We’ve certainly had a change in our practice of palliative care with technological developments and more recently, change has been accelerated by the pandemic.
This fascinating work by Palliverse’s very own Dr Anna Collins and teams at St Vincent’s Hospital, North Adelaide Palliative Care Service and Peter MacCallum Cancer Centre really accurately described what it’s been like for me working as a palliative care physician using telehealth. It’s been terrific for some aspects – we can quickly review the patient without having to drag them into hospital, preserving their energy and disrupting their lives less. However, I really struggle when patients are deteriorating and when they speak languages other than English as their first language.
Their research found that “palliative care patients and doctors at each site found telehealth wasn’t only acceptable (91 per cent and 86 per cent respectively) but also satisfactory (72 per cent and 65 per cent) in most situations.”
In their studies, “involving interviews and surveys of 130 palliative care patients and their doctors following a telehealth appointment, patients in rural and regional area reported telehealth as being highly satisfactory. Doctors too rated it highly satisfactory when a visual link (not just audio) was used, or if the appointment was for a routine review.
“However, patients were less satisfied when care goals or future planning were discussed, and doctors reported it as being less satisfactory when the patient’s condition was changing or rapidly worsening, or if patients spoke a language other than English.
“And both patients and doctors found telehealth unsatisfactory in the presence of changing or unstable symptoms, such as pain which required medication adjustment or change.
Safer Care Victoria and the Palliative Care Clinical Network hosted a webinar ‘Clinical Conversation Webinar: Adapting to a Brave New World – the role of Virtual/Telehealth in Palliative Care’
My colleague Kaye Basire wanted everyone to know about this event which will precede the Hospice New Zealand conference 2022. The draft agenda can be downloaded below:
Aotearoa Palliative Care Research Day – Hybrid Event
We all recognise the importance of research in enhancing patient care. However, clinician led research in Aotearoa is often restrained by lack of support and resources. This is particularly acute in palliative care where there is often a sense of isolation due to the lack of national palliative care research strategy and network.
The Aotearoa Palliative Care Research Day is an opportunity for all current and budding palliative care researchers, to network and share ideas on advancing palliative care research in clinical settings. Prior research experience is not required.
Content of the day includes sharing of experience by practitioners who have incorporated research in their clinical work, translation of research findings into practice/policy and collaboration with academics.
Applications are now open for The Dame Quentin Bryce Palliative Care Nursing Research Fund – a new funding opportunity created to support research into palliative care nursing. The funds are offered by the Centre for Palliative Care (c/o St Vincent’s Hospital) and the Department of Nursing, The University of Melbourne.
Existing scholarship holders are eligible to apply (though please check the terms and conditions of your scholarship before applying).
There is something about the human spirit, some amazing inner strength that people have that allows them to hold on for special occasions. Two major milestones for people are Christmas Day and New Year’s Day. Out of the past ten years I have worked 8/10 of the New Year’s holidays. What usually happened was that no matter what spiritual belief people had they would likely hold on for Christmas Day, and possibly for New Year’s Day and then we would see a large number of people dying once they had achieved their milestone(s.)
Sometimes it can be living through their wedding anniversary, or beyond a loved one’s birthday. People often will try not to die on a significant other’s birthday, so that the birthday will not be spoiled from thence on.
How does a comatose person even know the date let alone know what the time is? Somewhere deep inside ticks a very accurate body clock? People may be holding on for special occasions such as the wedding of their child, or grandchild. Or it might be the birth of the newest family member.
In Aotearoa New Zealand a lot depends on the national religion. People will hold on for the Rugby World Cup – the Rubgy League World Cup, not so much.
How can a person sense their environment when they physiologically have been made insensate?
The stream of information about cancer treatments and cures can be overwhelming. Articles in the media such as the Guardian describe new miracle cures. It’s hard to know what to believe. This article is a good example of how media interpretations of scientific papers can be misleading for patients and families.
HammondCare is looking for a post-doctoral researcher, who has a passion for research which can improve palliative and supportive care. Working within the Centre for Learning & Research in Palliative Care, the Research Fellow provides high level support for the research effort in palliative & supportive care across the organisation.
This role offers a post-doctoral researcher an excellent opportunity to develop their research skills, experience and track record within the themes of palliative and supportive care.
Position based at Pallister House, Greenwich Hospital.
Part time (0.6 FTE), flexible working arrangements. Three years fixed term position.
Provide high level support for research in palliative and supportive care
TITLE: Development of a core outcome set for effectiveness trials of interventions to prevent and/or treat delirium in palliative care (Del-COrS)
We are currently looking for volunteers including: patients, family members, carers, healthcare professionals and researchers with experience of delirium in palliative care.
Participants would complete two online surveys to establish their views on the outcomes that are important to include in future studies of interventions to prevent or to treat delirium in palliative care. We will subsequently invite participants to a meeting to discuss the findings and vote on outcomes they consider important.
Our goal is to develop international consensus on a core outcome set for research studies of treatments within a palliative care setting to prevent, and/or treat delirium.
Researchers look at the effects of potential treatments on patients by measuring an ‘outcome’. For example, in a study of how well a new delirium treatment works in a palliative care setting, an ‘outcome’ might be: whether a person hurt themselves because of delirium.
When a set of main outcomes has been agreed for a health condition, it’s called a ‘core outcome set’. This would allow all studies of delirium in palliative care to be compared and combined.
Please contact Dr Anna Bryans (Research Team Member) at firstname.lastname@example.org if you are interested in participating and pass on this information to anyone who may wish to take part.
Would you like to learn more about immunotherapy use and trials in cancer and in palliative care?
Immunotherapy Symptoms Clinical Trials: a new paradigm forum
Palliative, supportive and cancer care professionals are invited to attend the VCCC and CST co-hosted Immunotherapy Symptoms Clinical Trials: a new paradigm forum to progress clinical trials concepts in this evolving oncology field, recognise achievements, celebrate success and make connections for future directions.
Palliative care progress and achievements
The VCCC Building Trial Group Capability Program initial investment is focused on developing the palliative care group as a key priority area. The group’s development and activities have been underway for more than 12 months; it is timely to celebrate progress and achievements.
Delirium robs dying people of their autonomy, dignity and last conversations with loved ones, at a time when every moment is precious.
Symptoms are highly distressing to experience and watch. Confusion, incoherent communication, poor attention, agitation, drowsiness and hallucinations are some markers of this common complication for people dying in hospital from cancer and other advanced illnesses. On average one in three people in end-of-life hospital care are affected.
Doctors commonly prescribe antipsychotic medications to try to relieve these symptoms. However, our study just published in JAMA Internal Medicine, raises serious concerns about their safety and efficacy.
So, what are we to do for people experiencing delirium, who are robbed of their mental awareness and ability to communicate?
Kasia’s research aims to improve sustainable acute care health delivery for an ageing population, while her clinical experience includes general medical and acute palliative care. In her PhD, Kasia developed an approach to measure nurse-sensitive outcomes, which is currently being used to evaluate a Government-funded implementation of a cognitive identifier. Kasia has a passion for identifying and researching the structures and processes which impede or enable quality patient care, and sharing her learning and inquiry with nursing students, industry and professional groups. Here, Palliverse asks her about her latest research project and dipping her toe into the world of social media.