2014; Volume 15, No 5, May
Media Watch: an annotated list of recent articles about palliative care in the news media and the literature
The value of palliative medicine for the economy
Zeitschrift für Palliativmedizin, 2014;15(2):78-83. Expenditure for health care is assessed as a good investment in the economy as long as it is spent for the human labor force. Palliative medicine, however, causes costs for people who will not return to the production process. Despite that it would be wrong to assume that these costs are merely consumption. A functional economy in the postmodern era requires coworkers who are flexible, intrinsically motivated, strong in trust and willing to take risks. This moral capital of the economy requires ultimate reliability in life. Palliative medicine produces the trust that life can be lived in dignity irrespective of economic success or the materialization of risks. Consequently, palliative medicine is producing a value of high economic significance.
"You put it all together" – families' evaluation of participating in family health conversations
Scandinavian Journal of Caring Sciences | Online – 9 April 2014 – Families' experiences of the conversations embraced their structure and the interactions with the conversation leaders. All families [i.e., study participants] were satisfied with the conversations, pointing to the importance of having them early in the illness process. The opportunity to talk with someone outside the family was strongly emphasized as promoting well-being. The experienced significance of the conversations was captured in four categories: 1) creating a whole picture, that is, being given the opportunity to listen to other family members' experiences and fill in potential memory gaps; 2) making the situation manageable, that is, receiving support from other participants in order to handle problems and gain control; 3) facilitating healing, that is, being able to tell their story about what had previously been "the unspeakable"; 4) and, strengthened family cohesion, that is, increased understanding for each other's experiences, thus bringing family members closer together.
Improving communication on hope in palliative care. A qualitative study of palliative care professionals' metaphors of hope: Grip, source, tune and vision
Journal of Pain & Symptom Management | Online – 18 April 2014 – Participants described the hope of patients, patients' families, or themselves as: 1) a grip, which implied safety; 2) a source, which implied strength; 3) a tune, which implied harmony; and, 4) a vision, which implied a positive perspective. Compared with Dutch participants, Canadian participants generally put more emphasis on spirituality and letting go of their own hope as a grip (safety). Compared with other included professionals, physicians used hope as a grip (safety) most often, whereas chaplains used hope as a tune (harmony) most often.
Qualitative analysis of palliative care and support in medical practices in Democratic Republic of the Congo
Médecine et Santé Tropicales | Online – 1 April 2014 – This qualitative study was conducted among 30 doctors and 90 nurses with at least one year of experience in six hospitals in Kinshasa that receive patients at the end of life. The results show that health professionals believe that this care is time-consuming and that the inability to say some things to patients and families generates misunderstandings and concerns likely to prevent the application of palliative care. For them, it is often a futile therapeutic obstinacy, added hygienic care, and neglect of the patient. The obstacles to implementing this care might be linked to the lack of training about this approach and a health system based essentially on curative approaches. The representation of health professionals about palliative care and support are many and varied. They are, however, more structured among physicians than nurses.
Pediatric palliative care – the role of the GP
Australian Family Physician, 2014;43(4):176-180. This article highlights the important role of the GP in the management of pediatric palliative care (PPC) patients, especially if families want to care for their child at home. The support that specialist PPC teams can offer the GP is also emphasized. The GP has much to offer in conjunction with other local services, being part of a team managing the child with palliative care needs. Specialist PPC services can provide the GP with relevant information, specific education, advice and ongoing support to fulfil their important role for the child and family.
Research priorities in spiritual care: An international survey of palliative care researchers and clinicians
Journal of Pain & Symptom Management | Online – 31 March 2014 – Spiritual distress, including meaninglessness and hopelessness, is common in advanced disease. Spiritual care is a core component of palliative care, yet often neglected by health care professionals owing to the dearth of robust evidence to guide practice. An online, cross-sectional, mixed-methods survey was conducted. In total, 971 responses, including 293 from palliative care physicians, 112 from nurses, and 111 from chaplains, were received from 87 countries. Fifty-three percent reported their work as "mainly clinical," and less than 2.5% stated that no further research was needed. Integrating quantitative and qualitative data demonstrated three priority areas for research: 1) development and evaluation of conversation models and overcoming barriers to spiritual care in staff attitudes; 2) screening and assessment; and, 3) development and evaluation of spiritual care interventions and determining the effectiveness of spiritual care. In this first international survey exploring researchers' and clinicians' research priorities in spiritual care, the authors found international support for research in this domain.
Meeting the needs of siblings of children with life-limiting illnesses
Nursing Children & Young People, 2014;26(3):16-20. Siblings of children with life-threatening or life-limiting illnesses can face a number of challenges, yet this is a group that is often unacknowledged as needing specific support. It is essential that the needs of siblings are recognized and addressed as part of a family-centred approach. This article discusses the experiences and challenges faced by siblings in such families and what children's nurses can do to help. It outlines a group intervention offered by a community children’s palliative care service.
Media Watch is intended as an advocacy and research tool. The weekly report, published by Barry R. Ashpole, a Canadian communications consultant and educator, monitors the literature and the lay press on issues specific to the quality of end-of-life care. It is international in scope and distribution. Each month, this section of the IAHPC will publish an abstract or summary of an article or report of special interest noted in a recent issue of Media Watch (see below).
The current and back issues of the weekly report.