Search results for ‘Author:"higginson irene j."’ Sort:
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Evidence based palliative care
- Author:
- HIGGINSON Irene J.
- Journal article citation:
- British Medical Journal, 21.8.99, 1999, pp.462-463.
- Publisher:
- British Medical Association
Palliative care is a person centred approach concerned with physical, psychosocial and spiritual care in progressive disease. It focuses on both the quality of life of the patient and support for their carers. Some data suggest that patients in socially deprived areas, from minority groups or older patients have limited access to palliative care. This paper suggests that there have been difficulties in gathering evidence about palliative care, but this should not prevent it from being administered where patient and carer satisfaction, cost-effectiveness and efficacy have been shown.
Scoping exercise on generalist services for adults at the end of life: research, knowledge, policy and future research needs: report 1: overview and recommendations for future research in generalist and end of life care
- Authors:
- HIGGINSON Irene J., et al
- Publisher:
- National Co-ordinating Centre for NHS Service Delivery and Organisation
- Publication year:
- 2007
- Pagination:
- 47p., bibliog.
- Place of publication:
- London
The aims of this study were to define what was meant and understood by generalist end of life care, to map the existing knowledge base, to identify methodological and ethical issues, to consult with stakeholders, and to assess how existing knowledge and research mapped against priority issues identified by stakeholders. It included a literature review and consultation with key informants associated with care at the end of life in London, Cambridgeshire and the East of England, Warwickshire, and Scotland, and in English national organisations. The report makes four recommendations for future research: primary research to define and evaluate models of collaborative working in primary and secondary end of life care, primary research to define and evaluate models of provision of generalist out of hours care at the end of life, a systematic literature review of place of care and place of death of people dying from non-malignant disease, and primary research to define and evaluate models and/or organisation of care of the dying in different settings.
Factors influencing death at home in terminally ill patients with cancer: systematic review
- Authors:
- GOMES Barbara, HIGGINSON Irene J.
- Journal article citation:
- British Medical Journal, 4.03.06, 2006, pp.515-518.
- Publisher:
- British Medical Association
In this systematic review four electronic databases were searched: Medline (1966-2004), PsycINFO (1972-2004), CINAHL (1982-2004), and ASSIA (1987-2004); previous contacts with key experts were drawn on; and six relevant journals were hand searched. The authors generated a conceptual model, against which studies were analysed. Included studies had original data on risk factors for place of death among patients, over 80% of whom had cancer. Strength of evidence was assigned according to the quantity and quality of studies and consistency of findings. Odds ratios for home death were plotted for factors with high strength evidence. 58 studies were included, with over 1.5 million patients from 13 countries. There was high strength evidence for the effect of 17 factors on place of death, of which six were strongly associated with home death: patients' low functional status, their preferences, home care and its intensity, living with relatives, and extended family support. The risk factors covered all groups of the model: related to illness, the individual, and the environment (healthcare input and social support), the latter found to be the most important. The authors conclude that the network of factors that influence where patients with cancer die is complicated. Future policies and clinical practice should focus on ways of empowering families and public education, as well as intensifying home care, risk assessment, and training practitioners in end of life care.
Fit to care?: a comparison of informal caregivers of first-generation black Caribbeans and white dependants with advanced progressive disease in the UK
- Authors:
- KOFFMAN Jonathan S., HIGGINSON Irene J.
- Journal article citation:
- Health and Social Care in the Community, 11(6), November 2003, pp.528-536.
- Publisher:
- Wiley
Aims to describe and compare the main needs and problems experienced by informal caregivers of black Caribbean and white native-born patients in their last year of life. Of 106 black Caribbean and 110 white patients identified as dying during the survey period, 50 interviews per ethnic group were conducted, a response rate of 47% and 45%. Out of these, 31 respondents representing black Caribbean and 28 representing white dependants said they bore the brunt of caregiving. Compared with those who cared for white dependants, those who cared for black Caribbean dependants were more likely to be women (84% versus 46%) and younger than 55 (73% versus 37%). The personal care tasks caregivers assisted dependants with were similar as were the informal resources they drew on. Many caregivers reported restrictions in their daily lives; this was more pronounced for those who cared for black Caribbean dependants. Research is required to provide a qualitative narrative of the meaning caregivers from different communities ascribe to caring and the formal and informal resources they need to support them.
Palliative and end of life care for Black, Asian and Ethnic Minority groups in the UK: demographic profile and the current state of palliative and end of life care provision
- Authors:
- CALANZANI Natalia, KOFFMAN Jonathan, HIGGINSON Irene J.
- Publisher:
- Marie Curie Cancer Care
- Publication year:
- 2013
- Pagination:
- 79
- Place of publication:
- London
The End of Life Care Strategy highlights that inequalities still exist in the care that different groups of people receive at the end of life. This report draws on an analysis of statistical data and the findings from a systematic review to understand the profile of Black, Asian and Minority Ethnic (BAME) populations living in the UK, and their unmet needs regarding palliative and end of life care. First, the characteristics of BAME groups in the UK (ethnic groups by age and geographical region, religion, language and characteristics of the foreign born population) are described using data from 2001 and 2011 Census. Figures are provided separately for England, Wales, Scotland and Northern Ireland. The report then examines to what extent the BAME populations are expected to increase and grow older in the next few decades according to the most recent population projections. The second part of the report draws on a review of the current literature on the state of palliative and end of life care provision for BAME groups. The reviews primary focus on access to, and receipt of care. They also recognise the importance of social inequalities when analysing unmet needs. Recommendations for policy, practice and research from the literature are then presented. Lastly, based on these two sources of information the report presents further recommendations with the aim to improve care for BAME populations in the UK. Tables are included throughout. (Edited publisher abstract)
Current and future needs for hospice care: an evidence-based report
- Authors:
- CALANZANI Natalia, HIGGINSON Irene J., GOMES Barbara
- Publisher:
- Help the Hospices
- Publication year:
- 2013
- Pagination:
- 48
- Place of publication:
- London
Commissioned by the Commission into the Future of Hospice Care, this report focuses on crucial factors for planning for the future level of need for hospice care towards the end of life for the adult population in the UK. It is based on analysis of mortality trends and population projections, together with identification and review of studies assessing preferences for place of care or place of death, and survey data about factors associated with choosing hospice/palliative care units as a preferred place to die. The report presents evidence-based findings, covering likely changes in the size and shape of the UK population (including data on actual and projected number of deaths in England, Wales, Scotland and Northern Ireland and on trends in hospice care services), and where people wish to be cared for and die and whether their preferences are being met. It considers evidence about whether hospice care makes a difference to patients and caregivers and the effectiveness and cost-effectiveness of hospice care. It makes recommendations in each of these areas, discusses the implications for future care planning for adequate hospice care, and includes suggestions for further research.