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The integrated palliative care outcome scale for patients with palliative care needs: Factors related to and experiences of the use in acute care settings

Published online by Cambridge University Press:  07 March 2019

Susanne Lind*
Affiliation:
Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
Lars Wallin
Affiliation:
Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden School of Education, Health and Social Science, Dalarna University, Dalarna, Sweden Department of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Carl Johan Fürst
Affiliation:
Institute for Palliative Care, Lund University and Region Skåne, Sweden Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Oncology, Lund, Sweden
Ingela Beck
Affiliation:
Institute for Palliative Care, Lund University and Region Skåne, Sweden Faculty of Medicine, Department of Clinical Sciences Lund, Lund University, Oncology, Lund, Sweden Faculty of Health Sciences, Department of Nursing and Integrated Health Sciences, Kristianstad University, Kristianstad, Sweden
*
Author for correspondence: Susanne Lind, Department of Health Care Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, P.O. Box 111 89, SE-100 61 Stockholm. Sweden. E-mail: [email protected]

Abstract

Objective

Implementation of patient-reported outcome measures for patients with palliative care needs is characterized by both enablers and barriers. The ways in which healthcare professionals experience the use of assessment tools is important. Our aims were to explore factors contributing to or hindering patients with palliative care needs in assessing their symptoms with the Integrated Palliative Care Outcome Scale (IPOS) and to explore healthcare professionals’ experiences of the use of IPOS in acute care settings.

Method

Data were collected as a part of the evaluation of the feasibility of an implementation strategy for introducing IPOS. Data from three participating acute care units were included. We used descriptive and analytical statistics; a qualitative content analysis was also performed.

Result

A total of 309 patients were eligible to be offered assessment of symptoms with IPOS. Of these 69 (22%) had completed IPOS. A significant positive association was found between healthcare professionals’ participation in training sessions and completed IPOS. The experiences of IPOS were split into two categories: “IPOS acting as a facilitator” and “barriers to the use of IPOS.” The use of IPOS was described as contributing to person-centered care of patients with palliative care needs and inspiration to improved routines. Healthcare professionals’ feelings of uncertainty about how to approach severely ill patients and their family members appear to have hindered their use of IPOS.

Significance of results

We found an association between healthcare professionals’ participation in training sessions and patients who completed IPOS, indicating the need for a high degree of attendance at the training to achieve successful implementation. The healthcare professionals expressed feelings of insecurity concerning the use of IPOS indicating a need for further education and clinical support in its use of IPOS. Nevertheless, use of IPOS was considered to contribute to improved care of patients with palliative care needs.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2019 

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References

Antunes, B, Harding, R, Higginson, IJ, et al. (2014) Implementing patient-reported outcome measures in palliative care clinical practice: A systematic review of facilitators and barriers. Palliative Medicine 28(2), 158175. doi: 10.1177/0269216313491619Google Scholar
Bausewein, C, Simon, ST, Benalia, H, et al. (2011) Implementing patient reported outcome measures (PROMs) in palliative care - users' cry for help. Health and Quality of Life Outcomes 9. doi: 10.1186/1477-7525-9-27Google Scholar
Beck, I, Olsson Möller, U, Malmström, M, et al. (2017). Translation and cultural adaptation of the integrated palliative care outcome scale including cognitive interviewing with patients and staff. BMC Palliative Care 16(1), 49. doi: 10.1186/s12904-017-0232-xGoogle Scholar
Björk, J (2011) Practical statistics for medicine and health [In Swedish]. Stockholm: Liber.Google Scholar
Bloomer, M, Moss, C, and Cross, W (2011) End-of-life care in acute hospitals: An integrative literature review. Journal of Nursing and Healthcare of Chronic Illness 3, 165173.Google Scholar
Boyce, MB, Browne, JP, and Greenhalgh, J (2014) The experiences of professionals with using information from patient-reported outcome measures to improve the quality of healthcare: A systematic review of qualitative research. BMJ Quality & Safety 23(6), 508518. doi: 10.1136/bmjqs-2013-002524Google Scholar
Brinkmann, S and Kvale, S (2015) InterViews: Learning the craft of qualitative research interviewing. Los Angeles, CA: Sage Publications.Google Scholar
Broad, JB, Gott, M, Kim, H, et al. (2013) Where do people die? An international comparison of the percentage of deaths occurring in hospital and residential aged care settings in 45 populations, using published and available statistics. International Journal of Public Health 58(2), 257267. doi: 10.1007/s00038-012-0394-5Google Scholar
Creswell, JW and Plano Clark, VL (2011) Designing and conducting mixed methods research. Los Angeles, CA: SAGE Publications.Google Scholar
Dawson, J, Doll, H, Fitzpatrick, R, et al. (2010) The routine use of patient reported outcome measures in healthcare settings. British Medical Journal 340. doi: 10.1136/bmj.c186Google Scholar
Elo, S and Kyngäs, H (2008) The qualitative content analysis process. Journal of Advanced Nursing 62(1), 107115. doi: 10.1111/j.1365-2648.2007.04569.xGoogle Scholar
Etkind, SN, Daveson, BA, Kwok, W, et al. (2015) Capture, transfer, and feedback of patient-centered outcomes data in palliative care populations: Does it make a difference? A systematic review. Journal of Pain Symptom Management 49(3), 611624. doi: 10.1016/j.jpainsymman.2014.07.010Google Scholar
Frey, R, Gott, M, Raphael, D, et al. (2014) Clinical staff perceptions of palliative care-related quality of care, service access, education and training needs and delivery confidence in an acute hospital setting. BMJ Supportive and Palliative Care 4(4), 381389. doi: 10.1136/bmjspcare-2012-000346Google Scholar
Håkanson, C, Öhlén, J, Morin, L, et al. (2015) A population-level study of place of death and associated factors in Sweden. Scandinavian Journal of Public Health 43(7):744751. doi: 10.1177/1403494815595774Google Scholar
Kehl, KA and Kowalkowski, JA (2013) A systematic review of the prevalence of signs of impending death and symptoms in the last 2 weeks of life. American Journal of Hospice and Palliative Medicine 30(6), 601616. doi: 10.1177/1049909112468222Google Scholar
Kobewka, D, Ronksley, P, McIsaac, D, et al. (2017) Prevalence of symptoms at the end of life in an acute care hospital: A retrospective cohort study. CMAJ Open 5(1), E222E228. doi: 10.9778/cmajo.20160123Google Scholar
Lind, S, Sandberg, J, Brytting, T, et al. (2018) Implementation of the integrated palliative care outcome scale in acute care settings - a feasibility study. Palliative and Supportive Care 16(6):18. doi: 10.1017/S1478951517001158Google Scholar
McIlfatrick, S and Hasson, F (2014) Evaluating an holistic assessment tool for palliative care practice. Journal of Clinical Nursing 23(7–8), 10641075. doi: 10.1111/jocn.12320Google Scholar
Pivodic, L, Pardon, K, Morin, L, et al. , on behalf of Euro Impact. (2016) Place of death in the population dying from diseases indicative of palliative care need: A cross-national population-level study in 14 countries. Journal of Epidemiologic and Community Health, 70(1), 1724. doi: 10.1136/jech-2014-205365Google Scholar
Radbruch, L and Payne, S (2009) White Paper on standards and norms for hospice and palliative care in Europe: Part 1, recommendations from the European Association for Palliative Care. European Journal of Palliative Care 16(6), 278289.Google Scholar
Reich, O, Signorell, A, and Busato, A (2013) Place of death and health care utilization for people in the last 6 months of life in Switzerland: A retrospective analysis using administrative data. BMC Health Services Research 13(1), 116. doi: 10.1186/1472-6963-13-116Google Scholar
Reid, C, Gibbins, J, Bloor, S, et al. (2015) Healthcare professionals' perspectives on delivering end-of-life care within acute hospital trusts: A qualitative study. BMJ Supportive and Palliative Care 5(5), 490495. doi: 10.1136/bmjspcare-2013-000468Google Scholar
Romem, A, Tom, SE, Beauchene, M, et al. (2015) Pain management at the end of life: A comparative study of cancer, dementia, and chronic obstructive pulmonary disease patients. Palliative Medicine 29(5), 464469. doi: 10.1177/0269216315570411Google Scholar
Schildmann, EK, Groeneveld, EI, Denzel, J, et al. (2016) Discovering the hidden benefits of cognitive interviewing in two languages: The first phase of a validation study of the Integrated Palliative care Outcome Scale. Palliative Medicine 30(6), 599610. doi: 10.1177/0269216315608348Google Scholar
Siout, N, van Beek, K, Preston, N, et al. (2016a). Towards integration of palliative care in patients with chronic heart failure and chronic obstructive pulmonary disease: A systematic literature review of European guidelines and pathways. BMC Palliative Care 15, 18. doi: 10.1186/s12904-016-0089-4Google Scholar
Siouta, N, Van Beek, K, van der Eerden, ME, et al. (2016b) Integrated palliative care in Europe: A qualitative systematic literature review of empirically-tested models in cancer and chronic disease. BMC Palliative Care 15, 56. doi: 10.1186/s12904-016-0130-7Google Scholar
Öhlen, J, Russell, L, Hakanson, C, et al. (2017) Variations in care quality outcomes of dying people: Latent class analysis of an adult national register population. Journal of Pain and Symptom Management 53(1), 1324. doi: 10.1016/j.jpainsymman.2016.08.006Google Scholar
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