This episode features Jonathan Bayuo (Presbyterian University College, Abetifi, Eastern, Ghana and The Hong Kong Polytechnic University, Kowloon, Hong Kong).
The immediacy of death in the burn unit is usually in the order of hours or days requiring the timely application of palliative care. Although the culture of burns/ critical care units is evolving the support the integration of palliative care, several barriers such as prognostication and lack of guidelines exist. Clinicians working in burn/ critical care units may experience emotional exhaustion
The findings suggest a complex decision-making process which may delay the initiation of comfort care. Collaboration with palliative care practitioners and training are required to support the integration of palliative care in the burn unit. Guidelines to support the delivery of palliative care may focus on communication, symptom management, and post-bereavement support for families and staff.
A collaborative model of care is required to support palliative care integration in the burn unit. Palliative care for severely burned patients may need to commence alongside active burns management.
This episode features Dr Catriona Mayland (University of Sheffield, Sheffield, UK).
Advanced head and neck cancer patients have specific challenges due to the impact of the illness on vital functions such as eating, speaking and breathing. Identifying the palliative care needs of this specific cancer subgroup would help provide guidance about how services could best provide care.
Advanced head and neck cancer patients have a diverse range of palliative care needs, but there is variability in terms of access and timing to palliative care services. Dissonance between patients and family carers about information needs and decision-making represent additional complexities. Head and neck cancer patients frequently require acute interventions even during the last weeks of their life.
Tailored needs-based referral systems for advanced head and neck cancer patients may help address issues relating to access to palliative care services. Models of care focused on increased integration and coordination across different care settings and multi-disciplinary teams may help address issues relating to frequent use of acute interventions during the last weeks of life. Prospective multi-centre studies, potentially using mixed methods approaches, and focused on testing specific components of care may help further understand and tailor services more appropriately to meet needs.
If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu:
This episode features Jeanna Qiu (Harvard Medical School, Boston, MA, USA).
Maintaining quality of life for patients with malignant fungating wounds requires collaboration of diverse healthcare specialties, from oncology and palliative care to wound care. Research has explored the experiences of patients with malignant fungating wounds and the nurses who treat them. It is essential to understand the experiences and perceived roles of clinicians from different specialties and disciplines who treat patients with malignant fungating wounds
Different clinical specialties assumed the leading role at different points of the clinical care timeline with medical oncology prominent throughout care. Identifies the points in time when collaboration between specialties is essential, when communication fails, or when clinicians from different specialties have differing perspectives and experiences.
Wound care and medical oncology must collaborate effectively to ensure accurate assessment of the progression of the wound and cancer. Palliative care and oncology must partner effectively to ensure patients’ quality of life and when to stop curative treatment. Strategies like joint visits or strengthening the professional relationships across specialties such that palliative care and oncology clinicians can have open conversations about patients may help to reduce the prevalence of conflicting messages to patients.