Media Watch

2017; Volume 18, No 12, December

Media Watch: An annotated list of recent articles about palliative care in the news media and the literature

Psychosocial care models for families of critically ill children in pediatric emergency department settings: A scoping review

Journal of Pediatric Nursing, 2018; 38: 46-52. Due to individual family diversity and needs, in combination with health setting demands and socio-cultural factors, it is unlikely that there will ever be a definitive ‘one size fits all’ care model or intervention that works universally. Family care models must be therapeutic and tailored to individual family needs. The articles reviewed have developed models relevant to their individual service contexts, but translational ability is uncertain. This review adds valuable information to the limited pool of literature currently available, providing suggestions for clinical practice and improved care of families, decreasing both short- and long-term negative impacts of these unavoidable experiences, and promote improved coping capacity and resilience in families and staff. This review is also helpful to clinicians looking to develop clinical practice guidelines within their own health services, and to researchers wanting to evaluate them. Once developed, testing any models and interventions in single sites and across broader health services is vital, filling the gap in research and practice that currently exists for therapeutic interventions that begin the moment the family enters the hospital system.

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What can we learn from simulation-based training to improve skills for end-of-life care? Insights from a national project in Israel

Israel Journal of Health Policy Research | Online – 6 November 2017 – Simulation-based training of health care providers is an interesting and promising method to improve quality of end-of-life care (EoLC). A series of unanticipated consequences emerged: One participant conducted a study of preparedness to end of life (EoL) at nursing homes...that was presented at the Ministry of Health and called forth a national survey of preparedness to EoL at hospitals. As a result, many institutions enacted guidelines and set up palliative care (PC) units. Participants spread by word of mouth the value of training for EoLC—resulting in demands for workshops from different disciplines: intensive care, dialysis, oncology, emergency and family medicine. Electronic media (including TV channels), newspapers and magazines covered the topic of EoLC with reference to the authors’ workshops. They are invited each year to present insights from their project in lectures at dozens of national professional conferences, PC courses, research seminars, and institutional staff meetings as well as at general public audiences. While the authors cannot determine causality, coverage by media and public discourse led in recent years to the erection of several national committees for improved policy, training, and regulation of EoLC.

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Development and evaluation of the Dignity Talk question framework for palliative patients and their families: A mixed-methods study

Palliative Medicine | Online – 13 November 2017 – Interventions aimed at facilitating communication between palliative patients and their families are limited. This study developed a list of question prompts coined ‘Dignity Talk’ that may provide a viable means of facilitating important, sensitive conversations between palliative patients and their families. ‘Dignity Talk’ has the potential to enhance end-of-life experience by engendering a mutual sense of meaning for palliative patients and their families through the sharing of memories, gratitude, forgiveness, wishes, and hopes.

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Role of patient coping strategies in understanding the effects of early palliative care on quality of life and mood

Journal of Clinical Oncology | Online – 15 November 2017 – The state of oncology care has seen tremendous advances in precision medicine and targeted therapies; however, patients’ supportive care needs have never been greater, and the early integration of oncology and palliative care (EIPC) represents a novel, efficacious approach toward alleviating suffering and improving quality of life (QoL) for those with advanced disease. As the first mediation analysis of the EIPC model to our knowledge, this study provides evidence suggesting that palliative care clinicians help improve QoL and mood outcomes in patients with incurable cancer in part by enhancing effective coping processes.

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“Oh God, I have lost myself”: Palliative care and Alzheimer’s dementia

RAC Monitor | Online – 16 November 2017 –...As humanly horrible as a cancer death can be, it is only a single death. Those whose lives have been invaded by malignancy remain themselves—perhaps in pain, but sentient of who they are, who loves them and who they love, until the end. Those stricken with Alzheimer’s Disease die twice. First...they experience the death of who they are. This death of self is more frightful than the death of their body. It is harrowing to contemplate losing one’s identity, control of one’s life, the ability to care for loved ones, and instead becoming a burden to them... Dementia kills slowly, frequently over a span of years, and unlike many terminal medical processes, there isn’t a plug to pull—there is no life support to discontinue, no chemotherapy to stop, and no dialysis to terminate... The protracted courses of AD and the inevitable loss of patient competency make early planning especially crucial. Simply put, the PC plan must be devised not at the end stages of the dementia, but in the beginning, before the patients ‘lose themselves.’

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A Catholic perspective: The PAL-LIFE project

The Pontifical Academy for Life is now sponsoring an international project, to be known as PAL-LIFE, to improve clinical and spiritual care for the dying, with particular attention to the development of PC. The academy’s principal goal through this project is to make ecclesial institutions more aware of the need to develop effective PC around the world, together with bringing PC to the attention of all social and cultural organizations and promoting dialogue and cooperation in practical initiatives among stakeholders at all levels.

Reported in: The value of palliative care. Health Progress, 2017: November-December: 59-60.

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One teacher’s experiences: Responding to death through language

The author offers specific, language-based responses guided by experience and literature

English Journal, 2017; 107(2): 41-46. A survey by the American Federation of Teachers and New York Life Foundation found that ‘nearly 7 in 10 teachers (69%) reported having at least one grieving student currently in their classrooms.’ However, 93% of classroom teachers said they have ‘never received bereavement training,’ only 1% received training as part of their coursework in college, and just 3% said their school or district offers it... Do an Internet search for anything similar to ‘death in the classroom’ and you’ll find resources for helping students deal with the death of everyone from a pet to a parent. The challenge is how to apply all of the advice to meet students’ needs in specific circumstances. As important, I believe that English teachers have the unique opportunity to respond appropriately because of our understanding of context and our grounding in writing, reading, speaking, and communication.

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Teamwork and conflicts in pediatric end-of-life care

Acta Paediatrica | Online – 18 October 2017 – The paper by a great example of a team systematically examining the origins and nature of conflict in their own workplace. The professionals were physicians, nurses, psychologists, physiotherapists, and inhalotherapists. The aim of the study was to investigate their experiences with end-of-life conflicts and to explore other details of these conflicts, such as frequency, perceived importance, contributing factors and strategies for conflict resolution and coping. The authors report several important results. First, they state that a very high proportion of health care professionals (71%) had experienced at least one conflict in the preceding five years and these were more frequent between professionals (58%) than between professionals and parents (33%). This finding is remarkable and differs from most of the earlier pediatric studies, which reported conflicts between health care teams and families as the most common type of conflict. One interesting, and potentially worrisome, finding was the observation that most of the nurses did not express their opinions. The authors’ suggestion was that this phenomenon could be a barrier to truly interdisciplinary decision-making... It may also be that these nurses suffered in silence, because they were involved in conflicts but their voices were not heard or taken into account. Those of us who work in pediatric end-of-life care should recognize and address those risks.

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1. ‘Survey highlights the need for specific interventions to reduce frequent conflicts between health care professionals providing pediatric end-of-life care,’ Acta Paediatrica, published online 5 September 2017. Abstract

Media Watch is intended as an advocacy, education 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 recent issues of Media Watch (see below).

View the current and back issues of the weekly report.

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