Marie Curie Research Conference Abstracts 2017

Selected abstracts from the conference:

  • 14 Managing uncertainty in care for people with dementia at the end of life: the use of heuristics

Do Not Attempt Resuscitation Orders(DNAR) and their contemporary counterparts are cornerstones of End of Life care and as such, of importance within medical education. Previous research indicates the need for a better understanding of patient and physicians perceptions of DNAR topics.

Davies, N. et al. (2017) 14 Managing uncertainty in care for people with dementia at the end of life: the use of heuristics. BMJ Supportive & Palliative Care. Vol. 07 (Issue 03) p. A352.

  • 21 Exploring the effectiveness of a mindfulness-based intervention for staff in a palliative care setting

Palliative care staff engage in emotional and stressful work; however, research is yet to offer any insights as to what types of psychosocial intervention can effectively improve staff psychological well-being (Hill, Dempster, Donnelly, & McCorry, 2016). This research aims to evaluate the effectiveness of a Mindfulness-Based Intervention (MBI), which was condensed to make it more feasible for staff to attend, to improve the psychological well-being of palliative care staff.

Hill, R.C. et al. (2017) 21 Exploring the effectiveness of a mindfulness-based intervention for staff in a palliative care setting. BMJ Supportive & Palliative Care. Vol. 07 (Issue 03) pp. A354-A355.

  • 28 Do not attempt resuscitation: university of aberdeen student perspectives

Do Not Attempt Resuscitation Orders(DNAR) and their contemporary counterparts are cornerstones of End of Life care and as such, of importance within medical education. Previous research indicates the need for a better understanding of patient and physicians perceptions of DNAR topics.

Koshias, A. et al. (2017) 28 Do not attempt resuscitation: university of aberdeen student perspectives. BMJ Supportive & Palliative Care. Vol. 07 (Issue 03) pp. A357-A358

 

 

 

 

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Preparing future doctors for palliative care

Walker, S. et al. BMJ Supportive & Palliative Care | Published Online: 21 April 2017

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Background: Effective training at medical school is essential to prepare new doctors to safely manage patients with palliative care (PC) and end of life care (EOLC) needs. The contribution of undergraduate PC course organisers is central but their collective views regarding role are unknown.

Objective: To survey attitudes of PC course organisers regarding their course, organisation, the adequacy of training provided and level of personal satisfaction.

Conclusions: Approximately two-thirds of organisers were generally positive about their PC course, institution and role. A minority expressed concerns; these may reflect suboptimal PC training at their medical school and poor preparation of new doctors.

Read the full article here

East Midlands Evaluation Tool for measuring impacts on trainees’ confidence and competence following end of life care training

Whittaker B. et al. BMJ Supportive & Palliative Care. Published Online: 2 February 2017.

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Objectives: To develop, test and validate a versatile questionnaire, the East Midlands Evaluation Tool (EMET), for measuring effects of end of life care training events on trainees’ self-reported confidence and competence.

Conclusions: The EMET provides a time-efficient, reliable and flexible means of evaluating effects of training on self-reported confidence and competence in the key elements of end of life care.

Read the full article here

Distance learning for updating health professionals in palliative care

Taroco Jr., A.L.C et al. BMJ Supportive & Palliative Care. Published Online: 6 January 2017

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Objectives: To review literature regarding online educational initiatives in palliative care which are targeted to update health professionals and prepare distance courses suitable for a Brazilian context.

Conclusions Although the literature is abundant in this area, there is limited research exploring the construction process of courses and how they can be applied to countries with limited resources. It is important to highlight, however, that the mixed teaching strategy, which allows for theoretical and practical activities at a low cost, is imperative for countries with limited resources in healthcare. Thus, this review can support new initiatives around the world, particularly in the low-income and middle-income countries.

Read the full abstract here

Increasing the number of patients receiving information about transition to end-of-life care

Martinsson, L. et al. (2016) BMJ Supportive & Palliative Care. 6(4) pp. 452-458

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Image source: Rowena Dugdale – Wellcome Images // CC BY-NC-ND 4.0

Introduction: Honest prognostication and information for patients are important parts of end-of-life care. This study examined whether an educational intervention could increase the proportion of patients who received information about the transition to end-of-life (ITEOL care).

Method: Two municipalities (in charge of nursing homes) and two hospitals were randomised to receive an interactive half-day course about ITEOL for physicians and nurses. The proportion of patients who received ITEOL was measured with data from the Swedish Register of Palliative Care (SRPC). Patients were only included if they died an expected death and maintained their ability to express their will until days or hours before their death. Four hospitals and four municipalities were assigned controls, matched by hospital size, population and proportion of patients receiving ITEOL at baseline.

Results:The proportion of patients in the intervention group who received ITEOL increased from 35.1% (during a 6-month period before the intervention) to 42% (during a 6-month period after the intervention). The proportion in the control group increased from 30.4% to 33.7%. The effect of the intervention was significant (p=0.005) in a multivariable model adjusted for time, age, gender and cause of death.

Conclusion: More patients at end-of-life received ITEOL after an educative half-day intervention directed to physicians and nurses.

Read the full article here

Palliative care education for medical students: Differences in course evolution, organisation, evaluation and funding

Walker, S. et al. Palliative Medicine. Published online: October 6, 2016

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Background: A proportion of newly qualified doctors report feeling unprepared to manage patients with palliative care and end-of-life needs. This may be related to barriers within their institution during undergraduate training. Information is limited regarding the current organisation of palliative care teaching across UK medical schools.

Aims: To investigate the evolution and structure of palliative care teaching at UK medical schools.

Design: Anonymised, web-based questionnaire.

Settings/participants: Results were obtained from palliative care course organisers at all 30 UK medical schools.

Results: The palliative care course was established through active planning (13/30, 43%), ad hoc development (10, 33%) or combination of approaches (7, 23%). The place of palliative care teaching within the curriculum varied. A student-selected palliative care component was offered by 29/30 (97%). All medical schools sought student feedback. The course was reviewed in 26/30 (87%) but not in 4. Similarly, a course organiser was responsible for the palliative care programme in 26/30 but not in 4. A total of 22 respondents spent a mean of 3.9 h (median 2.5)/week in supporting/delivering palliative care education (<1–16 h). In all, 17/29 (59%) had attended a teaching course or shared duties with a colleague who had done so. Course organisers received titular recognition in 18/27 (67%; no title 9 (33%); unknown 3 (11%)). An academic department of Palliative Medicine existed in 12/30 (40%) medical schools. Funding was not universally transparent. Palliative care teaching was associated with some form of funding in 20/30 (66%).

Conclusion: Development, organisation, course evaluation and funding for palliative care teaching at UK medical schools are variable. This may have implications for delivery of effective palliative care education for medical students.

Read the abstract here

Tailored end-of-life care

In this case study from Leeds Teaching Hospitals NHS Trust,  find out how tailored training has helped staff to gain skills and confidence in:

  • symptom management for patients
  • facilitating end-of-life care at home
  • recognising end of life
  • knowledge of community services

Read previous end-of-life care case studies showing the different approaches that trusts use to deliver training.