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 will publish an abstract or summary of an article or report of special interest noted in a recent issue of Media Watch (see below).
BMC Health Services Research | Online – 17 September 2014 – As part of a European policy improvement program, quality indicators (QIs) have been developed to monitor and improve the organization of palliative care for patients with cancer and those with dementia in various settings in different European countries. A multidisciplinary, international panel of professionals participated in a modified RAND Delphi procedure to compose a set of palliative care QIs based on existing sets of QIs on the organization of palliative care. The procedure resulted in 23 useful QIs. These represent key elements of the organization of good clinical practice, such as the availability of palliative care teams, the availability of special facilities to provide palliative care for patients and their relatives, and the presence of educational interventions for professionals. The final set also includes QIs that are related to the process of palliative care, such as documentation of pain and other symptoms, communication with patients in need of palliative care and their relatives, and end-of-life decisions.
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British Medical Association, (U.K.) Resuscitation Council and the Royal College of Nursing | Online – Accessed 8 October 2014 – This new edition takes into account developments in clinical practice and developments in the law regarding anticipatory decisions about cardiopulmonary resuscitation. The guidance identifies key ethical and legal principles that should inform all CPR decisions. The high-level ethical principles are the same for all people, in all settings, but differences in clinical and personal circumstances make it essential that all CPR decisions are made on an individual basis. How these individual decisions are made is also guided by law, which differs between adults and children, and differs in England and Wales, in Scotland, and in Northern Ireland. For example, a central tenet of the mental capacity legislation in England and Wales is "best interests" and in Scotland it is "benefit." These terms – for the purposes of this guidance – are used interchangeably in parts. This guidance also provides a framework to support decisions relating to CPR and effective communication of those decisions. It also highlights relevant legal requirements and differences.
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Journal of Palliative Medicine | Online – 10 October 2014 – Cancer incidence in Middle Eastern countries, mostly categorized as low- and middle-income, is predicted to double in the next 10 years, greater than in any other part of the world. While progress has been made in cancer diagnosis/treatment, much remains to be done to improve palliative care for the majority of patients with advanced cancer. Improved pain management services are key facilitators. Top barriers include lack of designated palliative care beds/services, community awareness, staff training, access to hospice services, and personnel/time. Populations requiring special consideration comprise: patients with ethnic diversity, language barriers, and low literacy; pediatric and young adults; and the elderly. Most Middle Eastern patients with cancer are treated in outlying regions; the community is pivotal and must be incorporated into future plans for developing palliative care services. Promoting palliative care education and certification for physicians and nurses is crucial; home-based and hospice services must be sustained.
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(This article will shortly be available to download free of charge in the members’ area of the IAHPC website)
Journal of Palliative Medicine | Online – 16 September 2014 – The majority of young people in need of palliative care live in low- and middle-income countries, where curative treatment is less available. The most pervasive gaps were in national health system support (unavailable in 7 of 17 countries with programs reporting), specialized education (unavailable in 7 of 19 countries with programs reporting), and comprehensive opioid access (unavailable in 14 of 21 countries with programs reporting). Comprehensive pediatric palliative care provision is possible even in markedly impoverished settings. Improved national health system support, specialized training and opioid access are key targets for research and advocacy. Application of a checklist methodology can promote awareness of gaps to guide program evaluation, reporting, and strengthening.
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(This article will shortly be available to download free of charge in the members’ area of the IAHPC website)
New Europe | Online – 24 September 2014 – The European Union (EU) health ministers pledged to further promote the use of palliative care and pain therapy in the EU member states during a two-day informal meeting that concluded in Milan in September. The ministers reached a common position on the need to create a "network" ensuring training of professionals and exchange of information, Italian Health Minister, Beatrice Lorenzin, told a press conference. Italy was the first country in Europe to adopt a law in 2010, which defines pain therapy as a set of diagnostic and therapeutic initiatives intended to control and suppress moderate to severe chronic pain, she noted. "The necessity to develop domestic assistance networks to assure patients the possibility to remain at home until the end of their life is undeniable," Lorenzin pointed out. Presently, there are 221 hospices providing a total of 2,307 beds in Italy, she said, highlighting the importance of this philosophy of care centered on the needs, including the emotional ones, of chronically or terminally ill patients.
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