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Welcome to the official free Podcast site from SAGE Publications for Palliative Medicine & Chronic Care.
SAGE is a leading international publisher of journals, books, and electronic media for academic, educational, and professional markets with principal offices in Los Angeles, London, New Delhi, and Singapore.
SAGE is a leading international publisher of journals, books, and electronic media for academic, educational, and professional markets with principal offices in Los Angeles, London, New Delhi, and Singapore.
124 Episodes
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This episode features Dr Fiona Kenney and Koby Anderson, (Ottawa Hospital Research Institute, Ottawa, ON, Canada Bruyère Research Institute, Ottawa, ON, Canada) What is already known about the topic? Previous research demonstrates a high prevalence of severe grief symptoms up to a year post-death of a loved one among those who experienced bereavement during the COVID-19 pandemic. No previous study has assessed changes in the severity of grief more than a year after the death of a loved one during the COVID-19 pandemic. What this paper adds? This prospective cohort follow-up study found the prevalence of severe grief reaction remained high (28.8%) at 12–18 months post- family member death. One-third (33.3%) of family members experienced persistently high or worsening grief symptoms at the time of their 12–18-month assessment compared to baseline 6–12-month assessment. Grief severity was associated with endotracheal intubation in the deceased, but not with the cause of death (e.g., COVID vs non-COVID illness) or physical presence/absence of the family member at the bedside in the final 48 h of life. Implications for practice, theory, or policy There is a persistent, elevated risk of severe grief among family members who experience bereavement during the pandemic period, even up to 18 months post-death of the decedent. There is an urgent need for effective and scalable means of addressing severe grief in the wake of the COVID-19 pandemic. Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163231223394 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Sue-Ling Chang, (CHU de Québec-Université Laval Research Center, Oncology Division, Québec City, QC, Canada) What is already known about the topic? There is a growing interest in psilocybin-assisted therapy worldwide, particularly to treat existential distress at the end of life. What this paper adds? In this study, we show that the social acceptability of psilocybin-assisted therapy to treat existential distress at the end of life is high in Canada and identify factors associated with favourable attitudes of the population towards it. Implications for practice, theory, or policy Our findings may help mobilise resources to address barriers and challenges for implementing psilocybin-assisted therapy within palliative medicine and society. This could also have implications for policies regarding medical assistance in dying. Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163231222430 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Dr Carlos Seiça Cardoso (Faculty of Medicine, University of Coimbra, Coimbra, Portugal CINTESIS@RISE, MEDCIDS, Faculty of Medicine of the University of Porto, Porto, Portugal) What is already known about the topic? The burden of chronic, progressive, incurable and life-threatening illness is increasing, highlighting the need to integrate palliative care into patients’ care plans. Data indicate that involving General Practitioners in the provision of palliative care may improve outcomes for patients and families, but the evidence on the effectiveness of interventions for patients with palliative care needs in primary care is still scarce. What this paper adds? We developed a training programme, from logistics to content, to be feasible for General Practitioners and to address the main topics in which they identified training needs. A two-tiered intervention was implemented, involving training and a new consultation model; this was shown to be feasible and effective in reducing the physical and emotional symptoms of patients with palliative needs managed in primary care. To the best of our knowledge, this is the first intervention involving General Practitioners, that assesses the impact on patients’ self-reported symptoms and demonstrates positive effects. Implications for practice, theory, or policy General Practitioners may test whether the intervention is applicable in their own setting, as there is potential for transferability to similar primary care settings elsewhere in the world. We successfully implemented and evaluated an intervention with a statistically and clinically important impact on patients, showing that research in primary palliative care can and must expand, as it may be key in the initial care of patients with palliative needs. Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163231219682 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Ellis Slotman (Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands) What is already known about the topic? Potentially inappropriate end-of-life care in patients with cancer is still common. The COVID-19 pandemic has been shown to affect cancer diagnosis and treatment, but evidence on how the pandemic has affected end-of-life care is limited. What this paper adds? The COVID-19 pandemic was associated with less potentially inappropriate care at the end of life in patients with cancer. The decline in potentially inappropriate end-of-life care was driven by fewer hospitalizations and intensive care unit admissions in the last month of life and fewer hospital deaths. Implications for practice, theory, or policy The findings of this study raise important questions as to which pandemic related changes in end-of-life care delivery and decision making might be able to contribute to appropriate end-of-life care for future patients. Ensuring that awareness for triaging and advance care planning is maintained after the pandemic may be of great importance in this regard. Full paper available from: https://journals.sagepub.com/doi/10.1177/02692163231217373 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Dr Vanessa Abrahamson, (Centre for Health Services Studies, University of Kent, Kent, UK). What is already known about the topic? Increasingly, people at end-of-life want to die at home but this relies heavily on family carers to support the patient. Many carers struggle with the practical and emotional burden of caring for a loved one at home. Services providing hospice care at home are highly rated by carers but access is limited and the model of care varies greatly between services, with little data on how this affects patient/carer experiences. What this paper adds? Hospice-at-home services need to set clear expectations from the start so that families know exactly what the service can, or cannot, provide; this helps establish confidence in the service and build a strong relationship with the carer. Carers valued the expertise of hospice staff (in death and dying) and that they had time to care in a flexible and compassionate manner, which other services lacked. Carers felt ‘doubly’ bereaved when the person they cared for died and the hospice team immediately withdrew; existing bereavement services did not suit many carers, particularly younger families. Implications for practice, theory, or policy Carers appreciated early contact with services but placing the onus on carers to trigger increased help when needed was not found supportive. There should be regular review of needs for the carer as well as for the patient and services available to address both their needs; services could consider options to increase volunteer contributions to hospice-at-home services. Hospice services could consider how to provide bereavement support that meets carer preferences. Full paper available from: https://journals.sagepub.com/doi/10.1177/02692163231206027 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Dr Nivedita Ashok, (University College London, London, UK). What is already known about the topic? Individuals with intellectual disability or serious mental illness have high rates of mortality due to physical comorbidities. These populations have specific needs that should be met to provide optimum palliative care and maintain optimum mental healthcare at the end-of-life. While research exists describing the problems these populations face, little is known about how to improve care for them. What this paper adds? By focusing on lived experiences of patients/service users, carers and healthcare professionals this paper synthesises existing evidence into multivoiced perspectives on what works, does not work, plus challenges and opportunities for improvement. Assumptions and misunderstandings about the role of mental capacity assessment to appropriately involve the patient in decision-making are common, while adapting training for palliative care staff to address concerns and beliefs about mental illness helps to avoid diagnostic overshadowing. Professionals need help to work across divides between physical and mental healthcare services, so people can receive palliative care in familiar locations and/or from familiar people. Implications for practice, theory, or policy A significant research deficit exists regarding provision of optimal palliative care to people with psychosis, personality disorders, bipolar affective disorder and depression. Assessing capacity may be optimally achieved by involving professionals across specialities and organisations. Proactive identification of service arrangements for care needs of persons with serious mental illness will help optimise care. Full paper available from: https://journals.sagepub.com/doi/10.1177/02692163231175928 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Caitlin Spooner (Marie Curie Palliative Care Research Department, University College London, London, UK). What is already known about the topic? - Currently, there is no gold standard for evaluating how different methods of prognosticating in advanced cancer impact on patient care. - Prognostic models are principally evaluated by their statistical performance, determining their discrimination and calibration. However, before any prognostic model can be recommended for use in clinical practice, it is necessary to demonstrate whether or not it has a beneficial impact on patient care. - There is a lack of consensus among stakeholders about how to assess the impact of prognostication in advanced cancer, with prognostic studies varying in the outcomes they select. What this paper adds? - We identified a wide variety of outcomes and measures used in published studies, which makes inter-study comparability problematic. - Our findings highlight the widespread effect that prognostication in advanced cancer has on patients and informal caregivers. - The lived experiences of patients and informal caregivers regarding prognostication in advanced cancer are not always represented in the outcomes quantitative prognostic studies measure. Implications for practice, theory, or policy - Further research is needed to identify and prioritise outcomes to measure the impact of prognostication in advanced cancer. - Patients’ and informal caregivers’ experiences and perspectives should always be incorporated when evaluating the impact of prognostication. - Outcome selection in prognostication studies needs to be more consistent and standardised. Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163231191148 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Dr Amara Nwosu (Lancaster Medical School, Lancaster University, Lancaster, UK; Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK; and Marie Curie Hospice Liverpool, Liverpool, UK). The podcast is an overview of a published editorial on telehealth in palliative care. Dr Nwosu highlights the unrealised potential of palliative care telehealth, and discusses the opportunities and challenges associated with telehealth. Finally, Dr Nwosu describes the next steps needed for research evaluating palliative care telehealth. Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163231182461 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
Title "Hospital-service use in the last year of life by patients aged ⩾60 years who died of heart failure or cardiomyopathy: A retrospective linked data study" Description This episode features Dr Gursharan K Singh (Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia). What is already known about the topic? - Evidence based guidelines recommend palliative care for individuals with advanced heart failure, yet there is limited data on acute hospital and palliative care service use prior to death, to inform care planning and end-of-life services. What this paper adds? - Patients were generally aged ⩾80 years old and experienced repeat acute hospitalisations in the year preceding death. - Over half died in hospital, without a hospitalisation for palliative care recorded. - For those who had a hospitalisation for palliative care recorded, this mostly occurred in the last 7 days of life. Implications for practice, theory, or policy - Improving access to palliative care services in the outpatient or community setting is needed to reduce avoidable hospitalisation - Improving access to timely palliative care, including end-of-life care, for patients with heart failure is needed. Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163231180912 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Hannah May Scott (Florence Nightingale Faculty of Nursing Midwifery and Palliative Care, Cicely Saunders Institute, King’s College London, London, UK). What is already known about the topic? - Although spiritual concerns are recognised as a core component of palliative care for children, there is a paucity of primary data. - Self-report data from children is rare, and existing evidence is largely proxy data from parents or health and social care professionals and mainly focused on the religious aspect of spiritual care for cancer patients. What this paper adds? - Specific spiritual concerns among children with a range of life-limiting and life-threatening conditions and their families (parents and siblings) included: living life to the fullest, meaning of life and leaving a legacy, uncertainty about the future, determination to survive, accepting or fighting the future and role of religion. - This work broadens understanding of the spiritual domain for these children beyond religious needs to existential and value-based spiritual concerns. - Recognition of the way in which children conceptualise spirituality and being able to identify their spiritual concerns is essential for child- and family-centred holistic palliative and end-of-life care. Implications for practice, theory, or policy - Professionals can optimise children and family’s wellbeing through identification of the things that provide meaning for them, and working together to set goals and actions towards achieving them. - Such concerns must be assessed beyond religious considerations. - Simple tools and training to support professional may be useful in implementing this. Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163231165101 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Dr Jenny Lau (Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada; Division of Palliative Care, University Health Network, Toronto, ON, Canada) and Dr. Daniel Buchman (Everyday Ethics Lab, Centre for Addiction and Mental Health, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; University of Toronto Joint Centre for Bioethics, Toronto, ON, Canada) What is already known about the topic? • Communicable disease epidemics and pandemics, such as the COVID-19 pandemic, intensify the healthcare inequities encountered by people who use drugs. • Pandemics are expected to increase the demand for palliative care resources. • People who use drugs with life-limiting illnesses experience inequities in access to palliative care. • There is limited evidence beyond the HIV/AIDS context to guide decision-makers on the provision of palliative care for people who use drugs during communicable disease epidemics and pandemics. What this paper adds? • This paper demonstrates that there is limited knowledge about how to provide palliative care for people who use drugs during epidemics and pandemics other than HIV/AIDS. • We identified enablers and barriers to equitable palliative care access, which include organizational barriers, issues related to stigma and structural inequity, and access to opioids and other substances • Our findings build on past research that seeks to integrate the premises of health equity within palliative care so health systems can be better prepared for future epidemics and pandemics. Implications for practice, theory, or policy • The findings from our scoping review provides accessible and relevant evidence for healthcare professionals and decision-makers (e.g. policy makers, administrators) that can be applied to the COVID-19 pandemic response efforts and potentially future epidemics and pandemics. • More research is needed about palliative care access, policies, and programs for people who use drugs during communicable disease epidemics and pandemic beyond the HIV/AIDS context. Full paper available from: https://journals.sagepub.com/doi/10.1177/02692163221143153 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Dr Rachael Moss (Bradford Institute for Health Research, Bradford Teaching Hospitals Foundation Trust, Bradford, UK). What is already known about the topic: - The degree to which individuals access and use palliative and end-of-life care services varies across communities and countries. What this paper adds: - This study found that the South Asian community (in Bradford, UK) are currently not ready to engage with palliative and end-of-life care services despite local initiatives to improve awareness. They are at the “pre-planning stage” (see Table 1) about end-of-life care options and of the services that are available to them. - This study also found evidence that the services that aim to support people from minoritised ethnic communities at the end-of-life are not ready to address ethnic inequities. - Such services were found to have: (i) a narrow focus during advance care planning, (ii) poor integration of voluntary and community services (iii) and limited understanding of what a good death looks like for people from different cultural and religious backgrounds. Implications for practice, theory or policy: - This study highlights the importance of assessing the degree to which both the community and the health and social care systems are ready to incorporate new initiatives so they are effective and successful in addressing (and not strengthening) existing inequities. Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163221146587 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Isabel Vandenbogaerde (End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Ghent, Belgium). What is already known about the topic: Involvement of family carers in advance care planning conversations is crucial for end-of-life decision-making. Family carers are willing to engage in advance care planning conversations, but experience barriers in doing so. Healthcare professionals may play an important role in supporting family carers in these advance care planning conversations. What this paper adds: About half of the family carers have an advance care planning conversation with their relative in the final 3 months of life. Family carers were more likely to engage in advance care planning in case they were 55 of age or younger, had a medical degree (e.g. nurse or doctor), and when specialist palliative care services were involved The majority of family carers received advance care planning conversation support from a healthcare professional by performing the advance care planning conversation together. Implications for practice, theory or policy: Healthcare professionals can play an important role in introducing tools, website or information campaigns of advance care planning. Healthcare professionals may consider strategies to support and empower family carers to conduct advance care planning conversations outside the clinical context. Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163221135032 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Dr Joyce Chung and Weilin Chen (School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China). What is already known about the topic: End-of-life communication can improve patients’ quality of life, ease the bereavement experience, raise care satisfaction and reduce the utilisation of aggressive and expensive medical care. Healthcare professionals’ perceived barriers, such as fear of causing distress, impede the delivery of end-of-life conversations in a professional, sensitive and appropriate manner. The communication strategies available to healthcare professionals for discussing end-of-life issues with terminally ill patients and their families have not yet been systematically summarised. What this paper adds: This review systematically examines, summarises and presents recommended end-of-life communication strategies for healthcare professionals. It organises these communication strategies into seven themes that should be considered when delivering end-of-life conversations. This review highlights that further research is needed to explore patients’ and families’ perspectives on healthcare professionals’ end-of-life communication strategies; and available strategies in non-Anglo-Saxon countries. Implications for practice, theory or policy: The valuable strategies outlined in this review will assist and support healthcare professionals when having end-of-life conversations with their patients. Further training and education plans should be developed and implemented based on the study findings. Further research is needed to explore patients’ and their families’ experiences and views on end-of-life communication strategies used by healthcare professionals; and practical strategies to use in non-Anglo-Saxon countries. Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163221133670 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Suzanne Smith (Master of Palliative Care student, Flinders University, Australia; Victorian Paediatric Rehabilitation Service, Australia), Dr Megan Doherty (University of Ottawa, ON, Canada; Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada) and Dr Mostofa Kamal Chowdhury (BangabandhuSheikh Mujib Medical University, Dhaka, Bangladesh). What is already known about the topic: The majority of children who need, but cannot access essential palliative care and pain relief, live in low-and middle-income countries. An estimated 10 million Bangladeshi children live with a disability and associated serious health-related suffering that may lead to premature death. Children from low- and middle-income countries are underrepresented or absent from existing palliative care reviews. What this paper adds: This review illuminates the extreme health-related suffering experienced by children with disability and their families in Bangladesh in the physical, social, and emotional/spiritual domains. Financial hardship, stigma, limited knowledge and compromised children’s rights impede access to healthcare in Bangladesh. Children with disability living in an urban marginalised society and Rohingya children with disability living in refugee camps in Bangladesh may receive care commensurate with the International Association for Hospice and Palliative Care revised definition of palliative care Implications for practice, theory or policy: This review identifies innovative and novel models of effective service delivery, outside of mainstream healthcare settings, which combine both palliative care and rehabilitation principles. Further strengthening Child Rights in Bangladesh will reduce serious health-related suffering. Collaborations between Bangladeshi and International researchers are productive and should continue to inform future service development. Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163221136896 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Dr Richard Green (University of Surrey, Guildford, UK). Multimorbidity is increasing substantially worldwide, is associated with greater use of healthcare services, lower quality and quantity of life, and rises with age. Older people with multimorbidity are expected to become the main recipients of palliative care in the coming decades; however, there is limited evidence of their specific needs. Older people’s voices are vital to understanding their own palliative care needs and priorities, but these voices are hampered by structural inequities in service provision. This is the first paper reporting on the expressed palliative care needs of community-dwelling older people with multimorbidity. The most common palliative care needs identified across need domains were pain, function, unhappiness, staying socially connected, future planning, person-centred care and having meaning and purpose in life. This paper highlights different priorities between the reported items in tools used to collect palliative care need and needs expressed by older people with multimorbidity. Further evidence is required to understand need to support service changes required to provide accessible, person-centred care to this underserved population. Multidimensional palliative care tools require refining to encompass complexity beyond the standard domains of palliative care. Community palliative care provision should involve the integration of care across sectors and recognise the diversity of needs across the continuum of living and dying well for older people with multimorbidity Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163221118230 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Dr Andrew Page (Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK). Cancer pain is common, extremely debilitating, and undertreated worldwide. We do not know if non-steroidal anti-inflammatory drugs (aka NSAIDs or “anti-inflammatories”) are effective in managing cancer pain of any type. To further scientific understanding, UK palliative care doctors advocate a pragmatic trial to determine the role, if any, of NSAIDs as opioid adjuncts for treating cancer-induced bone pain. Numbers treated for cancer-induced bone pain at a single regional radiotherapy centre (478 per year) support the feasibility of trial recruitment. Considering eGFR and contraindicating co-morbidities, two-thirds could be suitable for NSAID prescription if proven efficacious. Suitability for NSAID prescription reduces with age, with the proportion unsuitable increasing in those over 65 years old. Recruitment to a future trial of NSAIDs in the management of cancer-induced bone pain appears feasible, particularly if multiple recruitment centres are used. Demonstrating feasibility allows the planning of a definitive clinical trial to determine the efficacy of NSAIDs in this patient group. Without a definitive clinical trial, the question remains: are effective analgesics being underutilised in cancer pain management, or are ineffective medications increasing the risk of side effects in an already co-morbid cancer population? Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163221122263 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Dr James Downar (University of Ottawa, Canada). Early studies in the COVID-19 pandemic have suggested a high prevalence of severe grief symptoms, although most have used convenience or survey sampling methods which may bias the results, and most have assessed symptoms before pathological grief can be diagnosed (<6 months). Little is known about how the burden of severe grief during the pandemic compares with pre-pandemic times, and whether the cause of death during the pandemic affects the grief experience. This prospective, matched cohort study shows that almost 30% of bereaved family members experience severe grief during the pandemic. This prevalence is higher than reported pre-pandemic rates (2%–3%), and that the prevalence was not affected by the cause or the circumstances around the death. There is an elevated risk of severe grief among family members of people who experience bereavement during the pandemic period, even if their family member died before the pandemic itself. The severity of grief may not be affected by factors that normally mitigate severity of grief, such as being present at the time of death. There is an urgent need for resources to identify and support people who lose loved ones during the COVID-19 pandemic. Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163221109711 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features Dr Sofia Morberg Jämterud (Linköping University, Linköping, Sweden) and Anna Sandgren (Linnaeus University, Växjö, Sweden). Serious illness conversations promote patients’ possibility of receiving care that is in accordance with their wishes and priorities. Identifying patients for serious illness conversations remains difficult even when palliative care needs are identified. Identification of patients for serious illness conversations is a process influenced by a multitude of factors, such as the patients’ palliative care needs, continuity in patient–professional relations and continuity of staff. Highlights the hesitation of non-palliative care professionals in identifying the patients for serious illness conversations due to existential and ethical concerns, such as fear of taking away hope. Identifying patients for serious illness conversations is a complex process involving several factors and is not limited to using generic tools, such as the surprise question. Identifying the right patient at the right time involves existential and ethical concerns which may impact healthcare professionals’ willingness to identify patients and offer serious illness conversations. Further research is needed on how health care professionals’ values and attitudes influence the identification process. Full paper available from: https://journals.sagepub.com/doi/full/10.1177/02692163221102266 If you would like to record a podcast about your published (or accepted) Palliative Medicine paper, please contact Dr Amara Nwosu: a.nwosu@lancaster.ac.uk
This episode features George Muishout (Department of History, European Studies and Religious Studies, Amsterdam School for Historical Studies, University of Amsterdam, Amsterdam, The Netherlands). To Muslims it is important that medical decisions are in accordance with Islamic values. In life-threatening illness, Muslims ask imams for religious advice on medical decision-making. So far, it is unknown how imams view and perform this task in palliative care. Imams advise the faithful not to consent to withholding or terminating treatment based on diagnostics because they feel this does not align with belief in God’s omnipotence and will. Imams are reluctant to advise patients to consent to termination of treatment for fear that all Muslims involved will be held accountable for someone’s death by God in the afterlife. Fatwas by Muslim expert committees play an important role in shaping medical decision-making in palliative care. Palliative care tailored to the cultural religious needs of Muslim minorities must be developed. Implementing adequate palliative care for Muslim minorities requires sustainable collaboration with imams and their congregations.
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