scholarly journals Palliative Care for People with Severe Persistent Mental Illness: A Review of the Literature

2008 ◽  
Vol 53 (11) ◽  
pp. 725-736 ◽  
Author(s):  
Anne Woods ◽  
Kathleen Willison ◽  
Cindy Kington ◽  
Alan Gavin
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Palliative Care ◽  
Empirical Studies ◽  
Practice Research ◽  
Care Providers ◽  
Care Needs ◽  
Persistent Mental Illness ◽  
Collaborative Ventures ◽  
Research And Education

A systematic overview of the literature on palliative care for people with severe persistent mental illness (SPMI) was conducted to inform clinical practice, research, and education. Empirical studies and nonempirical papers were included. Few empirical studies exist. There is even less information about the palliative care needs of, or the nature of palliative care provided to, people with SPMI. Mental health, primary care, and palliative care providers need to partner with people who have SPMI in developing and providing palliative care. The field of palliative care for people with SPMI is wide open and in need of methodologically sound studies that will help define the issues that exist for this vulnerable population. Recognizing the similarities between mental health and palliative care should lead to collaborative ventures and discussions in an attempt to address common and parallel issues.

scholarly journals Co-Design of an Evidenced Informed Service Model of Integrated Palliative Care for Persons Living with Severe Mental Illness: A Qualitative Exploratory Study

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1710
Author(s):  
Marianne Tinkler ◽  
Joanne Reid ◽  
Kevin Brazil
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Palliative Care ◽  
Severe Mental Illness ◽  
Palliative Care Service ◽  
Current Evidence ◽  
Study Phase ◽  
Service Model ◽  
Care Needs ◽  
Palliative Care Needs

Background: Globally, close to one billion people are living with a mental health disorder, and it is one of the most neglected areas in Public Health. People with severe mental illness have greater mortality risk than the general population, experience health care inequalities throughout life and represent a vulnerable, under-served and under-treated population, who have been overlooked in health inequality research to date. There is currently a dearth of evidence in relation to understanding the palliative care needs of people with severe mental illness and how future care delivery can be designed to both recognise and respond to those needs. This study aims to co-design an evidenced informed service model of integrated palliative care for persons living with a severe mental illness. Methods: This qualitative sequential study underpinned by interpretivism will have six phases. An expert reference group will be established in Phase 1, to inform all stages of this study. Phase 2 will include a systematic literature review to synthesise current evidence in relation to palliative care service provision for people with severe mental illness. In Phase 3, qualitative interviews will be undertaken with both, patients who have a severe mental illness and in receipt of palliative care (n = 13), and bereaved caregivers of people who have died 6–18 months previously with a diagnosis of severe mental illness (n = 13), across two recruitment sties in the United Kingdom. Focus groups (n = 4) with both mental health and palliative care multidisciplinary staff will be undertaken across the two recruitment sites in Phase 4. Phase 5 will involve the co-design of a service model of integrated palliative care for persons living with severe mental illness. Phase 6 will develop practice recommendations for this client cohort. Discussion: Palliative care needs to be available at all levels of care systems; it is estimated that, globally, only 14% of patients who need palliative care receive it. Reducing inequalities experienced by people with severe mental illness is embedded in the National Health Service Long Term Plan. Internationally, the gap between those with a mental illness needing care and those with access to care remains considerable. Future policy and practice will benefit from a better understanding of the needs of this client cohort and the development of a co-designed integrated care pathway to facilitate timely access to palliative care for people with a severe mental illness.

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

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 ◽  
Palliative Care Needs

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.

Comment: ‘Devining’ The Role of the Consultant Psychiatrist in a Public Mental Health Service

1998 ◽  
Vol 32 (5) ◽  
pp. 612-615 ◽  
Author(s):  
Alan Rosen
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Service ◽  
Public Mental Health ◽  
Consultant Psychiatrist ◽  
Persistent Mental Illness ◽  
Public Mental Health Service ◽  
Key Players ◽  
Recovery Program

We admitted to ourselves, …and to our colleagues that we cannot treat people with severe and persistent mental illness as independent practitioners, and asked to be key players on the multidisciplinary team (Extract from A 12-Step Recovery Program for Psychiatrists [1]).

The Case for Generic Working in Mental Health Occupational Therapy

2003 ◽  
Vol 66 (3) ◽  
pp. 110-112 ◽  
Author(s):  
Deborah Harrison
Keyword(s):  
Mental Health ◽  
British Journal ◽  
Occupational Therapy ◽  
Practice Research ◽  
Opinion Piece ◽  
Research And Education ◽  
Future Practice

There has been a lively exchange of views in the British Journal of Occupational Therapy about the role of occupational therapy in mental health. This opinion piece presents an argument that occupational therapy must be more flexible and develop generic working. Suggestions are made for future practice, research and education.

scholarly journals Needs of patient with advanced stages of cancer in a Thai community

2018 ◽  
Vol 32 (5) ◽  
pp. 342-351
Author(s):  
Panita Krongyuth ◽  
Pimpan Silpasuwan ◽  
Chukiat Viwatwongkasem ◽  
Cathy Campbell
Keyword(s):  
Palliative Care ◽  
Content Analysis ◽  
Pain Management ◽  
Care Providers ◽  
Care Needs ◽  
Open Communication ◽  
Content Type ◽  
Advanced Stages ◽  
Palliative Care Needs ◽  
At Home

Purpose The purpose of this paper is to explore the needs of people with cancer in advanced stages and to analyze factors that influence them. Design/methodology/approach A concurrent mixed-method design was used. Descriptive design was conducted in Ubon Ratchathani Province, Thailand. Data were collected from a convenience sample of patients with advanced cancer of any tissue or organ. Questionnaires were completed by 110 patients aged 60 years and above (response rate 110/130=84.6 percent). In-depth interviews were conducted with a total of eight patients. Content analysis of semi-structured interviews of a sub-sample was subsequently performed to better understand the real needs of patients with advanced stages of cancer at home setting. Findings The majority (77.5 percent) reported a preference to spend their final days at home. The four most common palliative care needs were more information about disease and medical treatment (98.2 percent), more treatment for pain (97.3 percent), health education for family caregivers (95.5 percent) and health volunteers visit at home (95.5 percent). Content analysis of the qualitative data suggested that patient needs health care providers to deliver open communication, pain management and provide psychosocial supports. Originality/value The result showed that patients-related variables are associated with the palliative care needs in patients with advanced stages of cancer. Communication skills and pain management are the key components to support the need for palliative care at home and to benefit the quality of life in terminally ill patients.

scholarly journals Heard, known and safe in general practice? An interview study with patients with severe and persistent mental illness

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0201
Author(s):  
Nancy Jennifer Sturman ◽  
Ryan Williams ◽  
Marianne Wyder ◽  
Johanna Lynch
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
General Practice ◽  
Physical Health ◽  
Mental Healthcare ◽  
Health Issues ◽  
Structured Interviews ◽  
Convenience Sample ◽  
Persistent Mental Illness ◽  
Community Mental Health Clinics

BackgroundAlthough GPs provide care to many patients with severe and persistent mental illness, the role and skillset of the GP in this space are contested. Patients are less satisfied with GP care of mental health than physical health issues.AimTo explore patient expectations and experiences of GP roles in their mental health, and identify opportunities for improving mental health care in general practice.Design & settingPatient participants were recruited from community mental health clinics in Brisbane, Australia.MethodIndividual semi-structured interviews were conducted with a convenience sample of patients. Interviews were audio-recorded and transcribed professionally. The authors conducted an inductive thematic analysis, attending to participant vulnerability and reflexivity.Results16 interviews were conducted by one author (RW), average duration 29 minutes. Three overarching themes were identified: being heard; being known; and being safe. Participants greatly valued ‘good GPs’ who were able to detect early signs of relapse, and with whom they came to feel heard, known and safe over time. Experiences of perfunctory, hurried care and avoidance of mental health issues were also reported. Many participants were uncertain whether GP training in mental health was sufficient to keep them safe. Patients may suspect negative attitudes to mental illness in GPs who actively engage predominantly with their physical health.ConclusionSome GPs play central roles in patients’ mental healthcare. Barriers for others need further exploration, and may include time, confidence and/or expertise. Findings challenge GPs to engage more actively and effectively with these patients in theirgeneral practice consultations.

scholarly journals Domiciliary Care Providers Views on Provision of Palliative Care for their Cancer Patients

2018 ◽  
Vol 4 (1) ◽  
pp. 1-7
Author(s):  
Meegoda MKDL ◽  
Fernando DMS ◽  
Sivayogan S ◽  
Atulomah NOS ◽  
Marasinghe RB
Keyword(s):  
Palliative Care ◽  
Sri Lanka ◽  
Cancer Patients ◽  
Family Care ◽  
Sampling Technique ◽  
Target Population ◽  
Care Providers ◽  
Care Needs ◽  
Domiciliary Care ◽  
Depth Interviews

A qualitative study was conducted to describe views and life experiences of domiciliary care providers in meeting the palliative care needs of adult cancer patients at the National Cancer Institute, Maharagama, Sri Lanka. The target population for this study was Domiciliary Care Providers (DCPs) who were the family care givers of patients at National Institute of Cancer, Maharagam (NICM), Cancer Home (CH), Maharagama, Shantha Sevana Hospice (SSH) and Ceylinco Oncology Unit (COU), Colombo, Sri-Lanka. Purposive sampling technique was used to select participants for the study. In-depth interviews were conducted using validated semi-structured interviewer guide. Data saturation was reached after 15 in-depth interviews with DCPs. Trustworthiness of the study was maintained. Phenomenological-hermeneutic approach was followed to analyze qualitative data and thematic analysis was performed. Data analysis was done concurrently with data gathering. Being reassured, having more expectations, need psychosocial help and inadequate knowledge were the key themes identified. They expect knowledge improvement to provide better care. As patients’ level of satisfaction on domiciliary care provided by DCPs was high, improving their knowledge on palliative care may be a cost effective method of improving palliative care.

Learning together about the needs of parents with a mental illness and their children: The implementation of the Mums' and Dads' Practice Research Project

2004 ◽  
Vol 29 (2) ◽  
pp. 35-40 ◽  
Author(s):  
Carmel Alakus
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Service ◽  
Health Service ◽  
Parent Education ◽  
Consumer Satisfaction ◽  
Practice Research ◽  
Short Term ◽  
Adult Mental Health ◽  
Difficult Issue

The busy clinical practitioner, while being encouraged to innovate and formally evaluate his or her work, has less time than ever before to do either.The Mums' and Dads' Project represented a modest attempt to implement a short-term parent education project in adult mental health and review it in the style of practice-research. A number of qualitative methods were employed to research the Project conducted in the Mid West Area Mental Health Service exploring consumer satisfaction and parents' perspectives of their children's needs.Consumers attended the sessions readily, demonstrating knowledge of child development and a willingness to confront the difficult issue of informing children about mental illness. They reiterated how much they appreciated meeting other parents with a mental illness.Service delivery to parents with a mental illness and their children deserves dedicated funding if their needs are to be addressed and programs carefully evaluated.

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