19 results on '"Engels, Yvonne"'
Search Results
2. Oncologist responses to advanced cancer patients’ lived illness experiences and effects: an applied conversation analysis study
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van Meurs, Jacqueline, Stommel, Wyke, Leget, Carlo, van de Geer, Joep, Kuip, Evelien, Vissers, Kris, Engels, Yvonne, and Wichmann, Anne
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- 2022
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3. Correction: Oncologist responses to advanced cancer patients’ lived illness experiences and effects: an applied conversation analysis study
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van Meurs, Jacqueline, Stommel, Wyke, Leget, Carlo, van de Geer, Joep, Kuip, Evelien, Vissers, Kris, Engels, Yvonne, and Wichmann, Anne
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- 2022
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4. Implementation of a palliative care intervention for patients with COPD – a mixed methods process evaluation of the COMPASSION study
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Broese, Johanna M. C., van der Kleij, Rianne M. J. J., Verschuur, Els M. L., Kerstjens, Huib A. M., Engels, Yvonne, and Chavannes, Niels H.
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- 2022
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5. What to consider when implementing a tool for timely recognition of palliative care needs in heart failure: a context-based qualitative study
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Ament, Stephanie M. C., van den Broek, Lisette M., van den Beuken-van Everdingen, Marieke H. J., Boyne, Josiane J. J., Maessen, José M. C., Bekkers, Sebastiaan C. A. M., Bellersen, Louise, Rocca, Hans-Peter Brunner-La, Engels, Yvonne, and Janssen, Daisy J. A.
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- 2022
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6. Experiences of bereaved family caregivers with shared decision making in palliative cancer treatment: a qualitative interview study
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van Oosterhout, Sanne P. C., Ermers, Daisy J. M., Ploos van Amstel, Floor K., van Herpen, Carla M. L., Schoon, Yvonne, Perry, Marieke, van Geel, Maartje, Kuip, Evelien J. M., and Engels, Yvonne
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- 2021
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7. A cluster randomized controlled trial on a multifaceted implementation strategy to promote integrated palliative care in COPD: study protocol of the COMPASSION study
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Broese, Johanna M. C., van der Kleij, Rianne M. J. J., Kerstjens, Huib A. M., Verschuur, Els M. L., Engels, Yvonne, and Chavannes, Niels H.
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- 2020
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8. Correction to: An online international comparison of thresholds for triggering a negative response to the “Surprise Question”: a study protocol
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White, Nicola, Oostendorp, Linda, Vickerstaff, Victoria, Gerlach, Christina, Engels, Yvonne, Maessen, Maud, Tomlinson, Christopher, Wens, Johan, Leysen, Bert, Biasco, Guido, Zambrano, Sofia, Eychmüller, Steffen, Avgerinou, Christina, Chattat, Rabih, Ottoboni, Giovanni, Veldhoven, Carel, and Stone, Patrick
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- 2020
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9. Implementing the theory-based advance care planning ACP+ programme for nursing homes: study protocol for a cluster randomised controlled trial and process evaluation
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Gilissen, Joni, Pivodic, Lara, Wendrich-van Dael, Annelien, Gastmans, Chris, Vander Stichele, Robert, Engels, Yvonne, Vernooij-Dassen, Myrra, Deliens, Luc, and Van den Block , Lieve
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- 2020
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10. An online international comparison of thresholds for triggering a negative response to the “Surprise Question”: a study protocol
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White, Nicola, Oostendorp, Linda, Vickerstaff, Victoria, Gerlach, Christina, Engels, Yvonne, Maessen, Maud, Tomlinson, Christopher, Wens, Johan, Leysen, Bert, Biasco, Guido, Zambrano, Sofia, Eychmüller, Steffen, Avgerinou, Christina, Chattat, Rabih, Ottoboni, Giovanni, Veldhoven, Carel, and Stone, Patrick
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- 2019
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11. Improving palliative care in selected settings in England using quality indicators: a realist evaluation.
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Iliffe, Steve, Davies, Nathan, Manthorpe, Jill, Crome, Peter, Ahmedzai, Sam H., Vernooij-Dassen, Myrra, and Engels, Yvonne
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CANCER patients ,CLINICAL medicine ,DEMENTIA ,HOSPICE care ,NURSING specialties ,PALLIATIVE treatment ,QUALITY assurance ,HOSPICE nurses ,KEY performance indicators (Management) - Abstract
Background: There is a gap between readily available evidence of best practice and its use in everyday palliative care. The IMPACT study evaluated the potential of facilitated use of Quality Indicators as tools to improve palliative care in different settings in England. Methods: 1) Modelling palliative care services and selecting a set of Quality Indicators to form the core of an intervention, 2) Case studies of intervention using the Quality Indicator set supported by an expert in service change in selected settings (general practice, community palliative care teams, care homes, hospital wards, in-patient hospices) with a before-and-after evaluation, and 3) realist evaluation of processes and outcomes across settings. Participants in each setting were supported to identify no more than three Quality Indicators to work on over an eight-month period in 2013/2014. Results: General practices could not be recruited to the study. Care homes were recruited but not retained. Hospital wards were recruited and retained, and using the Quality Indicator (QI) set achieved some of their desired changes. Hospices and community palliative care teams were able to use the QI set to achieve almost all their desired changes, and develop plans for quality improvements. Improvements included: increasing the utility of electronic medical records, writing a manual for end of life care, establishing working relationships with a hospice; standardising information transfer between settings, holding regular multi-disciplinary team meetings, exploration of family carers' views and experiences; developing referral criteria, and improvement of information transfer at patient discharge to home or to hospital. Realist evaluation suggested that: 1) uptake and use of QIs are determined by organisational orientation towards continuous improvement; 2) the perceived value of a QI package was not powerful enough for GPs and care homes to commit to or sustain involvement; 3) the QI set may have been to narrow in focus, or more specialist than generalist; and 4) the greater the settings''top-down' engagement with this change project, the more problematic was its implementation. Conclusions: Whilst use of QIs may facilitate improvements in specialist palliative care services, different QI sets may be needed for generalist care settings. [ABSTRACT FROM AUTHOR]
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- 2016
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12. Timely identification of palliative patients and anticipatory care planning by GPs: practical application of tools and a training programme.
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Thoonsen, Bregje, Groot, Marieke, Verhagen, Stans, van Weel, Chris, Vissers, Kris, and Engels, Yvonne
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CONTENT analysis ,EXPERIMENTAL design ,FOCUS groups ,GLOBAL Positioning System ,IDENTIFICATION ,INTERVIEWING ,LONGITUDINAL method ,RESEARCH methodology ,MEDICAL protocols ,PALLIATIVE treatment ,PATIENTS ,QUESTIONNAIRES ,RESEARCH evaluation ,STATISTICAL sampling ,STATISTICS ,TERMINAL care ,ADVANCE directives (Medical care) ,QUALITATIVE research ,DATA analysis ,THEMATIC analysis - Abstract
Background: Palliative care is mainly restricted to terminal care. General practitioners (GPs) are not trained to early identify palliative patients with cancer, COPD or heart failure. With the help of the RADboud indicators for PAlliative Care needs (RADPAC), we trained GPs to identify patients' needs and to make a proactive care plan. They were also able to join two role-plays where they discussed the patient's future, and consulted a palliative care consultant to fine-tune the care plan. We evaluated the programme with the GPs and consultants and noted its impact on their daily practice. Methods: Two years after they had participated in the programme, we held semi-structured interviews with the GPs and a focus group interview with the consultants and performed a thematic content analysis. Results: Six consultants and nine GPs participated in the programme. Most GPs and consultants mentioned positive changes in the thinking or acting of GPs regarding early palliative care. A number continued to use the tool to identify patients; most of the others noted they had internalised the indicators. Although half of them still considered discussing end-of-life aspects difficult, particularly in patients with organ failure, the others were more easily able to discuss the future with their palliative patients. Conclusion: Although most GPs and consultants were positive about the training programme and applying it in daily practice, we conclude that in future programmes, more attention needs to paid to timely identification of palliative patients with COPD or CHF and how to discuss the future with them. [ABSTRACT FROM AUTHOR]
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- 2016
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13. Identification of the palliative phase in people with dementia: a variety of opinions between healthcare professionals.
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Paap, Jasper van Riet, Mariani, Elena, Chattat, Rabih, Koopmans, Raymond, Kerhervé, Hélène, Leppert, Wojciech, Forycka, Maria, Radbruch, Lukas, Jaspers, Birgit, Vissers, Kris, Vernooij-Dassen, Myrra, and Engels, Yvonne
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ATTITUDE (Psychology) ,DEMENTIA ,CASE studies ,MEDICAL personnel ,NURSING care facilities ,PALLIATIVE treatment ,RESEARCH funding - Abstract
Background: People with dementia can benefit from a palliative care approach. Recommendations, such as those of the EAPC have been proposed to strengthen the provision of palliative care for this group of patients. Yet, it remains challenging for professionals to identify when a person with dementia is in need of palliative care. The objective of this study therefore was to explore when professionals in long-term care settings consider a person with dementia in need of palliative care. Methods: Teams with in total 84 professionals working in 13 long-term care settings from 6 countries (France, Germany, Italy, Norway, Poland and the Netherlands) received a case-vignette concerning a person with dementia recently admitted to a nursing home. Teams were asked to discuss when they considered people with dementia eligible for palliative care. The constant comparative method was used to analyse their answers. Results: Three different time points in the disease trajectory when people with dementia were considered to be eligible for palliative care were extracted: (1) early in the disease trajectory; (2) when signs and symptoms of advanced dementia are present; and (3) from the time point that curative treatment of co-morbidities is futile. Yet, none of these time points was uniformly considered by the professional teams across Europe. In some cases, professionals working in the same nursing home didn't even reach consensus when considering persons with dementia eligible for palliative care. Conclusion: The results of the study identified that professionals across Europe have different opinions regarding the time point when to consider a person with dementia in need of palliative care. [ABSTRACT FROM AUTHOR]
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- 2015
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14. Strategies to implement evidence into practice to improve palliative care: recommendations of a nominal group approach with expert opinion leaders.
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van Riet Paap, Jasper, Vissers, Kris, Iliffe, Steve, Radbruch, Lukas, Hjermstad, Marianne J., Chattat, Rabih, Vernooij-Dassen, Myrra, and Engels, Yvonne
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EXPERTISE ,MEDICAL personnel ,PALLIATIVE treatment ,RESEARCH funding ,EVIDENCE-based medicine ,QUALITATIVE research ,DESCRIPTIVE statistics - Abstract
Background: In the past decades, many new insights and best practices in palliative care, a relatively new field in health care, have been published. However, this knowledge is often not implemented. The aim of this study therefore was to identify strategies to implement improvement activities identified in a research project within daily palliative care practice. Methods: A nominal group technique was used with members of the IMPACT consortium, being international researchers and clinicians in cancer care, dementia care and palliative care. Participants identified and prioritized implementation strategies. Data was analyzed qualitatively using inductive coding. Results: Twenty international clinicians and researchers participated in one of two parallel nominal group sessions. The recommended strategies to implement results from a research project were grouped in five common themes: 1. Dissemination of results e.g. by publishing results tailored to relevant audiences, 2. Identification and dissemination of unique selling points, 3. education e.g. by developing e-learning tools and integrating scientific evidence into core curricula, 4. Stimulation of participation of stakeholders, and 5. consideration of consequences e.g. rewarding services for their implementation successes but not services that fail to implement quality improvement activities. Discussion: The added value of this nominal group study lies in the prioritisation by the experts of strategies to influence the implementation of quality improvement activities in palliative care. Efforts to ensure future use of scientific findings should be built into research projects in order to prevent waste of resources. [ABSTRACT FROM AUTHOR]
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- 2015
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15. Modelling the landscape of palliative care for people with dementia: a European mixed methods study.
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Iliffe, Steve, Davies, Nathan, Vernooij-Dassen, Myrra, van Riet Paap, Jasper, Sommerbakk, Ragni, Mariani, Elena, Jaspers, Birgit, Radbruch, Lukas, Manthorpe, Jill, Maio, Laura, Haugen, Dagny, and Engels, Yvonne
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TREATMENT of dementia ,MEDICAL care ,INTERVIEWING ,MATHEMATICAL models ,RESEARCH methodology ,PALLIATIVE treatment ,QUALITY assurance ,RESEARCH funding ,THEORY - Abstract
Background: Palliative care for people with dementia is often sub-optimal. This is partly because of the challenging nature of dementia itself, and partly because of system failings that are particularly salient in primary care and community services. There is a need to systematize palliative care for people with dementia, to clarify where changes in practice could be made. To develop a model of palliative care for people with dementia that captures commonalities and differences across Europe, a technology development approach was adopted, using mixed methods including 1) critical synthesis of the research literature and policy documents, 2) interviews with national experts in policy, service organisation, service delivery, patient and carer interests, and research in palliative care, and 3) nominal groups of researchers tasked with synthesising data and modelling palliative care. Discussion: A generic model of palliative care, into which quality indicators can be embedded. The proposed model includes features deemed important for the systematisation of palliative care for people with dementia. These are: the division of labour amongst practitioners of different disciplines; the structure and function of care planning; the management of rising risk and increasing complexity; boundaries between disease-modifying treatment and palliative care and between palliative and end-of-life care; and the process of bereavement. Summary: The co-design approach to developing a generic model of palliative care for people with dementia has placed the person needing palliative care within a landscape of services and professional disciplines. This model will be explored further in the intervention phase of the IMPACT project. [ABSTRACT FROM AUTHOR]
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- 2013
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16. Living at the end-of-life: experience of time of patients with cancer.
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Rovers, Jordy Johannes Eduardus, Knol, Elze Jantien, Pieksma, Jelte, Nienhuis, Wytse, Wichmann, Anne Barbara, and Engels, Yvonne
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CANCER patient medical care ,CANCER patient psychology ,COST effectiveness ,HEALTH status indicators ,HOSPICE care ,INTERVIEWING ,RESEARCH methodology ,MEDICAL care costs ,HEALTH policy ,MEDICAL practice ,PALLIATIVE treatment ,PSYCHOLOGY of the terminally ill ,TIME ,ACTIVITIES of daily living ,QUALITY-adjusted life years - Abstract
Background: The aim of this study was to gain insight into the experience of time of terminal patients with cancer. Experience of time is relevant in palliative care in both policy and practice. On a policy level, the Quality Adjusted Life Year (QALY), the most used outcome measure for cost-effectiveness analysis in healthcare, assumes time to be a linear and additive variable, which is one of the reasons that its applicability in palliative care is questioned. On a practice level, a better understanding of the experience of time of patients with limited time left, could help to recognize if and how these patients can have a more meaningful use of time. The main focus of this study was to discover whether time perception of these patients in their last months of life had changed as compared to earlier periods of time in their lives in good physical health. The pace of time and time dominance (comparison of past, present and future) were investigated. Methods: In several hospices and palliative care units in the Netherlands, twelve semi-structured interviews were conducted with terminal patients with cancer. Results: Time perception at the end of life had changed for most participants. They all lived on a day-to-day basis in the terminal phase, independent of their way of life in the healthy phase. Furthermore, the experienced duration of a day turned out to be very different between patients, but also between days, depending on daily activities. Besides, for most patients for whom the future was the dominant period of time in the healthy phase, the dominant period of time in the terminal phase had become the past. Conclusions: Time perception of terminal patients with cancer differed from the time perception in their relatively healthy phase of life. This suggests that the LY part of the QALY is not comparable for all phases of life. [ABSTRACT FROM AUTHOR]
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- 2019
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17. Integrating palliative care in long-term care facilities across Europe (PACE): protocol of a cluster randomized controlled trial of the ‘PACE Steps to Success’ intervention in seven countries.
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Smets, Tinne, Onwuteaka-Philipsen, Bregje B. D., Miranda, Rose, Pivodic, Lara, Tanghe, Marc, van Hout, Hein, Pasman, Roeline H. R. W., Oosterveld-Vlug, Mariska, Piers, Ruth, Van Den Noortgate, Nele, Wichmann, Anne B., Engels, Yvonne, Vernooij-Dassen, Myrra, Hockley, Jo, Froggatt, Katherine, Payne, Sheila, Szczerbińska, Katarzyna, Kylänen, Marika, Leppäaho, Suvi, and Barańska, Ilona
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INTEGRATED health care delivery ,CONCEPTUAL structures ,COST effectiveness ,EXECUTIVES ,HEALTH facilities ,HEALTH services accessibility ,LONG-term health care ,MEDICAL quality control ,MEDICAL care costs ,MEDICAL protocols ,PALLIATIVE treatment ,GENERAL practitioners ,PROFESSIONS ,SELF-efficacy ,SUCCESS ,SURVEYS ,TERMINAL care ,EXTENDED families ,RESIDENTIAL care ,RANDOMIZED controlled trials ,HUMAN services programs ,INFORMATION needs ,QUALITY-adjusted life years - Abstract
Background: Several studies have highlighted the need for improvement in palliative care delivered to older people long-term care facilities. However, the available evidence on how to improve palliative care in these settings is weak, especially in Europe. We describe the protocol of the PACE trial aimed to 1) evaluate the effectiveness and cost-effectiveness of the ‘PACE Steps to Success’ palliative care intervention for older people in long-term care facilities, and 2) assess the implementation process and identify facilitators and barriers for implementation in different countries. Methods: We will conduct a multi-facility cluster randomised controlled trial in Belgium, Finland, Italy, the Netherlands, Poland, Switzerland and England. In total, 72 facilities will be randomized to receive the ‘Pace Steps to Success intervention’ or to ‘care as usual’. Primary outcome at resident level: quality of dying (CAD-EOLD); and at staff level: staff knowledge of palliative care (Palliative Care Survey). Secondary outcomes: resident’s quality of end-of-life care, staff self-efficacy, self-perceived educational needs, and opinions on palliative care. Economic outcomes: direct costs and quality-adjusted life years (QALYs). Measurements are performed at baseline and after the intervention. For the resident-level outcomes, facilities report all deaths of residents in and outside the facilities over a previous four-month period and structured questionnaires are sent to (1) the administrator, (2) staff member most involved in care (3) treating general practitioner, and (4) a relative. For the staff-level outcomes, all staff who are working in the facilities are asked to complete a structured questionnaire. A process evaluation will run alongside the effectiveness evaluation in the intervention group using the RE-AIM framework. Discussion: The lack of high quality trials in palliative care has been recognized throughout the field of palliative care research. This cross-national cluster RCT designed to evaluate the impact of the palliative care intervention for long-term care facilities ‘PACE Steps to Success’ in seven countries, will provide important evidence concerning the effectiveness as well as the preconditions for optimal implementation of palliative care in nursing homes, and this within different health care systems. Trial registration: The study is registered at
www.isrctn.com – ISRCTN14741671 (FP7-HEALTH-2013-INNOVATION-1 603111) Registration date: July 30, 2015. [ABSTRACT FROM AUTHOR]- Published
- 2018
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18. An online international comparison of thresholds for triggering a negative response to the 'Surprise Question': a study protocol
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Yvonne Engels, Johan Wens, Linda J. M. Oostendorp, Maud Maessen, Patrick Stone, Christina Gerlach, Bert Leysen, Nicola White, Carel Veldhoven, Christina Avgerinou, Guido Biasco, Steffen Eychmüller, Rabih Chattat, Giovanni Ottoboni, Christopher Tomlinson, Sofia C. Zambrano, Victoria Vickerstaff, White, Nicola, Oostendorp, Linda, Vickerstaff, Victoria, Gerlach, Christina, Engels, Yvonne, Maessen, Maud, Tomlinson, Christopher, Wens, Johan, Leysen, Bert, Biasco, Guido, Zambrano, Sofia, Eychmüller, Steffen, Avgerinou, Christina, Chattat, Rabih, Ottoboni, Giovanni, Veldhoven, Carel, and Stone, Patrick
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Palliative care ,Survival ,Study Protocol ,0302 clinical medicine ,Belgium ,Germany ,Surveys and Questionnaires ,610 Medicine & health ,Netherlands ,Multiple choice ,media_common ,lcsh:RC952-1245 ,General Medicine ,Prognosis ,Death ,Surprise ,Italy ,Negative response ,030220 oncology & carcinogenesis ,0305 other medical science ,Psychology ,Switzerland ,medicine.medical_specialty ,Attitude to Death ,Attitude of Health Personnel ,Prognosi ,media_common.quotation_subject ,education ,lcsh:Special situations and conditions ,1117 Public Health and Health Services ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,03 medical and health sciences ,Surprise question ,All institutes and research themes of the Radboud University Medical Center ,General Practitioners ,030502 gerontology ,medicine ,Humans ,National level ,Protocol (science) ,Internet ,Correction ,Certificate ,United Kingdom ,Vignette ,Family medicine ,Human medicine ,Gerontology - Abstract
Background The Surprise Question (SQ) “would I be surprised if this patient were to die in the next 12 months?” has been suggested to help clinicians, and especially General Practitioners (GPs), identify people who might benefit from palliative care. The prognostic accuracy of this approach is unclear and little is known about how GPs use this tool in practice. Are GPs consistent, individually and as a group? Are there international differences in the use of the tool? Does including the alternative Surprise Question (“Would I be surprised if the patient were still alive after 12 months?”) alter the response? What is the impact on the treatment plan in response to the SQ? This study aims to address these questions. Methods An online study will be completed by 600 (100 per country) registered GPs. They will be asked to review 20 hypothetical patient vignettes. For each vignette they will be asked to provide a response to the following four questions: (1) the SQ [Yes/No]; (2) the alternative SQ [Yes/No]; (3) the percentage probability of dying [0% no chance – 100% certain death]; and (4) the proposed treatment plan [multiple choice]. A “surprise threshold” for each participant will be calculated by comparing the responses to the SQ with the probability estimates of death. We will use linear regression to explore any differences in thresholds between countries and other clinician-related factors, such as years of experience. We will describe the actions taken by the clinicians and explore the differences between groups. We will also investigate the relationship between the alternative SQ and the other responses. Participants will receive a certificate of completion and the option to receive feedback on their performance. Discussion This study explores the extent to which the SQ is consistently used at an individual, group, and national level. The findings of this study will help to understand the clinical value of using the SQ in routine practice. Trial registration Clinicaltrials.gov NCT03697213 (05/10/2018). Prospectively registered. Electronic supplementary material The online version of this article (10.1186/s12904-019-0413-x) contains supplementary material, which is available to authorized users.
- Published
- 2019
19. Identification of the palliative phase in people with dementia: a variety of opinions between healthcare professionals.
- Author
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van Riet Paap J, Mariani E, Chattat R, Koopmans R, Kerhervé H, Leppert W, Forycka M, Radbruch L, Jaspers B, Vissers K, Vernooij-Dassen M, and Engels Y
- Subjects
- Attitude of Health Personnel, Consensus, Dementia therapy, Europe, Humans, Dementia classification, Health Personnel psychology, Long-Term Care methods, Palliative Care, Patient Care classification
- Abstract
Background: People with dementia can benefit from a palliative care approach. Recommendations, such as those of the EAPC have been proposed to strengthen the provision of palliative care for this group of patients. Yet, it remains challenging for professionals to identify when a person with dementia is in need of palliative care. The objective of this study therefore was to explore when professionals in long-term care settings consider a person with dementia in need of palliative care., Methods: Teams with in total 84 professionals working in 13 long-term care settings from 6 countries (France, Germany, Italy, Norway, Poland and the Netherlands) received a case-vignette concerning a person with dementia recently admitted to a nursing home. Teams were asked to discuss when they considered people with dementia eligible for palliative care. The constant comparative method was used to analyse their answers., Results: Three different time points in the disease trajectory when people with dementia were considered to be eligible for palliative care were extracted: (1) early in the disease trajectory; (2) when signs and symptoms of advanced dementia are present; and (3) from the time point that curative treatment of co-morbidities is futile. Yet, none of these time points was uniformly considered by the professional teams across Europe. In some cases, professionals working in the same nursing home didn't even reach consensus when considering persons with dementia eligible for palliative care., Conclusion: The results of the study identified that professionals across Europe have different opinions regarding the time point when to consider a person with dementia in need of palliative care.
- Published
- 2015
- Full Text
- View/download PDF
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