Medicine and Health Sciences Commons^™

Key Features Of Palliative Care Service Delivery To Indigenous Peoples In Australia, New Zealand, Canada And The United States: A Comprehensive Review, Shaouli Shahid, Emma V. Taylor, Shelley Cheetham, John A. Woods, Samar M. Aoun, Sandra C. Thompson

Health Sciences Papers and Journal Articles

Background: Indigenous peoples in developed countries have reduced life expectancies, particularly from chronic diseases. The lack of access to and take up of palliative care services of Indigenous peoples is an ongoing concern.

Objectives: To examine and learn from published studies on provision of culturally safe palliative care service delivery to Indigenous people in Australia, New Zealand (NZ), Canada and the United States of America (USA); and to compare Indigenous peoples’ preferences, needs, opportunities and barriers to palliative care.

Methods: A comprehensive search of multiple databases was undertaken. Articles were included if they were published in English from 2000 onwards …

Morbidity Burden And Community-Based Palliative Care Are Associated With Rates Of Hospital Use By People With Schizophrenia In The Last Year Of Life: A Population-Based Matched Cohort Study, Katrina Spilsbury, Lorna Rosenwax, Kate Brameld, Brian Kelly, Glenn Arendts

Health Sciences Papers and Journal Articles

Objective: People with schizophrenia face an increased risk of premature death from chronic diseases and injury. This study describes the trajectory of acute care health service use in the last year of life for people with schizophrenia and how this varied with receipt of community based specialist palliative care and morbidity burden.

Method: A population-based retrospective matched cohort study of people who died from 01/01/ 2009 to 31/12/2013 with and without schizophrenia in Western Australia. Hospital inpatient, emergency department, death and community-based care data collections were linked at the person level. Rates of emergency department presentations and hospital admissions over …

Cultural Considerations At End Of Life In A Geriatric Inpatient Rehabilitiation Setting, Melissa J. Bloomer, Mari Botti, Fiona Runacres, Peter Poon, Jakqui Barnfield, Alison M. Hutchinson

Medical Papers and Journal Articles

Aim: To explore the impact of cultural factors on the provision of end-of-life care in a geriatric inpatient rehabilitation setting.

Background: Australia’s ageing population is now also one of the most culturally diverse. Individuals from culturally and linguistically diverse backgrounds may have specific care needs at the end of life according to various aspects of their culture.

Design: A mixed method approach using a retrospective audit of existing hospital databases, deceased patients’ medical records, and in-depth interviews with clinicians.

Findings: Patients’ and families’ cultural needs were not always recognised or facilitated in end-of-life care, resulting in missed opportunities to tailor …

The Voice Study: Valuing Opinions, Individual Communication And Experience: Building The Evidence Base For Undertaking Patient-Centred Family Meetings In Palliative Care - A Mixed Methods Study, Philippa J. Cahill, Christine R. Sanderson, Elizabeth A. Lobb, Jane L. Phillips

Medical Papers and Journal Articles

Background: Despite family meetings being widely used to facilitate discussion among patients, families, and clinicians in palliative care, there is limited evidence to support their use. This study aims to assess the acceptability and feasibility of Patient-Centred Family Meetings in specialist inpatient palliative care units for patients, families, and clinicians and determine the suitability and feasibility of validated outcome measures from the patient and family perspectives.

Methods: The study is a mixed-methods quasi-experimental design with pre-planned Patient-Centred Family Meetings at the intervention site. The patient will set the meeting agenda a priori allowing an opportunity for their issues to be …

Culturally And Linguistically Diverse Palliative Care Patients' Journeys At The End-Of-Life, Anna Green, Natalia Jerzmanowska, Marguerite Green, Elizabeth Lobb

Medical Papers and Journal Articles

Objective: To understand the clinical and psychosocial journey of culturally and linguistically diverse (CALD) palliative care patients.

Method: This study was conducted at a subacute hospital with a specialist palliative care unit and a community palliative care service in a metropolitan region of New South Wales, Australia. Medical records of 100 deceased patients from CALD backgrounds over a 12-month period from 2014 to 2015 were recorded on a data mining tool. The cohort had transitioned to either community or inpatient palliative care services with a life-limiting illness. We used descriptive statistical analyses to identify the patients’ end-of-life journeys in the …

General Practice Palliative Care: Patient And Carer Expectations, Advance Care Plans And Place Of Death-A Systematic Review, Claire E. Johnson, Peta Mcvey, Joel J. Rhee, Hugh Senior, Leanne Monterosso, Briony Williams, Julia Fallon-Ferguson, Matthew Grant, Harriet Nwachukwu, Michele Aubin, Patsy Yates, Geoffrey Mitchell

Nursing Papers and Journal Articles

Background: With an increasing ageing population in most countries, the role of general practitioners (GPs) and general practice nurses (GPNs) in providing optimal end of life (EoL) care is increasingly important.

Objective: To explore: (1) patient and carer expectations of the role of GPs and GPNs at EoL; (2) GPs’ and GPNs’ contribution to advance care planning (ACP) and (3) if primary care involvement allows people to die in the place of preference.

Method: Systematic literature review. Data sources: Papers from 2000 to 2017 were sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases.

Results: From 6209 journal …

Physician-Assisted Suicide And Euthanasia: Emerging Issues From A Global Perspective, Charles L. Sprung, Margaret Somerville, Lukas Radbruch, Nathalie Steiner Collet, Gunnar Duttge, Jefferson P. Piva, Massimo Antonelli, Daniel P. Sulmasy, Willem Lemmens, E Wesley Ely

Medical Papers and Journal Articles

Medical professional societies have traditionally opposed physician-assisted suicide and euthanasia (PAS-E), but this opposition may be shifting. We present 5 reasons why physicians shouldn’t be involved in PAS-E. 1. Slippery slopes: There is evidence that safeguards in the Netherlands and Belgium are ineffective and violated, including administering lethal drugs without patient consent, absence of terminal illness, untreated psychiatric diagnoses, and nonreporting; 2. Lack of self-determination: Psychological and social motives characterize requests for PAS-E more than physical symptoms or rational choices; many requests disappear with improved symptom control and psychological support; 3. Inadequate palliative care: Better palliative care makes most patients …

Identifying Systems Barriers That May Prevent Bereavement Service Access To Bereaved Carers: A Report From An Australian Specialist Palliative Care Service, Jane Phillips, Elizabeth A. Lobb, Paula Mohacsi, Nicole Heneka, David Currow

Medical Papers and Journal Articles

Background: Bereavement follow up is an integral element of palliative care. However, little is known about the systems that link bereavement services with bereaved carers.

Aim: To map how effectively a specialist palliative care service linked bereavement service to bereaved carers.

Methodology: A retrospective medical audit, using process mapping was undertaken within one Australian specialist palliative care service to identify the systems that linked bereavement services to a consecutive cohort of palliative care decedents (n=60) next of kin.

Results: Bereavement records were located for 80% of decedents. Nearly all (98%) had a nominated next of kin, with just over half …