Purpose This study aimed to evaluate what types and forms of support nursing staff need in providing palliative care for persons with dementia. Another aim was to compare the needs of nursing staff... Show morePurpose This study aimed to evaluate what types and forms of support nursing staff need in providing palliative care for persons with dementia. Another aim was to compare the needs of nursing staff with different educational levels and working in home care or in nursing homes.Design A cross-sectional, descriptive survey design was used.Methods A questionnaire was administered to a convenience sample of Dutch nursing staff working in the home care or nursing home setting. Data were collected from July through October 2018. Quantitative survey data were analyzed using descriptive statistics. Data from two open-ended survey questions were investigated using content analysis.Findings The sample comprised 416 respondents. Nursing staff with different educational levels and working in different settings indicated largely similar needs. The highest-ranking needs for support were in dealing with family disagreement in end-of-life decision making (58%), dealing with challenging behaviors (41%), and recognizing and managing pain (38%). The highest-ranking form of support was peer-to-peer learning (51%). If respondents would have more time to do their work, devoting personal attention would be a priority.Conclusions Nursing staff with different educational levels and working in home care or in nursing homes endorsed similar needs in providing palliative care for persons with dementia and their loved ones.Clinical Relevance It is critical to understand the specific needs of nursing staff in order to develop tailored strategies. Interventions aimed at increasing the competence of nursing staff in providing palliative care for persons with dementia may target similar areas to support a heterogeneous group of nurses and nurse assistants, working in home care or in a nursing home. Show less
Purpose Worldwide, more than 214 million people have left their country of origin. This unprecedented mass migration impacts health care in host countries. This article explores and synthesizes... Show morePurpose Worldwide, more than 214 million people have left their country of origin. This unprecedented mass migration impacts health care in host countries. This article explores and synthesizes literature on the healthcare experiences of migrants. Design A meta-ethnography study of qualitative studies was conducted. Methods Eight databases (Medline, the Cumulative Index to Nursing and Allied Health Literature [CINAHL], PsycINFO, Embase, Web of Science, Migration Observatory, National Health Service Scotland Knowledge Network, and Adaptive Spectrum and Signal Alignment [ASSIA]) were searched for relevant full-text articles in English, published between January 2006 and June 2016. Articles were screened against inclusion criteria for eligibility. Included articles were assessed for quality and analyzed using Noblit and Hare's seven-step meta-ethnography process. Findings Twenty-seven studies were included in the review. Five key contextualization dimensions were identified: personal factors, the healthcare system, accessing healthcare, the encounter, and the healthcare experience. These five areas all underlined the uniqueness of each individual migrant, emphasizing the need to treat a person rather than a population. Within a true person-centered approach, the individual's cultural background is fundamental to effective care. Conclusions From the findings, a model has been designed using the five dimensions and grounded in a person-centered care approach. This may help healthcare providers to identify weak points, as well as to improve the organization and healthcare professionals' ability to provide person-centered care to migrant patients. Clinical Relevance The proposed model facilitates identification of points of weakness in the care of migrant patients. Employing a person-centered care approach may contribute to improve health outcomes for migrant patients. Show less
