Core competencies for palliative care social work in Europe: an EAPC White Paper – part 2

European Journal of Palliative Care, 2015 January/February, Volume 22 Number 1 (38-44)
Sean Hughes, Pam Firth and David Oliviere

The competencies framework proposed is applicable to social workers in any role but specifically delineates the advanced competencies appropriate to the specialist work required in palliative and end of life contexts.

Available in print in the Arthur Rank House Library, Brookfields Hospital

Patients’ own drugs and bedside lockers: can they be of benefit in hospices?

European Journal of Palliative Care, 2015 January/February, Volume 22 Number 1 (10-13)
Stephen Ward, Max Watson and Clare White

In UK hospitals, the NHS encourages the use of patients’ own drugs (PODs) administrated directly from bedside lockers. So far, there is little evidence supporting their use in a hospice setting. The authors have evaluated a PODs locker scheme implemented at a hospice in Northern Ireland.

Available in print in the Arthur Rank House Library, Brookfields Hospital

Managing cholestatic pruritus in palliative care

European Journal of Palliative Care, 2014 November/December, Volume 21 Number 6 )266-9)

Claire Magee

How much do we know about pruritus and how is it best managed in palliative care? Claire Magee sums up current knowledge and evidence, outlining key treatment recommendations for healthcare practitioners.

Available in print in the Arthur Rank House Library, Brookfields Hospital

The development and evaluation of an oncological palliative care deprescribing guideline: the 'OncPal deprescribing guideline'

Supportive Care in Cancer, January 2015, vol./is. 23/1(71-8)

Lindsay J, Dooley M, Martin J, Fay M, Kearney A, Khatun M, Barras M

Current data suggests that potentially inappropriate medicines (PIMs) are common in palliative cancer patients; however, there is a lack of criteria to assist clinicians in identifying PIMs in these patients.  A guideline to assist in the de-escalation of inappropriate medications was developed from current literature.

Developing a best practice model for partnership practice between specialist palliative care and intellectual disability services: a mixed methods study

Palliative Medicine, December 2014, vol./is. 28/10(1213-21)

McLaughlin D, Barr O, McIlfatrick S, McConkey R

The lack of access to good quality palliative care for people with intellectual disabilities is highlighted in the international literature.  Joint working and learning between intellectual disability and specialist palliative care were seen as key and fundamental. A framework for partnership practice between both services has been developed which could have international applicability and should be explored with other services in end-of-life care.

Fulltext available in Palliative Medicine

Available in print in the Arthur Rank Hospice Library, Brookfields Hospital

The power of advance care planning in promoting hospice and out-of-hospital death in a dialysis unit

Journal of Palliative Medicine, January 2015, vol./is. 18/1(62-6)

Schmidt RJ, Weaner BB, Long D

This study found that comprehensive and systematic advance care planning among patients with ESRD on dialysis promotes greater hospice utilization and may facilitate the chance that death will occur out of hospital.

Exercise for the management of cancer-related fatigue in lung cancer: a systematic review.

European Journal of Cancer Care, January 2015, vol./is. 24/1(4-14)

Paramanandam VS, Dunn V

The role of exercise in lung cancer is not clear.   This review found that exercise is beneficial and safe in lung cancer-related fatigue but the studies are small and, without any control group, lack clinically significant effect. Thus, exercises could be used in the management of cancer-related fatigue in lung cancer, in view of the available evidence in other cancer cohorts, with due caution.

Available in the Arthur Rank House Library, Brookfields Hospital

Identifying the barriers and enablers to palliative care nurses' recognition and assessment of delirium symptoms: a qualitative study

Journal of Pain and Symptom Management, Nov 2014, vol. 48, no. 5 (815-830)

Hosie, Annmarie, Lobb, Elizabeth, Agar, Meera, Davidson, Patricia M., Phillips, Jane

Supporting the development of palliative care nursing delirium recognition and assessment practice requires attending to a range of barriers and enablers at the patient and family, health professional, and system levels.

Fulltext available in Journal of Pain and Symptom Management

Available in print in the Arthur Rank House Library, Brookfields Hospital

Do place-of-death preferences for patients receiving specialist palliative care change over time?

International Journal of Palliative Nursing, Dec 2014, vol. 21, no. 12, p. 579-583

Evans, Rebecca, Finucane, Anne, Vanhegan, Lynsey, Arnold, Elizabeth, Oxenham, David

The extent to which preferences may change is unclear so this retrospective case note review examines changes in PPD.  It found that once a clear preference is expressed, few patients changed their minds. The authors conclude that clinicians should continue to review patients whose initial preferences are unclarified so that they can be supported to die in their place of choice.

Full text available in International Journal of Palliative Nursing

Available in print in the Arthur Rank House Library, Brookfields Hospital

Working toward a good life as a cancer survivor: a longitudinal study on positive health outcomes of a rehabilitation program for young adult cancer survivors

Cancer Nursing, January 2015, vol./is. 38/1(3-15)

Hauken MA, Holsen I, Fismen E, Larsen TM

The aim of this study was to investigate whether a complex rehabilitation program improved the health-related quality of life (HRQOL) and physical capacities of young adult cancer survivors.  The authors conclude the program especially tailored for YACS seems to build positive health outcomes such as HRQOL and physical capacity in a long-term perspective.

Dying at home: a qualitative study of family carers' views of support provided by GPs community staff

British Journal of General Practice, December 2014, vol./is. 64/629(e796-803)
Seamark D, Blake S, Brearley SG, Milligan C, Thomas C, Turner M, Wang X, Payne S 

Bereaved carers in this qualitative study were interviewed to ascertain what community support made death at home possible. Family carers suggested that minimising the number of carers involved in care, increasing or ensuring personal continuity, and maximising the informational and organisational aspects of care could lead to a more positive experience.

Preferences of patients with Parkinson's disease for communication about advanced care planning

American Journal of Hospice & Palliative Medicine, February 2015, vol./is. 32/1(68-77)

Tuck KK, Brod L, Nutt J, Fromme EK

Despite shortening life, Parkinson's disease (PD) is often not considered "terminal" and uncertainty exists about when to discuss end-of-life planning. A survey was sent to patients with PD assessing attitudes toward the timing and initiation of discussions regarding their disease.  It was found that preferences regarding end-of-life discussions vary.  The authors suggest that patients should be asked about their preferences for this information and offer discussion periodically.

The benefits of rehabilitation for palliative care patients

American Journal of Hospice & Palliative Medicine, February 2015, vol./is. 32/1(34-43)

Barawid E, Covarrubias N, Tribuzio B, Liao S

This review article focuses on rehabilitation interventions that can be beneficial in patients with late stage illnesses. Rehabilitation may be useful in improving the quality of life by palliating function, mobility, activities of daily living, pain relief, endurance, and the psyche of a patient while helping to maintain as much independence as possible, leading to a decrease in burden on caregivers and family. Rehabilitative services are underutilized in the palliative care setting, and more research is needed to address how patients may benefit as they approach the end of their lives. 

Rehabilitation

Progress in Palliative Care, 01 December 2014, vol./is. 22/6

This a special issue of the journal, focusing on rehabilitation in palliative care and includes the following articles:

• Researching the rehabilitation needs of patients with life-limiting disease: challenges and opportunities
• An evaluation of the St Christopher's Hospice rehabilitation gym circuits classes: patient uptake, outcomes, and feedback
• Goal setting in palliative care: a structured review
• An analysis of the implementation of palliative rehabilitation in five UK hospices using the Stakeholder Salience Model
• A service evaluation of a specialist community palliative care occupational therapy service
• A physical exercise programme for palliative care patients in a clinical setting: observations and preliminary findings

Available in print in the Arthur Rank House Library, Brookfields Hospital

Are exercise programs effective for improving health-related quality of life among cancer survivors? a systematic review and meta-analysis

Oncology Nursing Forum, 01 November 2014, vol./is. 41/6(0-)

Mishra, Shiraz I., Scherer, Roberta W., Snyder, Claire, Geigle, Paula, Gotay, Carolyn

  

Objective: To evaluate the effectiveness of exercise interventions on overall health-related quality of life (HRQOL) and its domains among cancer survivors who have completed primary treatment.  Evidence presented in this review supports the inclusion of exercise programs in clinical guidelines for the management of cancer survivors who have completed treatment.

Available in print in the Arthur Rank House Library, Brookfields Hospital

Perspectives of postmenopausal breast cancer survivors on adjuvant endocrine therapy-related symptoms

Oncology Nursing Forum, 01 November 2014, vol./is. 41/6(660-668)

van Londen, G. J., Donovan, Heidi S., Beckjord, Ellen B., Cardy, Alexandra L., Bovbjerg, Dana H., Davidson, Nancy E., Morse, Jennifer Q., Switzer, Galen E., Verdonck-de Leeuw, Irma M., Dew, Mary Amanda

The objective of this qualitative focus group study was to investigate women's experiences related to adjuvant endocrine therapy (AET) and managing AET-related symptoms.  The findings suggest multiple opportunities to better prepare patients for AET and to improve assessment and management of AET-related symptoms and so promote AET adherence in breast cancer survivors.

Available in print in the Arthur Rank House Library, Brookfields Hospital

Effects of acupuncture and acupressure on cancer-related fatigue: a systematic review

Oncology Nursing Forum, 01 November 2014, vol./is. 41/6(581-592)

Ling, Wai-man, Lui, Liza Y. Y., So, Winnie K. W., Chan, Kuen

The aim of the review is to critically examine the evidence for acupuncture and acupressure in the management of cancer-related fatigue (CRF) in adult patients with cancer. The authors suggest that, although the results are inconclusive, acupuncture and acupressure tend to be effective in relieving CRF, with the former producing a greater improvement. 

Available in print in the Arthur Rank House Library, Brookfields Hospital

Wake up, sleep is important! Managing sleep disturbance in patients with advanced cancer

European Journal of Palliative Care, July/August 2014, vol/iss 21/4 (162-5)
Gunnhild Jakobsen, Anne Kari Knudsen and Pål Klepstad

Sleep disturbance is a relatively common, but often neglected, problem in advanced cancer. In this article the authors explain how to screen for sleep disturbance in cancer patients and outline the available treatment options.

Available in print in Arthur Rank House Library, Brookfields Hospital

Factors associated with haematological cancer survivors experiencing a high level of unmet need across multiple items of supportive care: a cross-sectional survey study

Supportive Care in Cancer, November 2014, vol./is. 22/11(2899-909)

Hall A, D'Este C, Tzelepis F, Lynagh M, Sanson-Fisher R

Of the 696 survivors included in this study, 175 (n=25 %) reported a "high/very high" level of unmet need on seven or more items of the Survivor Unmet Needs Survey. Additional and intensive supportive care may be needed for this subgroup of haematological cancer survivors. Assistance with accessing relevant financial support and highly accessible services that provide emotional and information support, such as online and telephone peer support programs, may prove beneficial in addressing their needs.

Palliative care for severely affected patients with multiple sclerosis: when and why? Results of a delphi survey of health care professionals

Journal of Palliative Medicine, October 2014, vol./is. 17/10(1128-36)Strupp J, Romotzky V, Galushko M, Golla H, Voltz R

The objective was to use a Delphi survey to analyse when and why specialised palliative care integration would be beneficial via examining health care professionals' attitudes.  The results identify specific areas in which palliative care will likely prove to be a valuable asset in the treatment course of MS.

Breathlessness, functional status, distress, and palliative care needs over time in patients with advanced chronic obstructive pulmonary disease or lung cancer: a cohort study

Journal of Pain & Symptom Management, October 2014, vol./is. 48/4(569-581.e1)Weingaertner V, Scheve C, Gerdes V, Schwarz-Eywill M, Prenzel R, Bausewein C, Higginson IJ, Voltz R, Herich L, Simon ST, PAALiativ Project, PAALiativ Project

The objective of this paper is to describe and compare the courses of refractory breathlessness, functional status, distress, and PC needs in patients with advanced chronic obstructive pulmonary disease (COPD) or lung cancer (LC) over time. The authors conclude that the PC needs of patients with advanced COPD are comparable with LC patients, and breathlessness severity and distress are even higher. 

Available in print in Arthur Rank House Library, Brookfields Hospital

Learning, development, and support needs of community palliative care clinical nurse specialists

International Journal of Palliative Nursing, September 2014, vol./is. 20/9(425-33)

Whittaker E, Kernohan WG, McLaughlin D

The aim of this study was to explore what learning, development, and support PC-CNSs in one hospice need to enable them to fulfil all components of their role: clinical practice, education, research, and leadership and management.  They identified that both organisational culture and individuals themselves influenced the learning and development support available. Working relationships and stability within teams affected how supported individuals felt and had implications for managers in meeting the needs of staff while balancing the needs of the service.

Full text available in International Journal of Palliative Nursing

Available in print in Arthur Rank House Library, Brookfields Hospital

Neuropathic pain in people with cancer (part 1): incidence, manifestation, and assessment

International Journal of Palliative Nursing, September 2014, vol./is. 20/9(442-7)

Taverner T

Nurses are well placed to identify patients with possible signs and symptoms of neuropathic pain. Part 1 of this paper provides an overview of neuropathic cancer pain incidence, manifestation, and assessment; part 2 will address management.

Full text available in International Journal of Palliative Nursing

Available in print in Arthur Rank House Library, Brookfields Hospital

Psychosocial, educational and communicative interventions for patients with cachexia and their family carers

Current Opinion in Supportive & Palliative Care, December 2014, vol./is. 8/4(334-8)

Reid J

Full text available in Current Opinion in Supportive and Palliative Care

Indications and practice of artificial hydration for terminally ill cancer patients

Current Opinion in Supportive & Palliative Care, December 2014, vol./is. 8/4(358-63)

Nakajima N, Satake N, Nakaho T

The purpose of this review is to update medical professionals on the role of artificial hydration in terminally ill cancer patients and to highlight recent research.

Full text available in Current Opinion in Supportive and Palliative Care

Role of corticosteroids for fatigue in advanced incurable cancer: is it a 'wonder drug' or 'deal with the devil'

Current Opinion in Supportive & Palliative Care, December 2014, vol./is. 8/4(346-51)

Yennurajalingam S, Bruera E

This review summarizes recent literature on the impact of corticosteroids on fatigue, its related symptoms, and the role of 'corticosteroid rotation' in improving the corticosteroid-related side-effects.  The two recently published artilces found confirm the short-term benefits for the symptomatic treatment of cancer-related fatigue and anorexia cachexia in advanced incurable cancer. Long-term use of corticosteroids is not recommended at this time because of the risk of debilitating side-effects and no evidence of its long-term benefits. Recent studies also suggest the possible role of corticosteroid rotation or switching similar to opioid rotation for improvement of these side-effects.

Full text available in Current Opinion in Supportive and Palliative Care

End-of-life matters in chronic heart failure patients

Current Opinion in Supportive & Palliative Care, December 2014, vol./is. 8/4(364-70)
Sobanski P, Jaarsma T, Krajnik M

The purpose of this review is to provide an update on current end-of-life issues specific to heart failure patients, including a proposed new model of end-of-life trajectories which takes into account the influence of comorbidities on the prognosis of heart failure and advance care planning for patients with implanted cardiac devices which has been shown to be unsatisfactory. A recent strategy for managing implantable cardioverter defibrillators in patients approaching death is presented.

Full text available in Current Opinion in Supportive and Palliative Care

Cancer-related insomnia

American Journal of Hospice & Palliative Medicine, November 2014, vol./is. 31/7(777-85)

Induru RR, Walsh D.

An overview of the assessment and management of insomnia in cancer patients is presented.

Persistent hiccups in advanced neuro-oncology patients: findings from a descriptive phenomenological study

Journal of Hospice and Palliative Nursing, Oct 2014, vol/iss 16/7(396-401)

Palese, Alvisa, Condolo, Giulio, Dobrina, Raffaella, Skrap, Miran

According to the patients' experience, living with persistent hiccups was characterized by 3 main themes: (a) resignation to its unpredictable nature; (b) despair that there is nothing worse than hiccups; and (c) learning to control the pauses. In trying to interrupt hiccups, patients learn to control their pauses, lengthening the interval between 1 spasm and the next, thereby achieving an acceptable level of symptom discomfort.

Identification and validation of premortem purge: a delphi study

Journal of Hospice and Palliative Nursing, Oct 2014, vol/iss 16/7 (430-437)

Schreiber, Tanya P., Bennett, Marsha J.

Anecdotal accounts offered by nurses suggest that some individuals in the final phase of dying experience a sudden, unexpected surge of energy and enhanced mental clarity, varying in intensity and duration. The Delphi method was used to systematically collect observations, opinions, and perceptions of the phenomenon, labeled premortem surge (PS).

Integrative review of dignity in end-of-life care

Palliative Medicine, July 2014, vol./is. 28/7(931-940)

Guo Q., Jacelon C.S

The aim of this review was to synthesize the meaning of dying with dignity and to identify common aspects of dignity in end-of-life care. 

Full text available in Palliative Medicine

Available in print in Arthur Rank House Library, Brookfields Hospital

Self-injury in youths who lost a parent to cancer: nationwide study of the impact of family-related and health-care-related factors

Psycho-Oncology, September 2014, vol./is. 23/9(989-97)

Bylund Grenklo T, Kreicbergs U, Valdimarsdottir UA, Nyberg T, Steineck G, Furst CJ

Self-injury, a manifestation of severe psychological distress, is increased in cancer-bereaved youths. The results of this study involving 622 youths (aged 18-26) who had lost a parent between the ages of 13 and 16 suggest that poor family cohesion before and after the loss of a parent to cancer is associated with an increased risk of self-injury in teenage children.

The volume of hydration in terminally ill cancer patients with hydration-related symptoms: a prospective study

Journal of Palliative Medicine, September 2014, vol./is. 17/9(1037-41)

Nakajima N, Takahashi Y, Ishitani K

This study aimed to clarify the effects of reducing the volume of artificial hydration, based on the Japanese guideline, in terminally ill cancer patients with hydration-related symptoms on the alleviation of various symptoms and QOL.  The results suggest that hydration-related symptoms were significantly improved after performing guideline-based AHT.

Insomnia among patients with advanced disease during admission in a Palliative Care Unit: a prospective observational study on its frequency and association with psychological, physical and environmental factors

BMC Palliative Care, 2014, vol./is. 13/(40)

Renom-Guiteras A, Planas J, Farriols C, Mojal S, Miralles R, Silvent MA, Ruiz-Ripoll AI

The authors conclude that insomnia was highly frequent and seemed to be influenced by several physical, psychological and environmental factors. They suggest that within the multimodal management of insomnia, the assessment of nocturnal rumination may be of particular interest, irrespective of emotional distress. 

Full text available in BMC Palliative Care

Exploring hope and healing in patients living with advanced non-small cell lung cancer

Oncology Nursing Forum, 01 September 2014, vol./is. 41/5(497-508)

Eustache, Chloe, Jibb, Emily, Grossman, Mary

The authors used an interpretive qualitative study design involving 12 patients. Four main themes were identified: (a) the morass of shattered hope, (b) tentative steps toward a new hope paradigm, (c) reframing hope within the context of a life-threatening illness, and (d) strengthening the link between hope and wellness. They highlight the importance of understanding the fluctuating nature of hope in patients with advanced lung cancer to foster it, therefore promoting healing.

Available in print in Arthur Rank House Library, Brookfields Hospital

How to conduct research in an independent hospice: practical tips and advice

European Journal of Palliative Care, 2014, Vol/iss 21/5 (236-9)

Paul Perkins, Rebecca Day, Julie Hapeshi, Lorraine Dixon and Rudo Nyakuhwa

Hospices, as centres of excellence, have a duty to drive and initiate research if they are to provide high-quality palliative care but they do face a number of challenges. In this paper, the authors use their experience at Sue Ryder to provide some insight into how independent hospices can become active in conducting research.

Full text available in European Journal of Palliative Care

Available in print in Arthur Rank House Library, Brookfields Hospital

How can you prove that you are delivering good care? Monitoring the quality of palliative care using quality indicators

European Journal of Palliative Care, 2014, Vol/iss 21/5 (228-31)

Joachim Cohen and Kathleen Leemans

Measuring the quality of palliative care in a systematic and valid manner, so that the results can be used to improve care where necessary, remains a challenge. In this article, the authors argue that quality indicators specifically designed for palliative care can address this challenge and illustrate this using an indicator set recently developed in Belgium.

Full text available in European Journal of Palliative Care

Available in print in Arthur Rank House Library, Brookfields Hospital

A survey about patients transferred from a specialist palliative care unit to an acute hospital setting

European Journal of Palliative Care, 2014, Vol/iss 21/5 (219-21)

Trisha Castanheira and Bethany Wright

Increasingly in both malignant and non-malignant disease, palliative care is being offered alongside active therapy so the interface between acute and specialist palliative care services is likely to be less clear-cut.  In this article the authors ask if hospice patients benefit from transfers to the acute hospital and consider how to achieve a balance between curative and palliative care?  They present and discuss the results of a survey conducted at Birmingham St Mary’s Hospice looking at patient transfers to the acute hospital.

Full text available in European Journal of Palliative Care
Available in print in Arthur Rank House Library, Brookfields Hospital

Is religion harmful or beneficial at the end of life?

European Journal of Palliative Care,  2014, Vol/iss  21/4 (188-92)

Nimisha Panchmatia

Nimisha Panchmatia has reviewed the literature in an attempt to understand the role and impact – whether positive or negative – of religion and spirituality for patients nearing the end of life.

Full text available in European Journal of Palliative Care

Available in print in Arthur Rank House Library, Brookfields Hoapital

Developing a complex intervention to improve advance care planning for care home residents

European Journal of Palliative Care,  2014, Vol/iss  21/4 (173-6)

Tamsin McGlinchey, Stephen Mason, Philip Saltmarsh, Maureen Gambles, Gerard Corcoran, Rebecca Bancroft and John E Ellershaw

This paper describes phase1 of a project set up in the North-West of England to develop, implement and evaluate a complex intervention aimed at improving the planning of future care for care home residents with and without mental capacity.

Full text available in European Journal of Palliative Care

Available in print in the Arthur Rank House Library, Brookfields Hospital