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ROYAUME UNI

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"A good death" during the Covid-19 pandemic in the UK - a report on key findings and recommendations

BEAR, Laura ; SIMPSON, Nikita ; ANGLAND, Michael ; BHOGAL, Jaskiran K. ; BOWERS, Rebecca ; CANNELL, Fenella ; GARDNER, Katy ; LOHIYA, Anishka ; JAMES, Deborah ; JIVRAJ, Naseem ; KOCH, Insa ; LAWS, Megan ; LIPTON, Jonah ; LONG, Nicholas J. ; VIEIRA, Jordan ; WATT, Connor ; WHITTLE, Catherine ; ZIDARU-BARBULESCU, Teo
London school of economics and political science, London School of Economics and Political Science , 10/04/2020 , 18 p.

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Covid-19 - where is the national ethical guidance?

HUXTABLE, Richard
BMC medical ethics, 01/05/2020, vol.21, n°1, p. 1-3

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Hospice advice and rapid response service for ambulance clinicians

DENT, Tom ; TIPPING, Inderia ; ANDERSON, Racquel ; DANIELS, Charles
BMJ supportive and palliative care, 27/03/2020, Pagination inconnue

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Uk palliative medicine trainees and multisource communication skills feedback - an educational tool?

WEBBER, Katherine ; SELMAN, Rebecca
BMJ supportive and palliative care, 31/03/2020, Pagination inconnue

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Young adults with life-limiting or life-threatening conditions - sexuality and relationships support

EARLE, Sarah ; BLACKBURN, Madeleine
BMJ supportive and palliative care, 02/04/2020, Pagination inconnue

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Determinants of quality of life in patients with incurable cancer - quality of life in incurable cancer

DALY, Louise E. ; DOLAN, Ross D. ; POWER, Derek G. ; NI BHUACHALLA, Éadaoin ; SIM, Wei ; CUSHEN, Samantha J. ; FALLON, Marie T. ; SIMMONS, Claribel ; MCMILLAN, Donald C. ; LAIRD, Barry J. ; RYAN, Aoife M.
Cancer, 08/04/2020, Pagination inconnue

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Thème : Soins.

CANCER ; QUALITE VIE ; FACTEUR ; IRLANDE ; ROYAUME UNI

Background: Optimizing quality of life (QoL) remains the central tenet of care in patients with incurable cancer; however, determinants of QoL are not clear. The objective of the current study was to examine which factors influence QoL in patients with incurable cancer.
Methods: A multicenter study of adult patients with advanced cancer was conducted in Ireland and the United Kingdom between 2011 and 2016. Data were collected from patients at study entry and included patient demographics, Eastern Cooperative Oncology Group performance status (ECOG-PS), nutritional parameters (the percentage weight loss [%WL]), muscle parameters assessed using computed tomography images (skeletal muscle index and skeletal muscle attenuation), inflammatory markers (modified Glasgow Prognostic score [mGPS]), and QoL data (the European Organization for Research and Treatment Quality-of-Life Questionnaire C-30). The relation between clinical, nutritional, and inflammatory parameters with QoL was assessed using the Spearman rank correlation coefficient and multivariate binary logistic regression. Components of the European Organization for Research and Treatment Quality-of-Life Questionnaire C-30 (physical function, fatigue, and appetite loss) and summary QoL scores were mean-dichotomized for the logistic regression analyses.
Results: Data were available for 1027 patients (51% men; median age, 66 years). Gastrointestinal cancer was most prevalent (40%), followed by lung cancer (26%) and breast cancer (9%). Distant metastatic disease was present in 87% of patients. The %WL, ECOG-PS, and mGPS were significantly correlated with deteriorating QoL functional and symptom scales (all P < .001). On multivariate regression analysis, >10% WL (odds ratio [OR], 2.69; 95% CI, 1.63-4.42), an ECOG-PS of 3 or 4 (OR, 14.33; 95% CI, 6.76-30.37), and an mGPS of 2 (OR, 1.58; 95% CI, 1.09-2.29) were independently associated with poorer summary QoL scores. These parameters were also independently associated with poorer physical function, fatigue, and appetite loss (all P < .05). Low skeletal muscle attenuation was independently associated with poorer physical functioning (OR, 1.67; 95% CI, 1.09-2.56), but muscle parameters were not independently associated with fatigue, appetite loss, or QoL summary scores.
Conclusions: The current findings indicate that QoL is determined (at least in part) by WL, ECOG-PS, and the systemic inflammatory response in patients with advanced cancer. Identifying early predictors of poor QoL may allow the identification of patients who may benefit from early referral to palliative and supportive care, which has been shown to improve QoL.

Origine : DOI.org (Crossref

When a child is sick - the role of social tourism in palliative and end-of-life care

HUNTER-JONES, Philippa ; SUDBURY-RILEY, Lynn ; AL-ABDIN, Ahmed ; MENZIES, Laura ; NEARY, Katie
Annals of tourism research, Elsevier, 07/2020, vol.83, Pagination inconnue

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The emergence and utilisation of frailty in the United Kingdom - a contemporary biopolitical practice

TOMKOW, Louise
Ageing and society, 04/2020, vol.40, n°4, p. 695-712

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Thème : Age de la vie, situations spécifiques liées à la fin de vie. Cote : eD05.04

VULNERABILITE ; ROYAUME UNI ; SANTE PUBLIQUE ; GERIATRIE

Frailty has recently emerged as a dominant concept against a backdrop of media and governmental narratives that frame the growing ageing population as an economic threat to the current configuration of health care in the United Kingdom (UK). Despite frailty's popularity amongst geriatricians and policy makers, the concept faces resistance from other health-care professionals and older people themselves. This paper draws on the Foucauldian idea of biopower; by suggesting that the contemporary emergence and utilisation of frailty represents a biopolitical practice a number or critical observations are made. First, despite biomedical experts acknowledging ambiguities in the definition of frailty, the concept is presented as a truth discourse. This is driven by the ability of frailty measurements to predict risk of costly adverse outcomes; the capability of frailty scores to enumerate complex needs; and the scientific legitimacy frailty affords to geriatric medicine. Consequently, frailty has become pervasive, knowable and measurable. Second, the routine delineation between frail and robust objectifies older people, and can be said to benefit those making the diagnosis over those being labelled frail, with the latter becoming disempowered. Last, studies show that frailty is associated with increasing wealth inequalities in the UK; however, experts’ suggested management of frailty shifts the focus of responsibility away from ideologically driven structural inequalities towards the frail older person, attempting to encourage individuals to modify lifestyle choices. This neglects the association between lifestyle opportunities and socio-economic deprivation, and the impact of long-term poverty on health. These observations, set against the contemporary political climate of economic austerity, cuts to public services and rationalisation of health resources, bring the urgency of a critical consideration of frailty to the fore.

Origine : Cambridge Core

Employing newly qualified nurses to work in hospices - a qualitative interview study

ROLT, Lucy ; GILLETT, Karen
Journal of advanced nursing, 18/03/2020, Pagination inconnue

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Thème : Soins.

INFIRMIERE ; UNITE SOINS PALLIATIFS ; PRATIQUE PROFESSIONNELLE ; ROYAUME UNI

AIM: To establish an understanding of the experiences of newly qualified nurses' working in hospices from the perspective of both newly qualified and senior nurses.
DESIGN: A qualitative interview study.
METHODS: Semi-structured interviews with six newly qualified nurses and five senior nurses from four United Kingdom hospices were conducted between March - July 2017.
RESULTS: The hospices involved in this study were among the first to recruit newly qualified nurses. Participants believed newly qualified nurses coped well with hospice working and received unique opportunities for professional development. Participants identified the value of formal and informal support however newly qualified nurses faced negative attitudes from some established staff. Newly qualified nurses expressed concerns about a perceived lack of technical clinical skills training however they highlighted gaining end-of-life care and communication skills that would be transferrable to other settings. Participants highlighted the need to allocate more time for education and formal support including preceptorship. Senior staff did not necessarily expect newly qualified nurses to remain in long-term hospice employment suggesting they could disseminate their hospice learning to future workplaces.
CONCLUSION: This study supports recruitment strategies that increasingly target newly qualified nurses to work in hospices with findings suggesting that hospices can be a suitable environment for recent graduates to work in. The senior nurses in this study viewed the employment of newly qualified nurses in a positive light but shared the concerns of newly qualified nurses regarding skills training.
IMPACT: At a time when hospices need to expand if they are going to meet demand for their services, they along with most areas of healthcare face difficulties recruiting and retaining registered nurses. To increase the appeal of hospice employment, recruitment campaigns aimed at newly qualified nurses should emphasise the transferability of skills gained in hospice settings.

Origine : PubMed

Disease trajectories, place and mode of death in people with head and neck cancer - findings from the 'head and neck 5000' population-based prospective clinical cohort study

MAYLAND, Catriona R. ; INGARFIELD, Kate ; ROGERS, Simon N. ; DEY, Paola ; THOMAS, Steven ; WAYLEN, Andrea ; LEARY, Sam D. ; PRING, Miranda ; HURLEY, Katrina ; WATERBOER, Tim ; PAWLITA, Michael ; NESS, Andy R.
PALLIATIVE MEDICINE, 27/02/2020, Pagination inconnue

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The dying parent and dependent children - a nationwide survey of hospice and community palliative care support services

COCKLE-HEARNE, Jane ; REED, Elizabeth ; TODD, Jennifer ; REAM, Emma
BMJ supportive and palliative care, 09/03/2020, p. 1-9

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The path of Cicely Saunders - the "peculiar beauty" of palliative care

MICCINESI, Guido ; CARACENI, Augusto ; GARETTO, Ferdinando ; ZANINETTA, Giovanni ; BERTE, Raffaella ; BROGLIA, Chiara M. ; FARCI, Bruno ; APRILE, P. Lora ; LUZZANI, Massimo ; MARZI, Annamaria M. ; MERCADANTE, Sebastiano ; MONTANARI, Luigi ; MORONI, Matteo ; PIAZZA, Elena ; PITTURERI, Cristina ; TASSINARI, Davide ; TRENTIN, Leonardo ; TURRIZIANI, Adriana ; ZAGONEL, Vittorina ; MALTONI, Marco
JOURNAL OF PALLIATIVE CARE, 01/2020, vol.35, n°1, p. 3-7

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Communicating about death and dying with adults with intellectual disabilities who are terminally ill or bereaved - a UK-wide survey of intellectual disability support staff

TUFFREY-WIJNE, Irene ; FINLAYSON, Janet ; BERNAL, Jane ; TAGGART, Laurence ; LAM, Claire Kar Kei ; TODD, Stuart
Journal of applied research in intellectual disabilities, 18/02/2020, Pagination inconnue

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Assisted dying - RCGP continues to oppose change in law after polling members

RIMMER, Abi
BMJ, 21/02/2020, vol.368, Pagination inconnue

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Understanding usual care in randomised controlled trials of complex interventions - a multi-method approach

YORGANCI, Emel ; EVANS, Catherine J. ; JOHNSON, Halle ; BARCLAY, Stephen ; MURTAGH, Fliss Em ; YI, Deokhee ; GAO, Wei ; PICKLES, Andrew ; KOFFMAN, Jonathan
PALLIATIVE MEDICINE, 21/02/2020, Pagination inconnue

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Assisted dying - BMA surveys its members for first time

RIMMER, Abi
BMJ, 05/02/2020, vol.368, Pagination inconnue

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The overlap between geriatric medicine and palliative care - a scoping literature review

VISSER, Renske ; BORGSTROM, Erica ; HOLTI, Richard
Journal of applied gerontology, 02/02/2020, Pagination inconnue

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Physical activity in hospice care - a social ecological perspective to inform policy and practice

BURKE, Shaunna ; UTLEY, Andrea ; BELCHAMBER, Caroline ; MCDOWALL, Louise
Research quarterly for exercise and sport, 28/01/2020, p. 1-14

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Palliative care for non-cancer conditions in primary care - a time trend analysis in the UK (2009-2014)

GADOUD, Amy ; KANE, Eleanor ; OLIVER, Steven Edward ; JOHNSON, Miriam J. ; MACLEOD, Una ; ALLGAR, Victoria
BMJ supportive and palliative care, 13/01/2020, Pagination inconnue

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Case studies on careers in palliative care community nursing

British journal of community nursing, 02/07/2019, vol.24, n°7, p. 344-346

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