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Background
Palliative care is specialized care provided to patients diagnosed with life-threatening diseases such as heart failure and cancer. The approach’s main goal is improving the quality of life by preventing and alleviating suffering via identifying early and managing physical, social, mental, spiritual needs of patients and their families. A team approach is usually employed in the delivery of palliative care to ensure holism; palliative care physicians, specialized nurses, nutritionists, pharmacists, social workers, and chaplains are some professionals involved in delivery of palliative care. Improving quality of life, ameliorating symptoms, lowering healthcare costs, and facilitating healthy bereavement are some crucial roles of palliative care. My research study will focus in detail on the role of palliative care in Canada. As an introduction, the following paper presents an annotated bibliography of some research articles that will be used in the development of my research study.
Annotated Bibliography
Connolly, M., Ryder, M., Frazer, K., Furlong, E., Escribano, T. P., Larkin, P., Carruthers E., & McGuigan, E. (2021). Evaluating the specialist palliative care clinical nurse specialist role in an acute hospital setting: A mixed methods sequential explanatory study.BMC Palliative Care 20, 134 (2021).
The authors, Connolly and colleagues, are reputable professionals working in the nursing profession and providing specialist palliative care services. These authors are investigating the responsibilities of nurses in acute settings such as hospitals in relation to specialized palliative health care services. I chose the article because, firstly, the authors are well-versed in my main topic, palliative care, and secondly, the research article is peer-reviewed and up-to-date. The use of qualitative research methods provides a detailed discussion about the roles of the nurses in palliative care. Although the study was orchestrated outside Canada, it provides a great insight and attitude towards specialized roles of nurses in delivery of palliative care healthcare facilities. The authors assert that many individuals are appreciative of the specialized roles which include supportive role, patient advocacy, guidance on management of symptoms, education, discharge planning, and continuity in care. Limitations, as the authors stipulate, include fewer than expected number of participants, and less than 61% response rate (mainly from nurses), that can be addressed by increasing response from other health professionals in future studies. Additionally, allowing patients to present their views about the specialize services can paint a clearer picture about the same. The article will be integral in my thesis about the role of palliative care in Canada and it will introduce the theme on settings of palliative care.
Moran, S., Bailey, M., & Doody, O. (2021). An integrative review to identify how nurses practicing in inpatient specialist palliative care units uphold the values of nursing.BMC Palliative Care, 20(1), 1-16.
The authors, Moran, Baily, and Doody are probing how advancements in medicine and nursing have affected the role of nurses and maintenance of nursing values during delivery of palliative care services. Baily and Doody are nursing professionals in the Department of Nursing and Midwifery, faculty of education and health sciences, and the Health Research Institute, University of Limerick, Limerick. With their expertise, along with peer-reviewing of the article, the source can provide information to build themes for my thesis. An integrative review through seven reputable databases was conducted as Crowe Critical Appraisal Tool was used to appraise identified research articles. The literature review demonstrated how palliative nurses uphold values of compassion, care, and commitment whilst failing to maintain nursing values. End-of-life has also been highlighted as a key concept in palliative care. One limitation is exclusion of articles because of stipulated timeframe and dearth of research articles. However, it would be important for future studies to carefully incorporate and utilize older research studies. The article will form the basis for my thesis because it builds on different approaches used to improve the quality of life of individuals diagnosed with terminal or life-threatening diseases.
Carvajal, A., Haraldsdottir, E., Kroll, T., McCormack, B., Larkin, P., & Errasti-Ibarrondo, M. B. (2019). Barriers and facilitators perceived by registered nurses to providing person-centred care at the end of life. A scoping review.
Carvajal and colleagues review barriers and facilitators the perceived enhancers and barriers that nurses encounter while provide end-of-life care. Data from a scoping review, reviewed and analyzed by the authors, was used to uncover factors which facilitate or impede provision of patient-centered end-of-life care. Knowledge of end-of-life care, communication skills, coping strategies, and teamwork were identified as barriers to quality end-of-life car. Three primary facilitators were identified: Knowing the person in a holistic way, nurses’ self-knowledge, and the development of a good nurse-person relationship. The article provides good themes for my research paper; that is, barriers and facilitators of end-of-life care, which is a portion of palliative care. Roles of palliative care cannot be understood without information about factors that enhance or derail its delivery. Being a scoping, the article gives a broad, international view of barriers and facilitators of generalist nurses when caring for patients during the terminal life stages. This was identified as the core limitation, but supplementing the findings with more studies on different sub-themes can address this limitation. The article will build my thesis and add important themes such as improving person-centeredness of palliative care.
Devik, S. A., Hellzen, O., & Enmarker, I. (2015). “Picking up the pieces”—Meanings of receiving home nursing care when being old and living with advanced cancer in a rural area.International Journal of Qualitative Studies on Health and Well-Being, 10(1), 28382.
The articles sought to illuminate the lived experiences of the elderly and those living with advanced cancers in rural areas. The authors are professors and a doctoral student at Mid-Norway, Steinkjer, Norway; Department of Nursing Mid-Sweden University, Sundsvall, Sweden. The article is recent and peer-reviewed and can be relied upon to inform my research study on palliative care. Qualitative research method, narrative interview, was completed on nine elderly patients to provide data to inform the aims of the study, and phenomenological hermeneutic approach was employed to give interpretations. The author’s primary focus was to discuss the actual experiences of patients in relation to palliative care within rural setting. Devik et al.’s research article is useful to my thesis as it unveils an important setting, rural areas, where palliative care is often under-provided with many patients preferring to receive such care from their homes in the rural area. The core limitation of the study was small sample size, and the authors note that future studies should consider using more participants within different areas to make it possible for generalization. I will use the research article to discuss different settings where palliative care can be provided to maximize outcomes, especially for the elderly patients.
Danielsen, B. V., Sand, A. M., Rosland, J. H., & Førland, O. (2018). Experiences and challenges of home care nurses and general practitioners in home-based palliative care–a qualitative study. BMC Palliative Care, 17(1), 1-13.
Danielsen, Sand, Rosland, and Førland conducted a study to scrutinize home-based palliative care under two domains; experiences and hurdles encountered by health professionals while providing home-based care for the elderly and the terminally sick. The source is up-to-date and the authors are reputable individuals working at the Department of Health and Caring Sciences, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, and the Department of Clinical Medicine, University of Bergen, Bergen, Norway Sunniva Centre for Palliative Care, Haraldsplass Deaconess Hospital Bergen, Bergen, Norway. Data gained through four focus groups using semi-structured interview (qualitative research design) was used to identify factors which hamper or promote efficient and effective home-based palliative care. The authors’ article provides good information about an important setting, home-based environment, and factors that can increase life expectancy and reduce deaths of patients with terminal illnesses while being cared for at home. I will use information on factors that increase provision of quality palliative care at home such as collaboration between healthcare professionals, patients, and family members to inform my thesis. Insights from both nurses and other healthcare providers provided a diversified view; an important strength for the study. However, the main limitation of the study was not focusing on professionals from hospital setting but only from primary healthcare setting. Such a limitation can be addressed by expanding focus to doctors and nurses from hospitals who discharge patients home for further palliative care. I will apply the source to discuss home-based palliative care and how to increase positive outcomes for patients and families with terminal illnesses.
Mittmann, N., Liu, N., MacKinnon, M., Seung, S. J., Look Hong, N. J., Earle, C. C., Gradin, S., Sati, S., Buchman, S., Jakda, A., & Wright, F. C. (2020). Does early palliative identification improve the use of palliative care services?PloS One, 15(1), e0226597.
Mittman and colleagues probe the impact of early palliative identification in improving its utilization in the healthcare system. The authors are considered expertise in their respective field and worked together to bring together the research article. Utilizing quantitative research design, the authors implemented the Integrating Early Palliative Care into Routine Practice for Patients with Cancer (INTEGRATE). Four different cancer centers were used during the study. Propensity score-matched study was used to compared uptake of palliative modalities by patients in centers using INTEGRATE against those patients in centers that did not use the same. The main limitation for the study was lack of randomization when selecting participants which could have resulted in selection bias. Therefore, future studies should randomly choose participants from different settings to avoid bias and allow generalization. The article is an excellent source that I will use to inform my thesis because it was conducted in Canada and provides the role of early palliative care under two important themes; ameliorate the quality of life and heighten life expectancy.
Abu-Odah, H., Molassiotis, A., & Liu, J. (2020). Challenges on the provision of palliative care for patients with cancer in low-and middle-income countries: A systematic review of reviews.BMC Palliative Care, 19(1), 1-16.
In the article, the authors through a systematic review of reviews investigate factors which impede the provision of palliative care. The authors being faculties in the School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, have expertise to conduct research in palliative care. Recent research articles and reputable databases have been used, making the source integral in my thesis. Abu-Odah and colleagues aim to provide personal, organizational, policy, and system barriers and facilitators in the verge of providing palliative care to cancer patients. Use of different databases makes the systematic review strong whereas the main limitation was the few number of original studies. However, the authors suggest the importance of future systematic review using original qualitative and quantitative studies to conduct original studies on palliative care. I will utilize the article as a basis for my research article because it provides background information about palliative care and challenges and facilitators encountered whilst providing the same. The authors borrow ideas from different peer-reviewed sources to inform their arguments, further inclining my choice for the article. Finally, I will integrate some concepts, including policy and organizational factors that influence palliative medicine, as themes for my research study.
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