Palliative Care for Community Patients with Dementia

Introduction

Palliative care is the interdisciplinary clinical approach that prioritizes the personalized needs of patients thereby improving their quality of life. Dementia is considered as one of the major causes of ill health and poor wellbeing of people worldwide. This poster will present the background, effectiveness and the benefits of palliative care in relation to improve the quality of living for community patients with dementia. For those seeking healthcare dissertation help, understanding the intersection of palliative care and dementia can be crucial in addressing the complexities of patient care.

Background:

Dementia is defined as the neurological disorders that is associated with lots of cognitive functions such remembering, thinking and reasoning (Arya et al. 2020). In the UK dementia is the growing challenge. A report from NHS (2019) shows that more than 676,000 people live with dementia in the England. Palliative care approach is proved to be most effective clinical intervention for managing the systems of dementia in community patients. By using the palliative care approach, health providers in UK supports families, individual and groups which suffers from dementia. Under the palliative care approach the personalized needs of community patients are determines and supported to improve their quality of life.

PICO and clinical questions:

PICO (patients Interventions, comparison and outcome) model is the widely used framework that is used in both the qualitative and quantitative research study for framing appropriate questions (Fadul et al. 2021). This tool uses 4 important aspects such as patients/problem, intervention, comparison and outcomes to design relevant questions. In this systematic review PICO tools is used for framing the foaling questions:

• P: Patients: Community patients (adults) with dementia
• I: Intervention: provide palliative care to manage symptom sand health outcomes of dementia thereby improving the query of living of target patients
• C; Comparison: compared with the region in UK where no palliative care approach is implemented
• O: Outcomes: improved cognition, memory, reasoning and thinking ability in people with dementia.

How effective the palliative care is to improve the quality of life of community patients with dementia?

Methods used to find out evidence

Database search strategy:

Search strategy is the main aspect of a systematic review that allows research to search for the relevant research paper which can be used to collect the necessary healthcare information (Radbruch et al. 2020). Specific areas of interest have been determined and implemented into CINAHL database for formulating a clinical question to investigate. Specific keywords are used to search for relevant research article in CINAHL database. The finding that is gained from the initial search had allowed the research to formulate the appropriate questions against the PICO framework. Boolean operators (AND, OR and NOT) are used to extend or narrow the literature search to retrieve the appropriate research journal and article. The key words that are used are: dementia OR primary care AND palliative care OR community nursing OR communication

Methods used in finding the evidences:

Inclusion and exclusion criteria:

Inclusion and exclusion criteria are the predefined characteristics that are used by researchers as the parameter to select valid and high relevant papers. The inclusion and exclusion criteria that are used in this research study are as follows:

• All the participants must be diagnosed with dementia
• All participants will be adults
• All the participants must have experience of being treated in the psychiatric ward as inpatients
• The research papers that will be included must be published within at least 5 year duration (2017-2022).
• All the research article which are selected must be written in English
• All the research journal and articles which are to be include must contain relevant and appropriate information on the research topic.

Exclusion criteria:

• If participants are children or older people must be excluded from the study
• Participants who do not have dementia are exceeded from the student
• The research paper which are published before 2017 are excluded from the dataset
• The research journals which present value or irrelevant information will be excluded from the list
• The participants who although having dementia o not have experiences of treatment I psychiatric ward in hospital setting are excluded form the study.

SR evidence and quality appraisal:

In this study the systematic review (SR) had ben appraised and critically analyzed by using the CASP tool. Critical appraisal skill program tool or CASP tool is the widely used tool that modern researcher use to analyses the validity of each research element of a selected research paper (Mercadante et al. 2018). In this study the CASP tool is proved to be highly useful in critically appraising the selected research article by Smith and Newbury (2019).

Framework for evidence translation

Evidence translation is the process of translate and apply the best practices that are obtained from the research base evidences to improve the overall health outcomes (Mercadante et al. 2018). There are 4 stages of knowledge translation such as discovery, translation, dissemination and change.

Discovery is the search for the relevant research evidence from the appropriate research sources such as research journals, article and books. The translation is translate as well as apply the necessary information that collected from the relevant journals and articles. The dissemination is the process of spreading, distribution and application of the collected research evidence in practices to achieve the target objectives. The change is the final process which is associated with making necessary modification in the healthcare system for improving the quality of care.

Appraisal of the evidence translation framework:

KTA framework is used for appraising knowledge translation. Here different processes under KTA framework are used such bas monitoring, assess, evaluate, sustain, adapt and selection. All these processes are used for analysing the validity of the database collected from the research article

Summary of evidence from SR:

Palliative care approach is the integrated and personalized care approach which allow modern health professionals to provide the high quality and effective care to dementia patients Community patients with dementia can receives the emotional, physical and psychological support under palliative care approach (Radbruch et al. 2020). There are many factors that influence the health outcomes associated with palliative care approach in treatment of dementia patients.

Tools to disseminate translated evidence:

The dissemination is the process of spreading, distribution and application of the collected research evidence in practice to achieve the target objectives. There are three major ways for evidence dissemination such as poster, paper and PPT. Here this research study has used poster for disseminating the research evidence from the research articles and hand it over to the target people for enhancing their awareness regarding dementia.

Tools to apprise evidence:

This study used CPG (clinical practices guideline) tools which is also termed as AGREE tool for appraising the research evidence ((Mercadante et al. 2018). By using this tools, this study determines the quality of the research elements of the selected research papers such as literature review, authors’ credibility, and quality of the data analysis, sampling process, database collection process and finding process. This tools assist this study to analyses the validity of the selected research article.

Barriers to evidence Dissemination:

Some barriers that are experiences by researcher while disseminating the research evidence from the research paper are shortage of tome, short fund, lack of sufficient team member, short geographic area allocated for this research, less number of research journal are analyzed for disseminating research evidence due to lack of time.

The issue can be solved by improving the communication and interaction within the research team and selecting as well as implementing more valid and aesthetic research papers in the practices.

Reference list:

Arya, A., Buchman, S., Gagnon, B. and Downar, J., 2020. Pandemic palliative care: beyond ventilators and saving lives. Cmaj, 192(15), pp.E400-E404.

Fadul, N., Elsayem, A.F. and Bruera, E., 2021. Integration of palliative care into COVID-19 pandemic planning. BMJ supportive & palliative care, 11(1), pp.40-44.

Mercadante, S., Gregoretti, C. and Cortegiani, A., 2018. Palliative care in intensive care units: why, where, what, who, when, how. BMC anesthesiology, 18(1), pp.1-6.

Radbruch, L., De Lima, L., Knaul, F., Wenk, R., Ali, Z., Bhatnaghar, S., Blanchard, C., Bruera, E., Buitrago, R., Burla, C. and Callaway, M., 2020. Redefining palliative care—a new consensus-based definition. Journal of pain and symptom management, 60(4), pp.754-764.

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