Barriers In End Of Life Care Essay

Question:

Disucss about the Barriers in End of life Care within Children and older adult is age groups.

Answer:

Care for end of life patients is very strenuous not only for the relatives but also for the personnel working in the nursing homes. This review is centered on the end of life care given to the terminally ill children and the end of life ailing elderly. This two are sections of the society whose end is imminent, and thus require care as the end encourages. Is care is expensive and taxing on the psychological as well as the physical welfare of the care over who are either parent of the terminally ill youngsters or the personnel in the elderly care homes.

In the first review, an institution's management employed the help of researchers to investigate the rising cases of hospital transfers experienced in the tree hundred bed care home. By use of focus group interviews, designing in a way treat the personnel in all the ranks could participate (B?kki, Neuhaus, & Paal, 2016). Twenty-two personnel in a total of the on the various positions attended the interviews. Te ranks included nurses/ assistant nurses, managers /experts, and the primary physicians.

After preparation of the full-length transcripts, researchers applied thematic content analysis to extract data. Meanings of the contents of the transcripts were identified, and then paraphrasing of the codes was done (Smith, 2015). Codes were converted in categories which were named after the original wording of the transcripts. In every stage, codes were assessed and reassessed. Summarization of the findings was done


Primarily four main factors were recurrent in the title categorization of the issues arising in the leadership, communication, personal and the conflict of aims and attitudes. Other issues that arose were the lack of basic training among the personnel as well as the sortie of resources was done. These were reasons that reverberated across all the ranks varying only in word sense.

Two limitations arise from this method of research since it could prevent its use in larger scales to refer to care homes in general. This is due to the exclusion of factors like cultural considerations, religious background, etc. which are significant factors that are to be considered (Van der Geest et al., 2014). Secondly, seen with discretion provided and the measures against discrimination some of the personnel may have died away from the interviews and thus the study may only give a finding half way.

In a nutshell, the issues raised by the study are primary issues tables in many other homes and sortie off personnel and resources. The more extensive study of more homes may prove more detailed and accurate since they have more factors considered by the personnel studied since different ones have different settings.

The second study was aimed at a study on the perceptions of parents of parents with terminally ill children in the palliative care phase and after. The reasons behind the prolonged relief periods as well as their mental health in the palliative care phase. A segment of 87 parents of 57 children who passed on between 2000 and 2004 was the basis for this study. The parents were asked to answer two questionnaires, one on the inventory of traumatic grief while the second was the interaction with the help professionals and suffering of their children in the palliative phase.


The ITG study was basically to evaluate the different levels of grief the parents suffered after and in the course of palliative care. On the other and the researchers used the questionnaire o understands the perceptions of parents towards the personnel on their response and success in managing their children's symptoms. Follow this the Likert’s test was used to understand the success in the management of symptoms of the children.

Statistical analysis was performed using SPSS software. Univariate analyses were utilized by the researchers to assess the different types of interaction with various healthcare staff, as well as the various symptom managements and different covariates on the social grief score. Covariates such as grief were then incorporated into the multivariate regression models (MRM), MRM helped in the investigation of the combined effect of the univariate statistically significant care-related aspects of long-term relations of parental grief.

Using SPSS software statistical, the analysis was performed. Covariates such as grief were then incorporated into the multivariate regression models(MRM), which helped in the investigation of the combined effect of the univariate statistically significant care-related aspects of long-term relations of parental grief. An individual regression model was run because of the multicollinearity among continuity of care, communication and parental involvement and symptoms (Ormston, Spencer, Barnard, & Snape, 2014). This helped to understand the contributions that the parents expect from the healthcare professionals and how any adverse effects result in long term grief among parents.

Parents rated to fly in communication and continuation of palliative care in which cases possibility of long term pain was comparatively low. Long-term pain possibilities rose with children's dyspnea as well as anxiety regarding te future and answer. This feedback was coupled with the tester parent’s perceptions and per possibilities of suffering long time grief. Limitations faced were that the response rate of the grieving parents was low and high anxiety from mothers.


The third study aimed at examining the views of the elderly in care homes and their view of ways they think would improve their conditions. In this 18 interviews in 6 elderly care homes were carried on 133 elderly persons suffering dementia. 18 interviews were conducted with the help of a four-year longitudinal mixed study that was given the name ‘Evidence-based Interventions for Dementia End of life study' called the ‘Evidem-Eol.' It was conducted in two phases. The first step was performed for one year where 133 older people from six care homes were tried to be included. The findings which were found from the previous phase were then used to prepare context-specific interventions by collaboration with home-care staff, general practitioners, community nurses and others.

Data was systemically sorted and were allocated to various categories. During reviewing of the categories, similarities were identified and then merged. After identification of the key themes, they were examined (Goodman et al., 2013). Elderly patients stated that their requests were often ignored and that to they have impaired them and even to look upon another for assistance. They also added relevance since in the course of their stay the needed to make deep, meaningful relationships which are the core for the one feeling they need from the care homes.

In this method, the subjects of study suffered from dementia; therefore, their feedback it will be inadmissible to use in meaningful research. However, since there is directly experiencing their state, they are the best persons to ask. By acknowledging their sentiments, the care homes may have the feedback they require to improve their workings.

The fourth paper is derived from the Journal of pain and symptom management whose aim was to study whether there is evidence that palliative care teams alter the end of life experiences of patients and their caregivers. In this review article, 44 studies were used in the evaluation of the palliative and hospice care teams (PCHCT) where 10 electronic databases were utilized to determine its impact (Irene et al., 2003). The quantitative study used different research teams, 22 from home care, 9 hospital-based, 3 impatient units, 6 integrated teams, and 4 hospital care. A meta-regression analysis using 19 different studies was used to demonstrate patient’s pains benefit using 98% confidence interval levels. The research findings showed that death related data was equivocal.


These research samples were formed by both children and the adult people between the rural, city, and urban areas. The study formed intervention teams since at least one or more health care workers at least possessed a special training skill or had an experience in palliative care (Irene et al., 2003).

The study populations were patients with progressive life with full of illness, depression, and grieve. Samples were randomly selected.

In this study, evidence of benefit was critical for home care. However, the research had some limitations since only one study provided a strong base for cost versus benefit analysis and quantitatively shown PCHCTs significance. These comparisons were limited by the poor quality of research.

In conclusion, standard care planning for infants by both the parents and other concerned parties contributes to efficient decision making on how to curb the adverse impacts of risky living environments for both the children and the aged. Parents valued palliative care and considered it wise for children to live a stress-free life. Therefore, the qualitative and quantitative research methods are useful in studying health living factors and challenges for the infants and aged people.

References

B?kki, J., Neuhaus, P. M., & Paal, P. (2016). End of life care in nursing homes: Translating focus group findings into action. Geriatric Nursing, 37(6), 440-445.

Goodman, C., Amador, S., Elmore, N., Machen, I., & Mathie, E. (2013). Preferences and priorities for ongoing and end-of-life care: A qualitative study of older people with dementia resident in care homes. International journal of nursing studies, 50(12), 1639-1647.

Irene, J.H., Ilora, G. F., Danielle, M. G., Kerry, H., (2003). Is There Evidence That Palliative Care Teams Alter End-of-Life Experiences of Patients and Their Caregivers? Journal of Pain and Symptom Management. Pp. 1-19.

Ormston, R., Spencer, L., Barnard, M., & Snape, D. (2014). The foundations of qualitative research. Qualitative research practice. A guide for social science students and researchers, 1-25.

Smith, J. A. (Ed.). (2015). Qualitative psychology: A practical guide to research methods. Sage.

Van der Geest, I. M., Darlington, A. S. E., Streng, I. C., Michiels, E. M., Pieters, R., & van den Heuvel-Eibrink, M. M. (2014). Parents' experiences of pediatric palliative care and the impact on long-term parental grief: Journal of pain and symptom management, 47(6), 1043-1053.

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