Investigation of Modifiable Variables to Increase Hospice Nurse Comfort With Care Provision to Children and Families in the Community: A Population-Level Study Across Tennessee, Mississippi, and Arkansas.
Pediatric
community
education
hospice
palliative care
training
Journal
Journal of pain and symptom management
ISSN: 1873-6513
Titre abrégé: J Pain Symptom Manage
Pays: United States
ID NLM: 8605836
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
09
05
2020
revised:
23
06
2020
accepted:
24
06
2020
pubmed:
6
7
2020
medline:
24
6
2021
entrez:
6
7
2020
Statut:
ppublish
Résumé
Most hospice nurses across Tennessee, Arkansas, and Mississippi report significant discomfort with provision of pediatric palliative and hospice care (PPHC). How best to target and modify variables to increase nurse comfort levels is not well understood. To determine whether modifiable variables are associated with increased hospice nurse comfort with PPHC provision in the community. A cross-sectional survey was developed, pilot tested, and distributed to hospice nurses across a tristate region to assess nurse training experiences and comfort with PPHC provision. Targeted subanalyses were conducted to investigate associations between nurse comfort level and clinical, training, and patient frequency variables. A total of 551 respondents representing 71 hospices across Tennessee, Arkansas, and Mississippi completed surveys. Hospice nurse comfort with provision of care to children was statistically significantly associated with exposure to prior PPHC clinical experiences (P < 0.001), receipt of formal pediatric PPHC training (P < 0.001), and higher hospice-level (P = 0.01) and individual-level frequency of PPHC provision (P < 0.001). PPHC clinical experience was the most impactful variable with respect to comfort with overall and end-of-life PPHC provision; formal training was the most impactful variable with respect to comfort with management of severe symptoms at the end of life. Modifiable variables exist that are readily targetable to improve hospice nurse comfort with PPHC provision. These findings should inform the development and investigation of clinical and educational interventions to empower both nurses and hospices to optimize the provision of quality care to children with serious illness and their families in the community.
Identifiants
pubmed: 32622898
pii: S0885-3924(20)30580-7
doi: 10.1016/j.jpainsymman.2020.06.036
pmc: PMC7680295
mid: NIHMS1608944
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1144-1153Subventions
Organisme : NCI NIH HHS
ID : R25 CA023944
Pays : United States
Informations de copyright
Copyright © 2020 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
Références
J Palliat Med. 2010 Nov;13(11):1331-8
pubmed: 20979524
BMC Palliat Care. 2010 Jun 02;9:10
pubmed: 20525166
Am J Hosp Palliat Care. 2007 Jun-Jul;24(3):191-5
pubmed: 17601842
Am J Hosp Palliat Care. 2014 Dec;31(8):836-44
pubmed: 24037541
J Hosp Palliat Nurs. 2019 Aug;21(4):E17-E23
pubmed: 31166302
Pediatr Nurs. 2009 Mar-Apr;35(2):86-90
pubmed: 19472671
Pediatr Blood Cancer. 2013 Nov;60(11):1875-81
pubmed: 23840035
Issues Compr Pediatr Nurs. 2013 Sep;36(3):188-211
pubmed: 23758218
Pediatrics. 2008 Feb;121(2):282-8
pubmed: 18245419
Ann Palliat Med. 2015 Apr;4(2):61-9
pubmed: 25971293
J Clin Oncol. 1991 Oct;9(10):1916-20
pubmed: 1919641
BMC Palliat Care. 2010 Jun 04;9:11
pubmed: 20525318
J Palliat Care. 2021 Jan;36(1):22-28
pubmed: 31771423
Pediatrics. 2013 Nov;132(5):966-972
pubmed: 28448256
Health Soc Care Community. 2012 Jul;20(4):420-9
pubmed: 22469189
Health Soc Care Community. 2010 Jul;18(4):337-45
pubmed: 20039968
Med J Aust. 2010 Jan 18;192(2):71-5
pubmed: 20078405
Am J Hosp Palliat Care. 2012 May;29(3):171-6
pubmed: 21712308
J Clin Oncol. 2007 Oct 1;25(28):4472-6
pubmed: 17906208
Palliat Support Care. 2019 Jun;17(3):269-275
pubmed: 29397055
J Pain Symptom Manage. 2019 Feb;57(2):241-250
pubmed: 30391654
J Nurs Manag. 2018 Jan;26(1):19-25
pubmed: 28695723
Pediatr Blood Cancer. 2014 May;61(5):859-64
pubmed: 24265171
Pediatrics. 2019 Aug;144(2):
pubmed: 31366685
Nurs Child Young People. 2013 Nov;25(9):31-6
pubmed: 24200187
Pediatrics. 2000 Aug;106(2 Pt 1):351-7
pubmed: 10920167
Palliat Med. 2020 Mar;34(3):403-412
pubmed: 31347446
Palliat Med. 2012 Apr;26(3):268-74
pubmed: 21680751
J Pain Symptom Manage. 2017 May;53(5):901-910.e1
pubmed: 28063867
CA Cancer J Clin. 2015 Jul-Aug;65(4):316-33
pubmed: 25955682
N Engl J Med. 2004 Apr 22;350(17):1752-62
pubmed: 15103002
Int J Palliat Nurs. 2010 May;16(5):233-40
pubmed: 20679971
Klin Padiatr. 2008 May-Jun;220(3):166-74
pubmed: 18478489
J Palliat Med. 2002 Feb;5(1):73-84
pubmed: 11839229