Contextual determinants of guideline-based family support during end-of-life cancer care and subsequent bereavement care: A cross-sectional survey of registered nurses.
In end-of-life cancer care, 10–20% of bereaved family members experience adverse mental health effects, including prolonged grief disorder. Despite great efforts, evidence-based recommendations to support their grieving process and well-being are often not successfully adopted into routine clinical...
| Published in: | European Journal of Oncology Nursing Vol. 70 |
|---|---|
| Main Authors: | , , , , , |
| Format: | research Journal Article |
| Published: |
Churchill Livingstone, Inc.
Jun2024
|
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=177655313&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 177655313 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14623889 8IF jtl: European Journal of Oncology Nursing issn: 14623889 maglogo: N pubinfo: dt: Jun2024 vid: 70 pid: 1242 pub: Churchill Livingstone, Inc. artinfo: ui: 177655313 177655313 177655313 10.1016/j.ejon.2024.102555 177655313 ppct: 1 formats: tig: atl: Contextual determinants of guideline-based family support during end-of-life cancer care and subsequent bereavement care: A cross-sectional survey of registered nurses. aug: au: Riguzzi, Marco Thaqi, Qëndresa Lorch, Anja Blum, David Peng-Keller, Simon Naef, Rahel affil: Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Universitaetstrasse 84, 8006 Zurich, Switzerland sug: subj: Neoplasms Nursing Neoplasms Therapy Practice Guidelines Family Support Bereavement Palliative Care Complicated Grief Implementation Science Health Services Accessibility Registered Nurses Psychosocial Factors Human Male Female Switzerland Cross Sectional Studies Logistic Regression Nursing Skills Organizational Culture Organizational Change Support, Psychosocial Professional-Family Relations Oncology Nursing Data Analysis Software Descriptive Statistics Male Female ab: In end-of-life cancer care, 10–20% of bereaved family members experience adverse mental health effects, including prolonged grief disorder. Despite great efforts, evidence-based recommendations to support their grieving process and well-being are often not successfully adopted into routine clinical care. This study identified facilitators and barriers using implementation science methodology. 81 registered nurses working in cancer care from four hospitals and three home care services in Switzerland assessed their current family support practices in end-of-life care and bereavement care. They then assessed organisational attributes of their institution and their own individual characteristics and skills regarding literature-based factors of potential relevance. Facilitators and barriers to guideline-based family support were determined using fractional logistic regression. Service specialisation in palliative care, a culture that supports change, the availability of family support guidelines, billing/reimbursement of bereavement support services, and individual knowledge of family support and skill were systematically associated with higher adoption of guideline-based family support practices. Lack of privacy with families and insufficient training acted as significant barriers. While several potentially relevant factors have emerged in the literature, certain organisational and individual determinants actually empirically predict guideline-based family support according to nurses in end-of-life cancer care, with some determinants having much stronger implications than others. This provides crucial guidance for focussing quality improvement and implementation efforts through tailored strategies, especially with scarce resources. Furthermore, adoption is lower in bereavement care than in end-of-life care, suggesting a particular need for supportive organisational cultures including specific training and billing/reimbursement options. • 10%–20% of bereaved family members of cancer patients suffer psychologically. • Guideline-based recommendations for family support are not consistently implemented. • It is unclear, which factors actually empirically predict successful implementation. • In this study, implementation science methods identify the strongest factors. • This enables implementation efforts to be effective and sustainable. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|