scholarly journals A National Rollout of an Insufficiently Evaluated Practice: How Evidence Based Are Our End-Of-Life Care Policies?

2011 ◽  
Vol 14 (7) ◽  
pp. 802-802 ◽  
Author(s):  
Raymond Chan ◽  
Joan Webster
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Evidence Based ◽  
Life Care ◽  
Care Policies

The Dying Neonate: Family-Centered End-of-Life Care

2009 ◽  
Vol 28 (2) ◽  
pp. 75-83 ◽  
Author(s):  
Martine De Lisle-Porter ◽  
Ann Marie Podruchny
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Evidence Based ◽  
Life Care ◽  
New Mothers ◽  
Mothers And Fathers ◽  
Intravenous Access ◽  
Care Guideline ◽  
The Family ◽  
Family Centered

There is a need in the NICU for an end-of-life care guideline that nurses can follow when working with dying infants and their families. Maintaining intravenous access to relieve the infant’s pain, communicating sensitively to the family, and creating precious, everlasting memories are goals that should be part of every dying infant’s care. The nurse’s ability to partner with the family in caring for the infant is integral to helping the family take the first steps in their grief journey. Evidence-based literature provides NICU nurses with the knowledge that they are the facilitators of end-of-life care for dying infants. New mothers and fathers are not aware of the caring parental tasks they can perform for their dying baby. They look to and depend on their infant’s nurses to encourage them. The guideline included here provides nurses with a tool for ensuring that families have the opportunity to create memories that will not only help them with their immediate pain, but also comfort them for a lifetime.

scholarly journals ‘It’s like trying to ice a cake that’s not been baked’: a qualitative exploration of the contextual factors associated with implementing an evidence-based information intervention for family carers at the end of life

2020 ◽  
Vol 21 ◽  
Author(s):  
Amy Mathieson ◽  
Karen Luker ◽  
Gunn Grande
Keyword(s):  
Home Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Evidence Based ◽  
Management Support ◽  
Life Care ◽  
Care Providers ◽  
Family Carers ◽  
Structured Interviews ◽  
Practice Development

Abstract Aim: To explore the introduction of an evidence-based information intervention – the ‘Caring for Someone with Cancer’ booklet – within home care and end-of-life care, to inform future implementation and practice development within this setting. Background: Family carers’ contribution is crucial to enable care and death of people at home. The ‘Caring for Someone with Cancer’ booklet received positive responses from family carers and District Nurses and is an evidence-based intervention designed to support carers to deliver basic nursing tasks. Further feasibility work was required to establish how it should be implemented. Little is known about how to successfully translate interventions into practice, particularly within home care settings and end-of-life care. Methods: Implementation of the ‘Caring for Someone with Cancer’ booklet, utilising a qualitative case study approach, in four home care sites. Semi-structured interviews, informed by Normalization Process Theory (NPT), were undertaken at implementation sites in May 2016–June 2017. Participants were generalist and specialist nurses, managers, and Healthcare Assistants (HCAs). A framework approach to analysis was adopted. Findings: Forty-five members of staff participated. Failed implementation was associated with organisational-level characteristics and conditions, including workforce composition and predictability of processes. Unstable work environments meant home care providers focused on short-term rather than long-term goals, precluding practice development. Staff’s perceptions of the time available to engage with and implement the intervention inhibited adoption, as many participants were “just getting through the day”. Implementation was successful in sites with explicit management support, including proactive implementation attempts by managers, which legitimatised the change process, and if all staff groups were engaged. To encourage uptake of evidence-based interventions in home care settings, practitioners should be given opportunities to critically reflect upon taken-for-granted practices. Future implementation should focus on work pertaining to the NPT construct ‘Collective Action’, including how staff interact and build confidence in new practices.

scholarly journals Bereavement during the Covid-19 pandemic in the UK: What do we know so far?

Bereavement ◽  
2022 ◽  
Vol 1 ◽  
Author(s):  
Emily Harrop ◽  
Lucy Selman
Keyword(s):  
Mental Health ◽  
Social Networks ◽  
End Of Life ◽  
End Of Life Care ◽  
Research Evidence ◽  
Coping Mechanisms ◽  
Informal Support ◽  
Evidence Based ◽  
Life Care ◽  
The Uk

The Covid-19 pandemic has been a devastating mass bereavement event, with measures to control the virus leading to unprecedented changes to end-of-life and mourning practices. In this review we consider the research evidence on the experiences of people bereaved during the pandemic. We summarise key findings reported in the first five publications from our UK-based Bereavement during COVID-19 study, drawing comparisons with available evidence from other studies of bereavement during the pandemic. We summarise these findings across three main topics: experiences at the end of life and in early bereavement; coping and informal support during the pandemic; and access to bereavement and mental health services. The synthesis demonstrates the exceptional challenges of pandemic bereavement, including high levels of disruption to end-of-life care, dying and mourning practices as well as to people’s social networks and usual coping mechanisms. We identified considerable needs for emotional, therapeutic and informal support among bereaved people, compounded by significant difficulties in receiving and accessing such support. We provide evidence-based recommendations for improving people’s experiences of bereavement and access to support at all levels.

scholarly journals An Exploration of Person-Centred Approach in End-of-Life Care Policies in England and Japan

2021 ◽  
Author(s):  
Chao Fang ◽  
Miho Tanaka
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Family Care ◽  
Cultural Analysis ◽  
Three Dimensions ◽  
Best Interests ◽  
Complex Nature ◽  
Life Care ◽  
Care Policies ◽  
Policy Discourses

Abstract Background: Increasing evidence has suggested that a person-centred approach is beneficial not only for improving care outcomes but also for mitigating the pressure on public health systems. However, policy implementation gaps have prevented the translation of this complex framework into useful practical, ethical and moral stances for end-of-life care. This article aims to explore the meaning and implications of person-centredness in end-of-life care policy discourses.Methods: By perceiving policy documents as a medium embodied with socio-political and cultural norms, we analysed how person-centred approach in end-of-life care is constructed within specific socio-cultural contexts and the implications of these contexts on resultant care. Focusing on England and Japan, we conducted a critical policy analysis to examine and compare key policy and legal documents collected between 2007 and 2019 in these two post-industrial and socio-culturally distinctive countries. Results: Our analysis found that the person-centred approach is mobilised in policy discourses primarily through three interconnected dimensions: individual, relational and existential. While acknowledging that both countries have developed varied policy and legal mechanisms to emphasise holistic and integrated care with respect to these three dimensions, we also identified significant gaps in the policies both within and between England and Japan. They include ambiguity in defining patients’ best interests, fragmented support for social and family care and the neglect of existential needs. Conclusions: This cross-cultural analysis has revealed the complex nature of discourses around person-centred approach in English and Japanese end-of-life care policies, which often concentrate on the multifaceted aspects of experiences as one approaches the end of life. Despite this, we argue that a more holistic construction of person-centred approach is needed in end-of-life care policies not only in England and Japan but also more broadly, to encapsulate the richness of end-of-life experiences.

Euthanasia and Withdrawal of Treatment in People with Disabilities and Intractable Diseases: Comparison Between Japan and Western Countries

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 171-171
Author(s):  
Miho Tanaka ◽  
◽  
Satoshi Kodama ◽  
◽  
Keyword(s):  
Literature Review ◽  
End Of Life ◽  
End Of Life Care ◽  
Assisted Suicide ◽  
People With Disabilities ◽  
Worth Living ◽  
Life Care ◽  
Deep Roots ◽  
Western Countries ◽  
Care Policies

"Background: In Japan, groups advocating for people with disabilities and intractable diseases (hereafter “PWDs”) have recently voiced serious concerns regarding end-of-life care policies. For example, when non-partisan MPs announced a draft bill on allowing forgoing life-sustaining treatments (LSTs) in 2012, these groups protested. One group in particular strongly protested against a TV documentary by the Japanese public broadcasting corporation in 2019, in which a patient with a serious neurologic intractable disease died by physician-assisted suicide in Switzerland. Objective: To present the specific concerns voiced by PWDs regarding end-of-life care policies and to compare debates between Japan and Western countries on the topic. Method: Comprehensive literature review. Results: Several important points emerged. In Japan, PWDs felt that those living with LSTs would consider it a life without dignity. In Western countries, the following issues surfaced: negative images of people with disabilities have deep roots in society due to the long and tragic history of discrimination; people with disabilities might become victims of society’s value judgment, such as “life with a severe disability is not worth living”; and laws and safeguard policies cannot eliminate the concerns of a slippery slope. Conclusion: Western countries have recently discussed the risks of legalising euthanasia, while discussions in Japan have focused more on the risks of legislation on forgoing LSTs. Future literature review studies and interviews with advocacy groups aimed at identifying similar situations in other East Asian countries are warranted. "

Declaration for Integrative, Evidence-Based, End-of-Life Care that Incorporates Nonlocal Consciousness

EXPLORE ◽  
2016 ◽  
Vol 12 (3) ◽  
pp. 162-164
Author(s):  
Stephan A. Schwartz ◽  
Gary E. Schwartz ◽  
Larry Dossey
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Evidence Based ◽  
Life Care

A Qualitative Metasynthesis From Nurses’ Perspective When Dealing With Ethical Dilemmas and Ethical Problems in End-of-Life Care

2015 ◽  
Vol 19 (1) ◽  
pp. 40-48
Author(s):  
Margareta Karlsson, ◽  
Ingela Berggren, ◽  
Anne Kasén, ◽  
Maud Söderlund,
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Evidence Based Practice ◽  
Ethical Dilemmas ◽  
Qualitative Studies ◽  
Best Interests ◽  
Evidence Based ◽  
Life Care ◽  
Human Beings ◽  
Ethical Problems

This metasynthesis aimed to translate, interpret, and present a synthesis of qualitative studies from nurses’ perspectives dealing with ethical dilemmas and ethical problems in end-of-life care and to gain a deeper understanding of the phenomena. Nurses and other care professionals need to gain a deeper understanding and alleviate the suffering of patients through evidence-based practice end-of-life care. The metasynthesis, inspired by Noblit and Hare, generated an overarching metaphor, The Loving Eye. The Loving Eye illustrates how nurses are deeply involved with patients as human beings and connotes an inner responsibility to struggle for patients’ best interests and wishes at the end of life. With The Loving Eye, nurses can see and feel patients’ need to be confirmed, comforted, and healed approaching the end of life.

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