Palliative care in the acute hospital setting: a qualitative interview study

ObjectivesAssisted suicide in Switzerland is mainly performed by right-to-die societies. Medical involvement is limited to the prescription of the drug and certification of eligibility. Palliative care has traditionally been perceived as generally opposed to assisted suicide, but little is known about palliative care physicians’ involvement in assisted suicide practices. This paper aims to describe their perspectives and involvement in assisted suicide practices.MethodsA qualitative interview study was conducted with 23 palliative care physicians across Switzerland. Thematic analysis was used to interpret data.ResultsSwiss palliative care physicians regularly receive assisted suicide requests while none reported having received specific training in managing these requests. Participants reported being involved in assisted suicide decision making most were not willing to prescribe the lethal drug. After advising patients of the limits on their involvement in assisted suicide, the majority explored the origins of the patient’s request and offered alternatives. Many participants struggled to reconcile their understanding of palliative care principles with patients’ wishes to exercise their autonomy. The majority of participants had no direct contact with right-to-die societies, many desired better collaboration. A desire was voiced for a more structured debate on assisted suicide availability in hospitals and clearer legal and institutional frameworks.ConclusionsThe Swiss model of assisted suicide gives palliative care physicians opportunities to develop roles which are compatible with each practitioner’s values, but may not correspond to patients’ expectations. Specific education for all palliative care professionals and more structured ways to manage communication about assisted suicide are warranted.

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Evaluating the specialist palliative care clinical nurse specialist role in an acute hospital setting: a mixed methods sequential explanatory study

BMC Palliative Care ◽

10.1186/s12904-021-00834-y ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Michael Connolly ◽

Mary Ryder ◽

Kate Frazer ◽

Eileen Furlong ◽

Teresa Plazo Escribano ◽

...

Keyword(s):

Palliative Care ◽

Phase 1 ◽

Hospital Setting ◽

Acute Hospital ◽

Nurse Specialist ◽

Phase 2 ◽

Specialist Palliative Care ◽

Clinical Nurse ◽

Acute Hospital Setting

Abstract Background Special palliative care is provided in a range of settings including a patient’s home (their primary place of dwelling), a hospice in-patient unit, or an acute hospital. The aim of the study was to evaluate the role of the specialist in palliative care clinical nurse specialist (SPC CNS) role in an acute hospital setting. Methods This study was conducted using a mixed methods sequential explanatory approach in two phases; phase 1 involved completion of a study questionnaire (n = 121) and phase 2 involved part-taking in a focus group (n = 6) or individual interview (n = 4). Results Phase 1 results indicated that respondents held positive attitudes towards the Specialist Palliative Care Clinical Nurses Specialist (SPC CNS) in relation to clinical care, education and patient advocacy. Phase 2 qualitative findings identified the importance of the role in terms of symptom management, education and support. Conclusions This study provides an evaluation of a SPC CNS role since it was established in an acute hospital setting. The evidence indicates that there is a varied understanding of the role of the SPC CNS. The role was seen as an important one particularly in terms of referrals to and support provided by the SPC CNS, as well as recognition of the importance of the role is providing ongoing education to staff.

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Transitions to palliative care in the acute hospital setting: reflections on a census at Royal Lancaster Infirmary

Morecambe Bay Medical Journal ◽

10.48037/mbmj.v6i4.293 ◽

2011 ◽

Vol 6 (4) ◽

pp. 106-109

Author(s):

Clare Gardiner ◽

Merryn Gott ◽

Christine Ingleton ◽

Mike Bennet

Keyword(s):

Palliative Care ◽

Hospital Setting ◽

Acute Hospital ◽

Acute Hospital Setting

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Connecting the Dots Between Theoretical Knowledge and Clinical Practice: A Palliative Care Social Worker Process Improvement Project in an Acute Hospital Setting

Journal of Social Work in End-of-Life & Palliative Care ◽

10.1080/15524256.2021.1984368 ◽

2021 ◽

pp. 1-12

Author(s):

Brittany Fuentes ◽

Marissa Pietrus

Keyword(s):

Palliative Care ◽

Clinical Practice ◽

Process Improvement ◽

Social Worker ◽

Hospital Setting ◽

Acute Hospital ◽

Theoretical Knowledge ◽

Improvement Project ◽

Connecting The Dots ◽

Acute Hospital Setting

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Factors of importance for reducing fatigue in persons with rheumatoid arthritis: a qualitative interview study

BMJ Open ◽

10.1136/bmjopen-2018-028719 ◽

2019 ◽

Vol 9 (5) ◽

pp. e028719 ◽

Cited By ~ 5

Author(s):

Caroline Feldthusen ◽

Kaisa Mannerkorpi

Keyword(s):

Rheumatoid Arthritis ◽

Physical Activity ◽

Qualitative Content Analysis ◽

Controlled Trial ◽

Hospital Setting ◽

Qualitative Interview ◽

Interview Study ◽

Pharmacological Intervention ◽

Physically Active ◽

Qualitative Interview Study

ObjectivePhysical activity plays an important role in the treatment of persons with rheumatoid arthritis (RA) and is the non-pharmacological intervention with the strongest evidence to reduce fatigue. However, physical activity can be challenging for persons who are fatigued. The aim of this study was to investigate factors of importance for reducing fatigue in persons with RA.DesignThis is a qualitative interview study based on semistructured, indepth individual interviews. Interviews were analysed using qualitative content analysis.ParticipantsParticipants were 12 people with RA recruited from a previous randomised controlled trial of a person-centred treatment model focusing on health-enhancing physical activity and daily balance to lessen fatigue in persons with RA.SettingInterviews were conducted in a hospital setting.ResultsThe analysis resulted in one theme:an intellectual and embodied understanding that sustainable physical activity is important to handle fatigue. This included five categories describing barriers and facilitating factors for sustainable physical activity:mentally overcoming the fatigue in order to be active,making exercise easy,reaching for balance,receiving support to be physically activeanddealing with RA disease to be physically active.ConclusionThe participants in this study expressed that physical activity was important in handling fatigue, but also that this insight could only come from personal experience. The use of a person-centred ethic in physiotherapy coaching for patients with fatigue appears to promote sustainable physical activity behaviours by facilitating patients’ resources to overcome barriers to physical activity.

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