Using a public health approach to improve end-of-life care: results and discussion of a health needs assessment undertaken in a large city in northern England

2014 ◽  
Vol 5 (2) ◽  
pp. 200-202 ◽  
Author(s):  
Kathryn Ingold ◽  
Fiona Hicks
2020 ◽  
Vol 19 (3) ◽  
pp. 203-211
Author(s):  
Jessica Blake ◽  
Anda Bayliss ◽  
Bethan Callow ◽  
Grace Futter ◽  
Navaneeth Harikrishnan ◽  
...  

Purpose Experiencing bereavement in childhood can cause profound changes to developmental trajectories. This paper aims to evaluate the feasibility of implementing a public health intervention in schools to encourage pupils aged 12-15 years to independently explore ideas of death, dying, loss and end of life care in a structured and creative format. Design/methodology/approach A co-produced storytelling intervention was implemented in an independent school in Norwich, UK. Pupils wrote up to 1,000 words in response to the title, “I Wish We’d Spoken Earlier”. Their participation was voluntary and extra-curricular. Stakeholder feedback was used in addition to the submissions as a measure of acceptability, appropriateness, adoption and feasibility. Findings In total, 24 entries were submitted. Pupils demonstrated their ability to engage thoughtfully and creatively with the subject matter. Feasibility for the storytelling intervention was demonstrated. Importantly, the intervention also prompted family conversations around preferences and wishes for end of life care. Research limitations/implications To determine whether the intervention has psychological and social benefits will require further study. Practical implications Educational settings can be considered as anchor institutions to support a public health approach to end of life care. Originality/value The positive response from all stakeholders in delivering and supporting the intervention indicates that schools are a community asset that could be further empowered to support children and families affected by death, dying and loss.


BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e030703 ◽  
Author(s):  
Joseph M Sawyer ◽  
Libby Sallnow ◽  
Nuriye Kupeli ◽  
Patrick Stone ◽  
Elizabeth L Sampson

Objectives(1) To develop an understanding of how social capital may be conceptualised within the context of end-of-life care and how it can influence outcomes for people with dementia and their families with specific reference to the context and mechanisms that explain observed outcomes. (2) To produce guidance for healthcare systems and researchers to better structure and design a public health approach to end-of-life care for people with dementia.DesignA realist review.Data sourcesMEDLINE, EMBASE, CINAHL and grey literature.AnalysisWe conceptualised social capital as a complex intervention and, in order to understand how change is generated, used realist evaluation methods to create different configurations of context, mechanism and outcomes. We conducted an iterative search focusing on social capital, social networks and end-of-life care in dementia. All study designs and outcomes were screened and analysed to elicit explanations for a range of outcomes identified. Explanations were consolidated into an overarching programme theory that drew on substantive theory from the social sciences and a public health approach to palliative care.ResultsWe identified 118 articles from 16 countries ranging from 1992 to 2018. A total of 40 context-mechanism-outcome configurations help explain how social capital may influence end-of-life care for people with dementia. Such influence was identified within five key areas. These included: (1) socially orientating a person with dementia following diagnosis; (2) transitions in the physical environment of care; (3) how the caregiving experience is viewed by those directly involved with it; (4) transition of a person with dementia into the fourth age; (5) the decision making processes underpinning such processes.ConclusionThis review contributes to the dispassionate understanding of how complex systems such as community and social capital might be viewed as a tool to improve end-of-life care for people with dementia.PROSPERO registration numberCRD42018084524.


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