Social media and palliative medicine: a retrospective 2-year analysis of global Twitter data to evaluate the use of technology to communicate about issues at the end of life

BMJ supportive & palliative care, June 2015  5(2):207-12
Nwosu AC;  Debattista M;  Rooney C;  Mason S.

The scope and breadth of the use of Twitter to discuss end-of-life care has not previously been reported. The authors' aim was to determine the frequency, sentiment and trend of Twitter 'tweets' containing palliative care-related identifiers (hashtags) and/or phrases sent by users over a 2-year period.  They found that a lot of discussion about palliative care is taking place on Twitter, and the majority of this is positive. Social media presents a novel opportunity for engagement and ongoing dialogue with public and professional groups. 

• Fulltext available in BMJ Supportive and Palliative Care
• • Available in print in Arthur Rank House Library, Brookfields Hospital

Is the use of negative pressure wound therapy for a malignant wound legitimate in a palliative context? "The concept of NPWT ad vitam": a case series

Palliative medicine, May 2015, vol. 29, no. 5, p. 470-473 

Riot, Samuel, de Bonnecaze, Guillaume, Garrido, Ignacio, Ferron, Gwenaël, Grolleau, Jean-Louis, Chaput, Benoit

The use of negative pressure wound therapy is usually not recommended for the management of malignant wounds that are often malodorous, highly exuding, and painful.  It is, however, an effective procedure for maintaining a good quality of life in certain palliative situations.  The authors report their experiences with five patients for whom manufacturers and health authorities contraindicated the use of negative pressure wound therapy because of its potential to encourage tumor growth, although it was considered to be beneficial for all of these patients.

Fulltext available in Palliative Medicine

Available in print in Arthur Rank House Library, Brookfields Hospital

Outcomes of lung transplant candidates referred for co-management by palliative care: a retrospective case series

Palliative Medicine, May 2015, vol. 29, no. 5, p. 429-435

Colman, Rebecca, Singer, Lianne G, Barua, Reeta, Downar, James

Lung transplant candidates are rarely referred for palliative care consultation until they are deemed ineligible for transplant.  In this article, the authors review the characteristics, interventions, and outcomes of lung transplant candidates referred for co-management by palliative care, to determine whether they safely received opioids and went on to transplantation.  They conclude that palliative care and opioids in particular can be safely provided without compromising eligibility for transplantation. 

Fulltext available in Palliative Medicine

Available in print in Arthur Rank House Library, Brookfields Hospital

 

Fixed-dose subcutaneous methylnaltrexone in patients with advanced illness and opioid-induced constipation: results of a randomized, placebo-controlled study and open-label extension

Journal of palliative medicine, Jul 2015, vol. 18, no. 7, p. 593-600 

Bull, Janet, Wellman, Charles V, Israel, Robert J, Barrett, Andrew C, Paterson, Craig, Forbes, William P

The study objective was to assess safety and efficacy of fixed-dose MNTX in two phase 4 trials. The authors report that fixed-dose MNTX administered in the RCT and in a follow-up open label extension study demonstrated robust efficacy and was well tolerated in treating OIC in patients with advanced illness.

Development of the Carers' Alert Thermometer (CAT) to identify family carers struggling with caring for someone dying at home: a mixed method consensus study

BMC palliative care, Jan 2015, vol. 14, p. 22

Knighting, Katherine, O'Brien, Mary R, Roe, Brenda, Gandy, Rob, Lloyd-Williams, Mari, Nolan, Mike, Jack, Barbara A

The aim of the study was to explore what professionals and carers of patients with cancer and advanced progressive illness, in their last year of life, find burdensome and to develop an alert system for use by non-specialist staff to help avoid crisis situations for the carer and avoidable hospital admissions.  The resultant CAT is an evidence-based alert thermometer consisting of 10 questions, guidance on the possible actions for each alert and space for an action plan to be jointly agreed by the assessor and carer.

Fulltext available in BMC Palliative Care

 

: 'I want to feel at home': establishing what aspects of environmental design are important to people with dementia nearing the end of life

BMC palliative care, Jan 2015, vol. 14, p. 26

Fleming, Richard, Kelly, Fiona, Stillfried, Gillian

Using a combination of focus groups and a Delphi survey, this study explored the views of people with dementia, family carers and professionals on what aspects of the physical environment would be important to support a good quality of life to the very end.

fulltext available BMC Palliative Care

Existential concerns about death: a qualitative study of dying patients in a Danish hospice

American Journal of Hospice & Palliative Medicine, June 2015  32(4):427-36

Moestrup L;  Hansen HP.

Research suggests that addressing dying patients' existential concerns can improve their quality of life. Here, the authors aimed to illuminate dying patients' existential concerns about the impending death through a descriptive analysis of semi-structured interviews with 17 patients in Danish hospices. The main findings demonstrated how the patients faced the imminent death without being anxious of death but sorrowful about leaving life.

Symptom management of bone metastasis at end of life

Journal of Hospice and Palliative Nursing, Jun 2015, vol. 17, no. 3, p. 183-186

Coyne, Paul Ensom

Through the use of a case narrative, this article demonstrates the complexity of palliative care as it relates to the pain management of bone metastasis at end of life from both the pharmacological and psychosocial perspectives. Treatment interventions for pain in each of these domains is explored, illustrating that metastatic bone pain at end of life is a multifaceted experience that requires a multimodal approach to care.

Barriers to research in palliative care: A systematic literature review

Progress in Palliative Care, 01 April 2015, vol./is. 23/2(75-84)

Blum, David, Inauen, Roman, Binswanger, Jacqueline, Strasser, Florian

The most often mentioned barriers to palliative care research are ethical concerns of performing research in a vulnerable population and issues of trial conduct due to difficulties obtaining informed consent or high attrition rates.  Possible strategies to overcome the barriers include international collaborative efforts and improving study designs to tailor them specifically to the PC population.

Available in print in Arthur Rank House Library, Brookfields Hospital

Ethics in palliative care

Progress in Palliative Care, 01 June 2015, vol./is. 23/3

This is a special issue exploring ethical issues.  It includes the following:

• Moral luck and the question of autonomy, choice and control in end of life decision making
• Decision-making capacity at the end of life
• Ethical dilemmas of surrogate decision making
• When mediation fails: identifying and working with inappropriate surrogate decision makers
• Palliative sedation: controversies and challenges
• CPR and hospice: incompatible goals, irreconcilable differences

Available in print in Arthur Rank House library, Brookfields Hospital

The Medicalization of Bereavement: (Ab)normal Grief in the DSM-5

Death Studies, 01 July 2015, vol./is. 39/6(347-352)

Bandini, Julia

This article first considers the removal of the bereavement exclusion from the criteria for the diagnosis of major depression DSM-5.  It then examines the consequences of this medicalization of grief, including overdiagnosis and overtreatment, a potential expanded market for pharmaceutical companies, and the loss of traditional and cultural methods of adapting to the loss of a loved one.

Coping flexibility, forward focus and trauma focus in older widows and widowers

Bereavement Care, 01 April 2015, vol./is. 34/1(17-23)

Knowles, Lindsey M, O'Connor, Mary-Frances

The primary aim of the present study was to assess whether trauma focus and forward focus coping strategies, and using strategies from both flexibly, would predict grief severity. Results showed that greater forward focus and coping flexibility predicted lower grief severity, and also predicted lower yearning, loneliness, and perceived stress. 

Available in print in Arthur Rank House Library, Brookfields Hospital 

Palliative care outcome measures resource pack launched

May 2015

The Cicely Saunders Institute and Hospice UK have joined forces to launch a new Palliative Care Outcome Measures Resource Pack. “Outcome measures are essential if hospices are to better understand – and be able to demonstrate to others – the positive difference they make for patients and families.” The packs are intended to help hospices and other palliative care teams learn more about outcome measures, and start to introduce a shared set of outcome measures into clinical practice.

Follow this link for the web article

New Macmillan toolkit for health and social care staff on discussing care plans

A new resource designed to help healthcare professionals discuss future care plans with patients, has been released by Macmillan Cancer Support.

The toolkit is aimed at generalists caring for people with progressive illnesses and those reaching the end stage of their lives. It covers a range of topics, and includes video clips and web links to assist professionals with their learning.

New free online training resource on Advance Care Planning

A new, free training resource is available to support healthcare professionals, carers, families and patients to prepare for the end of life by making advance care plans.

The training, which consists of 10 online modules, was produced by Kent Community Health NHS Foundation Trust and Canterbury Christ Church University and hospices in Kent.

'The Road Ahead': NCPC launches official strategy for 2015-18

NCPC has published its official strategy for 2015-18.

The new strategy has been agreed by NCPC's Board of Trustees and affirms its vision for palliative and end of life care, demonstrates how it can play an important role in shaping the future, and sets out the areas in which it will work to achieve these goals.

In the three years to March 2018 The Road Ahead will shape all NCPC's activities, including its work leading the Dying Matters Coalition.