Cardiac Arrest Registry (CCAR) including 541 patients admitted to the ICU after OHCA. Data abstracted included race, sex, preferred language, age, placement of a palliative care consult and number of palliative care meetings. A chi-squared test was used to determine statistical significance with a cutoff p value

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Introduction
Early palliative care (PC) in the clinical pathway of advanced cancer patients improves symptom control, quality of life and has a positive impact on overall quality of care. At present, standardised criteria for appropriate referral for early PC in oncology care are lacking. The aim of this project is to develop a set of standardised referral criteria and procedures to implement appropriate early PC for advanced cancer patients (the palliative care referral system, PCRS) and test its impact on user perception of quality of care received, on patient quality of life and on the use of healthcare resources.

Setting
Selected oncology clinics and PC outpatient clinic.

Methods and analysis
A scoping literature review and an expert consultation through a nominal group technique will be used to revise existing referral tools and to develop a new one, the PCRS. 25 patients will be enrolled in a pilot study to assess feasibility of the implementation of PCRS; 10 interviews with patients and healthcare professionals will be carried out to evaluate applicability.
A pretest–post-test quasiexperimental study involving 150 patients before implementation of the PCRS and 150 patients after implementation will be carried out.
Patient satisfaction with care received, quality of life and use of resources, and caregiver satisfaction with care will also be assessed to explore the impact of the intervention.

Ethics and dissemination
Ethical approval for the study has been granted by the Institutional Review board of the Fondazione IRCCS Istituto Nazionale Tumori; approval reference INT201/19.
Results will be disseminated through open access publications and through scientific communication presented at national and international conferences.

Trial registration number
NCT04936568.

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