Abstract:
BACKGROUND:Many people with advanced dementia live in residential aged care homes. Care home staff need the knowledge and skills to provide high-quality end-of-life (EOL) dementia care. However, several studies have found EOL dementia care to be suboptimal, and care staff have reported they would benefit from training in palliative care and dementia. Simulation offers an immersive learning environment and has been shown to improve learners' knowledge and skills. However, there is little research on simulation training for residential care staff. This article presents the development and evaluation protocol of IMproving Palliative care Education and Training Using Simulation in Dementia (IMPETUS-D) - a screen-based simulation training program on palliative dementia care, targeted at residential care staff. IMPETUS-D aims to improve the quality of palliative care provided to people living with dementia in residential care homes, including avoiding unnecessary transfers to hospital. METHODS:A cluster RCT will assess the effect of IMPETUS-D. Twenty-four care homes (clusters) in three Australian cities will be randomised to receive either the IMPETUS-D intervention or usual training opportunities (control). The primary outcome is to reduce transfers to hospital and deaths in hospital by 20% over 6-months in the intervention compared to the control group. Secondary outcomes include uptake of goals of care plans over 6 and 12 months, change in staff knowledge and attitudes towards palliative dementia care over 6 months, change in transfers to hospital and deaths in hospital over 12 months. For the primary analysis logistic regression models will be used with standard errors weighted by the cluster effects. A mixed methods process evaluation will be conducted alongside the cluster RCT to assess the mechanisms of impact, the implementation processes and contextual factors that may influence the delivery and effects of the intervention. DISCUSSION:In Australia, the need for high-quality advanced dementia care delivered in residential aged care is growing. This study will assess the effect of IMPETUS-D a new simulation-based training program on dementia palliative and EOL care. This large multisite trial will provide robust evidence about the impact of the intervention. If successful, it will be distributed to the broader residential care sector. TRIAL REGISTRATION:ANZCTR, ACTRN12618002012257 . Registered 14 December 2018.
journal_name
BMC Palliat Carejournal_title
BMC palliative careauthors
Tropea J,Johnson CE,Nestel D,Paul SK,Brand CA,Hutchinson AF,Bicknell R,Lim WKdoi
10.1186/s12904-019-0474-xsubject
Has Abstractpub_date
2019-10-23 00:00:00pages
86issue
1issn
1472-684Xpii
10.1186/s12904-019-0474-xjournal_volume
18pub_type
杂志文章,随机对照试验abstract:BACKGROUND:Communication in do not resuscitate (DNR) and artificial nutrition and hydration (ANH) at the end of life is a key component of advance care planning (ACP) which is essential for patients with advanced cancer to have cares concordant with their wishes. The SOP model (Shared decision making with Oncologists a...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-0521-7
更新日期:2020-02-04 00:00:00
abstract:BACKGROUND:The prevalence and implementation of institutional end-of-life policies has been comprehensively studied in Flanders, Belgium, a country where euthanasia was legalised in 2002. Developing end-of-life policies in hospitals is a first step towards improving the quality of medical decision-making at the end-of-...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-8-20
更新日期:2009-12-30 00:00:00
abstract:BACKGROUND:Globally the state of palliative care research remains uncertain. Questions remain regarding impact, funding, and research priorities. Building upon previous research, this review examines palliative care research in Ireland and contributes to a wider international debate on the state of palliative care rese...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-018-0364-7
更新日期:2018-09-27 00:00:00
abstract:BACKGROUND:Effective integration between hospices, palliative care services and other local health care services to support patients with palliative care needs is an important international priority. A previous model suggests that integration involves a cumulative stepped process of engagement with other organisations ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0250-8
更新日期:2017-11-28 00:00:00
abstract:BACKGROUND:Homeless people often suffer from complex and chronic comorbidities, have high rates of morbidity and die at much younger ages than the general population. Due to a complex combination of physical, psychosocial and addiction problems at the end of life, they often have limited access to palliative care. Both...
journal_title:BMC palliative care
pub_type: 杂志文章,评审
doi:10.1186/s12904-018-0320-6
更新日期:2018-04-24 00:00:00
abstract:BACKGROUND:Over the past decades there has been a significant increase in the number of published clinical trials in palliative care. However, empirical evidence suggests that there are methodological problems in the design and conduct of studies, which raises questions about the validity and generalisability of the re...
journal_title:BMC palliative care
pub_type: 杂志文章,评审
doi:10.1186/s12904-016-0181-9
更新日期:2017-01-25 00:00:00
abstract:BACKGROUND:Although spiritual care is a basic element of holistic nursing, nurses' spiritual care knowledge and abilities are often unable to satisfy patients' spiritual care needs. Therefore, nurses are in urgent need of relevant training to enhance their abilities to provide patients with spiritual care. DESIGN:A no...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0489-3
更新日期:2019-11-26 00:00:00
abstract::BACKGROUND: Transitions in the location of care and in who provides such care can be extremely stressful for individuals facing death and for those close to them. The objective of this study was to describe the distribution of transitions in care experienced by palliative care patients following admission to a compreh...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-4-3
更新日期:2005-02-22 00:00:00
abstract:BACKGROUND:The leading cause of death among young children in southern Africa is complications due to HIV infection and, in South Africa, over a third of all deaths of children younger than five are associated with HIV infection. There is a great and urgent need for children's palliative care in Africa, whether HIV-rel...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0114-7
更新日期:2016-04-09 00:00:00
abstract:BACKGROUND:Most patients with life-limiting illnesses are treated and cared for over a long period of time in primary care and guidelines suggest that ACP discussions should be initiated in primary care. However, a practical model to implement ACP in general practice is lacking. Therefore, the objective of this study i...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0091-x
更新日期:2016-02-11 00:00:00
abstract::BACKGROUND: Although guidelines for the care of the dying patient exist the evidence base to support the guidelines is poor. Some of the factors contributing to this include failure to recruit to trials, protective healthcare professionals and subsequent attrition from trials due to the death of the patients. Recent s...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-3-1
更新日期:2004-04-27 00:00:00
abstract:BACKGROUND:Discrepancies between the information that patients have received and the patients' awareness of their condition have frequently been observed in literature and given a number of different explanations. The chief contribution of this study is that by following patients over time it is possible not only to no...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-7-2
更新日期:2008-02-28 00:00:00
abstract:BACKGROUND:According to common practice based on a generally agreed interpretation of Icelandic law on the rights of patients, health care professionals cannot discuss prognosis and treatment with a patient's family without that patient's consent. This limitation poses ethical problems, because research has shown that,...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-13-8
更新日期:2014-03-11 00:00:00
abstract:BACKGROUND:Institutional deaths (hospitals and nursing homes) are an important issue because they are often at odds with patient preference and associated with high healthcare costs. The aim of this study was to examine deaths in institutions and the role of individual, regional, and healthcare supply characteristics i...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0156-x
更新日期:2016-09-23 00:00:00
abstract:BACKGROUND:More people die in hospital than in any other setting which is why it is important to study the outcomes of hospital care at end of life. This study analyses what influenced outcomes in a sample of patients who died in hospital in Ireland in 2008/9. The study was undertaken as part of the Irish Hospice Found...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-015-0014-2
更新日期:2015-04-18 00:00:00
abstract:BACKGROUND:More attention is being paid to the wellbeing of staff working in stressful situations. However, little is known about staff experience of providing end-of-life care to children within a hospice setting. This study aims to explore the experiences of care team staff who provide end-of-life care within a child...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0189-9
更新日期:2017-02-13 00:00:00
abstract:BACKGROUND:To understand the status of residents' awareness of and demand for hospice care services in Hangzhou and to provide a reference for promoting the formulation of hospice care-related policies in China. METHODS:A small cross-sectional survey of 519 adults aged over 40 years old living in the rural-urban fring...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00628-8
更新日期:2020-08-17 00:00:00
abstract:UNLABELLED: BACKGROUND:Parental palliative disease is a family affair, however adolescent's well-being and coping are still rarely considered. The objectives of this paper were a) to identify differences in psychosocial adjustment and health-related quality of life (HRQoL) among adolescents and young adults with paren...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-11-21
更新日期:2012-10-30 00:00:00
abstract:BACKGROUND:The Patient Satisfaction Questionnaire (PSQ) is an assessment tool used to evaluate patients' perspectives of their doctor's communication and interpersonal skills. The present pilot study investigated whether the PSQ could be administered successfully in a hospice inpatient setting and if it is an acceptabl...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-13-27
更新日期:2014-06-02 00:00:00
abstract:BACKGROUND:It has been recognised that more evidence about important aspects of family members' sense of security during palliative care is needed. The objectives of the study was: i) to discover what variables are associated with family members feeling secure during palliative care; ii) to develop a model of family me...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0446-1
更新日期:2019-07-25 00:00:00
abstract:BACKGROUND:Research has highlighted the need for improving the implementation of advance care planning (ACP) in nursing homes. We developed a theory-based multicomponent ACP intervention (the ACP+ programme) aimed at supporting nursing home staff with the implementation of ACP into routine nursing home care. We describ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0505-7
更新日期:2020-01-08 00:00:00
abstract:BACKGROUND:The focus of Specialized Palliative Care (SPC) is to improve care for patients with incurable diseases and their families, which includes the opportunity to make their own choice of place of care and ultimately place of death. The Danish Palliative Care Trial (DOMUS) aims to investigate whether an accelerate...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-13-44
更新日期:2014-09-09 00:00:00
abstract:BACKGROUND:Palliative and end-of-life care development is hindered by a lack of information about the circumstances surrounding dying in developing and resource-poor countries. Our aims were to develop and obtain face and content validity for a self-administered questionnaire on end-of-life care provision and medical d...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00630-0
更新日期:2020-08-14 00:00:00
abstract:BACKGROUND:There are many potential benefits to chaplaincy in transforming into a "research-informed" profession. However little is known or has been documented about the roles of chaplains on research teams and as researchers or about the effects of research engagement on chaplains themselves. This report describes th...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-015-0006-2
更新日期:2015-05-02 00:00:00
abstract:BACKGROUND:The goal of Canada's Compassionate Care Benefit (CCB) is to enable family members and other loved ones who are employed to take a temporary secured leave to care for a terminally ill individual at end of life. Successful applicants of the CCB can receive up to 55% of their average insured earnings, up to a m...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-7-14
更新日期:2008-08-28 00:00:00
abstract:BACKGROUND:An international discussion about whether or not to legally permit euthanasia and (or) physician assisted suicide (EAS) is ongoing. Unbearable suffering in patients may result in a request for EAS. In the Netherlands EAS is legally permitted, and unbearable suffering is one of the central compulsory criteria...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-13-62
更新日期:2014-12-23 00:00:00
abstract:UNLABELLED: BACKGROUND:The United Kingdom has led the world in the development of children's palliative care. Over the past two decades, the illness trajectories of children with life-limiting conditions have extended with new treatments and better home-based care. Future planning is a critically under-researched aspe...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-12-5
更新日期:2013-02-05 00:00:00
abstract:BACKGROUND:There is a dearth of data regarding the optimal method of detecting and treating depression in palliative care. This study applied the Delphi method to evaluate expert opinion on choice of screening tool, choice of antidepressant and choice of psychological therapy. The aim was to inform the development of b...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-10-10
更新日期:2011-05-27 00:00:00
abstract:BACKGROUND:Cervical cancer is mostly diagnosed at advanced stages among the majority of women in low-income settings, with palliative care being the only feasible form of care. This study was aimed at investigating palliative care knowledge and access among women with cervical cancer in Harare, Zimbabwe. METHODS:Seque...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-0523-5
更新日期:2020-02-13 00:00:00
abstract:BACKGROUND:The Palliative Performance Scale (PPS) was first introduced in1996 as a new tool for measurement of performance status in palliative care. PPS has been used in many countries and has been translated into other languages. METHODS:This study evaluated the reliability and validity of PPS. A web-based, case sce...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-7-10
更新日期:2008-08-04 00:00:00