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A better way to go: improving utilization of palliative care through patient, family, caregiver and provider engagement
Descriptive
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Title
A better way to go: improving utilization of palliative care through patient, family, caregiver and provider engagement
Name
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Hertzog
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Joyce C.
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Joyce C. Hertzog
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Gerti Heider
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Advisory Committee
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chair
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Barberio
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Judith
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Judith Barberio
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Advisory Committee
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internal member
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Knox
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Beth
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Beth Knox
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Advisory Committee
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Rutgers University
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School of Nursing - RBHS
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theses
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2019
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2019-05
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English
Abstract
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Purpose
Palliative Care is specialized medical care for patients with serious illnesses that can be provided concurrent with other treatment and cure-oriented therapies. Integration of palliative care early in the trajectory of illness enhances the well-being of patients, families and caregivers. Despite widespread acceptance of its value, palliative care remains an underutilized resource commonly introduced late in the course of serious illness, if at all. Knowledge deficits about palliative care exist among patients, families, caregivers, and clinicians. Research demonstrates that provision of information about palliative care to patients, families, caregivers, and members of the public results in increased understanding and a favorable opinion about palliative care. Physicians are identified as the most difficult group to influence, indicating the importance of increasing pressure from the demand side by patients, families, and caregivers, for palliative care utilization to improve.
Methodology
This project examined the effect of provision of customized palliative care toolkits on rates of referral to palliative care (by primary care providers) and self-assessed knowledge about palliative care (by patients, families and caregivers in a small-group setting). Referrals to palliative care by primary care providers (APN's, MD's, DO's, and PA's) were assessed through electronic health record entries for a three-month period of time before and after distribution of a multi-media tool kit via email. Self-assessed knowledge of palliative care among residents of a continuing care facility was assessed before and after a small-group meeting where palliative care information and a tool-kit were distributed.
Volunteer Palliative Care Ambassadors were recruited.
Results
Referrals to palliative care by providers were not significantly affected (p=.29). Knowledge about palliative care increased significantly in the small-group participants (p=.0005). The Palliative Care Ambassadors (n=3) did not continue participation in the project.
Implications for Practice
Increasing knowledge about palliative care among members of the public is possible. Increasing referrals to palliative care by clinicians is difficult. Improving utilization of palliative care may need to be accomplished through patient, family, and caregiver engagement in the referral process.
Palliative Care is specialized medical care for patients with serious illnesses that can be provided concurrent with other treatment and cure-oriented therapies. Integration of palliative care early in the trajectory of illness enhances the well-being of patients, families and caregivers. Despite widespread acceptance of its value, palliative care remains an underutilized resource commonly introduced late in the course of serious illness, if at all. Knowledge deficits about palliative care exist among patients, families, caregivers, and clinicians. Research demonstrates that provision of information about palliative care to patients, families, caregivers, and members of the public results in increased understanding and a favorable opinion about palliative care. Physicians are identified as the most difficult group to influence, indicating the importance of increasing pressure from the demand side by patients, families, and caregivers, for palliative care utilization to improve.
Methodology
This project examined the effect of provision of customized palliative care toolkits on rates of referral to palliative care (by primary care providers) and self-assessed knowledge about palliative care (by patients, families and caregivers in a small-group setting). Referrals to palliative care by primary care providers (APN's, MD's, DO's, and PA's) were assessed through electronic health record entries for a three-month period of time before and after distribution of a multi-media tool kit via email. Self-assessed knowledge of palliative care among residents of a continuing care facility was assessed before and after a small-group meeting where palliative care information and a tool-kit were distributed.
Volunteer Palliative Care Ambassadors were recruited.
Results
Referrals to palliative care by providers were not significantly affected (p=.29). Knowledge about palliative care increased significantly in the small-group participants (p=.0005). The Palliative Care Ambassadors (n=3) did not continue participation in the project.
Implications for Practice
Increasing knowledge about palliative care among members of the public is possible. Increasing referrals to palliative care by clinicians is difficult. Improving utilization of palliative care may need to be accomplished through patient, family, and caregiver engagement in the referral process.
Subject
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Topic
Palliative treatment
Subject
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Topic
Adult-Gerontology Primary Care Nurse Practitioner
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Rutgers University Electronic Theses and Dissertations
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1 online resource (121 pages) : illustrations
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DNP
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Includes bibliographical references
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School of Nursing (RBHS) DNP Projects
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rucore10004500001
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doi:10.7282/t3-wccs-xf27
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ETD doctoral
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Rights
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The author owns the copyright to this work.
RightsHolder
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Name
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Hertzog
GivenName
Joyce
MiddleName
C.
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Copyright Holder
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Permission or license
DateTime
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2018-12-08 20:01:47
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Name
Joyce Hertzog
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Affiliation
Rutgers University. School of Nursing - RBHS
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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Embargo
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2019-05-31
DateTime
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2099-12-31
Detail
Access to this PDF has been restricted at the author's request.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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