Evidence map›Paper›PMID 33256717›Full record

ArticleBMC palliative care2020

Experiences with the Liverpool care pathway for the dying patient in nursing home residents: a mixed-method study to assess physicians' and nurse practitioners' perceptions.

Maartje S Klapwijk, Natashe Lemos Dekker, Monique A A Caljouw, Wilco P Achterberg, Jenny T van der Steen

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC palliative care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.5field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Maartje S KlapwijkDepartment of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, Leiden, 2300 RC, the Netherlands. m.s.klapwijk@lumc.nl.ORCID http://orcid.org/0000-0002-4961-2978
Natashe Lemos DekkerInstitute of Cultural Anthropology and Development Sociology, Leiden University, Leiden, the Netherlands.
Monique A A CaljouwDepartment of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, Leiden, 2300 RC, the Netherlands.
Wilco P AchterbergDepartment of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, Leiden, 2300 RC, the Netherlands.
Jenny T van der SteenDepartment of Public Health and Primary Care, Leiden University Medical Center, P.O. Box 9600, Leiden, 2300 RC, the Netherlands.
Leiden University Medical Center · NLLeiden University · NLRijksmuseum · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Liverpool care pathway for the dying patient (LCP) is a multidisciplinary tool developed for the dying phase for use in palliative care settings. The literature reports divergent experiences with its application in a nursing home setting related to its implementation and staff competencies. The aim of this study is to understand how the LCP is being used in the context of the nursing home, including for residents with dementia, and experienced from the perspectives of those responsible for medical treatment in nursing homes.

methodsA mixed-methods approach was used, consisting of a survey followed by interviews. A link to a 9-item online survey with closed and open-ended questions was emailed to all physicians and nurse practitioners of 33 care organisations with nursing homes in three regions of the Netherlands (North, West and South). In addition, 10 respondents with particularly positive or negative experiences were selected for semi-structured interviews.

resultsThe survey was completed by 159 physicians and nurse practitioners. The respondents were very positive on the content and less positive on the use of the LCP, although they reported difficulties identifying the right time to start the LCP, especially in case of dementia. Also using the LCP was more complicated after the implementation of the electronic health record. The LCP was judged to be a marker of quality for the assessment of symptoms in the dying phase and communication with relatives.

conclusionAn instrument that prompts regular assessment of a dying person was perceived by those responsible for (medical) care to contribute to good care. As such, the LCP was valued, but there was a clear need to start it earlier than in the last days or hours of life, a need for a shorter version, and for integration of the LCP in the electronic health record. Regular assessments with an instrument that focusses on quality of care and good symptom control can improve palliative care for nursing home residents with and without dementia.

Indexed as

InpatientsPerceptionAdultAttitude to DeathFemaleHumansInterviews as TopicMaleMiddle AgedNetherlandsNurse PractitionersNursing HomesPhysiciansQualitative ResearchSurveys and QuestionnairesTerminal CareDementiaEnd-of-life careLiverpool care pathwayNursing homePalliative careQuality of care

Identifiers

PMID33256717
PMCPMC7706263
OpenAlexW3108963639

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.