Palliative and end-of-life care in the home in regional/rural Victoria, Australia : the role and lived experience of primary carers
- Miller, Elizabeth, Porter, Joanne, Peel, Rebecca
- Authors: Miller, Elizabeth , Porter, Joanne , Peel, Rebecca
- Date: 2021
- Type: Text , Journal article
- Relation: SAGE Open Nursing Vol. 7, no. (2021), p.
- Full Text:
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- Description: Introduction: Palliative support services (generalist or specialist) can provide much-needed assistance to carers who are providing palliative and end-of-life care in their homes, but access to such services in regional and rural areas of Australia is poorly understood. Objectives: This study aimed to explore the role and lived experience of primary carers who are providing palliative and end-of-life care in the home in regional/rural Victoria, Australia. Methods: Nine female participants, of whom six were bereaved between 7 and 20 months were interviewed using a semistructured interview technique. Each interview was audio-recorded, transcribed verbatim, and analyzed thematically. Results: Two themes emerged: “Negotiating healthcare systems” which described the needs for multidisciplinary supports and “The caring experience” which discussed daily tasks, relationships, mental and physical exhaustion, respite, isolation, medication management, and grief and loss. Findings show that regional/rural carers have an added burden of travel stress as well as feeling overwhelmed, isolated, and physically and emotionally exhausted. Carers would benefit from greater flexibility for short-term respite care. The engagement of specialist palliative care services assisted the participants to navigate the health care system. Some participants did not understand the value of palliative care, highlighting the need for general practitioners to conduct early conversations about this with their patients. Education is needed to build capacity within the primary palliative care workforce, confirming the importance of timely referrals to a specialist palliative care practitioner if pain or symptom control is not effectively managed. Conclusion: Providing palliative and end-of-life care in the home is an exhausting and emotionally draining role for unpaid, primary carers. Multiple supports are needed to sustain primary carers, as they play an essential role in the primary health care system. © The Author(s) 2021.
- Authors: Miller, Elizabeth , Porter, Joanne , Peel, Rebecca
- Date: 2021
- Type: Text , Journal article
- Relation: SAGE Open Nursing Vol. 7, no. (2021), p.
- Full Text:
- Reviewed:
- Description: Introduction: Palliative support services (generalist or specialist) can provide much-needed assistance to carers who are providing palliative and end-of-life care in their homes, but access to such services in regional and rural areas of Australia is poorly understood. Objectives: This study aimed to explore the role and lived experience of primary carers who are providing palliative and end-of-life care in the home in regional/rural Victoria, Australia. Methods: Nine female participants, of whom six were bereaved between 7 and 20 months were interviewed using a semistructured interview technique. Each interview was audio-recorded, transcribed verbatim, and analyzed thematically. Results: Two themes emerged: “Negotiating healthcare systems” which described the needs for multidisciplinary supports and “The caring experience” which discussed daily tasks, relationships, mental and physical exhaustion, respite, isolation, medication management, and grief and loss. Findings show that regional/rural carers have an added burden of travel stress as well as feeling overwhelmed, isolated, and physically and emotionally exhausted. Carers would benefit from greater flexibility for short-term respite care. The engagement of specialist palliative care services assisted the participants to navigate the health care system. Some participants did not understand the value of palliative care, highlighting the need for general practitioners to conduct early conversations about this with their patients. Education is needed to build capacity within the primary palliative care workforce, confirming the importance of timely referrals to a specialist palliative care practitioner if pain or symptom control is not effectively managed. Conclusion: Providing palliative and end-of-life care in the home is an exhausting and emotionally draining role for unpaid, primary carers. Multiple supports are needed to sustain primary carers, as they play an essential role in the primary health care system. © The Author(s) 2021.
What helps, what hinders? Undergraduate nursing students’ perceptions of clinical placements based on a thematic synthesis of literature
- Cant, Robyn, Ryan, Colleen, Hughes, Lynda, Luders, Elise, Cooper, Simon J.
- Authors: Cant, Robyn , Ryan, Colleen , Hughes, Lynda , Luders, Elise , Cooper, Simon J.
- Date: 2021
- Type: Text , Journal article , Review
- Relation: SAGE Open Nursing Vol. 7, no. (2021), p.
- Full Text:
- Reviewed:
- Description: Introduction: Clinical placements are a mandatory component of nursing students’ education internationally. Despite clinical education being a key to nursing students’ achievement of nursing competencies, few studies have reviewed students’ narratives to describe their experiences of learning during clinical placement. Such studies may be important in offering a deeper insight into clinical learning experiences than quantitative surveys. Methods: A systematic thematic synthesis of qualitative studies between 2010 and June 2020 was conducted. English language studies that offered a thematic analysis of undergraduate nursing students’ experiences of learning during placement were sought. A search was made of five databases PubMed, Ovid Medline, CinahlPlus, SCOPUS, and Google Scholar. The study was guided by the ENTREQ statement for enhancing transparency in reporting the synthesis of qualitative research. Results: Twenty-seven qualitative studies were included in the review. A thematic synthesis showed over 100 themes and subthemes across the studies. A cluster analysis revealed positive elements and others that were seen in the studies as a barrier (hindrance) to clinical learning. Positive elements included supportive instructors, close supervision, and belonging (in the team). Unsupportive instructors, a lack of supervision and not being included were seen as a hindrance. Three key overarching themes that could describe a successful placement were revealed as “Preparation,” “Welcomed and wanted” and “Supervision experiences”. A conceptual model of clinical placement elements conducive to nursing students’ learning was developed to enhance understanding of the complexities associated with supervision. The findings and model are presented and discussed. Conclusion: The conceptual model presents positive elements that influence students’ clinical placement experiences of learning. This model may provide a framework to guide professional development programs and strategies to support students and supervisors alike, an important step forward in moving beyond the current clinical placement rhetoric. © The Author(s) 2021.
- Authors: Cant, Robyn , Ryan, Colleen , Hughes, Lynda , Luders, Elise , Cooper, Simon J.
- Date: 2021
- Type: Text , Journal article , Review
- Relation: SAGE Open Nursing Vol. 7, no. (2021), p.
- Full Text:
- Reviewed:
- Description: Introduction: Clinical placements are a mandatory component of nursing students’ education internationally. Despite clinical education being a key to nursing students’ achievement of nursing competencies, few studies have reviewed students’ narratives to describe their experiences of learning during clinical placement. Such studies may be important in offering a deeper insight into clinical learning experiences than quantitative surveys. Methods: A systematic thematic synthesis of qualitative studies between 2010 and June 2020 was conducted. English language studies that offered a thematic analysis of undergraduate nursing students’ experiences of learning during placement were sought. A search was made of five databases PubMed, Ovid Medline, CinahlPlus, SCOPUS, and Google Scholar. The study was guided by the ENTREQ statement for enhancing transparency in reporting the synthesis of qualitative research. Results: Twenty-seven qualitative studies were included in the review. A thematic synthesis showed over 100 themes and subthemes across the studies. A cluster analysis revealed positive elements and others that were seen in the studies as a barrier (hindrance) to clinical learning. Positive elements included supportive instructors, close supervision, and belonging (in the team). Unsupportive instructors, a lack of supervision and not being included were seen as a hindrance. Three key overarching themes that could describe a successful placement were revealed as “Preparation,” “Welcomed and wanted” and “Supervision experiences”. A conceptual model of clinical placement elements conducive to nursing students’ learning was developed to enhance understanding of the complexities associated with supervision. The findings and model are presented and discussed. Conclusion: The conceptual model presents positive elements that influence students’ clinical placement experiences of learning. This model may provide a framework to guide professional development programs and strategies to support students and supervisors alike, an important step forward in moving beyond the current clinical placement rhetoric. © The Author(s) 2021.
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