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Downey J, Cooper S, Bassett L, Dubeibe Fong A, Doherty M, Cornwall J. Understanding how volunteer companionship impacts those during the end of life: A realist evaluation. DEATH STUDIES 2024:1-10. [PMID: 38573791 DOI: 10.1080/07481187.2024.2336006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Volunteers are a popular unpaid support role in end of life care yet how accompaniment influences the dying is underdeveloped. This study examined how companionship works, for whom, in what circumstances and why. Initial realist ideas were developed through participant observation (14 months), document analysis, and realist interviews with companionship trainers (n = 6). Theory testing involved volunteer interviews (n = 7), accounts from the dying, proxy accounts for the dying, and written reflections from companionship training. Companionship helps people live well until they die, prepare for death, and experience a good death. Four areas of volunteering explain these outcomes namely a loving friend, a holistic presence, a non-judgmental intermediary, and wrap around care. The four areas activate mechanisms related to reminiscing, preserving dignity/personhood, and easing suffering, contingent on specific contexts. The findings unpack how volunteering exerts its influence and what contextual factors facilitate outcomes, advancing the knowledge in this area.
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Affiliation(s)
- John Downey
- Faculty of Health, University of Plymouth, Plymouth, UK
| | - Susan Cooper
- Institute of Education, Plymouth Marjon University, Plymouth, UK
| | - Lynn Bassett
- The Centre for the Art of Dying Well, St Mary's University, London, UK
| | | | - Margaret Doherty
- The Centre for the Art of Dying Well, St Mary's University, London, UK
| | - Jon Cornwall
- St Vincent De Paul (England and Wales), Membership, UK
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2
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Oliver K, Brown M, Walshe C, Salifu Y. A Meta-Ethnographic Review of Paid Staff and Volunteers Working together in Palliative Care. J Pain Symptom Manage 2023; 66:656-670.e11. [PMID: 37574093 DOI: 10.1016/j.jpainsymman.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/15/2023]
Abstract
CONTEXT Volunteers in palliative care settings are an essential part of care provision for patients and those important to them. Effective collaboration between volunteers and paid staff has been regarded as an important element of successful working, however, at times failures in coordination, information sharing and tensions within teams have been highlighted. OBJECTIVES To explore the views expressed by volunteers and paid staff about their experiences of working together in palliative care settings. METHODS A systematic exploration of qualitative research using a meta-ethnographic approach. PsycINFO, CINAHL, Medline Complete, and AMED databases were searched from inception to December 2021 for the concepts "volunteers" and "palliative care." Repeated in-depth reading and appraisal of papers identified metaphors and concepts, providing new interpretations. RESULTS Included papers (n = 14) enabled the construction of five storylines: 1) "we are the cake, and they are the cream": understanding the volunteer role-separate, but part of a whole. 2) "…we don't know what's wrong with people but sometimes we need to know": access to information and importance of trust. 3) "everybody looks out for each other": access to paid staff and their support. 4) "...we don't meddle in the medical": boundaries. 5) "it's the small things that the staff does for me that makes me feel good about my work": sense of value and significance. CONCLUSIONS For effective working relationships between paid staff and volunteers, proactive engagement, recognition of each other's role and contribution, mutual sharing of information, and intentional interaction between both groups is needed.
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Affiliation(s)
- Katherine Oliver
- International Observatory on End of Life Care (K.O., C.W., Y.S.), Lancaster University, Lancaster, UK; Division of Nursing and Midwifery (K.O.), University of Sheffield, Sheffield, UK.
| | - Michelle Brown
- College of Health and Social Care (M.B.), University of Derby, Derby, UK
| | - Catherine Walshe
- International Observatory on End of Life Care (K.O., C.W., Y.S.), Lancaster University, Lancaster, UK
| | - Yakubu Salifu
- International Observatory on End of Life Care (K.O., C.W., Y.S.), Lancaster University, Lancaster, UK
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Preston G, Rampes S, Bayly J, Rice HT, Angelova R, Richardson H, Maddocks M. Using volunteers to improve access to community rehabilitation in palliative care: the St Christopher's Living Well at Home Team. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1229442. [PMID: 37791372 PMCID: PMC10544964 DOI: 10.3389/fresc.2023.1229442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/28/2023] [Indexed: 10/05/2023]
Abstract
Background UK hospices often provide outpatient rehabilitation services for people with advanced progressive illness. However, some people are unable to travel, leading to inequity in rehabilitation access. Objectives The Living Well at Home Team (LWAHT) at St Christopher's Hospice aimed to evaluate whether using volunteers to support rehabilitation in peoples' homes improved the reach of rehabilitation for people living in underserved localities and if it supported people to optimise their functional independence. Methods This service improvement project evaluated hospice rehabilitation uptake during the implementation of volunteer-supported community rehabilitation. Following assessment by an LWAHT therapist, eligible people were matched with a trained volunteer who supported four to eight rehabilitation sessions in the person's home. The evaluation assessed uptake of the rehabilitation sessions. Mobility, wellbeing, and goal attainment outcomes were assessed by the Life-Space Assessment (LSA), General Health Questionnaire (GHQ), and Goal Attainment Scale (GAS), respectively. Results In the first year, 183 patients were referred to the LWAHT; 123 were assessed and 96 received rehabilitation including 56 who were matched with a volunteer. Following volunteer support, patients reported significant improvements in mobility [LSA median 20 (IQR, 3.5-27.8)], general health [GHQ -2 (-5.25 to 0)], and achievement of goals [GAS T-score +8 (0-18.4)]. Conclusions It was feasible to support community rehabilitation using hospice volunteers for people with advanced progressive illness. The LWAHT service also increased the uptake of hospice centre-based rehabilitation. Further work should test efficacy and identify patients requiring additional professional input. Key message This is the first known study reporting on the use of trained rehabilitation volunteers to extend the reach of hospice rehabilitation services. People with limited access to the hospice, because of geographical location or personal circumstances, valued and benefited from tailored rehabilitation supported by the volunteers in their own homes.
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Affiliation(s)
- Gail Preston
- St Christopher’s Hospice, London, United Kingdom
| | - Sanketh Rampes
- Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Joanne Bayly
- King’s College London, Cicely Saunders Institute, London, United Kingdom
- St Barnabas Hospice, Worthing, United Kingdom
| | | | | | | | - Matthew Maddocks
- King’s College London, Cicely Saunders Institute, London, United Kingdom
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Tangcharoensathien V, Dhillon I. Health and Care Workers in Pandemic Recovery: Major Challenges and Solutions. Int J Health Policy Manag 2023; 12:8081. [PMID: 37579399 PMCID: PMC10425659 DOI: 10.34172/ijhpm.2023.8081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 04/26/2023] [Indexed: 08/16/2023] Open
Affiliation(s)
| | - Ibadat Dhillon
- World Health Organization, South-East Asia Regional Office, New Delhi, India
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5
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Holdsworth LM, Mui HZ, Winget M, Lorenz KA. "Never waste a good crisis": A qualitative study of the impact of COVID-19 on palliative care in seven hospitals using the Dynamic Sustainability Framework. Palliat Med 2022; 36:1544-1551. [PMID: 36305617 PMCID: PMC9618919 DOI: 10.1177/02692163221123966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND The COVID-19 pandemic led to rapid adaptations among palliative care services, but it is unclear how these adaptations vary in relation to their unique organizational contexts. AIM Understand how the pandemic impacted the implementation of new and existing palliative care programs in diverse hospital systems using the Dynamic Sustainability Framework. DESIGN Twelve in-depth interviews with 15 key informants representing palliative care programs from seven hospital systems between April and June 2020. SETTING Public, not-for-profit private, community, and academic teaching hospitals in the San Francisco Bay Area with existing palliative care programs that were expanding services to new clinical areas (e.g. new outpatient clinic or community-based care). RESULTS Six themes characterized how palliative care programs were impacted and adapted during the early stages of the COVID-19 pandemic: palliative care involvement in preparing for surge, increased emphasis on advance care planning, advocating for visitors for dying patients, providing emotional support to clinicians, adopting virtual approaches to care, and gaps in chaplaincy support. There was variation in how new and existing programs were able to adapt to early pandemic stresses; systems with new outpatient programs struggled to utilize their programs effectively during the crisis onset. CONCLUSIONS The fit between palliative care programs and practice setting was critical to program resiliency during the early stages of the pandemic. Reconceptualizing the Dynamic Sustainability Framework to reflect a bidirectional relationship between ecological system, practice setting, and intervention levels might better guide implementers and researchers in understanding how ecological/macro changes can influence interventions on the ground.
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Affiliation(s)
- Laura M Holdsworth
- Primary Care and Population Health, Department of Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Heather Z Mui
- Primary Care and Population Health, Department of Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Marcy Winget
- Primary Care and Population Health, Department of Medicine, School of Medicine, Stanford University, Stanford, CA, USA
| | - Karl A Lorenz
- Primary Care and Population Health, Department of Medicine, School of Medicine, Stanford University, Stanford, CA, USA.,Veterans Affairs Palo Alto Health Care System, Center for Innovation to Implementation, Palo Alto, CA, USA
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Irandoost SF, Sedighi S, Hoseini AS, Ahmadi A, Safari H, Ebadi Fard Azar F, Yoosefi Lebni J. Activities and challenges of volunteers in confrontation with COVID-19: A qualitative study in Iran. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 82:103314. [PMID: 36168596 PMCID: PMC9499992 DOI: 10.1016/j.ijdrr.2022.103314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/11/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
The control and prevention of COVID-19 requires the active and voluntary participation of the people. Because volunteers experience different activities and challenges, the present study aimed to identify the activities and challenges of volunteers in the face of COVID-19. The present study was conducted with a qualitative approach and conventional content analysis method among 35 volunteers in the field of COVID-19 using snowball sampling and semi-structured interviews. Data management was performed using MAXQDA-2018 software and its scrutiny was done by the Graneheim and Lundman analysis method. After analyzing the data, 2 main categories and 15 subcategories were obtained, including 1- Activities (instruction and training; production and distribution of hygiene items; economic aid; psychological and social support for COVID-19 affected people; cooperation with government organizations to implement quarantine; environmental disinfection; cooperation with and support of the medical staff; encouraging and persuading people to participate in voluntary work; attending and cooperating in high-risk centers) and 2- Challenges (fear and worry of getting infected; rejection; being different from other voluntary activities; experience of failure and helplessness; the difficulty of the recruitment and cooperation process; lack of adequate instruction on how to help). Volunteers have played wide and diverse roles in confrontation with COVID-19 and have been able to provide various types of support to government, health and social organizations and the general public in various ways, but due to the special circumstances of the COVID-19 epidemic, they have experienced many challenges at the same time.
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Affiliation(s)
- Seyed Fahim Irandoost
- Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Sardar Sedighi
- Health in Disasters and Emergencies, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ava Sadat Hoseini
- Health Education and Promotion, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ahmadi
- Educational Technology, Faculty of Psychology and Educational Sciences, Allameh Tabataba'i University, Tehran, Iran
| | - Hossein Safari
- Health Promotion Research Center, Iran University of Medical Sciences, Tehran, Iran
- School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | | | - Javad Yoosefi Lebni
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
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Frey R, Balmer D. COVID-19 and hospice community palliative care in New Zealand: A qualitative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4165-e4174. [PMID: 35403763 PMCID: PMC9111688 DOI: 10.1111/hsc.13810] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/08/2022] [Accepted: 03/29/2022] [Indexed: 05/27/2023]
Abstract
Within the context of an ageing population and the added challenges posed by COVID-19, the need to optimise palliative care management in the community - the setting where a significant proportion of people prefer to die - cannot be underestimated. To date, there has been a dearth of research exploring community palliative care delivery during the pandemic. This study aimed to explore the impact of and response to COVID-19 for hospice community services in Aotearoa/New Zealand. Eighteen structured interviews were conducted (10 February-18 August 2021) with healthcare professionals from sixteen purposively sampled community hospices from New Zealand regions according to the number of COVID-19-positive patients per 100,000 inhabitants (low, medium and high) with oversampling of high prevalence areas. Two overarching themes emerged 'challenges' and 'adaptations'. Each theme had several subthemes related to service delivery in communication, visiting, allied health team collaboration and volunteer services. Adaptations involved adjusting official health advice to the local context, increased use of telehealth, reducing infection risk during in-home visits through triaging of cases, division of the workforce into teams and repurposing volunteers' services. Despite these adaptations, challenges remained, including increased workload pressures for staff and an absence of the human touch for patients and families. Implications for hospice practice and recommendations for future research are discussed. Governments must acknowledge the essential contribution of hospice to the COVID-19 pandemic and ensure that these services are incorporated into the healthcare system response.
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Affiliation(s)
- Rosemary Frey
- School of NursingFaculty of Medical and Health SciencesUniversity of AucklandAucklandNew Zealand
| | - Deborah Balmer
- School of NursingFaculty of Medical and Health SciencesUniversity of AucklandAucklandNew Zealand
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8
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van Langen-Datta S, Wesson H, Fleming J, Eccles A, Grimley C, Dale J, Almack K, Mayland C, Mitchell S, Driscoll R, Tatnell L, Roberts L, MacArtney JI. The impact of Covid-19 pandemic on hospices: A systematic integrated review and synthesis of recommendations for policy and practice. AMRC OPEN RESEARCH 2022; 4:23. [PMID: 38708127 PMCID: PMC11064931 DOI: 10.12688/amrcopenres.13105.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 05/07/2024]
Abstract
Background The Covid-19 pandemic resulted in the development of numerous recommendations for practice and policy for specialist palliative care provided by hospices in United Kingdom (UK), as hospices were significantly affected by the pandemic and protections put in place.The aim of this review is to identify and synthesise recommendations or implications for policy and practice that have been generated for adult hospice specialist palliative care during the first 24 months of the Covid-19 pandemic. Methods AMED, BNI, CINAHL, EMBASE, EMCARE, HMIC, Medline, PsycINFO, PubMed databases were searched for peer-reviewed papers, as well as hand searchers for grey literature. Literature relating to hospices and Covid-19 in the UK were included and a thematic synthesis of recommendations for hospice policy and practice was undertaken. Results 858 articles were identified with 12 meeting the inclusion criteria. Fifty-eight recommendations or implications were identified: 31 for policy, 27 for practice, and 10 covering both. Recommendations were organised under ten themes. There were several recommendations seeking to secure hospice resources to mitigate the short-term impact of the pandemic, as well as those focused on longer-term implications such as core funding. The impact of the pandemic on the quality of hospice care was the focus for numerous recommendations around improving integration of hospice care in the community, provision of bereavement support and better use of Advance Care Plans (ACP). However, there were significant gaps related to carer visitation in hospices, inequities of palliative care, or hospice-at-home services. Conclusion The Covid-19 pandemic and protections exposed several ongoing policy and practice needs, especially around hospice resources, while generating novel issues for hospices to address. Significant policy gaps remain to be addressed to mitigate the impact of the pandemic on the quality of hospice specialist palliative care.
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Affiliation(s)
| | - Helen Wesson
- Unit of Academic Primary Care, Warwick Medical School, University of Warwick, Coventry, Warwickshire, CV4 7AL, UK
| | - Joanna Fleming
- Unit of Academic Primary Care, Warwick Medical School, University of Warwick, Coventry, Warwickshire, CV4 7AL, UK
| | - Abi Eccles
- Unit of Academic Primary Care, Warwick Medical School, University of Warwick, Coventry, Warwickshire, CV4 7AL, UK
| | - Catherine Grimley
- Unit of Academic Primary Care, Warwick Medical School, University of Warwick, Coventry, Warwickshire, CV4 7AL, UK
| | - Jeremy Dale
- Unit of Academic Primary Care, Warwick Medical School, University of Warwick, Coventry, Warwickshire, CV4 7AL, UK
| | - Kathryn Almack
- University of Hertfordshire, Hatfield, Hertfordshire, AL10 9AB, UK
| | - Catriona Mayland
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, S10 2TN, UK
| | - Sarah Mitchell
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, S10 2TN, UK
| | | | - Lynn Tatnell
- Patient or Public Involvement (PPI) Representative, University of Warwick, Coventry, CV4 7AL, UK
| | - Lesley Roberts
- Patient or Public Involvement (PPI) Representative, University of Warwick, Coventry, CV4 7AL, UK
| | - John I. MacArtney
- Unit of Academic Primary Care, Warwick Medical School, University of Warwick, Coventry, Warwickshire, CV4 7AL, UK
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Pesut B, Thorne S, Huisken A, Wright DK, Chambaere K, Tishelman C, Ghosh S. Is progress being made on Canada's palliative care framework and action plan? A survey of stakeholder perspectives. BMC Palliat Care 2022; 21:182. [PMID: 36242026 PMCID: PMC9561335 DOI: 10.1186/s12904-022-01074-4] [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] [Received: 06/20/2022] [Accepted: 10/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background The legalization of Medical Assistance in Dying in Canada in 2016 provided new impetus for improving palliative care. This commitment to improvement included the development of a National Palliative Care Framework and Action Plan. The purpose of this study was to understand the progress made in palliative care since 2016 from the perspective of persons working and volunteering in palliative care and compare geographic differences. Methods A digital survey was developed from goals identified in Canada’s Palliative Care Framework and Action Plan and administered online using Qualtrics. Participants were recruited through national palliative care organizations. The survey included both quantitative survey items designed to evaluate improvements across 5 domains and 29 items and included open-ended questions about impacts, innovations, and ongoing challenges. Descriptive statistics were generated for survey domains, items, and demographic variables. Geographic differences were compared using Independent-Samples Kruskal–Wallis test. Qualitative data was analyzed inductively into themes. Results One hundred fifty surveys met inclusion criteria and were analysed. Overall, the most improvement was reported in palliative care education and the least improvement was reported in support for family caregivers. Items on which respondents reported the most improvement included healthcare provider education in palliative care, advance care planning, and use of technology. Items on which respondents reported the least improvement were respite for family caregivers, access to bereavement services, and in-home support for family caregivers. Notably, rural participants reported more statistically significant improvements in the domains of education, access, and research and data collection than their urban counterparts. However, rural participants reported less improvement in places to die when home is not preferable. The COVID-19 pandemic was a significant contributor to these perceived improvements and ongoing challenges. Conclusion Canada’s Framework and Action Plan sets out a roadmap for improving palliative care in Canada. Participants in this survey noted significant improvements in key areas, a notable accomplishment amidst the effects of the COVID-19 pandemic. Some improvements were a result of greater use of distance technology. Further leveraging these improvements will make an important contribution to solving some of the rural and remote palliative care issues that have arisen from Canada’s unique geography.
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Affiliation(s)
- Barbara Pesut
- Professor School of Nursing, Principal Research Chair in Palliative and End-of-Life Care, University of British Columbia Okanagan. ARTS 3rdFloor, 1147 Research Road, Kelowna, BC, V1V 1V7, Canada.
| | - Sally Thorne
- Professor School of Nursing, University of British Columbia, Vancouver, BC, V6T 2B5, Canada
| | - Anne Huisken
- Research Coordinator Palliative and End of Life Research Lab, University of British Columbia Okanagan, BC, Kelowna, Canada
| | - David Kenneth Wright
- Associate Professor, School of Nursing, University of Ottawa, Ottawa, ON, K1H 8M5, Canada
| | - Kenneth Chambaere
- Professor Public Health, Sociology & Ethics of the End of Life, End-of-Life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, C. Heymanslaan 10, B-9000, Ghent, Belgium
| | - Carol Tishelman
- Professor of Innovative Care Karoliinska Institutet, Department of Learning, Informatics, Management and Ethics Division of Innovative Care Research, Stockholm, Sweden
| | - Sunita Ghosh
- Associate Clinical Professor/Research Scientist, University of Alberta/Alberta Health Services, Edmonton, Canada
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10
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Garner IW, Walshe C, Dunleavey L, Bradshaw A, Preston N, Fraser LK, Murtagh FE, Oluyase AO, Sleeman KE, Hocaoglu M, Bajwah S, Chambers RL, Maddocks M, Higginson IJ. Charitably funded hospices and the challenges associated with the COVID-19 pandemic: a mixed-methods study (CovPall). BMC Palliat Care 2022; 21:176. [PMID: 36210447 PMCID: PMC9548425 DOI: 10.1186/s12904-022-01070-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 09/28/2022] [Accepted: 10/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Independent charitably funded hospices have been an important element of the UK healthcare response to the COVID-19 pandemic. Hospices usually have different funding streams, procurement processes, and governance arrangements compared to NHS provision, which may affect their experiences during the COVID-19 pandemic. The aim of this study is to understand the challenges faced by charitably funded hospices during the COVID-19 pandemic. Methods Eligible Organisations providing specialist palliative or hospice care completed the online CovPall survey (2020) which explored their response to the COVID-19 pandemic. Eligible organisations were then purposively selected to participate in interviews as part of qualitative case studies (2020-21) to understand challenges in more depth. Free-text responses from the survey were analysed using content analysis and were categorised accordingly. These categorisations were used a priori for a reflexive thematic analysis of interview data. Results 143 UK independent charitably funded hospices completed the online CovPall survey. Five hospices subsequently participated in qualitative case studies (n = 24 staff interviews). Key themes include: vulnerabilities of funding; infection control during patient care; and bereavement support provision. Interviewees discussed the fragility of income due to fundraising events stopping; the difficulties of providing care to COVID-19 and non-COVID-19 patients within relatively small organisations; and challenges with maintaining the quality of bereavement services. Conclusion Some unique care and provision challenges during the COVID-19 pandemic were highlighted by charitably funded hospices. Funding core services charitably and independently may affect their ability to respond to pandemics, or scenarios where resources are unexpectedly insufficient.
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Affiliation(s)
- Ian W Garner
- Division of Health Research, Lancaster University, Lancaster, UK.
| | - Catherine Walshe
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Lesley Dunleavey
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Andy Bradshaw
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Nancy Preston
- Division of Health Research, Lancaster University, Lancaster, UK
| | - Lorna K Fraser
- Health Sciences, University of York, North Yorkshire, UK
| | - Fliss Em Murtagh
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK.,Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Adejoke O Oluyase
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Katherine E Sleeman
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.,King's College Hospital NHS Foundation Trust, Denmark Hill, UK
| | - Mevhibe Hocaoglu
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Sabrina Bajwah
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.,King's College Hospital NHS Foundation Trust, Denmark Hill, UK
| | - Rachel L Chambers
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Irene J Higginson
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.,King's College Hospital NHS Foundation Trust, Denmark Hill, UK
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11
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Chen H, Wang J, Yu X, Li C, Zhao Y, Xing Y, Li X. Policies of voluntary services involved in public health emergencies in China: Evolution, evaluation, and expectation. Front Public Health 2022; 10:946888. [PMID: 36062102 PMCID: PMC9433879 DOI: 10.3389/fpubh.2022.946888] [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] [Received: 06/17/2022] [Accepted: 07/25/2022] [Indexed: 01/21/2023] Open
Abstract
Background Public health emergencies have an immense effect on social stability, economic development, and human life. Volunteers played an indispensable role in health monitoring, assistance with daily life, and social network repairing. However, few policies analysis concentrated on the voluntary services involved in public health emergencies. Objectives This study aims to analyze and summarize the advantages and flaws of the policy documents relating to voluntary services involved in public health emergencies, and put forward the enlightenment on policymaking and optimization. Methods A three-dimensional analysis framework of "Policy instruments-Participants of voluntary services-Stages of voluntary services" was designed. Policy documents at the national level were retrieved from the official websites of the State Council of the People's Republic of China and its departments as well as the PKULAW Database. NVivo software was applied to analyze the contents of the included policy documents. Gephi software was adopted to conduct a visualized atlas analysis of the cooperative network among policymaking departments. Results A total of 77 policy documents were included, and most were published in 2020 (n = 40). The Ministry of Civil Affairs (n = 19) and the National Health Commission (n = 18) issued more documents than the other departments. They cooperated more extensively with other departments. In policy documents, supply-side policy instruments were utilized the most (65.4%), followed by demand-side (23.9%). Voluntary organizations in the form of ambiguous sense were most mentioned as service participants (n = 73). In the stages of service delivery, service content mainly involved the prevention and control of public health emergencies (27, 18.9%) and psychological counseling (26, 18.2%). Conclusion Time distribution of policy documents featured "incubation period-outbreak and continuous evolution period-elimination recovery period." Joint issuing became the dominant form. The internal structure of policy instruments was unbalanced with different priorities, and the overall structure is expected to be optimized to promote voluntary organization management, reinforce external resources, and close the gap between policymaking and policy implementation. Volunteers' competence and voluntary organizations' system needs to be improved, and the contents of voluntary services should be enriched for the preparedness for future public health emergency.
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12
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Bayly J, Bradshaw A, Fettes L, Omarjee M, Talbot-Rice H, Walshe C, Sleeman KE, Bajwah S, Dunleavy L, Hocaoglu M, Oluyase A, Garner I, Cripps RL, Preston N, Fraser LK, Murtagh FE, Higginson IJ, Maddocks M. Understanding the impact of the Covid-19 pandemic on delivery of rehabilitation in specialist palliative care services: An analysis of the CovPall-Rehab survey data. Palliat Med 2022; 36:319-331. [PMID: 34964384 DOI: 10.1177/02692163211063397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Palliative rehabilitation involves multi-professional processes and interventions aimed at optimising patients' symptom self-management, independence and social participation throughout advanced illness. Rehabilitation services were highly disrupted during the Covid-19 pandemic. AIM To understand rehabilitation provision in palliative care services during the Covid-19 pandemic, identifying and reflecting on adaptative and innovative practice to inform ongoing provision. DESIGN Cross-sectional national online survey. SETTING/PARTICIPANTS Rehabilitation leads for specialist palliative care services across hospice, hospital, or community settings, conducted from 30/07/20 to 21/09/2020. FINDINGS 61 completed responses (England, n = 55; Scotland, n = 4; Wales, n = 1; and Northern Ireland, n = 1) most frequently from services based in hospices (56/61, 92%) providing adult rehabilitation. Most services (55/61, 90%) reported rehabilitation provision becoming remote during Covid-19 and half reported reduced caseloads. Rehabilitation teams frequently had staff members on sick-leave with suspected/confirmed Covid-19 (27/61, 44%), redeployed to other services/organisations (25/61, 41%) or furloughed (15/61, 26%). Free text responses were constructed into four themes: (i) fluctuating shared spaces; (ii) remote and digitised rehabilitation offer; (iii) capacity to provide and participate in rehabilitation; (iv) Covid-19 as a springboard for positive change. These represent how rehabilitation services contracted, reconfigured, and were redirected to more remote modes of delivery, and how this affected the capacity of clinicians and patients to participate in rehabilitation. CONCLUSION This study demonstrates how changes in provision of rehabilitation during the pandemic could act as a springboard for positive changes. Hybrid models of rehabilitation have the potential to expand the equity of access and reach of rehabilitation within specialist palliative care.
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Affiliation(s)
- Joanne Bayly
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK.,St Barnabas Hospices, Worthing, UK
| | - Andy Bradshaw
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Lucy Fettes
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Muhammed Omarjee
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | | | | | - Katherine E Sleeman
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Sabrina Bajwah
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | | | - Mevhibe Hocaoglu
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Adejoke Oluyase
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | | | - Rachel L Cripps
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | | | - Lorna K Fraser
- Martin House Research Centre, Department of Health Sciences, University of York, York, UK
| | - Fliss Em Murtagh
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Irene J Higginson
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
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