CANCER FORUM, 2015;39(2):90-94. There is consensus that survivorship care should be integrated, risk or needs stratified, individualized, coordinated and multidisciplinary. But further research is needed to determine the service models that can best deliver optimal outcomes in the most cost-effective way. Model heterogeneity and diversity is needed to address issues that are disease, treatment or symptom specific, and account for other modifying influences such as co-morbid illness and lifestyle. Further work is needed to determine the key elements within models of care configured to support cancer survivors that positively influence outcomes, and how these elements can be best delivered across a diverse range of care settings. In the meantime, adopting a needs based approach to care at the individual patient level will ensure that those in most need have access to relevant support and care from specialist palliative care services. Fortunately, current Australian health reforms provide a climate of plasticity and innovation that is conducive to the paradigm shifts required.
JOURNAL OF PUBLIC HEALTH IN DEVELOPING COUNTRIES, 2015;1(1):31-39. Rapidly changing scenario of modern health care because of the scientific and technological advancements has generated a never-ending debate among socio-religio-ethical segments of the society. Physicians working in traditional societies with religious inclination constantly face a dilemma due to the lack of guidelines on the issues of ethics of creation, therapeutic and reproductive cloning, assisted reproductive techniques, abortions, contraception, transplantation and euthanasia. As in all other fields, Islamic teachings on ethics of patient care are primarily based on Qur’anic directives and the actions and guidance of the Prophet of Islam known as ‘Sunnah.’ This article analyzes some of the religio-ethical issues surrounding the modern health care system in the light of recent biomedical improvements, with relevance to Muslim physicians. There is an urgent need to have clear local and national guidelines in addition to universal ethical codes on this subject.
ONCOLOGY NURSING FORUM, 2015:42(4):294-301. Many patients shared their wishes and expectations about the end of life. Most healthcare providers (HCPs) said they felt that the patient-provider relationship had been strengthened as a result of the spiritual assessment. Almost all assessments raised new issues; however, many dyads had informally discussed spiritual issues before. This study suggests that HCPs believe that the AMM is a useful spiritual assessment tool. Guided by the model, HCPs can gather information about the context, life story, and meaningful connections of patients, which enables them to facilitate person-centered care.
PALLIATIVE MEDICINE | Online – 10 July 2015 – In one of the most ageing countries in the world, there is a long standing trend towards hospitalized dying, more pronounced among the oldest old. To meet people’s preferences for dying at home, the development of integrated specialist home palliative care teams is needed. There were 2,364,932 deceased adults in Portugal from 1988 to 2010. Annual numbers of deaths increased 11.1%, from 95,154 in 1988 to 105,691, mainly due to more than doubling deaths from people aged 85+ years. Hospital deaths increased by a mean of 0.8% per year, from 44.7% in 1988 to 61.7% in 2010. This rise was largest for those aged 85+ years. Regardless of the scenario considered, and if current trends continue, hospital deaths will increase by more than a quarter until 2030 (minimum 27.7%, maximum 52.1% rise) to at least 83,293 annual hospital deaths, mainly due to the increase in hospital deaths in those aged 85+ years.
PALLIATIVE MEDICINE & HOSPICE CARE | Online – 29 May 2015 – Despite the fact that sound enquiry is needed to improve health-related outcomes, what little research has been done with older lesbian, gay, bisexual and transgender (LGBT) adults in general and, specifically, with older LGBT adults, has focused mainly on HIV/ AIDS and other sexually transmitted diseases. LGBT persons are more likely to experience economic insecurity, lack health insurance, experience invisibility, and be victimized and mistreated. This is especially true of older LGBT adults who grew up in a less tolerant era when sexual minorities were criminalized and stigmatized as pathological, sinful, and immoral. Their minority status has led to health issues and health care disparities, and requires health professionals to consider systems in a way that redefines family, addresses legal concerns, and responds with options of care unlike those of their heterosexual counterparts. With recent changes in societal attitudes and some progress in addressing legal concerns, hospice and palliative care organizations have a unique opportunity to lead the health care community by pioneering culturally sensitive and appropriate methods to serve this population.
SCANDINAVIAN PSYCHOLOGIST | Online – 7 July 2015 – Many grief groups are conducted without any attempt at systematic evaluation or learning. This study indicates that a systematic program with weekend gatherings aimed at helping the bereaved with complicated grief can have a beneficial effect. The results show that the participants reported good effects on several levels, influencing complicated grief, post-traumatic reactions and general psychic distress. However, the study requires replication with a larger group of parents and a more rigorous methodological design. Although the bereaved commonly report both a strong desire to meet others and to benefit from this interaction, some bereaved benefit less from grief groups. People with complicated grief reactions view grief support groups less favorably, mainly because they do not meet their requirements or expectations. The presented format may be better tailored to meet the needs of this specific subgroup of people experiencing bereavement.
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 Newsletter will publish an abstract or summary of an article or report of special interest noted in a recent issue of Media Watch (see below).