Search results for ‘Subject term:"palliative care"’ Sort:
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Best practice for care in the last days of life
- Authors:
- MURPHY Deborah, BOLGER Maria, AGAR Ruth
- Journal article citation:
- Working with Older People, 11(3), September 2007, pp.25-28.
- Publisher:
- Emerald
This article describes the Liverpool Care Pathway (LCP), which is helping to improve palliative care and set standards for the future. The LCP provides a comprehensive template of appropriate, evidence-based, multidisciplinary care and is based on Integrated Care Pathway Methodology.
The evolution of the hospice movement in America
- Author:
- FINN William
- Journal article citation:
- Revija Za Socijalnu Politiku Journal of Social Policy, 9(3-4), 2002, pp.271-279.
- Publisher:
- University of Zagreb
The hospice movement in America has been shaped by several key factors, which in unison have created a unique and effective hospice model, yet a model that is also limited in creativity and scope to meet the changing future needs of America's dying. A home-care based hospice model has permitted rapid growth and disbursement of hospice services throughout America. The desire to de-institutionalize care of the dying and to provide holistic care and support shaped the culture of hospice care. However, the American dichotomy between care and cure underscores the need for end-of-life care that supports the transition from primarily curative to primarily palliative care. What should be recognized is that the two must co-exist to effectively support a terminally ill patient as he or she progresses toward the end of life. (Article in Croatian).
Implementation models of compassionate communities and compassionate cities at the end of life: a systematic review
- Authors:
- LIBRADA-FLORES Silvia, et al
- Journal article citation:
- International Journal of Environmental Research and Public Health, 17(17), 2020, Online only
- Publisher:
- Molecular Diversity Preservation International and Multidisciplinary Digital Publishing Institute
In the last decade, we have seen a growth of Compassionate Communities and Cities (CCC) at the end of life. There has been an evolution of organizations that help construct Community-Based Palliative Care programs. The objective is to analyze the implementation, methodology and effectiveness of the CCC models at the end of life. We conducted a systematic review following PRISMA ScR Guideline. The protocol was registered on PROSPERO (CRD42017068501). Five databases (MEDLINE, EMBASE, Web of Science, CINAHL and Google Scholar) were searched for studies (from 2000 to 2018) using set eligibility criteria. Three reviewers screened full-texts articles and extracted study data. Outcomes were filled in a registration form which included a narrative synthesis of each article. This study screened 1975 records. The researchers retrieved 112 articles and included 31 articles for the final analysis: 17 descriptive studies, 4 interventions studies, 4 reviews and 6 qualitative studies. A total of 11 studies regard the development models of CCC at the end of life, 15 studies were about evaluation of compassionate communities’ programs and 5 studies were about protocols for the development of CCC programs. There is poor evidence of the implementation and evaluation models of CCC at the end of life. There is little and low-/very low-quality evidence about CCC development and assessment models. This study found no data published on care intervention in advance disease and end of life. A global model for the development and evaluation of CCC at the end of life seems to be necessary. (Edited publisher abstract)
Understanding what works, why and in what circumstances in hospice at home services for end-of-life care: applying a realist logic of analysis to a systematically searched literature review
- Authors:
- HASHEM Ferhana, et al
- Journal article citation:
- Palliative Medicine, 34(1), 2020, pp.16-31.
- Publisher:
- Hodder Arnold
Background: This study has undertaken a systematically searched literature review using a realist logic of analysis to help synthesise the diverse range of literature available on hospice at home services. Aim: To find out in the existing literature what features of hospice at home models work best, for whom and under what circumstances. Design: A realist logic of analysis was applied to synthesise the evidence focusing on mechanisms by which an intervention worked (or did not work). An initial programme theory was developed using the National Association for Hospice at Home standards, Normalisation Process Theory and through refinement using stakeholder engagement. Data sources: PubMed, Science Direct, AMED, BNI, CINAHL, EMBASE, Health Business Elite, HMIC, Medline, PsychINFO, SCOPUS, Web of Science, DARE, Google Scholar, NHS Evidence, NIHR CRN portfolio database, NIHR journal library of funded studies, including searches on websites of relevant professional bodies (August 2014, June 2017, June 2019). Results: Forty-nine papers were reviewed, of which 34 contributed evidence to at least one of the eight theory areas: marketing and referral, sustainable funding model, service responsiveness and availability, criteria for service admission, knowledge and skills of care providers, integration and coordination, anticipatory care, support directed at carers. Conclusions: This literature review shows it is possible to develop a coherent framework and test it against 34 published papers and abstracts. Central to this review was theory building, and as further evidence emerges, programme theories can be refined and tested against any new empirical evidence.
Economic evaluations of palliative care models: a systematic review
- Authors:
- MATHEW Christine, et al
- Journal article citation:
- Palliative Medicine, 34(1), 2020, pp.69-82.
- Publisher:
- Hodder Arnold
BACKGROUND: Palliative care aims to improve quality of life by relieving physical, emotional, and spiritual suffering. Health system planning can be informed by evaluating cost and effectiveness of health care delivery, including palliative care., AIM: The objectives of this article were to describe and critically appraise economic evaluations of palliative care models and to identify cost-effective models in improving patient-centered outcomes., DESIGN: This study conducted a systematic review and registered the protocol in PROSPERO (CRD42016053973)., DATA SOURCES: A systematic search of nine medical and economic databases was conducted and extended with reference scanning and gray literature. Methodological quality was assessed using the Drummond checklist., RESULTS: This study identified 12,632 articles and 5 were included. This study included two modeling studies from the United States and England, and three economic evaluations from England, Australia, and Italy. Two studies compared home-based palliative care models to usual care, and one compared home-based palliative care to no care. Effectiveness outcomes included hospital readmission prevented, days at home, and palliative care symptom severity. All studies concluded that palliative care was cost-effective compared to usual care. The methodological quality was good overall, but three out of five studies were based on small sample sizes., CONCLUSION: Applicability and generalizability of evidence is uncertain due to small sample sizes, short duration, and limited modeling of costs and effects. Further economic evaluations with larger sample sizes are needed, inclusive of the diversity and complexity of palliative care populations and using patient-centred outcomes. (Edited publisher abstract)
PLISSIT interventions and sexual functioning: useful tools for social work in palliative care?
- Author:
- BENNETT Michael R.
- Journal article citation:
- Journal of Social Work in End-of-Life and Palliative Care, 15(4), 2019, pp.157-174.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
Discussing sexual health with healthcare patients and their partners is difficult and often avoided. The PLISSIT model is a framework to effectively initiate the conversation about sexual concerns. This rapid review and small meta-analysis explores and clarifies knowledge about the effectiveness of PLISSIT in resolving sexual dysfunction and glean insight into its utility as a social work intervention in a palliative care setting. Evidence from 15 interventional studies was synthesized. Cohen’s d-index served as the meta-analytic effect size statistic for each individual study. Significant ds were converted to Cohen’s U3 statistic to aid in practical interpretations. Between-study heterogeneity was evaluated with Cochran’s Q statistic to examine possible relationships between effect sizes and moderator variables. Statistically and practically significant evidence revealed that PLISSIT is effective in treating sexual dysfunction (d = 1.00, U3 = 84%, 95% CI = 1.06, 1.08): 84% of participants who received PLISSIT interventions scored lower on sexual dysfunction measures than did the typical participant in the comparison condition. Study design and frequency of intervention delivery moderated the overall effect. The findings and inferences may be best thought of as developed hypotheses for future research testing. (Edited publisher abstract)
Integrated palliative care definition and constitutive elements: scoping review
- Authors:
- MONDEJAR-PONT Meritxell, RAMON-ARIBAU Anna, GOMEZ-BATISTE Xavier
- Journal article citation:
- Journal of Integrated Care, 27(4), 2019, pp.285-304.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to propose a unified definition of integrated palliative care (IPC), and to identify the elements that facilitate or hinder implementation of an integrated palliative care system (IPCS). Design/methodology/approach: A scoping review of the conceptualization and essential elements of IPC was undertaken, based on a search of the PubMed, Scopus and ISI Web of Science databases. The search identified 79 unduplicated articles; 43 articles were selected for content analysis. Findings: IPC is coordinated and collaborative across different health organizations, levels of care and types of providers. Eight key elements facilitate implementation of an IPCS: coordination, early patient identification, patient-centred services, care continuity, provider education and training, a standard implementation model and screening tool, shared information technology system, and supportive policies and funding. These elements were plotted as a “Circle of Integrated Palliative Care System Elements.” Practical implications: This paper offers researchers an inclusive definition of IPC and describes the essential elements of its successful implementation. Originality/value: This study provides evidence from researchers on five continents, offering insights from multiple countries and cultures on the topic of IPC. The findings of this thematic analysis could assist international researchers aiming to develop a standard evaluative model or assess the level of integration in a health care system’s delivery of palliative care. (Edited publisher abstract)
What do we know about different models of providing palliative care? Findings from a systematic review of reviews
- Authors:
- BRERETON Louise, et al
- Journal article citation:
- Palliative Medicine, 31(9), 2017, pp.781-797.
- Publisher:
- Hodder Arnold
Background: A wide range of organisational models of palliative care exist. However, decision makers need more information about which models are likely to be most effective in different settings and for different patient groups. Aim: To identify the existing range of models of palliative care that have been evaluated, what is already known and what further information is essential if the most effective and cost-effective models are to be identified and replicated more widely. Design: A review of systematic and narrative reviews according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality was assessed using the AMSTAR (A MeaSurement Tool to Assess Reviews) tool. Data sources: MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Library, Web of Science and ASSIA were searched for reviews about models of service provision from 2000 to 2014 and supplemented with Google searches of the grey literature. Results: Much of the evidence relates to home-based palliative care, although some models are delivered across care settings. Reviews report several potential advantages and few disadvantages of models of palliative care delivery. However, under-reporting of the components of intervention and comparator models are major barriers to the evaluation and implementation of models of palliative care. Conclusion: Irrespective of setting or patient characteristics, models of palliative care appear to show benefits and some models of palliative care may reduce total healthcare costs. However, much more detailed and systematic reporting of components and agreement about outcome measures is essential in order to understand the key components and successfully replicate effective organisational models. (Publisher abstract)
Ageing, end-of-life care, and the National Disability Insurance Scheme: what can we learn from overseas?
- Author:
- WARK Stuart
- Journal article citation:
- Journal of Intellectual and Developmental Disability, 40(1), 2015, pp.92-98.
- Publisher:
- Taylor and Francis
The author of this conceptual article was awarded a Churchill Fellowship to travel to the United States, Ireland, and United Kingdom to meet with researchers, practitioners, and community agencies and review how support for people with intellectual disability is provided. A specific focus was upon provision of care for individuals who were either ageing or requiring palliative care. The project took place from June to August 2013 and involved face-to-face interviews and site visits with key academics, government representatives, and community providers in Los Angeles, Chicago, New York, New Jersey, Dublin, Edinburgh, London, Oxford, Cambridge, Bath, Bristol, Birmingham, and Stoke-on-Trent. A priority was placed upon examining how the key features of leading practice models could be implemented within the Australian environment featuring a National Disability Insurance Scheme (NDIS). On the basis of the observations of practice, key points are discussed regarding the potential for improvements to the support of people with intellectual disability within the Australian context of the NDIS (Publisher abstract)
Transforming end of life care in acute hospitals: the route to success 'how to' guide
- Author:
- NHS ENGLAND
- Publisher:
- NHS England
- Publication year:
- 2015
- Pagination:
- 138
- Place of publication:
- London
An update of the 2012 version, this document provides practical advice and support for clinicians and managers to help them improve end of life care in acute hospitals. It highlights existing models and practice tools already identified as examples of good practice and looks at how they can be used to improve the quality of end of life care for patients and families. It also draws on learning from The Productive Ward Releasing Time to Care programme and recent policy documents. The guide contains individual sections that can be used together or separately. Sections of the guide cover: prepare; assessment and diagnosis; planning - including who to involve, key enablers and how to measure progress; treatment, which uses the six step continuous improvement model as a guide through the process; evaluation; sustaining improvements; and leading large scale change. Each section includes practice examples and links to key resources. Links to additional resources are also included in the final section. (Edited publisher abstract)