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1 – 10 of over 1000The purpose of this paper is to investigate key milestones in development of standards of human rights to health care in particular context of addressing palliative care, relevant…
Abstract
Purpose
The purpose of this paper is to investigate key milestones in development of standards of human rights to health care in particular context of addressing palliative care, relevant efforts of advocacy in past decade and future area of growth.
Design/methodology/approach
In this study, analysis of human rights and its standards in context of palliative care has been provided through the lens of freedom from ill treatment and torture, right to health care and older persons’ and children’s rights.
Findings
Findings of this study highlighted significant developments in this area which include following: first treaty of human rights which explained right to palliative care; first resolution on palliative care by World Health Assembly; special rapporteur’s report focussed on denial of pain; and addressing issue of controlled medicine availability in special session of UN General Assembly.
Originality/value
Human rights standards and their development in context of palliative care have been most significant in relation to freedom from ill treatment and torture, right to health care and older persons’ rights. Further work is required in context of children’s rights and treaty bodies of human rights need to consistently address state obligations towards palliative care.
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S.S. Dulari, M. Dhanya and Indu Nair
This research paper aims to study the achievement of the objectives set by the Government of Kerala through the Arogyakeralam Pain and Palliative Care project.
Abstract
Purpose
This research paper aims to study the achievement of the objectives set by the Government of Kerala through the Arogyakeralam Pain and Palliative Care project.
Design/methodology/approach
The research paper delves into diverse facets of an individual’s well-being including medical, emotional, spiritual and social aspects, when confronted with an incurable and incapacitating disease through the intervention of the PPC project. This insightful study was conducted in the state of Kerala, India.
Findings
The analysis reveals that quality of life (QoL) is most influenced by spiritual, social and psychological factors. This paper raises pertinent questions about the effectiveness of PPC initiatives within the realm of medical care.
Social implications
The thought, conception and preparation of the subject is on improving social health care by assessing the existing practices followed by the local governance. This, by far, would benefit millions by formulating appropriate policies for improving the QoL.
Originality/value
The Kerala model of health care has garnered global acclaim, standing shoulder to shoulder with the health systems of developed nations. Adopting “active total care” to address pain and allied indications, the Arogyakeralam palliative care program significantly enhances patients' QoL. The focus was to uplift the QoL of patients suffering from terminal illnesses post-pandemic.
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Susanna Böling, Johan M. Berlin, Helene Berglund and Joakim Öhlén
Considering the great need for palliative care in hospitals, it is essential for hospital staff to have palliative care knowledge. Palliative consultations have been shown to have…
Abstract
Purpose
Considering the great need for palliative care in hospitals, it is essential for hospital staff to have palliative care knowledge. Palliative consultations have been shown to have positive effects on in-hospital care. However, barriers to contact with and uptake of palliative consultation advice are reported, posing a need for further knowledge about the process of palliative consultations. The purpose of this study therefore was to examine how palliative consultations in hospitals are practised, as perceived by consultants and health care professionals on receiving wards.
Design/methodology/approach
Focus groups with palliative care consultation services, health care personnel from receiving wards and managers of consultation services. Interpretive description and constant comparative method guided the analysis.
Findings
Variations were seen in several aspects of practice, including approach to practice and represented professions. The palliative consultants were perceived to contribute by creating space for palliative care, adding palliative knowledge and approach, enhancing cooperation and creating opportunity to ameliorate transition. Based on a perception of carrying valuable perspectives and knowledge, a number of consultation services utilised proactive practices that took the initiative in relation to the receiving wards.
Originality/value
A lack of policy and divergent views on how to conceptualise palliative care appeared to be associated with variations in consultation practices, tentative approaches and a bottom-up driven development. This study adds knowledge, implying theoretical transferability as to how palliative care consultations can be practised, which is useful when designing and starting new consultation services.
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Siobhan Fox, Niamh O'Connor, Johnathan Drennan, Suzanne Guerin, W. George Kernohan, Aileen Murphy and Suzanne Timmons
The Model for Dementia Palliative Care Project will develop a service-delivery model for community-based dementia palliative care. Many countries provide dementia palliative care…
Abstract
Purpose
The Model for Dementia Palliative Care Project will develop a service-delivery model for community-based dementia palliative care. Many countries provide dementia palliative care services, albeit with considerable variability within these. However, little is known about what service providers consider to be the most important components of a dementia palliative care model. This study aimed to address this knowledge gap.
Design/methodology/approach
An exploratory design using a survey method was used as an initial phase of the wider project. A web-based survey was developed, piloted (n = 5), revised, and distributed within five healthcare jurisdictions: the Republic of Ireland, Northern Ireland, England, Scotland, and Wales. The target population was health and social care professionals, policymakers, and academics interested in dementia and palliative care. Content analysis of open-ended questions identified common themes; descriptive statistics were applied to the closed-ended questions.
Findings
Overall, N = 112 complete surveys were received. Key care principles incorporated the philosophies of palliative care and dementia care; many described “holistic” and “person-centred care” as the core. Important individual service components were the support for carers, advanced care planning, information, education and training, activities for “meaningful living”, comprehensive disease management, coordinated case management, and linking with community health services and social activities. Barriers included poor availability and organisation of healthcare services, stigma, misconceptions around dementia prognosis, insufficiently advanced care planning, and dementia-related challenges to care. Facilitators included education, carer support, and therapeutic relationships.
Originality/value
This study, as part of the larger project, will directly inform the development of a novel service delivery Model of Dementia Palliative Care for Ireland. The results can also inform service planning and design in other countries.
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To begin a process of understanding how palliative care organisations are configured to enable innovative multidisciplinary patient care teams and their management in an…
Abstract
Purpose
To begin a process of understanding how palliative care organisations are configured to enable innovative multidisciplinary patient care teams and their management in an uncertain, complex and dynamic environment.
Design/methodology/approach
A range of literature was reviewed to suggest configuration and characteristics that were tested using semi‐structured interviews with the senior medical staff member at each of three Australian case study organisations. Data gathered from these interviews was supplemented with data gathered from semi‐structured interviews with multidisciplinary management teams and patient care teams dealing with inpatients and home‐care patients.
Findings
A hybrid configuration is suggested, based on Mintzberg's typology of organisations. Responses from interviews modify some characteristics of the suggested configuration, though generally appearing to support it. Characteristics of the external and internal environments are described.
Research limitations/implications
Palliative care is rarely written off outside the healthcare literature and comparatively infrequently within it. Configuration is used to suggest the characteristics of innovative teams in an uncertain, dynamic, complex environment. The use and management of multidisciplinary patient care teams in palliative care offers interesting insights for a broad range of organisations.
Practical implications
A contribution to the discourse on the relationship between configuration and innovation based in organisations without commercial imperative, delivering multi‐level care for and by people involved in the end‐of‐life process.
Originality/value
The paper continues a line of publications, beginning in 2002, describing the management of innovation in multidisciplinary palliative care teams. The originality and value of this paper and this line of research is in taking a management view of a unique environment that offers insights and lessons to a broad range of organisations.
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Muhammad Yusuf Shaharudin, Zulkhairi Mohamad and Asmah Husaini
The wake of the novel coronavirus (COVID-19) pandemic had caused substantial disruptions to the usual delivery of healthcare services. This is because of restrictive orders that…
Abstract
The wake of the novel coronavirus (COVID-19) pandemic had caused substantial disruptions to the usual delivery of healthcare services. This is because of restrictive orders that were put in place to curb the spread of the infection. Palliative care services in Brunei also face challenges to deliver effective services during this period. However, the impact of advanced illnesses on patients' health and end-of-life care are issues that cannot be planned, postponed or cancelled. Hence, the palliative care team needs to continue to deliver effective palliative care services. As Brunei faced its second pandemic wave in August 2021, crucial adaptations were made to ensure palliative care service was not disrupted. This reflective case study aims to discuss the adaptations made in providing palliative care during this era of disruptions.
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Marina Raco, Teresa Burdett and Vanessa Heaslip
Due to an international ageing population, global health organisations have recognised the challenges arising from fragmented interaction between health and social sectors in the…
Abstract
Purpose
Due to an international ageing population, global health organisations have recognised the challenges arising from fragmented interaction between health and social sectors in the end of life care. The purpose of this paper is to explore the existing literature on integrative palliative care services for older people.
Design/methodology/approach
An integrative review was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Papers included in the review focused upon integrated care within palliative care systems (January 2007–2017). A certain number of papers were excluded when the review focused on individuals younger than 65, not written in English and not being focused on integrated palliative care.
Findings
Nine studies fitted the inclusion criteria and three themes were identified: person-centred care, co-ordination of care, and education and training. The review identifies that integrated palliative care requires co-ordinated techniques that focus upon the quality of life, individual needs and awareness of vulnerability rather than fixation on inevitable mortality.
Research limitations/implications
The emerging presence of the need for integrated palliative care requires further research in order to develop coherent models of integrated palliative care which can be incorporated into practice.
Originality/value
This review identified themes relevant to the emerging issues in the global health sector of end of life care. The literature suggests that the optimised use of an integrated care approach to a palliative model of care is required and in need of further investigation.
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Graydon Davison and Paul Hyland
This paper is the first in a series that will examine the management of innovation by cross‐functional, multi‐disciplinary patient care teams in a palliative care environment…
Abstract
This paper is the first in a series that will examine the management of innovation by cross‐functional, multi‐disciplinary patient care teams in a palliative care environment. This highly innovative environment is singularly focused on relieving the suffering of patients and their socially related carers during an end of life experience. The singular focus enables and encourages palliative care practitioners to break through and diminish or accommodate professionally‐based paradigm conflicts and organisational politics. This facilitates collaborative team‐based efforts, including the patient and the patient’s social support group, to address the multi‐causal uncertainties that characterise end of life in palliative care. The continuous innovation model used in the European Union funded CIMA project is used as a starting point for this research. While many businesses have struggled to implement self‐regulating teams and have invested considerable resources in attempting to gain some advantage from teamwork it appears palliative care professionals have adopted self‐regulating work teams in a highly uncertain environment as the most suitable human resource structure and practice.
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Irene Tuffrey‐Wijne, Leopold Curfs and Sheila Hollins
This paper explores access to palliative care services by people with learning disabilities. It is based on a study of specialist palliative care professionals in London…
Abstract
This paper explores access to palliative care services by people with learning disabilities. It is based on a study of specialist palliative care professionals in London, involving 32 semi‐structured interviews and 543 postal questionnaires. We focus on one aspect of the findings, related to the current use of specialist palliative care services by people with learning disabilities. The results indicate that such services are under‐used by this group. We discuss possible reasons for low referral rates, including late diagnosis and lack of understanding among both learning disability services and palliative care services about each other's roles. We highlight the importance of collaboration, and the need for further staff training.
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