Psychological Care

Nurse Jennifer was asked to interview Mr. Folkman on his admission to the ward for minor dentalsurgery the following day. Mr. Folkman, a 32-year-old engineer, was married and had two children, agirl and a boy. He lived with his family near the hospital and in a factory in a nearby town. During theinterview, Nurse Jennifer noticed that while Mr. Folkman appeared to be in good health and to have aclear understanding of the surgery he was facing he seemed uneasy. Knowing that many patients feel ap-     

The Hospice Care

Hospiceisawordthathascomedownfrom[2 ] theMiddleAgesinEurope .Itwasusedtodescribeaway -stationwheretravelers ,pilgrims[3] ,andillpeoplecouldstopanddependonreceivinghumanecare .ThefirstpioneerofthemodernhospicemovementwasDr .CicelySaunderswithherbackgroundinmedicine ,nursing ,andsocialwork .ShefoundedSt.Christopher’shospiceinLondonin 1 96 7,whichrepresentsthebeginningoftoday’shospicesintheworld .Saundersusedthetermofhospicetomeanaway -stationwheredyingpeopleinacar ingenviromentcanliveoutth…     

Health Care Providers’ Knowledge,Practices, and Barriers to Hepatitis Vaccination Guidelines

We administered an online survey to 400 health care providers (HCPs) to evaluate knowledge and self-reported practices regarding hepatitis A (HepA)/hepatitis B (HepB) vaccination. Most HCPs (73%) were familiar with the Advisory Committee on Immunization Practices; 89% and 90% reported adhering to the guidelines always/most of the time for HepA and HepB, respectively. Self-reported adherence to guidelines varied across specialties, with nurse practitioners reporting the highest adherence rate of 94%. Survey results, including perceived barriers, reasons for not stocking vaccines, and predictors of adherence to and familiarity with guidelines, may inform strategies to improve compliance with hepatitis vaccination recommendations.     

Understanding Palliative Care and Hospice: A Review for Primary Care Providers

Palliative care provides invaluable clinical management and support for patients and their families. For most people, palliative care is not provided by hospice and palliative medicine specialists, but rather by their primary care providers. The recognition of hospice and palliative medicine as its own medical subspecialty in 2006 highlighted the importance of palliative care to the practice of medicine, yet many health care professionals harbor misconceptions about palliative care, which may be a barrier to ensuring that the palliative care needs of their patients are identified and met in a timely fashion. When physicians discuss end-of-life concerns proactively, many patients choose more comfort-focused care and receive care more aligned with their values and goals. This article defines palliative care, describes how it differs from hospice, debunks some common myths associated with hospice and palliative care, and offers suggestions on how primary care providers can integrate palliative care into their practice.     

词“Care”释义

随着护理事业的发展,整体护理在全国各地已经广泛开展。在新的护理模式下,护理人员不再单纯按传统方式护理病人和执行医嘱,而更多地肩负着向病人、家属以及社会提供卫生咨询健康指导等。护理观念的转变让我们必须对“护理”一词的内涵作出更深的理解。本人曾在新加坡陈...     

HIV, Aging, and Advance Care Planning: Are We Successfully Planning for the Future?

Abstract Introduction: Studies of advance care planning (ACP) completion rates in HIV-infected persons pre-date the "graying" of the HIV epidemic. We sought to examine current ACP completion rates and factors influencing completion among HIV-infected persons. Methods: HIV-1-seropositive persons aged 45-65 years on effective antiretroviral therapy for a minimum of 6 months were enrolled in a cross-sectional survey. Likelihood of ACP was assessed by demographic and clinical characteristics, tested with odds ratios (OR) and 95% Wald confidence intervals (CI), and adjusted for gender. Results: Of 238 participants, 112 (47%) completed ACP. Persons ≥55 years of age (OR 2.8; CI 1.6,5.0; p<0.001), males (OR 4.1; CI 1.8,9.3; p=0.004), and persons with higher education (OR 2.2; CI 1.3,4.0; p=0.007) were more likely to have completed ACP. Persons with a cardiac event were more likely to have completed ACP (OR 5.5; CI 1.6,25; p=0.03), although this effect was diminished after adjusting for gender (OR 4.5; CI 0.95,21.4; p=0.06). HIV infection diagnosed for greater than 5 years was not associated with ACP completion (OR 1.3; CI 0.7,2.7; p=0.4). Current CD4(+) cell counts were similar between those completing and not completing documentation (588 cells/μL and 604 cells/μL, respectively; p=0.7). The likelihood of ACP did not significantly differ with other comorbidities. Discussion: Less than 50% of middle-aged patients in HIV care had documented ACP. In particular, women and those with lower education were at greatest risk of non-completion and may need interventions to improve ACP.     

Radiation Therapy Students′ Knowledge,Attitudes, and Beliefs about Palliative and End-of-Life Care for Cancer Patients

Background and PurposeAlthough radiation therapy students are highly interested in providing palliative and end-of-life care (PEOLC), students often lack understanding of what palliative care is and express a lack of confidence when interacting with palliative patients. This study examined radiation therapy students' existing knowledge, attitudes, and beliefs toward PEOLC for cancer patients and how professional and personal experiences influenced those factors.MethodsThis study used a cross-sectional online questionnaire. After informed consent, data were collected from a sample of students in an undergraduate radiation therapy program in Canada. Questions were both quantitative and qualitative in nature. Responses were comprised of Likert scales and true or false responses, a case study–based vignette and several short open-ended questions.ResultsSixty-one students completed the questionnaire; the response rate was 42%. Responses indicate students had an incomplete understanding of PEOLC principles despite reporting positive views and interest in the topic. Professional and personal experiences improved students' knowledge regarding the role of PEOLC and attitudes and beliefs became more positive with increased real-life experiences.ConclusionsExperiential learning influences students' knowledge, attitudes, and beliefs about PEOLC. To better prepare students for their future professional roles, it is necessary for radiation therapy undergraduate programs to include PEOLC educational initiatives in its curricula. These initiatives should emphasize holistic care to prepare students to be competent radiation therapists who can address patients' complex PEOLC needs.