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SAGE Palliative Medicine & Chronic Care

Want to hear latest research in Palliative Medicine? Want to receive practical guidance to clinical practice in palliative patient care?   Every month, this podcast features an author from Palliative Medicine, a highly ranked, peer reviewed scholarly journal dedicated to improving knowledge and clinical practice in the palliative care. In these focussed 10 minute episodes, the authors provide a personal interpretation of their published work. You’ll hear learn from original papers, reviews, case reports, editorials and other interesting work published in the journal.
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Now displaying: June, 2020
Jun 25, 2020

This episode features Minna Hökkä (Research Unit of Nursing Science and Health Management, Medical Department, Oulu University, Oulu, Finland).

Palliative care is provided across a wide range of healthcare settings, from tertiary hospitals to primary care. It has been recognized that palliative care services should be delivered in at least two or three levels (i.e., palliative care approach, generalist palliative care, specialist palliative care).
All healthcare professionals should have the appropriate education and competencies to provide high-quality palliative care. Nurses have an important role in the provision of palliative care in all levels.

This systematic integrative review is the first to focus on empirical studies defining the core competencies of palliative care nursing aligned with the different levels of palliative care provision.
The results show that both the distinct levels of palliative care provision and corresponding palliative care nursing competencies are rarely defined.

Rather than describing which core nursing competencies are the most related to each level of palliative care, previous research has concentrated on identifying the diverse competencies necessary for different specific settings and how they can be categorized in different aspects of nursing (e.g., competencies related to patient–nurse relationship).
Nurses with a specialized or advanced nurse practitioner role in palliative care have extended clinical competencies, which include the ability to provide informal education and guidance to colleagues.

Nursing competencies in palliative care, especially the ones that are more relevant to each level of palliative care provision, should be better outlined to enhance palliative care development, education and practice.
Further research that addresses how nursing competencies differ across the levels of palliative care provision is needed.

Full paper available from: https://journals.sagepub.com/doi/10.1177/0269216320918798  


If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk

Jun 25, 2020

This episode features Rebecca Anderson (Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK).

Honest prognostic communication with families of patients in the final hours and days of life is important for enabling a good death and for families’ preparedness for that death.
Prognostic uncertainty makes this communication challenging for clinicians and families.

Clinicians provided what we term ‘absolute categorical time estimates’ (suggesting a prognosis of ‘hours’ or ‘days’) and explained how that prognosis was reached, allowing them to reduce prognostic uncertainty without committing to an overly specific timescale.
When requesting prognostic information, relatives helped to relieve the burden of uncertainty for clinicians by alluding to their awareness that prognostication is a subjective judgement.
Clinicians and relatives could be direct about prognosis without explicitly referring to ‘death’ and ‘dying’, as references to time were understood by both parties as referring to prognosis.

This paper identified key practices for communicating prognosis with families of patients at the very end of life, such as explicitly stating the uncertainty while invoking expertise, and using absolute categorical time estimates when providing a prognosis.
These practices could be taught as part of communication training using clips of recordings from real-life interactions.


Full paper available from:    

https://journals.sagepub.com/doi/full/10.1177/0269216320910934

If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: 
a.nwosu@lancaster.ac.uk

Jun 25, 2020

This episode features Dr Emily Harrop (Marie Curie Research Centre, Division of Population Medicine, Cardiff University, Cardiff, UK).

The support needs of people experiencing bereavement vary significantly. Bereavement support in palliative care involves different types and levels of provision to accommodate these needs. Specialist grief therapy is known to be effective for those with high-level risk and needs.
Bereavement interventions were wide ranging and included bereavement support and social groups, psychological and counselling interventions and other types of support such as arts-based, befriending and relaxation interventions.
Good quality randomised controlled trial evidence was only available for targeted family therapy and a non-targeted group–based therapy intervention, both of which were introduced during the caregiving period and found to be partially effective.
The synthesis of qualitative evidence identified three core impacts which were common across interventions: ‘loss and grief resolution’, ‘sense of mastery and moving ahead’ and ‘social support’.

The qualitative evidence suggests the value of peer support alongside opportunities for reflection, emotional expression and restoration-focused activities for those with moderate-level needs.
These findings suggest the relevance of resilience and public health–based approaches to bereavement care.

Full paper available from:    
https://journals.sagepub.com/doi/10.1177/0269216320920533


If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: 
a.nwosu@lancaster.ac.uk

Jun 25, 2020

This episode features Professor Catherine Walshe (International Observatory on End of Life Care, Lancaster University, UK).  Publication bias is known, but usually associated with direction of research findings. Bibliographic analysis of databases shows publication rates differ between countries, and an increase in total number of publications over time. No journal focused analysis has yet been undertaken to understand their role in the geographical dissemination of knowledge. Papers in highest ranked palliative care journals are typically cited between 1-9 times in the time period used to calculate an annual impact factor, with some journals having high numbers of uncited papers. Most authors in the highest ranked palliative care journals come from North American (54.18%) or European (27.94%) institutions. Preliminary sensitivity tests show that the odds of an author being from a North American institution increase 16.4 times if the journal is North American, and of being from a European institution 14.0 times increased if the journal is European. Palliative care research publication is clustered geographically, and readers may not be widely exposed to potentially relevant research from other cultures or contexts if they only read journals from their own continents.

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