Policy and practice on psychosocial care in palliative care programs

2018 ◽  
pp. 148-169
Author(s):  
Mai-Britt Guldin ◽  
Sheila Payne
Keyword(s):  
Palliative Care ◽  
Psychosocial Care ◽  
Policy And Practice

scholarly journals Missing in Action: Reports of Interdisciplinary Integration in Canadian Palliative Care

2021 ◽  
Vol 28 (4) ◽  
pp. 2699-2707
Author(s):  
Maggie C. Robinson ◽  
Maryam Qureshi ◽  
Aynharan Sinnarajah ◽  
Srini Chary ◽  
Janet M. de Groot ◽  
...  
Keyword(s):  
Palliative Care ◽  
Social Work ◽  
Spiritual Care ◽  
Psychosocial Care ◽  
Research And Practice ◽  
Barriers And Enablers ◽  
Special Concern ◽  
Missing In Action ◽  
Interdisciplinary Integration

Palliative care has an interdisciplinary tradition and Canada is a leader in its research and practice. Yet even in Canada, a full interdisciplinary complement is often lacking, with psychosocial presence ranging from 0–67.4% depending on the discipline and region. We sought to examine the most notable gaps in care from the perspective of Canadian palliative professionals. Canadian directors of palliative care programs were surveyed with respect to interdisciplinary integration. Participants responded in writing or by phone interview. We operationalized reports of interdisciplinary professions as either “present” or “under/not-represented”. The Vaismoradi, Turunen, and Bondas’ procedure was used for content analysis. Our 14 participants consisted of physicians (85.7%), nurses (14.3%), and a social worker (7.1%) from Ontario (35.7%), British Columbia (14.3%), Alberta (14.3%), Quebec (14.3%), Nova Scotia (14.3%), and New Brunswick (7.1%). Psychology and social work were equally and most frequently reported as “under/not represented” (5/14, each). All participants reported the presence of medical professionals (physicians and nurses) and these groups were not reported as under/not represented. Spiritual care and others (e.g., rehabilitation and volunteers) were infrequently reported as “under/not represented”. Qualitative themes included Commonly Represented Disciplines, Quality of Multidisciplinary Collaboration, Commonly Under-Represented Disciplines, and Special Concern: Psychosocial Care. Similar to previous reports, we found that (1) psychology was under-represented yet highly valued and (2) despite social work’s relative high presence in care, our participants reported a higher need for more. These finding highlight those psychosocial gaps in care are most frequently noted by palliative care professionals, especially psychology and social work. We speculate on barriers and enablers to addressing this need.

scholarly journals The public health end-of-life care movement: history, principles, and styles of practice

2018 ◽  
Author(s):  
Aliki Karapliagou ◽  
Allan Kellehear ◽  
Klaus Wegleitner
Keyword(s):  
Public Health ◽  
Palliative Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Psychosocial Care ◽  
Care Practice ◽  
Life Care ◽  
The Public ◽  
Civic Practice ◽  
Practice Methods

This chapter briefly outlines the history, key concepts, and main practice methods from public health approaches to end-of-life care. Although linked to psychosocial care approaches, its main methods draw not from psychology or health services inspired approaches but rather from health promotion, community development, and civic engagement. Key methods covered include community volunteering, social networking, community engagement, and compassionate communities and cities. The aim of these kinds of approaches is to embed palliative care practice as a social and civic practice in all sectors of society and to ensure that palliative care as a policy is represented in all civic policies (e.g. schools, workplaces, faith groups, and cultural activities) and not solely in health care.

scholarly journals Knowledge of managers on the National Mental Health Policy

2020 ◽  
Vol 73 (1) ◽  
Author(s):  
Rafaella Leite Fernandes ◽  
Francisco Arnoldo Nunes de Miranda ◽  
Kalyane Kelly Duarte de Oliveira ◽  
Clara Tavares Rangel ◽  
Danyella Augusto Rosendo da Silva Costa ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Mental Health Policy ◽  
Psychosocial Care ◽  
Structured Interview ◽  
Policy And Practice ◽  
Care Network ◽  
Public Managers ◽  
National Mental Health ◽  
Service Managers

ABSTRACT Objective: Identify the knowledge of mental health service managers about the national mental health policy. Method: This is a qualitative study conducted with 20 coordinators, who were submitted to a structured interview. Data were categorized in a thematic analysis using ALCESTE software. Results: The results produced the following categories: Back to society: protagonism and autonomy of patients; Interprofessional team: assignments and activities; Structuring of a psychosocial care network; Challenges affecting the service; Distance between policy and practice. Final Considerations: Public managers demonstrated they are aware of the key concepts for effective structuring of a psychosocial care network based on patient protagonism and autonomy, the assignments and activities performed by interprofessional teams, and the challenges found while structuring a psychosocial care network.

Rural community-based nurses’ self-reported knowledge and skills in the provision of psychosocial care to palliative and end-of-life clients and carers

2021 ◽  
pp. 1-9
Author(s):  
Eli Ristevski ◽  
Michael Leach ◽  
Ellen Bolton ◽  
Melissa Spargo ◽  
Anny Byrne ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Rural Community ◽  
Psychosocial Care ◽  
Assessment Tools ◽  
Formal Training ◽  
Educational Strategies ◽  
Community Based ◽  
Knowledge And Skills ◽  
Practice Gaps

Abstract Objective This study examined rural community-based nurses' self-reported knowledge and skills in the provision of psychosocial care to rural residing palliative and end-of-life clients and carers. We further sought to determine correlates of knowledge gaps to inform workforce education and planning. Method Nurses from a rural area of Victoria, Australia, were invited to complete an electronic questionnaire rating their knowledge against 6 national palliative care standards and 10 screening and assessment tools. A 5-point scale of (1) No experience to (5) Can teach others was used to rate knowledge. Results were classified into three categories: practice gaps, areas of consolidation, and strengths. Descriptive and logistical regression was used to analyze data. Results A total of 122 of 165 nurses (response rate = 74%) completed the survey. Of these nurses, 87% were Registered Nurses, 43% had ≥10 years' experience in palliative care, and 40% had palliative care training. The majority of practices across the standards and screening and assessment tools were rated as knowledge strengths (N = 55/67, 82%). Gaps and areas of consolidation were in the use of client and carer assessment tools, the care of specific populations such as children, supporting carers with appropriate referrals, resources, and grief, and facilitating the processes of reporting a death to the coroner. Lack of formal training and lower years of experience were found to be associated with practice gaps. Significance of results Our study found rural nurses were confident in their knowledge and skills in the majority of psychosocial care. As generalist nurses make up the majority of the rural nursing workforce, further research should be undertaken on what educational strategies are needed to support and upskill rural community-based nurses to undertake formal training in palliative care.

scholarly journals EXPERIENCE OF LGBT PATIENTS AND FAMILY WITH HOSPICE AND PALLIATIVE CARE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S623-S624
Author(s):  
Gary L Stein ◽  
Cathy Berkman
Keyword(s):  
Palliative Care ◽  
Staff Training ◽  
Online Survey ◽  
Research Policy ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Future Research ◽  
Policy And Practice ◽  
Cross Sectional ◽  
Hospice And Palliative Care

Abstract This study examines the degree to which hospice and palliative care staff observe or perceive inadequate, disrespectful, or abusive care to LGBT patients and family members. A cross-sectional study using an online survey completed by 865 providers, including social workers, physicians, nurses, and chaplains. Among respondents, 55% reported that LGB patients were more likely to experience discrimination at their institution than non-LGB patients; 24% observed discriminatory care; 65% reported that transgender patients were more likely than non-transgender patients to experience discrimination; 20% observed discrimination to transgender patients; 14% observed the spouse/partner of LGBT patients having their treatment decisions disregarded or minimized; and 13% observed the spouse/partner being treated disrespectfully. Findings reported also include: institutional non-discrimination policy, staff training, intake procedures, and comfort in assessing LGBT status. Implications for future research, policy, and practice will be presented.

Flying beyond Gray's Anatomy: A psychologist's experience in palliative care and psycho-oncology

2014 ◽  
Vol 13 (6) ◽  
pp. 1803-1808 ◽  
Author(s):  
Casey L. O'Brien
Keyword(s):  
Palliative Care ◽  
Hospital Setting ◽  
Psychosocial Care ◽  
Psychotherapy Training ◽  
Corticosteroid Treatment ◽  
Psychological Skills ◽  
Psychological Practice ◽  
Loss And Grief ◽  
Surgical Teams ◽  
The Impact

AbstractA clinical fellowship provides opportunities for health professionals to learn specialist skills from experienced mentors in “real-world” environments. In 2010–2011, I had the opportunity to complete a palliative care and psycho-oncology clinical fellowship in a public hospital. I found ways to integrate academic training into my practice and become a more independent psychologist. In this essay, I aim to share my experience with others and highlight key learnings and challenges I encountered. In providing psychosocial care, I learned to adapt my psychological practice to a general hospital setting, learning about the medical concerns, and life stories of my patients. I faced challenges navigating referral processes and had opportunities to strengthen my psychotherapy training. In the fellowship, I engaged in educational activities from the more familiar psychological skills to observing surgical teams at work. I also developed confidence facilitating groups and an interest in group psychological support for young adult offspring of people with cancer. I was able to engage participants with haematological cancer in qualitative research about their experiences of corticosteroid treatment. In this process, I came to understand the complexity of chemotherapy regimens. Overseeing my development were multiple supervisors, offering unique insights that I could take in and integrate with my personal practice and worldview. Throughout this process I became increasingly tuned into my own process, the impact of the work, and developed self-care routines to help disconnect from my day. I also reflected on my experiences of loss and grief and developed a deeper understanding of myself as a person. I use the metaphor of a parachuting journey to illustrate various aspects of my learning.

Palliative care and psychosocial care in metastatic non-small cell lung cancer: factors affecting utilisation of services and impact on patient survival

2018 ◽  
Vol 27 (3) ◽  
pp. 911-919 ◽  
Author(s):  
Kirsten J. Duggan ◽  
Jennifer Wiltshire ◽  
Rebecca Strutt ◽  
Miriam M. Boxer ◽  
Angela Berthelsen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Palliative Care ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Patient Survival ◽  
Psychosocial Care ◽  
Small Cell ◽  
Small Cell Lung ◽  
Factors Affecting

National survey of oncology fellows on palliative care education

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9541-9541
Author(s):  
M. K. Buss ◽  
D. S. Lessen ◽  
J. Von Roenn ◽  
A. M. Sullivan ◽  
R. M. Arnold ◽  
...  
Keyword(s):  
Palliative Care ◽  
Multiple Testing ◽  
Psychosocial Care ◽  
Cord Compression ◽  
Type I ◽  
Bone Marrow Biopsies ◽  
Opioid Rotation ◽  
Palliative Care Education ◽  
Hospice Referral

9541 Background: Palliative care (PC) is recognized as an integral part of the practice of oncology, yet many oncologists report inadequate training in critical PC domains, such as symptom management, psychosocial care and communication skills. We sought to assess the quantity and quality of PC education within oncology fellowships. Methods: Second year fellows enrolled in US oncology fellowships were invited to complete a 104 item survey that was modified from a national telephone survey of medical students and residents. Topics included: 1) quality and quantity of teaching and education, 2) observation and feedback, 3) knowledge, 4) attitudes and preparation. Items were designed to allow comparison between PC and non-PC topics. To reduce Type I errors from multiple testing, an alpha level of 0.01 was considered statistically significant. Results : Of 402 eligible fellows, 63.5% responded (n=254). Respondents were: 52% male, 62% White, 27% Asian and 64% US medical school graduates. One-quarter (26%) had completed a PC rotation and 68% reported exposure to palliative care during their fellowship. On a 5-point Likert Scale, fellows rated teaching on PC less highly than the overall quality of fellowship teaching (3.0 v 3.7; p<0.001). Fellows rated attending oncologists less favorably in performing PC skills compared to other oncology skills: managing pain in the terminally ill versus managing spinal cord compression (3.9 v. 4.5; p < 0.001); discussing the decision to stop chemotherapy versus discussing chemotherapy side effects (3.8 v. 4.2; p < 0.001). Fellows were less likely to be observed (81% v 93%; p =0.005) or receive feedback (80 v 93%; p= 0.02) on end-of-life (EOL) discussions than bone marrow biopsies. Many fellows reported not receiving explicit education on PC topics: managing depression at the EOL (68%), opioid rotation (67%), telling a patient she is dying (42%) and hospice referral (37%). Fellows who completed a PC rotation were more likely to report explicit teaching on opioid rotation (p =0.005) and hospice referral (p = 0.002). Conclusions: Our study reveals opportunities for improving the PC training of oncology fellows. No significant financial relationships to disclose.

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