Media Watch

2018; Volume 19, No 12, December

Media Watch

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

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.

Thematic Issue

This issue of The Journal of Contemporary Social Services is focused on the robust intersection of palliative care with social work knowledge, values, and skills.

Surveys & Solutions

Suggestions for pediatric palliative care researchers, possible solutions for medication management, conflicting attitudes of doctors and prosecutors in Brazil toward end-of-life care.

Article Abstracts

Interprofessional palliative care education for pediatric oncology clinicians: An evidence-based practice review

BMC Research Notes | Online – 7 November 2018 – Although pediatric oncology clinicians care for patients with life-threatening illnesses, there is great variation in their formal palliative care (PC) training. Essential components for successful pediatric PC educational programs include: 1) Establishing effective modalities and teaching strategies for content delivery; 2) Developing an interprofessional PC curriculum; and 3) Evaluating programs. Despite limited evidence of the effects on pediatric oncology practice, suggested evaluation methods are: 1) Eliciting patient and family feedback; 2) Standardizing care delivery measures; and 3) Evaluating outcomes of care. To the authors’ knowledge, this was the first study addressing PC education for pediatric oncology clinicians through an interprofessional lens... Limitations stem from the lack of high-level evidence available on this topic... Studies utilized clinician self-report measures and there was no systematic evaluation of educational intervention impact on care delivery. Only one study was multi-modal, with all others consisting of a single modality and time-limited interventions. One program incorporated all core competencies, with only one study utilizing an internationally validated pediatric curriculum.

DOI: 10.1186/s13104-018-3905-5

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Access to palliative care for homeless people: Complex lives, complex care

BMC Palliative Care | Online – 24 October 2018 - People experiencing homelessness often encounter progressive incurable somatic diseases in combination with psychiatric and psychosocial problems, and many need palliative care (PC) at the end of their lives. Little is known about how PC for this group can be started in good time and provided optimally. Three key themes [that emerged in this study] were: “late access,” “capricious trajectory,” and “complex care.” The first key theme refers to the often delayed start of PC, because of the difficulties in recognizing the need for PC, the ambivalence of people experiencing homelessness about accepting PC, and the lack of facilities with specific expertise in PC for them. The second key theme refers to the illness trajectory, which is often capricious because of the challenging behaviour of people experiencing homelessness, an unpredictable disease process, and a system not being able to accommodate or meet their needs. The third key theme refers to the complexity of their care with regard to pain and symptom control, psychosocial and spiritual aspects, and the social network. The care in the palliative phase does not satisfy the core requirements of PC since there are bottlenecks regarding timely identification, the social network, and the assessment and management of physical symptoms, and psychosocial and spiritual care needs.

DOI: 10.1186/s12904-018-0368-3

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A systematic review in support of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care

Journal of Pain & Symptom Management | Online – 31 October 2018 – This systematic review highlights the large and varied body of research that exists in palliative care (PC). Most promising areas in terms of structure and process of care are home-based PC, interdisciplinary team care, and telehealth approaches. There is documented evidence for comprehensive PC and music/art therapy addressing physical and psychological aspects of care. The existing evidence base for social needs assessments and culturally sensitive care remains very limited. There is documented evidence for life review/dignity therapy in the area of spiritual assessment approaches. Grief/bereavement support services appear to improve key outcomes for caregivers, but the evidence base for effective approaches for care in the last days of life is very limited. Evidence for ethics consults and advance directive/physician order interventions show the strongest evidence in the ethical and legal aspects of care domain. This comprehensive review underscores the importance of targeting future research toward building high-quality evidence in key areas of clinical practice and patient/caregiver needs.

DOI: 10.1016/j.jpainsymman.2018.09.008

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