Search results

The growing numbers of terminally ill and dying in prison has high economic and moral costs as global correctional systems and the society at large. However, to date little is known about the extent to which palliative and end-of-life care is infused within global prison health care systems. The purpose of this paper is to fill a gap in the literature by reviewing and critically appraising the methods and major findings of the international peer-reviewed literature on palliative and end-of-life care in prison, identify the common elements of promising palliative and end-of-life services in prison, and what factors facilitate or create barrier to implementation.

A content analysis was conducted of the existing peer-reviewed literature on palliative and end-of-life care in prison. English-language articles were located through a comprehensive search of peer-reviewed journals, such as Academic Search Premier Literature databases using differing combinations of key word search terms, “prison,” “palliative care,” and “end-of-life care.” A total of 49 studies published between 1991 and 2013 met criteria for sample inclusion. Deductive and inductive analysis techniques were used to generate frequency counts and common themes related to the methods and major findings.

The majority (n=39) of studies were published between 2001-2013 in the USA (n=40) and the UK (n=7). Most were about US prison hospice programs (n=16) or barriers to providing palliative and end of life care in prisons (n=10). The results of the inductive analysis identified common elements of promising practices, which included the use of peer volunteers, multi-disciplinary teams, staff training, and partnerships with community hospices. Obstacles identified for infusing palliative and end-of-life care in prison included ethical dilemmas based on custody vs care, mistrust between staff and prisoners, safety concerns, concern over prisoners’ potential misuse of pain medication, and institutional, staff, and public apathy toward terminally ill prisoners and their human rights to health in the form of compassionate and palliative care, including the use of compassionate release laws.

Implications for future research that foster human rights and public awareness of the economic and moral costs of housing the sick and dying in prisons. More research is needed to document human rights violations as well as best practices and evidence-based practices in palliative and end-of-life care in prisons. Future studies should incorporate data from the terminally ill in prison, peer supports, and family members. Future studies also should employ more rigorous research designs to evaluate human rights violations, staff and public attitudes, laws and policies, and best practices. Quantitative studies that use experimental designs, longitudinal data, and multiple informants are needed. Qualitative data would allow for thick descriptions of key stakeholders experiences, especially of the facilitators and barriers for implementing policy reform efforts and palliative care in prisons.

This review provides a foundation on which to build on about what is known thus far about the human right to health, especially parole policy reform and infusing palliative and end-of-life care for the terminally ill and dying in prisons. This information can be used to develop or improve a new generation research, practice, policy, and advocacy efforts for that target terminally ill and dying in prison and their families and communities.

There are significant social implications to this review. From a human rights perspective, the right to freedom from torture and cruel and unusual punishment is a fundamental human right along with prisoners’ rights for an appropriate level of health care. These rights should be guaranteed regardless of the nature of their crime or whether they are in a prison placement. The information provided in this review can be used to educate and possible transform individual's and society's views toward the terminally ill and dying who are involved in the criminal justice system.

This paper extends the extant literature by using both quantitative and qualitative analysis methods to organize, summarize, and critically analyze the international literature on palliative care and end of life care in prison. This review is designed to increase awareness among the international community of the pain and suffering of the terminally ill in prison and the facilitators and barriers to providing them compassionate care while in custody.

Literature suggests that integrated palliative care (IPC) increases the quality of care for palliative patients at lower costs. However, knowledge on models encompassing all integration levels for successfully implementing IPC is scarce. The purpose of this paper is to describe the experiences of IPC leaders in seven European countries regarding core elements, facilitators and barriers of IPC implementation and provides recommendations for future policy and practice.

A qualitative interview study was conducted between December 2013 and May 2014. In total, 34 IPC leaders in primary and secondary palliative care or public health in Belgium, Germany, Hungary, Ireland, the Netherlands, Spain and the UK were interviewed. Transcripts were analysed using thematic data analysis.

IPC implementation efforts involved a multidisciplinary team approach and cross-sectional coordination. Informal professional relationships, basic medical education and general awareness were regarded as facilitators of IPC. Identified barriers included lack of knowledge about when to start palliative care, lack of collaboration and financial structures. Recommendations for improvement included access, patient-centeredness, coordination and cooperation, financing and ICT systems.

Although IPC is becoming more common, action has been uneven at different levels. IPC implementation largely remains provisional and informal due to the lack of standardised treatment pathways, legal frameworks and financial incentives to support multilevel integration. In order to make IPC more accessible, palliative care education as well as legal and financial support within national healthcare systems needs to be enhanced.

The purpose of this paper is to use a descriptive case study to establish how collaboration, innovation and knowledge‐management strategies have scaled‐up learning and development in rural, remote and other resource‐constrained Canadian delivery settings.

Intervention design was realized through a one‐time, collaborative, national capacity‐building project. A project portfolio of 72 sub‐projects, initiatives and strategic activities was used to improve access, enhance quality and create capacity for palliative and end‐of‐life care services. Evaluation was multifaceted, including participatory action research, variance analysis and impact analysis. This has been supplemented by post‐intervention critical reflection and integration of relevant literature.

The purposeful use of collaboration, innovation and knowledge‐management strategies have been successfully used to support a rapid scaling‐up of learning and development interventions. This has enabled enhanced and new pan‐Canadian health delivery capacity implemented at the local service delivery catchment‐level.

The intervention is bounded by a Canada‐specific socio‐cultural/political context. Design variables and antecedent conditions may not be present and/or readily replicated in other nation‐state contexts. The findings suggest opportunities for future integrative and applied health services and policy research, including collaborative inquiry that weaves together concepts from adult learning, social science and industrial engineering.

Scaling‐up for new capacity is ideally approached as a holistic, multi‐faceted process which considers the total assets within delivery systems, service catchments and communities as potentially being engaged and deployed.

The Pallium Integrated Capacity‐building Initiative offers model elements useful to others seeking theory‐informed practices to rapidly and effectively scale‐up learning and development efforts.

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.

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.

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.

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.

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.

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.

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.

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.

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 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.

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.

This paper situates a large‐scale learning and service development capacity‐building initiative for hospice palliative care services within the current Canadian policy context for use by international readers.

In 2000 a national initiative using action research as its design was crafted to support continuing professional development and knowledge management in primary‐health care environments.

The Canadian health policy context is complex and requires innovative solutions to achieve desired changes in response to emerging population health demands for quality end‐of‐life care. Employment of educational and social science constructs, including complexity theory, communities of practice, transformative learning theory, and workplace learning methods, has proven helpful in supporting the creation of national capacity for hospice palliative care.

There is a significant contribution for social scientists to make in aiding a better understanding of the complexity in health systems. At the same time, an aging population in industrial countries demands more active engagement of legal and bioethical scholars in a range of emerging policy and legislative questions about quality end‐of‐life care. Educational research is also required to understand better and reform curricula to prepare an emerging generation of health science practitioners for the demands of an aging population.

Changing health service delivery environments demand rethinking of the knowledge and skills leaders require to influence desired change. A broader understanding of where and how learning takes place is essential for enhancing the quality of patient care.

The Pallium Project represents a generative response to facilitating learning and building longer‐term system capacity. The journey of project development to date illustrates some important lessons that can be adopted from hospice palliative care to inform other primary‐health care initiatives, including, potentially, mental health, cardiology, diabetes, geriatrics, where productive change can result from productively linking specialists and primary‐care colleagues.

Characteristics that impact the levels of palliative care are introduced. Patients with the potential to be classified as palliative may be overlooked or simply so not seek medical attention. The population is much higher than those being treated on an annual basis. Data from the American Community Survey (ACS) and the Behavioral Risk Factor Surveillance System (BRFSS) are applied to the characteristics of palliative care and used to estimate the size of the palliative population in the United States (US).

The purpose of this study is to examine the corruption prevalent in the distribution of COVID-19 palliatives during the lockdown and movement restrictions in the country. This study seeks to analyse the current state of corruption in the distribution of COVID-19 palliatives and public health facilities in Nigeria while also providing a legal insight and strategic blueprint to combat corruption. To this end, this study will address the current legal framework for combating corruption and build upon this to formulate a working strategy for tackling corruption in the future.

Using a doctrinal legal research methodology, this study draws upon existing literature, tertiary data sources and information from the Nigeria Centre for Disease Control. The collected data is analysed and compared with current literature to identify key findings. Rent-seeking and utilitarian theories of the law were examined to guide this study. This study offers useful insights into combating corruption. The use of this method is justified, as it enhances the credibility of the findings on the importance of strategies for future emergencies. This legal research approach is consistent with the law and can be easily verified. The empirical aspect of this study involved a survey of multidimensional health-care and economic data set of 36 states in Nigeria plus the Federal Capital Territory on COVID-19 in Nigeria. A survey linearised regression model was estimated to determine the influence of government revenue and public health-care facilities in the control of the virus spread in Nigeria.

This study reveals the need for emphasis on the imperative of combating corruption in the distribution of COVID-19 palliatives and establishing economic resilience through transparent and accountable practices, supported by legal frameworks.

Rent-seeking and utilitarian theories of law are evaluated because of their impacts on combating corruption. The limitation of this study is the intricacy of gathering data on COVID-19 palliatives corruption in Nigeria because of secrecy and the absence of reliable data on the subject.

Estimating the exact number of stolen palliatives and their fiscal impact on Nigeria's economy proves to be a formidable task because of the covert nature of corruption. This study equips policymakers in Nigeria with a better understanding of the legal challenges posed by corruption in the health care sector and provides an effective strategy to combat it.

The lack of reliable data on the extent of palliative theft hinders the ability of lawmakers to enact effective legislation and strategies for combating corruption in the distribution of COVID-19 palliatives and addressing future emergencies in Nigeria. The policy implications of this study can assist policymakers in Nigeria and other countries in formulating measures to combat corruption in the distribution of COVID-19 palliatives and other future emergencies. Furthermore, it recommends the overhaul of anti-corruption laws and mechanisms in Nigeria to ensure effective measures against corruption.

In conclusion, this study contributes to knowledge by proposing a legal model centred on people's participation to enhance transparency and accountability in future palliative distribution processes. This study recommends legal strategies that can effectively address corruption in future emergencies or shocks. This study proposes a strategic blueprint to tackle corruption in the future. This blueprint includes an analysis of existing laws and regulations, as well as potential policy changes and legislative reform. This study also includes recommendations for improved enforcement and oversight mechanisms and for improved public awareness and education. As part of this, this study considers the potential for public–private partnerships to increase transparency and accountability in public health and health-care services.