2015; Volume 16, No 10, October
Media Watch: an annotated list of recent articles about palliative care in the news media and the literature
General practice and palliative care – The Swiss approach
BAOJ PALLIATIVE MEDICINE | Online – Accessed 27 August 2015 – This article summarizes the current state of end-of-life care and general practice in Switzerland. It focuses on public awareness concerning end-of-life care, outlines political actions to strengthen end-of-life care, links general practice and end-of-life care, shows the situation in undergraduate and postgraduate training, and reimbursement and financing of end-of-life treatments. It illustrates especially, that important steps are to be made in order to improve the provision of end-of-life care. Further action is necessary and special attention needs to be paid to the aging workforce of Swiss GPs.
A mobile hospice nurse teaching team’s experience: Training care workers in spiritual and existential care for the dying – a qualitative study
BMC PALLIATIVE CARE | Online – 18 September 2015 –The mobile teaching team taught care workers to identify spiritual and existential suffering, initiate existential and spiritual conversations and convey consolation through active presencing, and silence. The team members transferred their personal spiritual and existential care knowledge through situated ‘bedside teaching’ and reflective dialogues. The mobile teaching team perceived that the care workers benefited from the situated teaching because they observed that care workers became more courageous in addressing dying patients’ spiritual and existential suffering.
Medical ethical principles may drive improvement of quality of dying in Hong Kong
JOURNAL OF PALLIATIVE CARE & MEDICINE | Online – 6 August 2015 – Population aging raises concern regarding the quality of end-of-life care (EOLC), not only for people with cancer but for all dying of end stage chronic diseases, particularly for dementia. Medical ethical principles, legal and cultural factors affect the quality of end-of-life care. This article discusses how these three factors currently contribute to EOLC in Hong Kong, in the context of differing trajectories of development in China, other Asian countries, and the U.S. EOLC for non-cancer patients has only recently been highlighted, where ethical, legal, and cultural issues are being debated. Although there is no statute or case law that directly governs the legal status of advance directives in Hong Kong, a validly made advance directive is generally recognized at common law. However, there is a range of other legal barriers to providing EOLC according to medical ethical principles. There is little discussion among healthcare providers or the public regarding advance directives, euthanasia, physician assisted suicide, or withdrawal of life support, particularly for those with dementia.
Addressing palliative sedation during expert consultation: A descriptive analysis of the practice of Dutch palliative care consultation teams
PLOS ONE | Online – 24 August 2015 – Expert consultation in the field of palliative sedation is advocated when physicians lack sufficient knowledge or expertise in the field of palliative sedation. However, mandatory consultation for palliative sedation, as argued by some, remains an ongoing debate in the recent literature. The use of expert consultation services for palliative sedation does not appear to be a common practice. This might indicate a limited need for expert consultation as a result of physicians being sufficiently skilled in this area. It might also point to an already covered need for expert consultation provided by other healthcare professionals beyond regular consultation services. Finally, there might be a neglected need for expert consultations due to physicians being unaware of their limited expertise concerning palliative sedation.
The family’s experience of the child and/or teenager in palliative care: Fluctuating between hope and hopelessness in a world changed by losses
REVISTA LATINO-AMERICANA DE ENFERMAGEM, 2015; 23(3):560-7. The study has shown that recognizing palliative care is an uphill battle for the family, since it puts them in uncertainty regarding the future and the possibility of death. The narrative of the family, recognizing the benefits of palliative care, does not mean accepting death because this is a reality that will never be accepted, but it is their way of dealing with loss along the way and keeping their hope and perseverance, to focus on the management of child care. This means that the family experiences the sense of loss over the journey of the disease and not just after their child’s death, what needs to be recognized by the professional who is attending them. Thus, this study in conjunction with [the published] literature, demonstrates that the family can find a new way to continue living despite the loss in which the process of experiencing the palliative care and the consequent death of the child occurs with less conflict. But this is only possible when the context admits the recognition of suffering, doubt, offers appropriate information, and allows a space where the family can share ideas, feelings and facilitates access to social support. These conditions need to be respected, when working with the family, so that it allows its members to give meaning and construct a new reality regarding the experiences and interactions where they can support each other and seek to decrease the suffering existing in these experiences. This caring of the family, which should be carried out gradually during the path of palliative care, will reflect in their confrontation of later formulations regarding the issues of grief and death and how they will lead their life after the death of their loved one.
N.B. Original Portuguese-language article: ‘La experiencia del familiar de niños y/o adolescentes en los cuidados paliativos: fluctuante entre la esperanza y la desesperanza en un mundo transformado por las pérdidas.’
Unmet supportive cancer care needs: An exploratory quantitative study in rural Australia
WORLD JOURNAL OF ONCOLOGY, 2015;6(4):387-393. This study, the first in rural Australia, has identified areas in supportive care in which the patients with advanced incurable types of cancer have unmet needs. Further, the study has shown that research on developing strategies to deal with cancer related fatigue, and improvements in psychosocial supports, especially in remote areas will serve the purpose of helping advanced cancer patients. The study has also brought to light that there should be greater emphasis to include psychosocial outcome measures in oncology trials and the idea of ‘personalized cancer therapy’ should be broadened encompassing physical, psychological and social aspects of cancer care. Imparting the unmet care needs of patients to the healthcare professionals periodically by training initiatives will enable them to inform the patients on the existing care services available and also give scope for the patients to conceive and communicate their own priorities on supportive care against the backdrop of indefinite treatment outcomes, thus, bridging the care-management gaps in cancer care.
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 Newsletter 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.