2016; Volume 17, No 9, September
Media Watch: an annotated list of recent articles about palliative care in the news media and the literature
Health care professionals’ attitudes regarding palliative care for patients with chronic heart failure: An interview study
BMC PALLIATIVE CARE | Online – 15 August 2016 – Even though struggling with similar symptom burden, patients with chronic heart failure (CHF) receive less palliative care (PC) than patients suffering from malignant diseases. Researchers have found that this might be related to lack of knowledge about PC, insufficient interprofessional communication as well as the cyclic course of disease, which makes accurate prognosis difficult. However, research findings have shown that patients with CHF benefit from PC. As there are no studies for the German health care system this study aimed to assess health care professionals’ attitudes regarding PC of CHF patients in order to identify barriers and facilitators for this patient group and hence to develop recommendations for improvement of CHF patients’ access to PC in Germany.
Patients’ perception of types of errors in palliative care: Results from a qualitative interview study
BMC PALLIATIVE CARE | Online – 11 August 2016 – In times where more and more studies are conducted to generate “hard facts” and high-grade evidence to develop standards that define right and wrong, the authors consider this study as an important counterbalance to this development through the integration of the patients’ perspective, especially in the area of medical error management. Errors in PC touch similar aspects as in other areas of medicine, but there are also aspects specific to PC mainly related to issues such as communication, professionalism or advance care planning. The issue of errors in PC, and particularly errors from the patients’ perspective, needs much more clinical and scientific engagement and this study may be seen as a baseline and index of important aspects. Therefore, the three level model developed – including 1) Definition of and differences between errors; 2) Types of errors; and, 3) Causes, consequences, recognition, meaning, handling and prevention of errors – gives a specification of issues to explore in more depth and detail in future projects.
Mismatch between physicians and family members views on communications about patients with chronic incurable diseases receiving care in critical and intensive care settings in Georgia: a quantitative observational survey
BMC PALLIATIVE CARE | Online – 22 July 2016 – The survey, conducted in four cities of Georgia, revealed the mismatch between the views of clinical and intensive care (CIC) physicians and family members of the patients with chronic incurable diseases receiving care in CIC settings – on communication topics covering possible deterioration of a patient’s condition, future treatment plan, how death may occur, and respect to patients’ spiritual attitudes and religiousness. Only one quarter of patients family members were satisfied with the communication level. The reason for their dissatisfaction was sense of inadequate appreciation of their needs and requirements. In contrast, 78.5 % of physicians considered their communication with patients’ family members as positive. This mismatch indicates that in order to provide the best care for chronic incurable patients and their family members in a holistic way the physicians of CIC settings must have both relevant clinical knowledge and skills as well as the ability to provide effective communication with patients and their families.
Palliative psychiatry for severe persistent mental illness as a new approach to psychiatry? Definition, scope, benefits, and risks
BMC PSYCHIATRY | Online – 22 July 2016 – Despite psychiatrists’ efforts to prevent mental illness and to promote recovery, some patients will develop “severe persistent mental illness” (SPMI). These represent a particularly vulnerable population, at risk of either therapeutic neglect or overly aggressive care. As proposed, a new variation on an old approach – the explicit application of palliative care principles to psychiatric illnesses – has the potential to improve quality of care, person-centredness, and autonomy for these patients. The working definition of palliative psychiatry suggested here may serve as a starting point for further development of a conceptual framework and clinical approach. Important milestones will include consensus around definitions of SPMI, palliative approaches, care decisions, and futility judgments, along with international acceptance of these concepts among psychiatrists and service users. Establishing an evidence-based staging model of mental illness may be an important prerequisite for these tasks.
Does the culture of modern day palliative care social work leave room for leadership?
JOURNAL OF SOCIAL WORK PRACTICE, 2016; 30(2): 203-218. This paper draws on interviews with six high profile leaders at the forefront of end of life care sector in the U.K. Its findings and emerging themes offer insights about the opportunities for social work leaders in palliative care (PC) in the future and how the profession and PC sector address current barriers to taking advantage of such opportunity. The main focus of this paper is leadership related to PC social work. However, it relates to much broader themes including the history, politics and culture of this profession and the requirements for leadership on the part of social work in the broader contexts of health and social care.
Serious illness and end-of-life care in the homeless: Examining a service system and a call for action for social work
SOCIAL WORK & SOCIETY, 2016; 14(1). This study [in a medium sized city in the Midwestern U.S.] suggests very sick homeless patients are often discharged based on the recommendations of social workers to the streets or to a shelter, both of which are inappropriate solutions. In attempting to support the dignity and worth of the patients, social workers should advocate for better discharge practices, and should gain more direct familiarity with the needs of serious and chronically ill homeless individuals. Hospital based social workers need to be educated about the healthcare needs of the homeless, the gaps and barriers to services, and the options for care at the end of life. There needs to be much greater communication and cooperation between agencies as they attempt to serve the homeless population. The lack of such cooperation found in the present study was striking. In a medium sized city, it should be possible to develop a coordinated system of care. Social workers can play a pivotal role in the development of such a system. As a profession that focuses on case management and referral, social workers could be trained to be leaders in identifying appropriate patients and making those referrals.
Media Watch is intended as an advocacy, education 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 recent issues of Media Watch (see below).
Read the current and back issues of the weekly report.