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 publishes selected abstracts or summaries of articles or reports of special interest from recent issues of Media Watch.
INTERNATIONAL JOURNAL GERIATRIC PSYCHIATRY | Online – 1 July 2018 – This study reveals several key issues regarding integration and implementation of observational pain tools (OPTs) as part of pain assessment protocols in primary, secondary, hospice, and nursing home settings. Difficulties in applying the tools in practice, lack of guidance regarding the rationale for changing practice, and how to integrate tools with existing protocols, along with uncertainty regarding clinical validity and reliability of these tools with dying patients with advanced dementia, were significant barriers to their use. Policy makers should exercise caution in placing emphasis on ease and simplicity of OPT use alone, particularly in clinically challenging and complex areas, as this could prove counterintuitive, leading to lack of engagement with OPT use. Health care professionals continue to report pain assessment as challenging and emphasise a need for ongoing investment in training and education, which must take into consideration educational needs, and balance theory with practical application of knowledge and skills.
YALE JOURNAL OF BIOLOGY & MEDICINE, 2018;91(2):173-176. The question of whether to provide artificial nutrition and hydration (ANH) to a patient with terminal illness or at end of life has been debated over many years. Due to the nature of the question and the setting in which it presents, prospective trials are not feasible, and the health care professional is left to work with the patient and family to make decisions. This perspectives piece addresses the issue in a format designed to inform the reader as to the pertinent considerations around ANH. The authors briefly review significant historic, religious, ethical, and legal contributions to this discussion and physiologic underpinnings. They address the beliefs of patient, family, and health care providers surrounding this issue. The authors’ goal is to provide a review of the considerations for health care providers as they address this issue with patients and families in the course of compassionate care.
ANNALS OF PALLIATIVE MEDICINE | Online – Accessed 1 July 2018 – Palliative care is patient- and family-centered care that enhances quality of life throughout the illness trajectory and can ease the symptoms, discomfort, and stress for children living with life-threatening conditions and their families. This paper aims to increase nurses’ and other healthcare providers’ awareness of selected recent research initiatives aimed at enhancing life and decreasing suffering for these children and their families. Topics were selected based on identified gaps in the pediatric palliative care literature. Published articles and authors’ ongoing research were used to describe selected components of pediatric palliative nursing care including (I) examples of interventions (legacy and animal-assisted interventions); (II) international studies (parent-sibling bereavement, continuing bonds in Ecuador, and circumstances surrounding deaths in Honduras); (III) recruitment methods; (IV) communication among pediatric patients, their parents, and the healthcare team; (V) training in pediatric palliative care; (VI) nursing education; and (VII) nurses’ role in supporting the community. Nurses are in ideal roles to provide pediatric palliative care at the bedside, serve as leaders to advance the science of pediatric palliative care, and support the community.
BMC PALLIATIVE CARE | Online – 29 June 2018 – Although attention to palliative care (PC) is increasing, further developments and policy initiatives are needed to improve access to and quality of PC for all citizens who are in need of this type of care. The following policy implications can be drawn based on the findings of this study in a community parish in Portugal. First, while the study highlights the positive impact of education initiatives about PC in early ages, further research is needed to assess the actual impact of education about PC in the acquisition of specific knowledge, development of competences and change of attitudes among teenagers and younger age groups (e.g., children). Second, education about palliative and end-of-life care should be promoted at local communities, for instance in primary and secondary schools, to foster community involvement, participation and empowerment. Finally, compassionate communities, described as networks that could encourage people to take some active responsibility for care and recognize that ageing and dying, death and bereavement are part of everyday life and happen to everyone, could and should be promoted to enhance the health and wellbeing of all citizens at the end of their life.
REVISTA DA ESCOLA DE ENFERMAGEM DA UNIVERSIDADE DE SÃO PAULO | Online – 25 June 2018 – The findings show a significant number of articles related to palliative care (PC) in oncology, which mainly address topics such as professional and team practices, diagnoses and prognoses, and quality of life. The profile drawn by the results, as well as the recommendation grades and the lowly expressive levels of evidence found in the studies, reflect the practice of PC, which is still largely empirically performed and without theoretical-scientific foundation.
N.B. Click on respective icons to access full text in either Portuguese or English.
PALLIATIVE MEDICINE | Online – 4 July 2018 – This study highlights specific knowledge gaps. Although the authors found that many problematic issues are the same across countries, huge heterogeneity persists even after adjusting for confounders. Knowledge about basic palliative care (PC) issues is generally poor among nurses and care assistants in all countries, but particularly so in Poland and in Italy... As expected, the authors found that in all countries nurses have better PC knowledge than care assistants... A White Paper of the European Association for Palliative Care on PC education identifies nursing homes as a setting in which the staff, irrespective of their discipline, need to know the basic principles of PC.1 This implies that all levels of staff need to be able to provide high-quality care to residents at the end of life. In this respect, this study shows very clearly that there is a strong need to further invest in basic PC knowledge and skills, especially for care assistants.
1. ‘Core competencies in palliative care: White Paper on palliative care education – Part 1,’ European Journal of Palliative Care, 2013;20(2):86-91. Journal contents page.