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Bakelants H, Dury S, Chambaere K, De Donder L, Deliens L, Vanderstichelen S, Marynissen S, Cohen J, Van Droogenbroeck F. Mapping the ripple effects of a compassionate university for serious illness, death, and bereavement. Palliat Care Soc Pract 2024; 18:26323524241272110. [PMID: 39220470 PMCID: PMC11366097 DOI: 10.1177/26323524241272110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 07/02/2024] [Indexed: 09/04/2024] Open
Abstract
Background Compassionate communities have been put forward as a promising model for community-based support for people facing serious illness, caregiving, dying, and loss. In particular, educational institutions are increasingly acknowledged as potential settings to function as compassionate schools and compassionate workplaces, cultivating acceptance and validation of these experiences beyond the university setting. Objectives This paper investigates the activities and outcomes of a compassionate community initiative-the Compassionate University program at the Vrije Universiteit Brussel in Belgium. Design Ripple Effects Mapping was used to guide the focus group and individual interviews conducted with core team members responsible for the development and implementation of the Compassionate University program. Methods During the focus group and individual interviews, the core team members reflected on the program contributions, with their narratives visually depicted via a hand-drawn mind map. Qualitative data derived from this mind map were entered into XMIND mapping software and fine-tuned based on the focus group and individual interview transcripts and additional project records. Results Thematic analysis identified four outcome areas that encapsulate the key contributions of the Compassionate University program: (i) increased acceptance and integration of topics such as serious illness, death, and bereavement into existing practices; (ii) broader support for and formalization of compassionate procedures and policies; (iii) emergence of informal networks and internal collaboration on the topics; and (iv) diffusion of compassionate ideas beyond the university. Conclusion The Compassionate University program facilitates a cultural shift within the university environment, fostering greater acceptance of integrating topics such as serious illness, death, and bereavement into existing practices. Additionally, compassionate procedures and policies for students and staff have been formalized, and core team members are increasingly called upon to provide support on these matters. Notably, Compassionate University stands out as one of the pioneering initiatives in Europe, attracting different educational institutions seeking guidance on cultivating a more compassionate environment.
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Affiliation(s)
- Hanne Bakelants
- Department of Adult Educational Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels and Ghent, Belgium
- Compassionate Communities Center of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Sarah Dury
- Department of Adult Educational Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Compassionate Communities Center of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Kenneth Chambaere
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels and Ghent, Belgium
- Compassionate Communities Center of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Liesbeth De Donder
- Department of Adult Educational Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Compassionate Communities Center of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Luc Deliens
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels and Ghent, Belgium
- Compassionate Communities Center of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Steven Vanderstichelen
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels and Ghent, Belgium
- Compassionate Communities Center of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Silke Marynissen
- Department of Adult Educational Sciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Joachim Cohen
- End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels and Ghent, Belgium
- Compassionate Communities Center of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Filip Van Droogenbroeck
- Data Analytics Lab, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Compassionate Communities Center of Expertise (COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Barnestein-Fonseca P, Nebro-Gil A, Aguiar-Leiva VP, Víbora-Martín E, Ruiz-Torreras I, Martín-Rosello ML. Barriers and drivers of public engagement in palliative care, Scoping review. BMC Palliat Care 2024; 23:117. [PMID: 38711035 PMCID: PMC11075334 DOI: 10.1186/s12904-024-01424-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 03/26/2024] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND The integral model of Palliative Care recognizes the community as essential element in improving quality of life of patients and families. It is necessary to find a formula that allows the community to have a voice. The aim of this scoping review is to identify barriers and facilitators to engage community in PC. METHODS Systematic search was conducted in NICE, Cochrane Library, Health Evidence, CINAHL and PubMed database. KEYWORDS Palliative care, End of life care, community networks, community engagement, public engagement, community participation, social participation, barriers and facilitators. RESULTS Nine hundred seventy-one results were obtained. Search strategy and inclusion criteria yielded 13 studies that were read in detail to identify factors influencing community engagement in palliative care, categorized into: Public health and public engagement; Community attitudes towards palliative care, death and preferences at the end of life; Importance of volunteers in public engagement programs; Compassionate communities. CONCLUSION Societal awareness must be a facilitated process to catalyse public engagement efforts. National policy initiatives and regional system support provide legitimacy and focus is essential for funding. The first step is to get a sense of what is important to society, bearing in mind cultural differences and to channel those aspects through health care professionals; connecting the most assistential part with community resources. The process and long-term results need to be systematically evaluated.
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Affiliation(s)
- Pilar Barnestein-Fonseca
- Instituto de Formación E Investigación CUDECA, Fundación CUDECA Instituto IBIMA-BIONAND, Grupo CA15, Málaga, Spain.
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Chan WS, Funk L, Krawczyk M, Cohen SR, Cherba M, Dujela C, Stajduhar K. Community perspectives on structural barriers to dying well at home in Canada. Palliat Support Care 2024; 22:347-353. [PMID: 37503570 DOI: 10.1017/s1478951523001074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
OBJECTIVES To analyze how structural determinants and barriers within social systems shape options for dying well at home in Canada, while also shaping preferences for dying at home. METHODS To inform a descriptive thematic analysis, 24 Canadian stakeholders were interviewed about their views, experiences, and preferences about dying at home. Participants included compassionate community advocates, palliative care professionals, volunteers, bereaved family caregivers, residents of rural and remote regions, service providers working with structurally vulnerable populations, and members of francophone, immigrant, and 2SLGBTQ+ communities. RESULTS Analysis of stakeholders' insights and experiences led to the conceptualization of several structural barriers to dying well at home: inaccessible public and community infrastructure and services, a structural gap in death literacy, social stigma and discrimination, and limited access to relational social capital. SIGNIFICANCE OF RESULTS Aging in Canada, as elsewhere across the globe, has increased demand for palliative care and support, especially in the home. Support for people wishing to die at home is a key public health issue. However, while Canadian policy documents normalize dying in place as ideal, it is uncertain whether these fit with the real possibilities for people nearing the end of life. Our analysis extends existing research on health equity in palliative and end-of-life care beyond a focus on service provision. Results of this analysis identify the need to expand policymakers' structural imaginations about what it means to die well at home in Canada.
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Affiliation(s)
- Wing-Sun Chan
- Department of Sociology and Criminology, University of Manitoba, Winnipeg, MB, Canada
| | - Laura Funk
- Department of Sociology and Criminology, University of Manitoba, Winnipeg, MB, Canada
| | - Marian Krawczyk
- School of Interdisciplinary Studies, University of Glasgow, Dumfries, UK
| | | | - Maria Cherba
- Department of Communication, University of Ottawa, Ottawa, ON, Canada
| | - Carren Dujela
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Kelli Stajduhar
- School of Nursing, University of Victoria, Victoria, BC, Canada
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Peeler A, Doran A, Winter-Dean L, Ijaz M, Brittain M, Hansford L, Wyatt K, Sallnow L, Harding R. Public health palliative care interventions that enable communities to support people who are dying and their carers: a scoping review of studies that assess person-centered outcomes. Front Public Health 2023; 11:1180571. [PMID: 37564426 PMCID: PMC10410270 DOI: 10.3389/fpubh.2023.1180571] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/05/2023] [Indexed: 08/12/2023] Open
Abstract
Background Public health palliative care views communities as an integral part of care delivery at the end of life. This community-provider partnership approach has the potential to improve end-of-life care for people who are dying and their carers. Objective To identify and appraise the current literature related to public health interventions that enable communities to support people who are dying and their carers. Methods A scoping review was conducted, applying Arksey and O'Malley's methods. Data was extracted and synthesized using narrative techniques, and results are reported using PRISMA guidelines. Results The search yielded 2,902 results. Eighteen met inclusion criteria and were included in the analysis. Interventions were categorized according to their target population: people with life-limiting illness (ex. facilitated social interaction, helplines and guided discussions about death and dying); carers (ex. social support mapping, psychoeducation, and community resource identification and facilitation); or dyads (ex. reminiscence activities, practical and emotional support from volunteers, online modules to bolster coping mechanisms). Public health palliative care approaches were delivered by key community stakeholders such as community health workers, volunteers, peer mentors, and pre-established support groups. Despite reported challenges in identifying appropriate tools to measure effectiveness, studies report improvement in quality of life, loneliness, social support, stress and self-efficacy. Conclusion We found that community-engaged palliative care interventions can lead to appreciable changes in various outcomes, though it was difficult to determine in which contexts this approach works best because of the dearth of contextual information reported. Based on the varied design and implementation strategies, it is clear that no one method for enhancing end of life care will benefit all communities and it is crucial to engage community members at all stages of the design and implementation process. Future research should be grounded in appropriate theory, describe contextual differences in these communities, and should specifically examine how demographics, resource availability, and social capital might impact the design, implementation, and results of public health palliative care interventions.
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Affiliation(s)
- Anna Peeler
- Cicely Saunders Institute of Palliative Care, Policy, and Rehabilitation, King's College London, London, United Kingdom
| | - Alexandra Doran
- GKT School of Medical Education, King's College London, London, United Kingdom
| | - Lee Winter-Dean
- Cicely Saunders Institute of Palliative Care, Policy, and Rehabilitation, King's College London, London, United Kingdom
| | - Mueed Ijaz
- GKT School of Medical Education, King's College London, London, United Kingdom
| | - Molly Brittain
- Cicely Saunders Institute of Palliative Care, Policy, and Rehabilitation, King's College London, London, United Kingdom
| | - Lorraine Hansford
- Wellcome Centre for Cultures and Environments of Health, University of Exeter, Exeter, United Kingdom
| | - Katrina Wyatt
- Department of Health and Community Sciences, University of Exeter Medical School, Exeter, United Kingdom
| | - Libby Sallnow
- St Christopher's Hospice, London, United Kingdom
- End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussels, Belgium
- Marie Curie Palliative Care Research Group, University College London, London, United Kingdom
| | - Richard Harding
- Cicely Saunders Institute of Palliative Care, Policy, and Rehabilitation, King's College London, London, United Kingdom
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Lessard É, Marcoux I, Daneault S, Panaite AC, Jean L, Talbot M, Weil D, Rouly G, Sallnow L, Kellehear A, Boivin A. How does community engagement evolve in different compassionate community contexts? A longitudinal comparative ethnographic research protocol. Palliat Care Soc Pract 2023; 17:26323524231168426. [PMID: 37113622 PMCID: PMC10126598 DOI: 10.1177/26323524231168426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/21/2023] [Indexed: 04/29/2023] Open
Abstract
Background Compassionate communities build on health promoting palliative care that aims to address gaps in access, quality, and continuity of care in the context of dying, death, loss, and grief. While community engagement is a core principle of public health palliative care, it has received little attention in empirical studies of compassionate communities. Objectives The objectives of this research are to describe the process of community engagement initiated by two compassionate communities projects, to understand the influence of contextual factors on community engagement over time, and assess the contribution of community engagement on proximal outcomes and the potential for sustaining compassionate communities. Research Approach and Design We use a community-based participatory action-research approach to study two compassionate communities initiatives in Montreal (Canada). We develop a longitudinal comparative ethnographic design to study how community engagement evolves in different compassionate communities contexts. Methods and Analysis Data collection includes focus groups, review of key documents and project logbooks, participant observation, semi-structured interviews with key informants, and questionnaires with a focus on community engagement. Grounded in the ecology of engagement theory and the Canadian compassionate communities evaluation framework, data analysis is structured around longitudinal and comparative axes to assess the evolution of community engagement over time and to explore the contextual factors influencing the process of community engagement and its impacts according to local context. Ethic This research is approved by the research ethics board of the Centre hospitalier de l'Université de Montréal (approval certificate #18.353). Discussion Understanding the process of community engagement in two compassionate communities will contribute to a deeper understanding of the relationships between local context, community engagement processes, and their effect on compassionate communities outcomes.
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Affiliation(s)
- Émilie Lessard
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 850 rue St-Denis, Montréal, QC H2X 0A9, Canada
- Centre de Recherche et d'Intervention sur le Suicide, Enjeux Éthiques et Pratiques de Fin de Vie (CRISE), Montréal, QC, Canada
- Réseau Québécois de Recherche en Soins Palliatifs et de Fin de Vie (RQSPAL), Centre Intégré de Cancérologie du CHU de Québec - Université Laval, Québec, QC, Canada
| | - Isabelle Marcoux
- Réseau Québécois de Recherche en Soins Palliatifs et de Fin de Vie (RQSPAL), Centre Intégré de Cancérologie du CHU de Québec - Université Laval, Québec, QC, Canada
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Serge Daneault
- Réseau Québécois de Recherche en Soins Palliatifs et de Fin de Vie (RQSPAL), Centre Intégré de Cancérologie du CHU de Québec - Université Laval, Québec, QC, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Andreea-Catalina Panaite
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | - Lise Jean
- Compassion Montréal Centre-Sud, Montréal, QC, Canada
| | - Mélodie Talbot
- Association Québécoise Pour la Promotion de la Santé des Personnes Utilisatrices de Drogues (AQPSUD), Montréal, QC, Canada
| | - Dale Weil
- Montreal Institute for Palliative Care, Kirkland, QC, Canada
| | - Ghislaine Rouly
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
| | | | - Allan Kellehear
- College of Nursing and Health Sciences, University of Vermont, Burlington, VT, USA
| | - Antoine Boivin
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada
- Réseau Québécois de Recherche en Soins Palliatifs et de Fin de Vie (RQSPAL), Centre Intégré de Cancérologie du CHU de Québec - Université Laval, Québec, QC, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
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Challenges and Facilitators for Psychosocial Support when Aging and Dying in Place: A Rapid Review of the Literature. Can J Aging 2023; 42:135-153. [PMID: 35762308 DOI: 10.1017/s071498082200023x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Most seniors in Canada live at home and consistently indicate that they prefer to stay there for as long as possible. Consequently, this desire places increasing pressure on supports such as informal caregivers and community services. The current rapid review set out to examine the psychosocial aspects of aging and dying in place that point to gaps in programs and services to support this preference. We searched PubMed, PsycInfo, and Google Scholar for peer-reviewed entries, and identified 42 articles for analysis, which we charted on a form we created and tested. Lack of attention to the whole person, lack of preparation for the journey ahead, and difficulties establishing collaborative and trusting relationships were, broadly, the challenges identified. A blend of initiatives in the community combined with an integrated palliative approach to care may mitigate some of the challenges that limit options for aging and dying in place.
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7
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Bakelants H, Vanderstichelen S, Chambaere K, Van Droogenbroeck F, De Donder L, Deliens L, Dury S, Cohen J. Researching Compassionate Communities: Identifying theoretical frameworks to evaluate the complex processes behind public health palliative care initiatives. Palliat Med 2023; 37:291-301. [PMID: 36576313 DOI: 10.1177/02692163221146589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Compassionate Communities have been put forward as a new model for community-based palliative care to positively impact the health and wellbeing of those experiencing challenges of serious illness, death, dying, and loss. Despite the growing international movement to develop these public health initiatives to end-of-life care, only a handful of initiatives have undergone some form of evaluation. AIM To provide guidance on designing evaluation research by identifying theoretical frameworks to understand the development, implementation, and underlying mechanisms of Compassionate Communities. METHODS To identify suitable theoretical frameworks for the study of Compassionate Communities, we applied two steps. The first step examined the characteristics of Compassionate Communities and translated them into assessment criteria for the selection of theoretical frameworks. The second step consisted of applying the identified assessment criteria to a list of widely used and highly cited theoretical frameworks. RESULTS Three well-established theoretical frameworks were identified as being most suitable to study the development, implementation, and underlying mechanisms of Compassionate Communities: The Consolidated Framework for Implementation Research (CFIR), the integrated-Promoting Action on Research Implementation in Health Services framework (i-PARIHS), and the Extended Normalization Process Theory (ENPT). CONCLUSIONS The article supports and encourages the use of theoretical frameworks to evaluate the complex processes behind public health palliative care initiatives. The complementary use of two determinant frameworks and an implementation theory provides theoretical grounding to gain rich insights into the emergent and shifting interplays between agency, social processes, and contextual factors that shape the development and implementation of Compassionate Communities.
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Affiliation(s)
- Hanne Bakelants
- Vrije Universiteit Brussel (VUB) and Ghent University, End-of-Life Care Research Group, Belgium.,Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium.,Vrije Universiteit Brussel (VUB), Society and Ageing Research Lab, Belgium
| | - Steven Vanderstichelen
- Vrije Universiteit Brussel (VUB) and Ghent University, End-of-Life Care Research Group, Belgium.,Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium
| | - Kenneth Chambaere
- Vrije Universiteit Brussel (VUB) and Ghent University, End-of-Life Care Research Group, Belgium.,Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium
| | - Filip Van Droogenbroeck
- Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium.,Vrije Universiteit Brussel (VUB), Tempus Omnia Revelat, Belgium
| | - Liesbeth De Donder
- Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium.,Vrije Universiteit Brussel (VUB), Society and Ageing Research Lab, Belgium
| | - Luc Deliens
- Vrije Universiteit Brussel (VUB) and Ghent University, End-of-Life Care Research Group, Belgium.,Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium
| | - Sarah Dury
- Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium.,Vrije Universiteit Brussel (VUB), Society and Ageing Research Lab, Belgium
| | - Joachim Cohen
- Vrije Universiteit Brussel (VUB) and Ghent University, End-of-Life Care Research Group, Belgium.,Vrije Universiteit Brussel (VUB), Compassionate Communities Center of Expertise (COCO), Belgium
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8
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Librada-Flores S, Pérez-Solano Vázquez MJ, Lucas-Díaz MÁ, Rodríguez Álvarez-Ossorio Z, Herrera-Molina E, Nabal-Vicuña M, Guerra-Martín MD. "Compassionate City" in Patients with Advanced Illnesses and at the End of Life: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2234. [PMID: 36767601 PMCID: PMC9914945 DOI: 10.3390/ijerph20032234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES To evaluate, in a Compassionate City pilot experience (Sevilla), the impact results on health in a population of people with advanced illness and at the end of life. METHODS The project was undertaken in Sevilla, Spain, between January 2019 and June 2020. A longitudinal, descriptive study was conducted using a longitudinal cohort design with two cross-sectional measurements, pre and post intervention. All patients who entered the program on the start date were included. The networks of care around people with advanced illness and at the end of life, palliative care needs, quality of life, loneliness, anxiety, depression, caregivers' burden and family satisfaction were evaluated. The interventions were conducted by community promoters assigned to the "Sevilla Contigo, Compassionate City" program. RESULTS A total of 83 people were included in the program. The average number of people involved in care at the beginning of the evaluations was 3.6, increasing to 6.1 at the end of the interventions. The average number of needs detected at the beginning was 15.58, and at the end of interventions, it was 16.56 out of 25. The unmet needs were those related to last wishes (40.7%), emotional relief (18.5%), entertainment (16%), help to walk up and down stairs (8.6%) and help to walk (6.2%). A total of 54.2% showed improved loneliness in the final evaluation. Out of 26 people evaluated for pre and post quality of life, 7 (26.9%) improved their quality of life in the general evaluation and 5 (19.2%) displayed improved anxiety/depression. A total of 6 people (28.6%) improved their quality-of-life thermometer scores. A total of 57.7% of caregivers improved their burden with a mean score of 17.8.
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D’Eer L, Chambaere K, Van den Block L, Dury S, Deliens L, Cohen J, Smets T. Civic Engagement in Neighbourhoods regarding serious illness, death and loss (CEIN): a study protocol for a convergent-parallel mixed-methods process and outcome evaluation that balances control and flexibility. Palliat Care Soc Pract 2023; 17:26323524231168417. [PMID: 37138931 PMCID: PMC10150425 DOI: 10.1177/26323524231168417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/21/2023] [Indexed: 05/05/2023] Open
Abstract
Background New public health approaches in palliative care attribute an active role to civic society in providing care for those who are seriously ill, caring, or bereaved. Accordingly, Civic Engagement In Neighbourhoods regarding serious illness, dying and loss (CEIN) are emerging worldwide. However, study protocols that advise on how to evaluate the impact and complex social change processes underlying these civic engagement initiatives are lacking. Objectives The main objective of this study is to describe the study protocol for the evaluation of civic engagement initiatives in serious illness, dying, and loss in two neighbourhoods in Flanders, Belgium. Design A convergent-parallel mixed-method process and outcome evaluation for the CEIN study. Methods & analysis We look at the evaluation of CEIN through a critical realist lens, thereby including the social, political, and economic determinants of social change in CEIN, the mechanisms to achieve this social change, the outcomes, and the mutual connection between these three aspects. We will conduct a convergent-parallel mixed-method process and outcome evaluation in which qualitative (i.e. observations, interviews, group discussions, and ego network mapping) and quantitative data (i.e. a pre-post survey) are simultaneously but separately collected and analysed and in the last stage combined by narrative synthesis. Discussion This protocol illustrates the difficulty of operationalising the desired long-term impact of social changes regarding serious illness, dying, and loss into more manageable outcomes. We recommend a well-cogitated logic model that connects the outcomes of the study to its potential actions. Applying this protocol in practice is a constant exercise between providing sufficient flexibility to meet feasibility, desirability, and context-specific needs in the CEIN study and providing sufficient guidelines to structure and control the evaluation process.
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Affiliation(s)
| | - Kenneth Chambaere
- End-of-Life Care Research Group, Vrije
Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
- Compassionate Communities Centre of Expertise
(COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Lieve Van den Block
- End-of-Life Care Research Group, Vrije
Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
- Compassionate Communities Centre of Expertise
(COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Sarah Dury
- Compassionate Communities Centre of Expertise
(COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Society and Ageing Research Lab, Vrije
Universiteit Brussel (VUB), Brussels, Belgium
| | - Luc Deliens
- End-of-Life Care Research Group, Vrije
Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
- Compassionate Communities Centre of Expertise
(COCO), Vrije Universiteit Brussel (VUB), Brussels, Belgium
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10
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Vanderstichelen S, Dury S, De Gieter S, Van Droogenbroeck F, De Moortel D, Van Hove L, Rodeyns J, Aernouts N, Bakelants H, Cohen J, Chambaere K, Spruyt B, Zohar G, Deliens L, De Donder L. Researching Compassionate Communities From an Interdisciplinary Perspective: The Case of the Compassionate Communities Center of Expertise. THE GERONTOLOGIST 2022; 62:1392-1401. [PMID: 35263765 DOI: 10.1093/geront/gnac034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Indexed: 12/13/2022] Open
Abstract
Compassionate Communities are places and environments in which people, networks, and institutions actively work together and are empowered to improve the circumstances, health, and well-being of those facing serious illness, death, dying, and loss. The study of their development, implementation, and evaluation requires an interdisciplinary research approach that has hitherto been lacking. In 2020, 8 research groups from 4 faculties at Vrije Universiteit Brussel united in the interdisciplinary Compassionate Communities Center of Expertise (COCO) to investigate Compassionate Communities. This article describes the first results of COCO: (a) an interdisciplinary mode of collaboration, (b) a shared conceptual understanding and definition of Compassionate Communities, and (c) a shared research agenda on Compassionate Communities.
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Affiliation(s)
- Steven Vanderstichelen
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Sarah Dury
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Belgian Ageing Studies, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Sara De Gieter
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Work and Organisational Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Filip Van Droogenbroeck
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Tempus Omnia Revelat, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Deborah De Moortel
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Interface Demography, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Lisa Van Hove
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Brussels University Consultation Centre, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Julie Rodeyns
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Brussels Research Centre on Innovation in Learning and Diversity, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Nele Aernouts
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Cosmopolis Centre for Urban Research, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Hanne Bakelants
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - Joachim Cohen
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - Kenneth Chambaere
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,End-of-Life Care Research Group, Ghent University, Ghent, Belgium
| | - Bram Spruyt
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Tempus Omnia Revelat, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Gabriel Zohar
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Brussels Research Centre on Innovation in Learning and Diversity, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Luc Deliens
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium
| | - Liesbeth De Donder
- Compassionate Communities Centre of Expertise, Vrije Universiteit Brussel (VUB), Brussels, Belgium.,Belgian Ageing Studies, Vrije Universiteit Brussel (VUB), Brussels, Belgium
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11
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Aoun SM, Richmond R, Gunton K, Noonan K, Abel J, Rumbold B. The Compassionate Communities Connectors model for end-of-life care: implementation and evaluation. Palliat Care Soc Pract 2022; 16:26323524221139655. [PMID: 36478890 PMCID: PMC9720808 DOI: 10.1177/26323524221139655] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/31/2022] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVES This pilot project aimed to develop, implement and evaluate a model of care delivered by community volunteers, called Compassionate Communities Connectors. The Connectors' principal task was to support people living with advanced life-limiting illnesses or palliative care needs by enhancing their supportive networks with Caring Helpers enlisted from the local community. METHODS The project was undertaken in Western Australia, 2020-2022. A mixed methods research design incorporated a prospective cohort longitudinal design with two cross-sectional measurements, pre- and post-intervention. The primary outcome was the effect of the intervention on social connectedness. Secondary outcomes were the effect of the intervention on unmet practical or social needs and support from social networks, and the self-reported impact of the programme on social wellbeing such as coping with daily activities, access to formal services, community links, social activity and reducing social isolation. RESULTS Twenty Connectors were trained but 13 participated; 43 patients participated but 30 completed the study. Over half of these patients lived alone and 80% of their needs were in the social domain. There were significant improvements in social connectedness, reflected in reduced social isolation, better coping with daily activities and a two-fold increase in supportive networks. The programme was able to address gaps that formal services could not, particularly for people who lived alone, or were socially isolated in more rural communities that are out of the frequent reach of formal services. CONCLUSIONS This project led to an ongoing programme that has been incorporated by the health service as 'business as usual', demonstrating rapid translation into practice. It has laid solid grounds for community capacity building with successful measurable outcomes in line with reports on similar programmes. Ongoing work is focused on replication in other communities to help them establish a similar model of care that better integrates formal and informal networks.
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Affiliation(s)
- Samar M. Aoun
- The University of Western Australia, Perth, WA,
AustraliaPerron Institute for Neurological and Translational Science, Perth,
WA, AustraliaLa Trobe University, Melbourne, VIC, Australia
| | - Robyn Richmond
- Perron Institute for Neurological and
Translational Science, Perth, WA, Australia
| | - Kerry Gunton
- Health Department of Western Australia, Perth,
WA, AustraliaPerron Institute for Neurological and Translational Science,
Perth, WA, Australia
| | - Kerrie Noonan
- Perron Institute for Neurological and
Translational Science, Perth, WA, AustraliaWestern Sydney University,
Penrith, NSW, Australia
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12
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Reynolds CF, Jeste DV, Sachdev PS, Blazer DG. Mental health care for older adults: recent advances and new directions in clinical practice and research. World Psychiatry 2022; 21:336-363. [PMID: 36073714 PMCID: PMC9453913 DOI: 10.1002/wps.20996] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The world's population is aging, bringing about an ever-greater burden of mental disorders in older adults. Given multimorbidities, the mental health care of these people and their family caregivers is labor-intensive. At the same time, ageism is a big problem for older people, with and without mental disorders. Positive elements of aging, such as resilience, wisdom and prosocial behaviors, need to be highlighted and promoted, both to combat stigma and to help protect and improve mental health in older adults. The positive psychiatry of aging is not an oxymoron, but a scientific construct strongly informed by research evidence. We champion a broader concept of geriatric psychiatry - one that encompasses health as well as illness. In the present paper, we address these issues in the context of four disorders that are the greatest source of years lived with disability: neurocognitive disorders, major depression, schizophrenia, and substance use disorders. We emphasize the need for implementation of multidisciplinary team care, with comprehensive assessment, clinical management, intensive outreach, and coordination of mental, physical and social health services. We also underscore the need for further research into moderators and mediators of treatment response variability. Because optimal care of older adults with mental disorders is both patient-focused and family-centered, we call for further research into enhancing the well-being of family caregivers. To optimize both the safety and efficacy of pharmacotherapy, further attention to metabolic, cardiovascular and neurological tolerability is much needed, together with further development and testing of medications that reduce the risk for suicide. At the same time, we also address positive aging and normal cognitive aging, both as an antidote to ageism and as a catalyst for change in the way we think about aging per se and late-life mental disorders more specifically. It is in this context that we provide directions for future clinical care and research.
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Affiliation(s)
| | - Dilip V. Jeste
- Department of PsychiatryUniversity of California San DiegoLa JollaCAUSA
| | | | - Dan G. Blazer
- Department of Psychiatry and Behavioral SciencesDuke UniversityDurhamNCUSA
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13
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Laranjeira C, Dixe MA, Querido A, Stritch JM. Death cafés as a strategy to foster compassionate communities: Contributions for death and grief literacy. Front Psychol 2022; 13:986031. [PMID: 35983204 PMCID: PMC9379088 DOI: 10.3389/fpsyg.2022.986031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Leiria, Portugal
- Research in Education and Community Intervention (RECI), Piaget Institute, Viseu, Portugal
- *Correspondence: Carlos Laranjeira
| | - Maria Anjos Dixe
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Leiria, Portugal
| | - Ana Querido
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal
- Centre for Innovative Care and Health Technology (ciTechCare), Leiria, Portugal
- Center for Health Technology and Services Research (CINTESIS), NursID, University of Porto, Porto, Portugal
| | - Jennifer Moran Stritch
- Department of Applied Social Sciences, Social Sciences ConneXions Research Institute, Technological University of the Shannon, Limerick, Ireland
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14
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Dumont K, Marcoux I, Warren É, Alem F, Alvar B, Ballu G, Bostock A, Cohen SR, Daneault S, Dubé V, Houle J, Minyaoui A, Rouly G, Weil D, Kellehear A, Boivin A. How compassionate communities are implemented and evaluated in practice: a scoping review. BMC Palliat Care 2022; 21:131. [PMID: 35854292 PMCID: PMC9297657 DOI: 10.1186/s12904-022-01021-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Compassionate communities are rooted in a health promotion approach to palliative care, aiming to support solidarity among community members at the end of life. Hundreds of compassionate communities have been developed internationally in recent years. However, it remains unknown how their implementation on the ground aligns with core strategies of health promotion. The aim of this review is to describe the practical implementation and evaluation of compassionate communities. Methods We undertook a scoping review of the empirical peer-reviewed literature on compassionate communities. Bibliographic searches in five databases were developed with information specialists. We included studies in English describing health promotion activities applied to end-of-life and palliative care. Qualitative analysis used inductive and deductive strategies based on existing frameworks for categorization of health promotion activities, barriers and facilitators for implementation and evaluation measures. A participatory research approach with community partners was used to design the review and interpret its findings. Results Sixty-three articles were included for analysis. 74.6% were published after 2011. Health services organizations and providers are most often engaged as compassionate community leaders, with community members mainly engaged as target users. Adaptation to local culture and social context is the most frequently reported barrier for implementation, with support and external factors mostly reported as facilitators. Early stages of compassionate community development are rarely reported in the literature (stakeholder mobilization, needs assessment, priority-setting). Health promotion strategies tend to focus on the development of personal skills, mainly through the use of education and awareness programs. Few activities focused on strengthening community action and building healthy public policies. Evaluation was reported in 30% of articles, 88% of evaluation being analyzed at the individual level, as opposed to community processes and outcomes. Conclusions The empirical literature on compassionate communities demonstrates a wide variety of health promotion practices. Much international experience has been developed in education and awareness programs on death and dying. Health promotion strategies based on community strengthening and policies need to be consolidated. Future research should pay attention to community-led initiatives and evaluations that may not be currently reported in the peer-review literature. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-01021-3.
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Affiliation(s)
- Katia Dumont
- Canada Research Chair in Partnership With Patients and Communities, University of Montreal Hospital Research Center (CRCHUM), Pavillon S, 850 Saint-Denis Street, Montreal, QC, S01.136H2X 0A0, Canada
| | - Isabelle Marcoux
- Faculty of Health Sciences, University of Ottawa, 25 University Street, office 206, Ottawa, K1N 6N5, Canada
| | - Émilie Warren
- Canada Research Chair in Partnership With Patients and Communities, University of Montreal Hospital Research Center (CRCHUM), Pavillon S, 850 Saint-Denis Street, Montreal, QC, S01.136H2X 0A0, Canada
| | - Farah Alem
- Canada Research Chair in Partnership With Patients and Communities, University of Montreal Hospital Research Center (CRCHUM), Pavillon S, 850 Saint-Denis Street, Montreal, QC, S01.136H2X 0A0, Canada
| | - Bea Alvar
- Canada Research Chair in Partnership With Patients and Communities, University of Montreal Hospital Research Center (CRCHUM), Pavillon S, 850 Saint-Denis Street, Montreal, QC, S01.136H2X 0A0, Canada
| | - Gwenvaël Ballu
- Canada Research Chair in Partnership With Patients and Communities, University of Montreal Hospital Research Center (CRCHUM), Pavillon S, 850 Saint-Denis Street, Montreal, QC, S01.136H2X 0A0, Canada
| | - Anitra Bostock
- Montreal Palliative Care Institute, 265 André-Brunet Street, Kirkland, QC, H9H 3R4, Canada
| | - S Robin Cohen
- Departments of Oncology and Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.,Lady Davis Research Institute of the Jewish General Hospital, Palliative Care Research, room E8.06, 3755 Côte Ste. Catherine Road, Montreal, QC, H3T 1E2, Canada
| | - Serge Daneault
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal, 2900 Édouard-Montpetit Boulevard, Montreal, QC, H3T 1J4, Canada.,Centre de Recherche de L'Institut Universitaire de Gériatrie de Montréal, 4565 Chemin Queen-Mary, , Montreal, QC, H3W 1W5, Canada
| | - Véronique Dubé
- Marguerite d'Youville Research Chair On Humanistic Nursing Interventions, Faculty of Nursing, Centre-Ville Station, Université de Montréal, P.O Box 6128, Montreal, QC, H3C 3J7, Canada
| | - Janie Houle
- Department of Psychology, Université du Québec À Montréal, 100 Sherbrooke Street West, Montreal, QC, H2X 3P2, Canada
| | - Asma Minyaoui
- Canada Research Chair in Partnership With Patients and Communities, University of Montreal Hospital Research Center (CRCHUM), Pavillon S, 850 Saint-Denis Street, Montreal, QC, S01.136H2X 0A0, Canada
| | - Ghislaine Rouly
- Canada Research Chair in Partnership With Patients and Communities, University of Montreal Hospital Research Center (CRCHUM), Pavillon S, 850 Saint-Denis Street, Montreal, QC, S01.136H2X 0A0, Canada
| | - Dale Weil
- Montreal Palliative Care Institute, 265 André-Brunet Street, Kirkland, QC, H9H 3R4, Canada
| | - Allan Kellehear
- College of Nursing and Health Sciences, University of Vermont, Burlington, USA
| | - Antoine Boivin
- Canada Research Chair in Partnership With Patients and Communities, University of Montreal Hospital Research Center (CRCHUM), Pavillon S, 850 Saint-Denis Street, Montreal, QC, S01.136H2X 0A0, Canada.,Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université de Montréal, 2900 Édouard-Montpetit Boulevard, Montreal, QC, H3T 1J4, Canada
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15
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Jeste DV, Koh S, Pender VB. Perspective: Social Determinants of Mental Health for the New Decade of Healthy Aging. Am J Geriatr Psychiatry 2022; 30:733-736. [PMID: 35172936 DOI: 10.1016/j.jagp.2022.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Dilip V Jeste
- Department of Psychiatry (DVJ, SK), University of California San Diego, San Diego, CA; Sam and Rose Stein Institute for Research on Aging, University of California San Diego (DVJ), San Diego, CA; Department of Neurosciences (DVJ), University of California San Diego, San Diego, CA.
| | - Steve Koh
- Department of Psychiatry (DVJ, SK), University of California San Diego, San Diego, CA
| | - Vivian B Pender
- Department of Psychiatry (VBP), Weill-Cornell Medical College, New York, NY
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16
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Kleijberg M, Hilton R, Ahlberg BM, Tishelman C. Conceptualizing impact in community-based participatory action research to engage communities in end-of-life issues. Palliat Care Soc Pract 2022; 16:26323524221095107. [PMID: 35573090 PMCID: PMC9092577 DOI: 10.1177/26323524221095107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/25/2022] [Indexed: 11/17/2022] Open
Abstract
Background: A health promotion approach to end-of-life (EoL) care is gaining traction
internationally. However, there is a lack of evaluations of the impact of
this approach, particularly regarding community-based initiatives.
Conceptualizations of impact in participatory action research (PAR) may
contribute to understanding ways in which impact can be investigated in
community-based health promotion approaches to EoL issues. We aim to
investigate impact and the process of impact development in our
community-based PAR project, Studio DöBra, a Swedish health promotion
initiative to engage communities in EoL issues. Methods: We do this through a qualitative framework analysis expanding on Banks
et al.’s theory of co-impact in PAR, based on
longitudinal empirical data of Studio DöBra. Studio DöBra was developed in
partnership with a range of community organizations and engaged children (9
years old) and older adults (most 80+) with topics related to dying, death,
and loss through arts activities. The analyzed empirical data reflect the
perspectives of community-partners and academic partners from interviews and
meetings spanning 4.5 years. Findings: We present a model of impact development consisting of impact on individual
and group development, action-oriented impact, and strategy-oriented impact;
ways they relate to and evolve from one another; and how they may be
affected by contextual influences. Conclusion: Besides contributing to conceptualizations of impact in PAR, findings
contribute a community perspective to the limited literature investigating
the impact of health promotion initiatives related to EoL issues.
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Affiliation(s)
- Max Kleijberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Flemingsberg, 14183 Stockholm, Sweden
| | - Rebecca Hilton
- Research Centre, Stockholm University of the Arts, Stockholm, Sweden
| | - Beth Maina Ahlberg
- Skaraborg Institute for Research and Development, Skövde, Sweden
- Department of Sociology, Uppsala University, Uppsala, Sweden
| | - Carol Tishelman
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Stockholm Health Care Services (SLSO), Region Stockholm, Stockholm, Sweden
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17
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D'Eer L, Quintiens B, Van den Block L, Dury S, Deliens L, Chambaere K, Smets T, Cohen J. Civic engagement in serious illness, death, and loss: A systematic mixed-methods review. Palliat Med 2022; 36:625-651. [PMID: 35287517 DOI: 10.1177/02692163221077850] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND New public health approaches to palliative care such as compassionate communities aim to increase capacity in serious illness, death, and loss by involving civic society. Civic engagement has been described in many domains of health; a description of the characteristics, processes, and impact of the initiatives in palliative care is lacking. AIM To systematically describe and compare civic engagement initiatives in palliative care in terms of context, development, impact, and evaluation methods. DESIGN Systematic, mixed-methods review using a convergent integrated synthesis approach. Registered in Prospero: CRD42020180688. DATA SOURCES Six databases (PubMed, Scopus, Sociological Abstracts, WOS, Embase, PsycINFO) were searched up to November 2021 for publications in English describing civic engagement in serious illness, death, and loss. Additional grey literature was obtained by contacting the first authors. We performed a quality appraisal of the included studies. RESULTS We included 23 peer-reviewed and 11 grey literature publications, reporting on nineteen unique civic engagement initiatives, mostly in countries with English as one of the official languages. Initiatives involved the community in their development, often through a community-academic partnership. Activities aimed to connect people with palliative care needs to individuals or resources in the community. There was a variety of evaluation aims, methods, outcomes, and strength of evidence. Information on whether or how to sustain the initiatives was generally lacking. CONCLUSIONS This is the first review to systematically describe and compare reported civic engagement initiatives in the domain of palliative care. Future studies would benefit from improved evaluation of impact and sustainability.
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Affiliation(s)
- Louise D'Eer
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Laarbeeklaan, Brussels, Belgium.,Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Pleinlaan, Brussels, Belgium
| | - Bert Quintiens
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Laarbeeklaan, Brussels, Belgium.,Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Pleinlaan, Brussels, Belgium
| | - Lieve Van den Block
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Laarbeeklaan, Brussels, Belgium.,Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Pleinlaan, Brussels, Belgium
| | - Sarah Dury
- Belgian Ageing Studies Research Group, Vrije Universiteit Brussel (VUB), Pleinlaan, Brussels, Belgium.,Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Pleinlaan, Brussels, Belgium
| | - Luc Deliens
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Laarbeeklaan, Brussels, Belgium.,Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Pleinlaan, Brussels, Belgium
| | - Kenneth Chambaere
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Laarbeeklaan, Brussels, Belgium.,Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Pleinlaan, Brussels, Belgium
| | - Tinne Smets
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Laarbeeklaan, Brussels, Belgium.,Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Pleinlaan, Brussels, Belgium
| | - Joachim Cohen
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) and Ghent University, Laarbeeklaan, Brussels, Belgium.,Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel (VUB), Pleinlaan, Brussels, Belgium
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18
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Quintiens B, D'Eer L, Deliens L, Van den Block L, Chambaere K, De Donder L, Cohen J, Smets T. Area-Based Compassionate Communities: A systematic integrative review of existing initiatives worldwide. Palliat Med 2022; 36:422-442. [PMID: 35354413 DOI: 10.1177/02692163211067363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Area-Based Compassionate Communities are community public health interventions which focus on the role of the community in palliative care provision. They apply a set of actions based on the Ottawa Charter for Health Promotion which aims to increase people's control over their health. AIM To review and compare Area-Based Compassionate Communities with respect to their contextual characteristics, development processes and evaluations. DESIGN A systematic integrative review with narrative synthesis. Registered in Prospero: CRD42020173406. DATA SOURCES Five databases (Pubmed, Web of Science, PsycInfo, Embase and Scopus) were consulted, consisting of publications from 1999 onwards. This was supplemented with grey literature and author-provided documentation. RESULTS Twenty articles were drawn from the peer reviewed search, three from grey literature and two from author-provided documentation. Notwithstanding the substantial variation in what is reported, all Area-Based Compassionate Community initiatives focus on multiple action areas of the Ottawa Charter for Health Promotion. Variability in their contextual and developmental characteristics is high. Only a minority of initiatives have been evaluated and although conclusions are generally positive, what is evaluated often does not match their aims. Attaining support from policy makers can help in obtaining funding early in the project. Strengthening people's social networks was a recurring community engagement strategy. CONCLUSIONS While the concept of Area-Based Compassionate Communities is gaining momentum as a new paradigm for the creation of palliative care capacity across society, only a handful of initiatives have been described. The lack of formal evaluations of their envisaged health benefits indicates a pressing need for rigorous research about ongoing and future initiatives.
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Affiliation(s)
- Bert Quintiens
- End-of Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium.,Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel, Brussels, Belgium
| | - Louise D'Eer
- End-of Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium.,Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel, Brussels, Belgium
| | - Luc Deliens
- End-of Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium.,Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel, Brussels, Belgium
| | - Lieve Van den Block
- End-of Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium
| | - Kenneth Chambaere
- End-of Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium.,Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel, Brussels, Belgium
| | - Liesbeth De Donder
- Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel, Brussels, Belgium.,Adult Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Joachim Cohen
- End-of Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium.,Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel, Brussels, Belgium
| | - Tinne Smets
- End-of Life Care Research Group, Vrije Universiteit Brussel and Ghent University, Brussels, Belgium.,Compassionate Community Centre of Expertise (COCO), Vrije Universiteit Brussel, Brussels, Belgium
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19
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Community Based Participatory Research For The Development of a Compassionate Community: The Case of Getxo Zurekin. Int J Integr Care 2022; 22:2. [PMID: 35087351 PMCID: PMC8782087 DOI: 10.5334/ijic.5707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 01/06/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction: In the face of a growing ageing population and rising care needs, compassionate communities seek to visualize the community as an equal partner in the complex task of providing quality social and health care at the end of life. Description: Getxo Zurekin is a social innovation example for the creation of a compassionate community in Getxo, one of the most populated cities in the province of Biscay, with 25.46% of its population aged over 65. Mixed methodologies have been applied, active listening and co-creation of actions and strategies towards improving care and quality of life for people and families facing advanced disease and end of life situations, with more than 80 people interviewed to conform the basis for a collective sense making. The initiative has reached more than 1,000 people in Getxo. Discussion: Following a systemic approach, horizontal relationships and cross-sectoral collaborations have allowed engaging the active involvement of local agents in the collective sense making and co- creation process. Conclusion: Getxo Zurekin represents an example of a participatory action research model, which has shown to be effective to meet initial targets towards creation of a compassionate community.
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20
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Affiliation(s)
- Samar M. Aoun
- University of Western Australia, Crawley, Western Australia 6009, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia 6009, Australia
- La Trobe University, Melbourne, Victoria 3086, Australia
- South West Compassionate Communities Network, Bunbury, Western Australia 6230, Australia
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21
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Gursahani R, Lorenzl S. International models of neuropalliative care. HANDBOOK OF CLINICAL NEUROLOGY 2022; 190:73-84. [PMID: 36055721 DOI: 10.1016/b978-0-323-85029-2.00012-9] [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: 06/15/2023]
Abstract
Can equitable Neuropalliative care (NpC) be delivered globally? This chapter surveys existing services and ground realities in different parts of the world. In many countries, universal healthcare (UHC) seems to have been a precondition for the establishment of palliative care (PC). PC has been recognized as a basic human right as a part of UHC. Quality of Death and PC surveys provide an overview of the existing situation. Currently, PC is largely focused on the needs of cancer patients and this is a legacy issue for professionals and systems. Communities however recognize suffering and do not distinguish between medical diagnoses. The development of NpC as a subspecialty of neurology allows neurologists everywhere to become primary palliative care providers for their own patients. It is also necessary to integrate neurology with existing palliative care services. There is much that can be done to improve NpC provision even within the limits that bound every jurisdiction and trial evidence is emerging to inform this practice. This chapter is a survey of the challenges and the potential.
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Affiliation(s)
- Roop Gursahani
- Department of Neurology, P.D. Hinduja National Hospital, Mumbai, India.
| | - Stefan Lorenzl
- Institute of Palliative Care and Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
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22
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Pfaff K, Krohn H, Crawley J, Howard M, Zadeh PM, Varacalli F, Ravi P, Sattler D. The little things are big: evaluation of a compassionate community approach for promoting the health of vulnerable persons. BMC Public Health 2021; 21:2253. [PMID: 34895200 PMCID: PMC8665321 DOI: 10.1186/s12889-021-12256-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Vulnerable persons are individuals whose life situations create or exacerbate vulnerabilities, such as low income, housing insecurity and social isolation. Vulnerable people often receive a patchwork of health and social care services that does not appropriately address their needs. The cost of health and social care services escalate when these individuals live without appropriate supports. Compassionate Communities apply a population health theory of practice wherein citizens are mobilized along with health and social care supports to holistically address the needs of persons experiencing vulnerabilities. AIM The purpose of this study was to evaluate the implementation of a compassionate community intervention for vulnerable persons in Windsor Ontario, Canada. METHODS This applied qualitative study was informed by the Consolidated Framework for Implementation Research. We collected and analyzed focus group and interview data from 16 program stakeholders: eight program clients, three program coordinators, two case managers from the regional health authority, one administrator from a partnering community program, and two nursing student volunteers in March through June 2018. An iterative analytic process was applied to understand what aspects of the program work where and why. RESULTS The findings suggest that the program acts as a safety net that supports people who are falling through the cracks of the formal care system. The 'little things' often had the biggest impact on client well-being and care delivery. The big and little things were achieved through three key processes: taking time, advocating for services and resources, and empowering clients to set personal health goals and make authentic community connections. CONCLUSION Compassionate Communities can address the holistic, personalized, and client-centred needs of people experiencing homelessness and/or low income and social isolation. Volunteers are often untapped health and social care capital that can be mobilized to promote the health of vulnerable persons. Student volunteers may benefit from experiencing and responding to the needs of a community's most vulnerable members.
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Affiliation(s)
- Kathryn Pfaff
- Faculty of Nursing, University of Windsor, Windsor, Canada.
| | - Heather Krohn
- Faculty of Nursing, University of Windsor, Windsor, Canada
| | - Jamie Crawley
- Faculty of Nursing, University of Windsor, Windsor, Canada
| | - Michelle Howard
- Department of Family Medicine, McMaster University, Hamilton, Canada
| | | | | | - Padma Ravi
- Faculty of Nursing, University of Windsor, Windsor, Canada
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