This paper explores the reasons why homeless people do not experience good care at the end of life and demonstrates that there are many opportunities to improve standards of care.
Fulltext available here
A current awareness bulletin produced by the library service at Arthur Rank Hospice
Friday, 16 February 2018
A second class ending: Exploring the barriers and championing outstanding end of life care for people who are homeless (discussion paper)
Care Quality Commission and Faculty for Homeless and Inclusion Health, November 2017
This paper explores the reasons why homeless people do not experience good care at the end of life and demonstrates that there are many opportunities to improve standards of care.
This paper explores the reasons why homeless people do not experience good care at the end of life and demonstrates that there are many opportunities to improve standards of care.
The effect of relaxation techniques on edema, anxiety and depression in post-mastectomy lymphedema patients undergoing comprehensive decongestive therapy: A clinical trial
PloS One 2018 13 (1): e0190231
Bahareh
Abbasi, Navid Mirzakhany, Leila Angooti Oshnari, Ashkan Irani, Samaneh Hosseinzadeh,
Seyed Mehdi Tabatabaei, Shahpar Haghighat
This
study aimed to assess the effects of relaxation techniques on the level of edema,
anxiety and depression in women undergoing Comprehensive Decongestive Therapy
(CDT). It concluded that relaxation
techniques reduced the anxiety and depression scores and the volume of edema in
the patients with lymphedema. Further studies are required to determine the cost-effectiveness of this intervention.
Fulltext available in PloS One
Recommendations to reduce inequalities for LGBT people facing advanced illness: ACCESSCare national qualitative interview study
Palliative Medicine; 2018 32(1) p. 23-35
Bristowe, Katherine; Hodson, Matthew; Wee, Bee; Almack, Kathryn; Johnson, Katherine; Daveson, Barbara A; Koffman, Jonathan; McEnhill, Linda; Harding, Richard
ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. It shows that despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access to, and outcomes of, care for LGBT people.
Bristowe, Katherine; Hodson, Matthew; Wee, Bee; Almack, Kathryn; Johnson, Katherine; Daveson, Barbara A; Koffman, Jonathan; McEnhill, Linda; Harding, Richard
ACCESSCare is the first national study to examine in depth the experiences of LGBT people facing advanced illness. It shows that despite recent legislative change, experiences of discrimination and exclusion in health care persist for LGBT people. Ten recommendations, for health-care professionals and services/institutions, are made from the data. These are simple, low cost and offer potential gains in access to, and outcomes of, care for LGBT people.
End-of-life care for homeless people: A qualitative analysis exploring the challenges to access and provision of palliative care
Palliative Medicine; 2018 32(1) p. 36-45
Shulman, Caroline; Hudson, Briony F; Low, Joseph; Hewett, Nigel; Daley, Julian; Kennedy, Peter; Davis, Sarah; Brophy, Niamh; Howard, Diana; Vivat, Bella; Stone, Patrick
The aim of this study was to explore the views and experiences of current and formerly homeless people, frontline homelessness staff (from hostels, day centres and outreach teams) and health- and social-care providers, about the challenges of supporting homeless people with advanced ill health, and to make suggestions for improving care. It highlights the complexities of identifying who is palliative and the lack of appropriate services for homeless people who have high support needs, particularly in combination with substance misuse issues. Recommendation include increased collaboration between services, the promotion of in-reach into hostels and greater training and support for all professional groups.
Shulman, Caroline; Hudson, Briony F; Low, Joseph; Hewett, Nigel; Daley, Julian; Kennedy, Peter; Davis, Sarah; Brophy, Niamh; Howard, Diana; Vivat, Bella; Stone, Patrick
The aim of this study was to explore the views and experiences of current and formerly homeless people, frontline homelessness staff (from hostels, day centres and outreach teams) and health- and social-care providers, about the challenges of supporting homeless people with advanced ill health, and to make suggestions for improving care. It highlights the complexities of identifying who is palliative and the lack of appropriate services for homeless people who have high support needs, particularly in combination with substance misuse issues. Recommendation include increased collaboration between services, the promotion of in-reach into hostels and greater training and support for all professional groups.
Development and evaluation of the Dignity Talk question framework for palliative patients and their families: A mixed-methods study
Palliative Medicine; 2018 32(1) p. 195-205
Guo, Qiaohong; Chochinov, Harvey Max; McClement, Susan; Thompson, Genevieve; Hack, Tom
Effective patient-family communication can reduce patients' psychosocial distress and relieve family members' current suffering and their subsequent grief but terminally ill patients and their family members often experience great difficulty in communicating their true feelings, concerns, and needs to each other. The aims of this study were to develop a novel means of facilitating meaningful conversations for palliative patients and family members, coined Dignity Talk and to explore the anticipated benefits and challenges. The questions were endorsed by a majority of participants who felt that Dignity Talk would be valuable in promoting conversations, enhancing family connections and relationships, enhancing patient sense of value and dignity, promoting effective interaction, and attending to unfinished business.
Guo, Qiaohong; Chochinov, Harvey Max; McClement, Susan; Thompson, Genevieve; Hack, Tom
Effective patient-family communication can reduce patients' psychosocial distress and relieve family members' current suffering and their subsequent grief but terminally ill patients and their family members often experience great difficulty in communicating their true feelings, concerns, and needs to each other. The aims of this study were to develop a novel means of facilitating meaningful conversations for palliative patients and family members, coined Dignity Talk and to explore the anticipated benefits and challenges. The questions were endorsed by a majority of participants who felt that Dignity Talk would be valuable in promoting conversations, enhancing family connections and relationships, enhancing patient sense of value and dignity, promoting effective interaction, and attending to unfinished business.
Pharmacovigilance in hospice/palliative care: net effect of haloperidol for nausea or vomiting
Journal
of Palliative Medicine; 2018 21(1) p. 37-43
Digges,
Madeline; Hussein, Akram; Wilcock, Andrew; Crawford, Gregory B; Boland, Jason
W; Agar, Meera R; Sinnarajah, Aynharan; Currow, David C; Johnson, Miriam J
The objective of this study war to
explore the immediate and short-term net clinical effects of haloperidol when
treating nausea and/or vomiting in palliative care patients. The authors conclude that haloperidol
as an antiemetic provided rapid net clinical benefit with low-grade, short-term
harms.
Drugs for treating opioid-induced constipation: a mixed treatment comparison network meta-analysis of randomized controlled clinical trials
Journal
of Pain and Symptom Management; Feb 2018; vol. 55 (no. 2); p. 468-479
Sridharan, Kannan; Sivaramakrishnan, Gowri
The objective of this study was to compare available interventions for the treatment of opioid-induced constipation, using principles of network meta-analysis. The authors found the quality of evidence for the comparisons is either low or very low but concluded that subcutaneous methyl naltrexone performed better than other interventions for managing opioid-induced constipation.
Sridharan, Kannan; Sivaramakrishnan, Gowri
The objective of this study was to compare available interventions for the treatment of opioid-induced constipation, using principles of network meta-analysis. The authors found the quality of evidence for the comparisons is either low or very low but concluded that subcutaneous methyl naltrexone performed better than other interventions for managing opioid-induced constipation.
Moral distress at the end of a life: when family and clinicians do not agree on implantable cardioverter-defibrillator deactivation
Journal
of Pain and Symptom Management; 2018 55(2) p. 530-534
Steiner, Jill M; Patton, Kristen K; Prutkin, Jordan M; Kirkpatrick, James N
An implantable cardioverter-defibrillator can serve to avoid sudden death but may lead to a prolonged death from heart failure. Although ethical consensus holds that defibrillator deactivation is legal and ethical, disagreements about life prolongation may complicate decision making. The ethical, technical, and medical complexity involved in the case study presented in this article speaks to the need for clear, prospective communication involving the patient, the patient's family, and members of the care team.
Steiner, Jill M; Patton, Kristen K; Prutkin, Jordan M; Kirkpatrick, James N
An implantable cardioverter-defibrillator can serve to avoid sudden death but may lead to a prolonged death from heart failure. Although ethical consensus holds that defibrillator deactivation is legal and ethical, disagreements about life prolongation may complicate decision making. The ethical, technical, and medical complexity involved in the case study presented in this article speaks to the need for clear, prospective communication involving the patient, the patient's family, and members of the care team.
Addressing a patient's hope for a miracle
Journal
of Pain and Symptom Management; 2018 55(2) p. 535-539
Shinall, Myrick C; Stahl, Devan; Bibler, Trevor M
Ill patients may make decisions to continue aggressive life-prolonging care based on hope for a miraculous recovery, and clinicians can find goals of care discussions with these patients extremely challenging.This case presents a typology of ways patients express hope for a miracle along with analysis of the motivations and beliefs underlying such hopes and suggestions for tailored responses by palliative care providers.
Shinall, Myrick C; Stahl, Devan; Bibler, Trevor M
Ill patients may make decisions to continue aggressive life-prolonging care based on hope for a miraculous recovery, and clinicians can find goals of care discussions with these patients extremely challenging.This case presents a typology of ways patients express hope for a miracle along with analysis of the motivations and beliefs underlying such hopes and suggestions for tailored responses by palliative care providers.
The development of a 'wet leg' pathway for chronic oedema
International Journal of Palliative Nursing; 2018 24(1) p. 40-46
Morgan, Karen; Thomas, Melanie
This article presents the Chronic Oedema 'Wet Leg' Pathway which provides nurses and therapists with clear guidelines to support prompt, efficient and effective management of all patients with chronic oedema and wet legs.
Available in print in Arthur Rank Hospice Library, Cambridge
Morgan, Karen; Thomas, Melanie
This article presents the Chronic Oedema 'Wet Leg' Pathway which provides nurses and therapists with clear guidelines to support prompt, efficient and effective management of all patients with chronic oedema and wet legs.
Available in print in Arthur Rank Hospice Library, Cambridge
Psychological impairments burden and spirituality in caregivers of terminally ill cancer patients
European Journal of Cancer Care; 2018 27(1)
Lai, C; Luciani, M; Di Mario, C; Galli, F; Morelli, E; Ginobbi, P; Aceto, P; Lombardo, L
Spirituality is mostly studied in the context of terminally ill patients but this study investigates the association between spirituality, burden, and psychological state in caregivers of terminally ill cancer patients. The authors conclude that in these caregivers, higher levels of intrinsic spirituality predicted a higher amount of time devote to caregiving, and also protected against the emotional distress linked to providing assistance.
Lai, C; Luciani, M; Di Mario, C; Galli, F; Morelli, E; Ginobbi, P; Aceto, P; Lombardo, L
Spirituality is mostly studied in the context of terminally ill patients but this study investigates the association between spirituality, burden, and psychological state in caregivers of terminally ill cancer patients. The authors conclude that in these caregivers, higher levels of intrinsic spirituality predicted a higher amount of time devote to caregiving, and also protected against the emotional distress linked to providing assistance.
Wednesday, 14 February 2018
Acupuncture in hospice settings: A qualitative exploration of patients' experiences
European Journal of Cancer Care; January 2018
McPhail, P; Sandhu, H; Dale, J; Stewart-Brown, S
The aim of this study was to explore patients' experiences of acupuncture in the hospice setting. Acupuncture was found to be a highly acceptable, accessible and popular treatment with positive holistic effects reported across the domains of physical, mental and spiritual health and no serious adverse effects.
McPhail, P; Sandhu, H; Dale, J; Stewart-Brown, S
The aim of this study was to explore patients' experiences of acupuncture in the hospice setting. Acupuncture was found to be a highly acceptable, accessible and popular treatment with positive holistic effects reported across the domains of physical, mental and spiritual health and no serious adverse effects.
The acceptability and potential benefits of mindfulness-based interventions in improving psychological well-being for adults with advanced cancer: A systematic review
Complementary Therapies in Clinical Practice; February 2018 30 p.68-78
Zimmermann, Fernanda F; Burrell, Beverley; Jordan, Jennifer
This systematic review aims to describe, evaluate and synthesize the acceptability and potential benefits of mindfulness-based interventions (MBIs) for the psychological well-being of people with advanced cancers. It concludes that there is evidence of acceptability and of effectiveness, indicating potential benefit for this population.
Zimmermann, Fernanda F; Burrell, Beverley; Jordan, Jennifer
This systematic review aims to describe, evaluate and synthesize the acceptability and potential benefits of mindfulness-based interventions (MBIs) for the psychological well-being of people with advanced cancers. It concludes that there is evidence of acceptability and of effectiveness, indicating potential benefit for this population.
Psychological ideas in palliative care: behaviour change
European
Journal of Palliative Care; 2017 24(6) p. 260-265
Strachan, Jenny
There is little written about behaviour change in palliative care settings. In this article Jenny Strachan examines how encouraging patients to change certain types of behaviour – such as non-compliance with medicines, persistent reassurance seeking and strain in family relationships – comes down to understanding and adjusting the relationship between the behaviour and its reinforcers.
Fulltext available in European Journal of Palliative Care
Available in print in Arthur Rank Hospice Library, Cambridge
Strachan, Jenny
There is little written about behaviour change in palliative care settings. In this article Jenny Strachan examines how encouraging patients to change certain types of behaviour – such as non-compliance with medicines, persistent reassurance seeking and strain in family relationships – comes down to understanding and adjusting the relationship between the behaviour and its reinforcers.
Fulltext available in European Journal of Palliative Care
Available in print in Arthur Rank Hospice Library, Cambridge
What do patients with cancer and their families value most at the end of life? A critical analysis of advance care planning
International Journal of Palliative Nursing; 2017 23(12) p. 596-604
Johnson, Stephanie B; Butow, Phyllis N; Kerridge, Ian; Tattersall, Martin Hn
The findings from this study suggest that models of ACP which are constructed around patients' 'rights' to determine what happens to their bodies may do little to enhance the quality of EoL care, as patients value veracity, trust and comfort at the EoL more than autonomy. Quality EoL care should focus on paying increased attention to the relational and social aspects of care.
Johnson, Stephanie B; Butow, Phyllis N; Kerridge, Ian; Tattersall, Martin Hn
The findings from this study suggest that models of ACP which are constructed around patients' 'rights' to determine what happens to their bodies may do little to enhance the quality of EoL care, as patients value veracity, trust and comfort at the EoL more than autonomy. Quality EoL care should focus on paying increased attention to the relational and social aspects of care.
'A strange kind of balance': inpatient hospice volunteers' views on role preparation and training
Progress
in Palliative Care; 2017 25(6) p. 279-285
Dean, Antonia; Willis, Susan
In the UK, there have been calls for the development of a core curriculum for hospice volunteers but debate exists around the potential for unnecessary 'professionalization' of volunteers. This qualitative, focus group study explores the views of UK inpatient hospice volunteers regarding initial training for role preparation. This study will inform local practice, shaping the education and support of future volunteers, and adds to the wider evidence-base surrounding the development of this crucial group within the hospice workforce.
Fulltext available in Progress in Palliative Care
Dean, Antonia; Willis, Susan
In the UK, there have been calls for the development of a core curriculum for hospice volunteers but debate exists around the potential for unnecessary 'professionalization' of volunteers. This qualitative, focus group study explores the views of UK inpatient hospice volunteers regarding initial training for role preparation. This study will inform local practice, shaping the education and support of future volunteers, and adds to the wider evidence-base surrounding the development of this crucial group within the hospice workforce.
Fulltext available in Progress in Palliative Care
Available in print in Arthur Rank Hospice Library, Cambridge
Fear in palliative care
Progress
in Palliative Care; 2017 25(6) p 273-278
Macleod, A. D.
In this article the author discusses the difference between fear and anxiety and considers the limited literature on the management of fear in terminally ill patients.
Fulltext available in Progress in Palliative Care
Available in print in Arthur Rank Hospice Library, Cambridge
Macleod, A. D.
In this article the author discusses the difference between fear and anxiety and considers the limited literature on the management of fear in terminally ill patients.
Fulltext available in Progress in Palliative Care
Available in print in Arthur Rank Hospice Library, Cambridge
Hidden losses and ‘forgotten’ suffering: the bereavement experiences of British Romany Gypsies and Travellers
Bereavement Care; Dec 2017; 36(3) p94-102
Rogers, Carol; Greenfields, Margaret
This paper presents a narrative review of the literature illustrated by quotes from a from a recently completed study that examines the bereavement support needs of Gypsies and Travellers and best practice for organisations seeking to support these ‘hard to reach’ populations.
Rogers, Carol; Greenfields, Margaret
This paper presents a narrative review of the literature illustrated by quotes from a from a recently completed study that examines the bereavement support needs of Gypsies and Travellers and best practice for organisations seeking to support these ‘hard to reach’ populations.
"Unexpected and distressing": understanding and improving the experience of transferring palliative care inpatients to residential care
Journal
of Social Work in End-of-Life and Palliative Care; 2017 13(2-3) p193-204
Kallianis, Voula; Joubert, Lynette; Gorman, Sue; Posenelli, Sonia; Lethborg, Carolyn
When a patient no longer requires specialist palliative care services, transfer from an inpatient palliative care facility to residential care may be necessary. This research explored the impact of this transition on the patient and their families and on the interdisciplinary health care team treating the patient and makes recommendations for best managing the transition.
Kallianis, Voula; Joubert, Lynette; Gorman, Sue; Posenelli, Sonia; Lethborg, Carolyn
When a patient no longer requires specialist palliative care services, transfer from an inpatient palliative care facility to residential care may be necessary. This research explored the impact of this transition on the patient and their families and on the interdisciplinary health care team treating the patient and makes recommendations for best managing the transition.
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