Physiotherapy in palliative care

Author(s):

Anne M. English

Keyword(s):

Palliative Care ◽

Malignant Disease ◽

Interdisciplinary Team ◽

Vital Role ◽

Valuable Contribution ◽

Care Needs ◽

Good Communication ◽

Patient Pathway ◽

This chapter gives an overview of the role of the physiotherapist and some of the conditions they assess and treat. Physiotherapy in the field of oncology and palliative care is a continuously evolving and developing speciality in cancer and other non-malignant disease. Patients with palliative care needs often present with multifaceted problems associated with an increasing range of underlying pathologies. The physiotherapist is involved in the treatment of patients with active and progressive conditions some of which include cancer, neurological, cardiac, respiratory, musculoskeletal conditions, and lymphoedema. Rehabilitation is now considered a crucial aspect of the patient pathway in which the physiotherapist plays a vital role. Assessment and good communication skills are an essential component when managing challenging and complex problems. This chapter demonstrates the physiotherapist’s valuable contribution to the interdisciplinary team and the importance of the role within palliative care.

The Role of Palliative Care in Oncology

Seminars in Interventional Radiology ◽

10.1055/s-0037-1608702 ◽

2017 ◽

Vol 34 (04) ◽

pp. 307-312 ◽

Author(s):

Rajiv Agarwal ◽

Andrew Epstein

Keyword(s):

Palliative Care ◽

Symptom Burden ◽

Well Being ◽

Care Needs ◽

Patients With Cancer ◽

Living With Cancer ◽

Palliative Care Needs ◽

Shed Light

AbstractPalliative care is a powerful adjunct to oncology that adds distinct value to the physical, mental, and psychosocial well-being of patients living with cancer. Its expanding role and integration with standard oncologic care has proven clinical benefit, as the practice of palliative care can help alleviate symptom burden, enhance illness and prognostic understanding, and improve both the quality of life and overall survival for patients. The primary aim of this review article is to highlight the significant interplay between palliative care and oncology and, in doing so, shed light on the areas for improvement and modern challenges that exist to meet the complex palliative care needs of patients with cancer.

Characterising the growth in palliative care prescribing 2011–2015: Analysis of national medical and non-medical activity

Palliative Medicine ◽

10.1177/0269216317739805 ◽

2017 ◽

Vol 32 (4) ◽

pp. 767-774 ◽

Cited By ~ 3

Author(s):

Lucy Ziegler ◽

Michael I Bennett ◽

Matt Mulvey ◽

Tim Hamilton ◽

Alison Blenkinsopp

Keyword(s):

Palliative Care ◽

Descriptive Analysis ◽

National Level ◽

Care Patient ◽

Care Needs ◽

National Medical ◽

Team Working ◽

Total Community ◽

Background: The role of non-medical prescribers working in palliative care has been expanding in recent years and prescribers report improvements in patient care, patient safety, better use of health professionals’ skills and more flexible team working. Despite this, there is a lack of empirical evidence to demonstrate its clinical and economic impact, limiting our understanding of the future role of non-medical prescribers within a healthcare system serving an increasing number of people with palliative care needs. Aim: We developed a unique methodology to establish the level of non-medical prescribers’ activity in palliative care across England and consider the likely overall contribution these prescribers are making at a national level in this context in relation to medical prescribing. Setting/participants: All prescriptions for 10 core palliative care drugs prescribed by general practitioners, nurses and pharmacists in England and dispensed in the community between April 2011 and April 2015 were extracted from the Prescribing Analysis Cost Tool system. Design: The data were broken down by prescriber and basic descriptive analysis of prescription frequencies by opioid, non-opioids and total prescriptions by year were undertaken. To evaluate the yearly growth of non-medical prescribers, the total number of prescriptions was compared by year for each prescribing group. Results: Non-medical prescribers issued prescriptions rose by 28% per year compared to 9% in those issued by medical prescribers. Despite this, the annual growth in non-medical prescribers prescriptions was less than 1% a year in relation to total community palliative care prescribing activity in England. Impact on medical prescribing is therefore minimal.

Role of the clinical nurse specialist as a non-medical prescriber in managing the palliative care needs of individuals with advanced lung cancer

International Journal of Palliative Nursing ◽

10.12968/ijpn.2021.27.4.205 ◽

2021 ◽

Vol 27 (4) ◽

pp. 205-212

Author(s):

Jenny Osborne ◽

Helen Kerr

Keyword(s):

Lung Cancer ◽

Palliative Care ◽

Positive Impact ◽

Clinical Nurse Specialist ◽

Advanced Lung Cancer ◽

Nurse Specialist ◽

Care Needs ◽

Clinical Nurse ◽

Background: Rapid identification of the palliative care needs of individuals with a diagnosis of advanced lung cancer is crucial to maximise the patient's quality of life by upholding exemplary standards of patient-centred holistic care. The clinical nurse specialist is in an ideal position to contribute to the identification and management of the palliative care needs of individuals with advanced lung cancer through the assessment and timely prescribing of medications to manage distressing symptoms. Aim: This paper reviews and critiques the role of the clinical nurse specialist as an independent non-medical prescriber in the management of palliative symptoms in end-of-life care for patients with advanced lung cancer. Results: Published literature highlights the positive impact the clinical nurse specialist has as a non-medical prescriber in addressing the palliative needs of individuals with lung cancer. However, there are barriers and challenges, and to overcome these, maximising resources and the availability of support is required to ensure the delivery of timely, person-centred care. Conclusion: The clinical nurse specialist as a non-medical prescriber is an evolving role. There are a range of factors that may influence the clinical nurse specialist to confidently and competently undertake this role. These include the perception that there will be an escalation in the workload, concerns about increased accountability and inadequate mentoring for this new role. To incentivise this role, multidisciplinary support is essential in promoting the clinical nurse specialist's confidence for developing this service to individuals with advanced lung cancer.

Teaching and training in palliative medicine

10.1093/med/9780199656097.003.0042 ◽

2015 ◽

Author(s):

Karen Forbes ◽

Jane Gibbins

Keyword(s):

Palliative Care ◽

Role Model ◽

Training Needs ◽

Care Needs ◽

Research Partnerships ◽

Good Communication ◽

Main Challenge ◽

Almost All ◽

Palliative Care Needs ◽

And Training

Patients die in almost all areas of medicine; it is therefore essential for doctors to be equipped with the knowledge, skills, attitudes, and behaviours necessary to look after patients who need care at the end of life. This chapter explores what the training needs of the various doctors caring for patients with palliative care needs are, how their curricula have developed, and the variety of ways training is delivered. It suggests that learners need to move out of the classroom to achieve exposure to real clinical experience with patients approaching the end of their lives with support from seniors who acknowledge patients’ needs, role model good communication and care, and facilitate their juniors’ reflection and learning from these encounters. However, the main challenge is to encourage and develop innovative clinical and research partnerships to design, deliver, and evaluate educational packages to demonstrate how education in palliative care best benefits patients and their families.

Physicians

10.1093/med/9780198821328.003.0116 ◽

2021 ◽

pp. 1233-1241

Author(s):

Karen Forbes ◽

Jane Gibbins

Keyword(s):

Palliative Care ◽

End Of Life ◽

Role Models ◽

Teaching And Learning ◽

Care Needs ◽

Research Partnerships ◽

Good Communication ◽

Main Challenge ◽

Almost All ◽

Patients die in almost all areas of medicine; therefore, all doctors must be equipped with the knowledge, skills, attitudes, and behaviours necessary to care for patients at the end of life. This chapter explores the training needs of doctors caring for patients with palliative care needs, how their curricula have developed, and the variety of ways training is delivered. It confirms that learners need to move out of the classroom to interact with patients approaching the end of life with support from seniors who acknowledge patients’ needs, are role models for good communication and care, and facilitate their juniors’ reflection and learning from these encounters. However, the main challenge is to encourage and develop further innovative clinical and research partnerships to design, deliver, and evaluate educational packages to demonstrate how teaching and learning in palliative care best benefits patients and their families.

Implementation of a Multi-Modal Palliative Care Curriculum for Pediatric Residents

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909121990826 ◽

2021 ◽

pp. 104990912199082

Author(s):

Eleny Romanos-Sirakis ◽

Seleshi Demissie ◽

Alice Fornari

Keyword(s):

Palliative Care ◽

Active Learning ◽

Role Play ◽

Pediatric Palliative Care ◽

Care Needs ◽

Pediatric Residents ◽

Breaking Bad ◽

Role Play Simulation ◽

Objectives: To evaluate the feasibility and efficacy of a new multi-modal pediatric palliative care curriculum. We sought to determine the effect on comfort in palliative care, knowledge, and change in behavior by utilizing these skills with patients, and determine which modalities were most effective for residents. Study Design: 25 pediatric residents were exposed to the 4-part curriculum. The modalities utilized in this curriculum included didactics, role-play, videos, case-discussion, small group activities, simulation, poetry and reflection. Results: The pediatric residents self-reported an increase in comfort and knowledge of the components of pediatric palliative care after this curriculum. In addition, 74% of residents were able to identify a patient experience in which a component of the palliative care curriculum was utilized directly in patient care. The effectiveness of techniques utilized in this multimodal curriculum varied; residents reported that the poetry and reflection components were less effective, as compared with the role-play, simulation and other active learning components. Conclusions: Implementation of a multi-modal palliative care curriculum was effective in increasing knowledge in palliative care, comfort in breaking bad news, and caring for patients with palliative care needs. This can be translated into a change in behavior to utilize these new skills in the care of various patients in pediatrics. Among the various techniques used to teach this curriculum, residents reported that the techniques that most incorporated active learning and were directly applicable to the professional role of the resident were rated most valuable. This curriculum was well received, feasible and effective for pediatric residents.

The Importance of Early Identifications of Palliative Care Needs in Emergency Wards

10.26226/morressier.5c76c8bde2ea5a7237612860 ◽

2019 ◽

Author(s):

Mia Grillfors Mård

Keyword(s):

Palliative Care ◽

Care Needs ◽

What makes palliative care needs “complex”? A multisite sequential explanatory mixed methods study of patients referred for specialist palliative care

BMC Palliative Care ◽

10.1186/s12904-020-00700-3 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Anne M. Finucane ◽

Connie Swenson ◽

John I. MacArtney ◽

Rachel Perry ◽

Hazel Lamberton ◽

...

Keyword(s):

Palliative Care ◽

Focus Groups ◽

Healthcare Professionals ◽

Psychological Needs ◽

Care Providers ◽

Specialist Palliative Care ◽

Care Needs ◽

Complex Needs ◽

Sequential Explanatory ◽

Abstract Background Specialist palliative care (SPC) providers tend to use the term ‘complex’ to refer to the needs of patients who require SPC. However, little is known about complex needs on first referral to a SPC service. We examined which needs are present and sought the perspectives of healthcare professionals on the complexity of need on referral to a hospice service. Methods Multi-site sequential explanatory mixed method study consisting of a case-note review and focus groups with healthcare professionals in four UK hospices. Results Documentation relating to 239 new patient referrals to hospice was reviewed; and focus groups involving 22 healthcare professionals conducted. Most patients had two or more needs documented on referral (96%); and needs were recorded across two or more domains for 62%. Physical needs were recorded for 91% of patients; psychological needs were recorded for 59%. Spiritual needs were rarely documented. Referral forms were considered limited for capturing complex needs. Referrals were perceived to be influenced by the experience and confidence of the referrer and the local resource available to meet palliative care needs directly. Conclusions Complexity was hard to detail or to objectively define on referral documentation alone. It appeared to be a term used to describe patients whom primary or secondary care providers felt needed SPC knowledge or support to meet their needs. Hospices need to provide greater clarity regarding who should be referred, when and for what purpose. Education and training in palliative care for primary care nurses and doctors and hospital clinicians could reduce the need for referral and help ensure that hospices are available to those most in need of SPC input.