2014; Volume 15, No 6, June
Media Watch: an annotated list of recent articles about palliative care in the news media and the literature
Palliative sedation: An analysis of international guidelines and position statements
American Journal of Hospice & Palliative Medicine | Online – 7 May 2014 – Guidelines were published by American College of Physicians-American Society of Internal Medicine (2000), Hospice and Palliative Nurses Association (2003), American Academy of Hospice and Palliative Medicine (2006), American Medical Association (2008), Royal Dutch Medical Association (2009), European Association for Palliative Care (2009), National Hospice & Palliative Care Organization (2010), and National Comprehensive Cancer Network (2012). Variances throughout guidelines include definitions of the practice, indications for its use, continuation of life-prolonging therapies, medications used, and timing/prognosis. The development and implementation of institutional-based guidelines with clear stance on the discussed variances is necessary for consistency in practice. Data on provision of palliative sedation after implementation of guidelines needs to be collected and disseminated for a better understanding of the current practice in the U.S..
Strategies for the economic evaluation of end-of-life care
Expert Review of Pharmacoeconomics & Outcomes Research | Online – 2 May 2014 – Economic evaluation of end of life care is increasingly expected from both research funders and those making decisions about the use of health and social care resources. There are, however, difficulties in applying the currently established evaluative methods to end of life. These are partly associated with the sensitivity of the topic and the feasibility of data collection but also, more fundamentally, a lack of agreement about the terms in which such care should be evaluated. This paper examines different theoretical perspectives from which economic evaluation of end of life care could be conducted, and argues for the application of a capability approach focusing on the opportunity for a good death. It then examines challenges with taking forward such an approach, including defining, measuring and valuing appropriate outcomes. Such an approach is viable, and explores how it might be taken forward to assist with resource allocation decisions.
Volunteers in palliative care – a comparison of seven European countries: A descriptive study
Pain Practice | Online – 28 April 2014 – In Europe, volunteers have an important role in the delivery of palliative care. As part of the European Union co-funded Europall project, four aspects of volunteering in palliative care were studied for 7 European countries (Belgium, England, France, Germany, the Netherlands, Poland, and Spain). These included: 1) involvement of volunteers in palliative care; 2) organization of palliative care volunteering; 3) legal regulations concerning volunteering; and, 4) education and training of palliative care volunteering. In all countries, volunteers appeared to be involved in palliative care, yet their involvement across health care settings differed per country. England, for example, has the highest number of volunteers whereas Spain has the lowest number. Volunteering is embedded in law and regulations in all participating countries except for England and The Netherlands. In all participating countries, training programs are available and volunteers are organized, both on a national and a regional level.
Importance of psychological research in palliative care: barriers in its development
Palliative Medicine & Hospice Care Open, 2014;1(1):1-3. The analysis of the psychosocial aspects in patients with advanced illness or at the end of life has a number of characteristics that are difficult to study. The barriers to psychological research [identified in this study] are related to the following aspects: 1) psychological issues are subjective, variables or constructs are complex and difficult to operationalize; 2) psychological variables are difficult to measure; 3) the patients are fragile, their condition (both their physical and psychological state) is mediated by the progress of the disease and the presence of impending death; 4) health professionals have limited time to conduct assessments or research; and, 5) there is a lack of validated clinical tools.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.