2016; Volume 17, No 4, April
Media Watch: an annotated list of recent articles about palliative care in the news media and the literature
When parents face the death of their child: A nationwide cross-sectional survey of parental perspectives on their child’s end-of-life care
BMC PALLIATIVE CARE | Online – 9 March 2016 – This is one of the few studies that quantitatively described and explored parental experiences related to their child’s end-of-life care (EOLC) in a [Swiss] population-based sample of bereaved mothers and fathers of children from the major diagnostic groups in which childhood deaths occur. Overall, parental scores on their experiences and perceived satisfaction with their child’s end-of-life care were high across all six quality domains. Parents of a child with cancer rated their experiences highest in most of the six quality domains and reported the highest satisfaction with care. The lowest scores were mainly reported by parents from the neurology group, with the exception of the domain shared decision-making, where parents of neonates reported significantly less positive experiences.
More information.
The use of reflective diaries in end of life training programmes: A study exploring the impact of self-reflection on the participants in a volunteer training programme
BMC PALLIATIVE CARE | Online – 5 March 2016 – In this study, the use of reflective diaries provided the opportunity to examine the lived experience of a volunteer training programme to support dying patients in the acute hospital setting. The diaries facilitated an open dialogue between the volunteers, training leads and the researcher, and offered the opportunity to explore the volunteers’ understanding of the course content together with an account of their learning processes on a sessional basis. The volunteers’ reflections have been a driving influence in the revision and development of the education and training programme, which will now be used to train a further cohort of participants. For example, whilst the pilot reinforced the value of reflection, it also highlighted that the skill of reflection is not a given. Not everyone was able to ‘connect’ fully with the completion of reflective diaries and in order to maximize the potential for full involvement in this element of the process, further guidance, encouragement and support have been built into the training and ongoing supervision of a new cohort of volunteers.
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To what degree is palliative care integrated in guidelines and pathways for adult cancer patients in Europe: A systematic literature review
BMC PALLIATIVE CARE | Online – 3 March 2016 – Five studies were found to fulfill at least 10/11 of the criteria for completeness on integrated palliative care (IPC). These guidelines/pathways proposed very similar strategies for the realization of these criteria and were based on high levels of evidence. Consequently, they could serve as benchmarks of how palliative care (PC) can be integrated in cancer guidelines. As such, they also can provide a base to further investigate what constitutes integrated PC in cancer. The review has revealed the importance of a holistic approach and interventions aimed at reducing suffering by deploying an integrated palliative care approach. Additionally, the results illustrate that there is disagreement on the appropriate referral criteria for IPC, which remains a contentious and challenging topic in terms of the integration of PC in cancer care. The included guidelines/pathways do not embody aspects of implementation. Therefore, even though the theoretical framework of these guidelines/pathways conforms reasonably well to the state of the art in IPC, their applicability in practice needs to be further investigated. Overall, the findings have identified both the strengths and the weaknesses of the available guidelines and pathways in Europe for patients with cancer in terms of the integration of palliative care.
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Challenging aspects of bereavement and grief in older adults with dementia: A case series and clinical consideration
JOURNAL OF GERONTOLOGY & GERIATRIC RESEARCH | Online – Accessed 8 March 2016 – Normal grief reactions of denial, anger, bargaining, depression and acceptance can be experienced in early dementia. As the disease progresses, persons with dementia (PWD) may be too cognitively impaired to experience and express their grief. A vague sense that something is wrong with inner distress may manifest as behavioral disturbances, for although cognition declines, feelings and states of emotional pain remain. PWD may not be aware of the loss or may confuse the present loss with earlier losses. Seemingly non-reactions of mourning were noted to be much more common than those found among persons with normal intellectual ability.
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Negative outcomes of unbalanced opioid policy supported by clinicians, politicians, and the media
JOURNAL OF PAIN & PALLIATIVE CARE PHARMACOTHERAPY | Online – 18 February 2016 – Harmful and non-medical use of prescription opioids has increased precipitously in the U.S. and some other countries in recent years, but not everywhere around the world. Addressing this problem requires attention to scientific data and to objective and balanced consideration of factors driving the problems. Unfortunately, the situation has been blurred by some politicians, health professionals, and the media by their using inadequate concepts, misrepresenting and exaggerating facts, and demonizing pain patients. The authors analyze what has occurred and present what they believe to be a balanced view of the problems. They advocate comprehensive drug control policies implemented in a way to reduce harmful use and diversion problems balancing the public health benefits and risks of opioid medications. The authors make recommendations for responsible prescribing, including implementing the World Health Organization policy guidelines and similar United Nations Office of Drug Control, which they believe can contribute measurably to the prevention of diversion of prescription opioids while ensuring patient access to the most appropriate medicines. Measures to reduce the risks of non-medical use of opioid medicines should be based to the greatest extent possible on accurate evaluation of the mechanisms leading to such use, including diversion activities.
More information.
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).
Read the current and back issues of the weekly report.