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Feeney R, Willmott L, Wilson J, White B. Legal issues in end-of-life care for speech-language pathologists and social workers: A scoping review. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 26:244-256. [PMID: 37490012 DOI: 10.1080/17549507.2023.2205061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
PURPOSE End-of-life law governs end-of-life decision-making in clinical practice. There has been little analysis of the specific legal issues relevant to allied health professionals working in end-of-life care. METHOD A scoping review was undertaken to identify and examine the extent, range, and nature of literature on the legal issues relevant to end-of-life practice for Australian speech-language pathologists and social workers, including current gaps. Literature was identified by searching six electronic databases, Google Scholar, the websites of relevant professional organisations and State/Territory health departments, scanning reference lists, and drawing on existing knowledge. Data charting and thematic analysis of findings was performed. RESULT Twenty documents were included, spanning various document types. Most focused on adult clinical practice. Documents demonstrated that the two professions encounter similar legal issues. CONCLUSION Key gaps exist in the literature. Findings will inform these professionals of the legal issues relevant to their clinical practice and inform the development of further resources.
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Affiliation(s)
- Rachel Feeney
- Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Australia
| | - Lindy Willmott
- Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Australia
| | - Jill Wilson
- School of Nursing, Midwifery and Social Work, The University of Queensland, Saint Lucia, Australia
| | - Ben White
- Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Australia
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Oftedal S, McCormack S, Stevenson R, Benfer K, Boyd RN, Bell K. The evolution of nutrition management in children with severe neurological impairment with a focus on cerebral palsy. J Hum Nutr Diet 2024. [PMID: 38196166 DOI: 10.1111/jhn.13277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/15/2023] [Indexed: 01/11/2024]
Abstract
Nutritional management of children with severe neurological impairment (SNI) is highly complex, and the profile of this population is changing. The aim of this narrative review was to give the reader a broad description of evolution of the nutritional management of children with SNI in a high resource setting. In the last decade, there has been an emphasis on using multiple anthropometric measures to monitor nutritional status in children with SNI, and several attempts at standardising the approach have been made. Tools such as the Feeding and Nutrition Screening Tool, the Subjective Global Nutrition Assessment, the Eating and Drinking Ability Classification System and the Focus on Early Eating and Drinking Swallowing (FEEDS) toolkit have become available. There has been an increased understanding of how the gut microbiome influences gastrointestinal symptoms common in children with SNI, and the use of fibre in the management of these has received attention. A new diagnosis, 'gastrointestinal dystonia', has been defined. The increased use and acceptance of blended food tube feeds has been a major development in the nutritional management of children with SNI, with reported benefits in managing gastrointestinal symptoms. New interventions to support eating and drinking skill development in children with SNI show promise. In conclusion, as the life expectancy of people with SNI increases due to advances in medical and nutrition care, our approach necessitates a view to long-term health and quality of life. This involves balancing adequate nutrition to support growth, development and well-being while avoiding overnutrition and its associated detrimental long-term effects.
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Affiliation(s)
- Stina Oftedal
- Queensland Cerebral Palsy Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, Brisbane, Queensland, Australia
| | - Siobhan McCormack
- Department of Child Development and Neurodisability, Children's Health Ireland at Tallaght, Dublin, Ireland
- Department of Paediatrics, School of Medicine, University of Galway, Galway, Ireland
| | - Richard Stevenson
- Division of Neurodevelopmental and Behavioral Pediatrics, Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, Virginia, USA
| | - Katherine Benfer
- Queensland Cerebral Palsy Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, Brisbane, Queensland, Australia
| | - Roslyn N Boyd
- Queensland Cerebral Palsy Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, Brisbane, Queensland, Australia
| | - Kristie Bell
- Queensland Cerebral Palsy Rehabilitation Research Centre, Faculty of Medicine, The University of Queensland Child Health Research Centre, Brisbane, Queensland, Australia
- Dietetics and Food Services, Children's Health Queensland, South Brisbane, Queensland, Australia
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Aravind A, Sathyaprasad S, Ilyas I. Anticipatory Guidance through Online Motivational Interviewing for Mothers on Early Childhood Caries among Young Children of Age 9-24 Months amidst Pandemics: A Nonrandomized Clinical Trial. Int J Clin Pediatr Dent 2023; 16:227-236. [PMID: 37519978 PMCID: PMC10373787 DOI: 10.5005/jp-journals-10005-2567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
Early childhood caries (ECC) is a multifactorial disease with known etiologic factors and can be very devastating to the oral and general well-being of a child, including psychological impact on a growing child. The irony is among the different factors responsible for milk that is wholesome nutrition, if fed in a wrong pattern, can be the main factor that helps this type of rampant caries spread within no time, leading to pulp exposures and complicating proceedings. Awareness is the mainstay in prevention, and creating it becomes our sole responsibility as a pediatric dentists. A multidisciplinary approach with the involvement of mothers as a main stakeholder in this front becomes a very promising move, so this project is phase two of interprofessional collaboration involving mothers in prevention; the aim of the study is to create awareness among mothers during COVID lockdown so as to prevent ECC in this covid pandemic. Materials and methods A total of 222 mothers with 9-24 months old children were selected and added to the e-groups. The allocated mothers were given a pretest questionnaire and collected back with a photo of their child's oral health, and anticipatory guidance and in-depth interviewing were given to them. Follow-up is done in 2, 4, and 6 months. Awareness is evaluated by pre- and posttest questionnaires. Reversal of the white spot is evaluated through indices, and progression is noted. Statistical analysis The data was analyzed using Statistical Package for the Social Sciences 13. Result Pretest and postquestionnaire analysis were done using the Chi-squared test. The test shows the marked raise in knowledge, attitude, and practice of mothers on their children after postintervention, which was given through motivational interviewing (MI). Conclusion In summary, the MI intervention appeared to improve maternal knowledge but had no effect on oral health behaviors or on the progression of early childhood caries (ECC). How to cite this article Aravind A, Sathyaprasad S, Ilyas I. Anticipatory Guidance through Online Motivational Interviewing for Mothers on Early Childhood Caries among Young Children of Age 9-24 Months amidst Pandemics: A Nonrandomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(2):227-236.
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Affiliation(s)
- A Aravind
- Department of Pediatric and Preventive Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
| | - Savitha Sathyaprasad
- Department of Pediatric and Preventive Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
| | - Irfana Ilyas
- Department of Pediatric and Preventive Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
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Shrestha S, Poudel A, Reeve E, Linsky AM, Steadman KJ, Nissen LM. Development and validation of a tool to understand health care professionals' attitudes towards deprescribing (HATD) in older adults with limited life expectancy. Res Social Adm Pharm 2022; 18:3596-3601. [DOI: 10.1016/j.sapharm.2022.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/13/2022] [Accepted: 03/04/2022] [Indexed: 10/18/2022]
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Krikheli L, Carey LB, Erickson S, Carey-Sargeant CL, Ann Mathisen B. Recommendations for speech-language pathologists in paediatric palliative care teams (ReSP 3CT): An international modified Delphi study. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 23:486-496. [PMID: 33625295 DOI: 10.1080/17549507.2020.1866073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose: There is emerging recognition within the literature that speech-language pathologists (SLPs) have a role in the provision of paediatric palliative care (PPC). SLPs, however, experience unique challenges when working with this vulnerable young cohort of patients, their families and multidisciplinary teams. This study aims to develop practice recommendations based on best available evidence.Method: A modified Delphi technique was utilised to develop group consensus over a series of survey rounds. Statements for voting were synthesised by critically reviewing recurring themes from previous studies, involving (i) a scoping literature review, (ii) an online survey, and (iii) interview data. Nine participants were recruited using consecutive sampling from the interview phase related to this study.Result: Twenty-one statements were voted upon over two survey rounds (100% response rate). Agreement levels of ≥70% across all statements were reached after the first round. There was a significant correlation between rating a statement as "essential" and a strong level of agreement (p < 0.0001). Intraparticipant agreement between rounds is also reported.Conclusion: The 21 statements form Recommendations for Speech-Language Pathologists in Paediatric Palliative Care Teams (ReSP3CT). The statements will support SLPs working within PPC to promote advocacy, professional development and enhance team involvement in this developing field.
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Affiliation(s)
- Lillian Krikheli
- Public Health Palliative Care Unit, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Lindsay Brian Carey
- Public Health Palliative Care Unit, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Shane Erickson
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Christa Lynn Carey-Sargeant
- Public Health Palliative Care Unit, School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, Australia
- School of Audiology and Speech Pathology, Faculty of Dentistry, Medicine and Health Sciences, University of Melbourne, Parkville, Victoria, Australia, and
| | - Bernice Ann Mathisen
- Discipline of Speech Pathology, School of Health and Human Sciences, Southern Cross University, Bilinga, Queensland, Australia
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Krikheli L, Erickson S, Carey LB, Carey-Sargeant CL, Mathisen BA. Speech-Language Pathologists in Pediatric Palliative Care: An International Study of Perceptions and Experiences. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:150-168. [PMID: 33352058 DOI: 10.1044/2020_ajslp-20-00090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The purpose of this study is to gather qualitative data regarding the experiences and perceptions of speech-language pathologists (SLPs) practicing in pediatric palliative care (PPC) and investigate their approaches for working with patients, families, and the multidisciplinary team. Method Ten participants from Australia, Canada, and the United States were recruited from a previous survey study. In-depth interviews were conducted via videoconferencing. Two coders used NVivo software to record and organize the data into themes. Interrater reliability of the coding was established with a third coder. The COnsolidated criteria for REporting Qualitative research 32-item checklist has been used for reporting the research. Results Interrater coding reliability (using weighted kappa) was .81, indicating "almost perfect" agreement on the selection of themes from the code frame. Emerging themes included clinical interventions, unique SLP skills in PPC, multidisciplinary team relationships, workforce issues, education and training, governance, medicolegal considerations, bioethical issues, and holistic care. Additional subthemes are also noted. In the absence of research evidence and practice recommendations, SLPs rely on client perspectives and clinical experience to guide their professional practice in PPC. Conclusions Qualitative survey analysis of the perceptions and experiences of SLP clinicians from three postindustrial countries identified nine major themes regarding PPC. Results expand on limited literature to date in the area of PPC. Future research using larger samples is needed to provide clinicians with best practice recommendations for working with patients, families, and the broader care team.
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Affiliation(s)
- Lillian Krikheli
- Public Health Palliative Care Unit, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Shane Erickson
- Discipline of Speech Pathology, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia
| | - Lindsay B Carey
- Public Health Palliative Care Unit, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Christa L Carey-Sargeant
- Public Health Palliative Care Unit, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- School of Audiology and Speech Pathology, University of Melbourne, Victoria, Australia
| | - Bernice A Mathisen
- Public Health Palliative Care Unit, School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
- Discipline of Speech Pathology, School of Health and Human Sciences, Southern Cross University, East Lismore, New South Wales, Australia
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