bluuebunny/crossref_metadata_2025 huggingface dataset:
Time for non-cancer
Authors: Connolly Michael
Published: May 2014

At the European Association of Palliative Care congress (The Hague, April 2–5, 2003) it was clear that most of the delegates were talking about cancer. Palliative care in non-malignant disease is not yet a major priority in most European countries, although there are hopeful signs. First, those researchers and practitioners who presented studies on heart failure, respiratory diseases and renal failure were paid great interest by other delegates. Second, the American delegates made the application of palliative care to non-malignant diseases sound very straightforward. Although, there is considerable evidence that end-of-life care in America remains far from ideal (Lynn et al, 1997), it does seem that the services are applied equitably, rather than for one diagnostic group (cancer) as they are in much of Europe.
The personal cost of caring
Authors: Dunne Kathleen
Published: May 2014

Although palliative care nursing brings many rewards, it also places many demands and stresses on nurses. These can include the emotional demands of caring, the pressure of large patient numbers, the demands of caring for young patients and the need to support children and adolescents with a dying parent. The uniqueness of each family unit means that nurses are confronted with many varying situations. Nurses are clearly affected by some of these and may feel personally touched by circumstances. Bearing up under profound sadness can be difficult and nurses often feel pushed to the limit. Their emotional state can be fragile or they may feel emotionally drained. Sadly, there is often no clear strategy to help nurses cope. How do nurses debrief and express their emotions so that there is closure for them? Of course this issue is not unique to palliative care nursing, but somehow the closeness of the nurse–patient relationship in this field means that nurses become involved in the family unit in a very meaningful and supportive way.
The first 2 years of a palliative care consultation team in the Netherlands
Authors: Schrijnemaekers Veron , Courtens Annemie , van den Beuken Marieke , Oyen Paul
Published: May 2014

In January 1999 an integrated Palliative care Outcome Scale consultation (PCC) team was established in Maastricht in the Netherlands. The team included experts in palliative care who had extensive experience in a variety of settings. One of the major tasks of the PCC team was to give support, information and advice to health-care professionals caring for terminally ill patients. The PCC team was asked by the government to consecutively register and evaluate all consultations. This article describes these consultations, including information on the requesting caregivers, the patients, the questions asked and the recommendations given in the first 26 months. The results show that the PCC team served the needs of professional caregivers in a variety of settings. Most consultations concerned physical and pharmacological problems and the majority of recommendations were evaluated as positive.
Campto® effective and flexible chemotherapy for advanced colorectal cancer
Authors: Ferns Helen
Published: May 2014

The use of chemotherapy with patients with advanced colorectal cancer is increasing. There is a growing appreciation of the potential of traditional and newer treatments to improve quality of life, and of their value in the palliation of symptoms, in addition to providing modest gains in overall survival. Possible benefits have to be weighed up against the risk of side effects and patients need to be supported in making difficult decisions. This article provides a brief overview of chemotherapy agents for advanced colorectal cancer and focuses on one new agent, Campto®. The evidence supporting its use, common side effects and management recommendations are discussed. The role of the oncology team and the implications for nurses are outlined.
Breast cancer resources
Authors: Smyth Dion
Published: May 2014

Breast cancer is a major public health concern. It is the most common of all malignant diseases in women, with a steadily increasing incidence in the developed Western world over the past 50 or so years. It is also the leading cause of death from malignant disease in Western women.
Prescribing - a crucial skill for the palliative care nurse of the future
Authors: Mula Carole
Published: May 2014

Almost 2 years ago I was one of the first nurses in the UK to undertake extended independent nurse prescribing (Department of Health (DoH), 2002). This is an exciting development for nurses working in palliative medicine, which is having a positive impact on patient care. It has relieved doctors’ workloads, facilitated rapid discharge from hospital and helped nurses keep patients at home, thereby reducing crisis admissions to hospitals.
The IJPN Awards. Have you applied yet?
Authors: Cooley Candy
Published: May 2014

The problem with awards and award ceremonies is about perception. People will say ‘Oh! I don’t do anything special’ and ‘It’s just part of my job’ or ‘I wouldn’t want anyone to think I was bigheaded’. But then, when the awards are announced, people say ‘Well we do that’ or ‘I could have written/presented that better’.
A time to pause
Authors: Aranda Sanchia , Cooley Candy
Published: May 2014

The close of the year is here and this offers us a time to reflect on the directions taken in palliative care. The year has been a good one for the journal with the quality of papers always increasing and the editorial team would like to thank all of our readers and authors for their consistent support and offer our best wishes for a safe and festive Christmas break. The introduction of commentaries and other forms of debate in the journal offers us an opportunity to reflect on our work and consider the ways forward for our specialism.
Palliative care and the family
Authors: Aranda Sanchia
Published: May 2014

Palliative care is commonly said to focus on the family as the unit of care. However, delivery of family-centred care offers practical and ethical challenges for nurses. Practical challenges arise because families are complex and frequently the nurse’s involvement is mediated through the patient and a single primary carer. The family is also defined in a variety of ways; it may represent a close nuclear family in one context or non-blood bonds in another. Ethical challenges arise because not all families provide a loving and supportive environment within which the patient is cared for until death. Family conflict and abusive family relationships are examples of challenges that do not disappear simply because a person is dying. Becker’s Open Dialogue on page 66 sets the scene for this themed issue by disrupting the often-ideological portrayal of families in palliative care philosophy.
Standardize or individualize: finding a balance
Authors: Daniels Lilian
Published: May 2014

Emphasis on quality and equity of access to palliative care services has resulted in the development of a variety of standards and guidelines in the UK. These can promote multidisciplinary team working by requiring roles to be more clearly defined and team working methods to be used.
Promoting ownership in palliative care audit
Authors: Cooper Jan , Pettifer Annie
Published: May 2014

Audit in health care is the systematic and critical analysis of the quality of care (Department of Health (DoH), 1989). Although not new to palliative care, it has been given fresh impetus in the UK through the introduction of clinical governance (DoH, 1998). Clinical governance has been described as:

‘a framework through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish’

(DoH, 1998)
Integrated care: hospice and palliative care services lead the way
Authors: Howell Doris
Published: May 2014

Integration of health-care services has become a worldwide issue as countries seek solutions to care fragmentation, escalating costs and discontinuities in care experienced by individuals and their families. Integration is particularly relevant to the terminally ill person and family whose health-care needs require input from varied health-care disciplines and different care sectors along the continuum of illness.
Organization of palliative care across the world
Authors: Smyth Dion
Published: May 2014

The principles and practice of palliative care promote a model of care centred on the concept of quality of life. This philosophy is increasingly being recognized and realized internationally as a new caring paradigm. This month’s Web Words looks at some sites that help to develop our knowledge and understanding of the interest in, and issues facing, palliative care across the globe.
Conferences: opportunities for all
Authors: Payne Sheila
Published: May 2014

Having just returned from two recent conferences, the 3rd European Association of Palliative Care Methodology conference in Stresa, Italy and the 1st Collaborative Palliative Care Conference in London, England organized by the International Journal of Palliative Nursing and Palliative Medicine, I would like to devote this editorial to considering the advantages and disadvantages of conference attendance. Reactions to plans for conference attendance vary from assumptions that they are a waste of time – a ‘jolly’ or holiday away from the ‘real’ work of nursing, to assumptions that conferences are an essential part of continuing professional development. As a busy clinician, researcher or manager, what are the advantages and disadvantages of taking time out to go to a conference?
Identifying the palliative care role of the nurse working in community hospitals: an exploratory study
Authors: Hamilton Faye , McDowell Joan
Published: May 2014

Aim To ascertain registered nurses’ and GPs’ perceptions of and influences on the nurse’s role in providing palliative care in community hospitals.

Design Qualitative exploratory/descriptive study.

Setting Two community hospital sites within Perth and Kinross, Scotland.

Method Taped semi-structured interviews with four registered nurses and two GPs. Participants’ perceptions were sought on the roles of nursing and medical professionals and of factors facilitating and hindering the provision of palliative care within the community hospital setting.

Findings Six key themes were identified through thematic analysis of the information: communication, teamwork and relationships, holistic care, resources, culture, professional role.

Conclusion The themes were inter-related and gave valuable insight into the multi-dimensional nature and significance of the nurse’s role in palliative care in the community hospital setting.
Outcome measures in palliative care
Authors: Smyth Dion
Published: May 2014

The increasing interest in outcome measures to study the effects of our interventions and care is one way of improving standards and the evidence upon which care is based.
What do you do to look after yourself? A priority for 2005?
Authors: Kinghorn Shaun
Published: May 2014

While working in our outpatient therapy clinic I was recently reminded of the importance of taking care of ourselves. As the appointment came to a close out of the blue the patient remarked, ‘It cannot be easy for you all working in this place – what do you do to look after yourself?’ This question caused me to reflect, and is something that we all need to ask ourselves from time to time.
A personal reflection on sitting at the bedside of a dying loved one: the final hours of life
Authors: Woodhouse Jan
Published: May 2014

This article is the second of two pieces in which the author reflects on the experience of her family at the bedside of her dying father. The author, a lecturer in palliative nursing, observed the family and health-care staff and reflected on the situation as a means of coping during this difficult time. Although not a piece of research, palliative care literature has been used in this reflection to inform the author’s interpretations. The first article (Woodhouse, 2004) gave some insight into the family experience in the 3days leading up to her father’s death. This piece shares some thoughts on what happened during the last few hours of his life.
How basic is palliative care? A response to the responses so far
Authors: Gupta Harmala
Published: May 2014

Continuing the debate on the nature of palliative care (Gupta, 2004; Downing et al, 2005), Harmala Gupta comes back with her thoughts on the issues raised so far.
Palliative care response to HIV/AIDS in South Africa
Authors: Gwyther Liz
Published: May 2014

In this short piece Liz Gwyther reports on a programme addressing the needs of patients and families affected by the HIV/AIDs epidemic in South Africa.
Ethical considerations in spiritual care
Authors: Farvis Rachel A
Published: May 2014

Responding to the article on spirituality by Seymour and Ingleton (1999), reprinted in the special anniversary issue of IJPN, this author argues that it is imperative that ethical considerations are not overlooked in providing spiritual care. Ethical issues abound, including confidentiality, categorization of spiritual needs and the appropriateness of spiritual care for patients and staff. This brief comment piece raises a number of questions relating to these issues, which need to be addressed if best practice is to be ensured.
Embracing education in palliative care
Authors: Becker Robert
Published: May 2014

We learn by observing, by listening, by reading and, most of all, by doing. This is carried out in all facets of our job as palliative care professionals and, if repeated often enough, the learning becomes permanent. Values, belief systems and professional ethics that underpin the context of learning are absorbed. If it is effective, our behaviour should replicate that learning in the skills we demonstrate, the attitudes we display and be reflected in the wisdom projected in our personality. At least that’s the theory, but the reality is fraught with financial, social, and bureaucratic obstacles. As you read this special edition, you will discover just how complex, difficult and yet creative education has become.
Palliative care education in Croatia
Authors: Oliver David
Published: May 2014

Croatia is a small country with a population of only 4.3 million and, owing to the conflicts and problems experienced over the last 15 years, palliative care services are only now starting to develop.
Website resources that explore nurse education in palliative care
Authors: Smyth Dion
Published: May 2014

The American publishing mogul Malcolm S Forbes suggested that ‘education’s purpose is to replace an empty mind with an open one’. The internet allows us to access more readily and share information, advice, experience, expertise and research with our colleagues. It allows us to open our minds to countless opportunities and resources that may be used to develop ourselves and our services.
Improving oral health with dental colleagues
Authors: Marston Angela
Published: May 2014

Imagine that you have a cotton ball in each cheek, now try to talk — difficult? Feel like eating or drinking? What about kissing your partner — couldn’t possibly? For many of us, these are normal, everyday activities that we take for granted, but if you are a palliative care patient with oral thrush or a dry mouth, these simple activities may cause more pain and suffering. The patient may wonder why the doctor or nurse forgot to tell them that the opioid to help their pain might adversely affect their oral health. As a patient, you may have been interested to know that there was something you could do to help minimize these adverse effects and, if you were unable to do this yourself, that your nurse or carer would help.
Growing, living and learning at end of life
Authors: Drew Donna
Published: May 2014

Children and their families face a difficult and uncertain journey along the illness trajectory as they approach death. As palliative care professionals we need to be aware of the levels of understanding of their illness, treatment and death that children and adolescents may have, in order to be able to address their needs and fears. Children are great protectors and will often not want to discuss what they are thinking or feeling, for fear of upsetting those close to them.
Compassion, campaigning and care this Christmas
Authors: Smyth Dion
Published: May 2014

For many people, the weekly 9–5 working life goes beyond beingmerely a way to make a living. The various roles and responsibilities associated with employment often fulfil a fundamental social and psychological need and not just a financial demand on our time. Illnesses, such as cancer, can alter our ability to perform these functions and, without adequate legal protection, employees whose disease is incurable may find they are discriminated against at a time when the sense of meaning and self-esteem are already compromised. This month’s web words looks first at resources to further the discussion raised in the commentary article on p554 of this issue: Compassion in the workplace? Discrimination against an employee with cancer.
Don’t let the real heroes go unsung
Authors: Becker Robert
Published: May 2014

This is the season for award ceremonies. The entertainment industry corners the market in terms of publicity for such awards and it is easy to be cynical about such events and the egos involved, but at another level it important that palliative care be prepared to engage in acknowledging and celebrating its own achievements. The self-effacing, hard working professionals who commit so much of themselves and make a real difference to peoples lives often go unnoticed. The world of palliative care is full of such people, who would never consider that they should get an award, but are nevertheless richly deserving of recognition.
Lest we forget: online information and resources for palliative care
Authors: Smyth Dion
Published: May 2014

The majority of patients who require palliative care now are older adults. These are people with life experiences that are often dramatically different to ours, not least because they lived through a war, and its aftermath, that affected most of the world’s countries and empires.
Giving patients the option to die at home
Authors: Moffat Polly
Published: May 2014

Welcome to this final edition of IJPN in 2007. The issue of dying at home is a vital one and provokes impassioned debate whenever it is raised. A recent report from Marie Curie Cancer Care demonstrated that a pilot project, the first of its kind in the UK, has helped to double the number of terminally ill people able to die at home. The Delivering Choice Programme was launched in 2004 to determine whether it was possible to provide greater choice for patients in end-of-life care.
Work-Based Learning in Cancer and Palliative Care
Authors: Cooley Candy
Published: May 2014

This is a fascinating review of the process of developing the Macmillan National Institute of Education and the partnership with educational establishments across the United Kingdom. Each chapter, written by a member of staff from within the institute, explains a different part of the institute’s role.
Making a difference in palliative care nursing
Authors: Duggleby Wendy
Published: May 2014

One of the benefits of an international journal such as the International Journal of Palliative Nursing is that it showcases the diverse nature of palliative nursing. The published articles reflect a variety of work settings, roles, cultures and populations, as well as our commonalities, one of which I believe is our commitment to palliative nursing. We are constantly striving to make a difference in the lives of those we care for.
Health professionals’ opposition to euthanasia and assisted suicide: a personal view
Authors: de Vocht Hilde , Nyatanga Brian
Published: May 2014

This commentary evaluates the motives of health professionals’ opposition to the legislation of assisted dying. We argue that there are no rational or justifiable grounds for such opposition in the case of patients who are suffering unbearably and whose request to be helped to die is competent, enduring and voluntary.

We then engage in plausible speculation about what other, more hidden motives of health professionals might lead to them reject the legislation of assisted dying. We assert that, while these hidden motives are understandable from a psychological perspective, they also suffocate the self-determination of palliative patients. Therefore, the challenge is for health professionals to reconsider extending their own limits in order to fully support their patients’ needs.

Finally we discuss the consequences of NOT legalising assisted dying, and conclude that this position might be more detrimental than legalising it.
Rehabilitation in care: online information and resources
Authors: Smyth Dion
Published: May 2014

Many of us will start the New Year with resolutions to better ourselves, heal damaged relationships or curb the excesses our body has been subjected to over a period of festive over-indulgence.
Palliative care in changing economic times
Authors: Ling Julie
Published: May 2014

Listening to the radio on my way to work, I am struck by just how gloomy the news is regarding the world economy. During media discussion and debate regarding the issue of whether we are officially in recession or not, we are reminded that it was the 1980s when we last saw a recession in Europe, and before that? It was the 1970s. So it would seem that for each generation there have been uncertain economic times. This time, however, we are told it is the end of the financial world as we know it – palliative care for the current banking system.
Quality of life in palliative care: being at ease in the here and now
Authors: Crang Clare , Muncey Tessa
Published: May 2014

Quality of Life (QoL) is an important issue for users of hospice services and may be assessed in a quantitative way. This study set out to evaluate the effectiveness of the Schedule for the Evaluation of Individual Quality of Life – Direct Weighting (SEIQoL-DW). A sequential mixed methods design was used to examine both quantitative and qualitative factors relating to quality of life. Five participants were recruited from an inpatient specialist palliative care (hospice) unit in East Anglia. Each participant completed the SEIQoL-DW followed by unstructured interviews, which were analysed using Giorgi’s (1985) psychological phenomenological method.

It was found that SEIQoL-DW provided an opening or ‘window’ onto participants’ QoL as they travelled from their past to their future. Themes emerging from the unstructured interviews suggest that QoL was about ‘being at ease’ in the ‘here and now’ and was influenced by past experiences and future expectations. Existential and spiritual issues, which were not all captured by the SEIQoL-DW, were of more importance than physical symptoms. This needs to be taken into account when caring for those nearing the end of their lives and particularly when using medications that have an adverse effect on mental acuity.
Religious festivals: online information and resources
Authors: Smyth Dion
Published: May 2014

Hinduism is one of the world’s oldest belief systems and there are almost one billion devoted adherents, the majority based in and around the Indian sub-continent. Nevertheless, global migration and cultural integration have meant that many palliative care communities will now see members of this faith. Perhaps, like me, many of you had previously thought this belief was based on a conviction that several gods existed; however, Hindus believe in one God – Brahman – and all the other gods are different expressions of this divinity. This month’s Web Words continues the series of sites that examine and explain the world’s disparate and distinct faiths so that our philosophy of care and clinical practice providing culturally sensitive care can be better qualified.
Religious beliefs: online information and resources
Authors: Smyth Dion
Published: May 2014

Buddhism is not a revealed religion or belief in a personal deity who has established a particular relationship with humanity; rather it is a set of teachings based on the experience and spiritual enlightenment of Siddhartha Gautama or Buddha. In the ‘four noble truths’ Buddha taught that all existence is unsatisfactory and filled with suffering but it is possible to find an end to this anguish; compassion for all living things is important.
Discussions at the end of life
Authors: Mula Carole
Published: May 2014

Currently, in England and Wales over half a million people die every year (Office for National Statistics, 2004). Of this number, more than half die in hospital, despite the majority choosing home as their preferred place of death (Higginson, 2003). Discussions to promote patient choice and preferences have far-reaching implications for patients, carers, professionals and service delivery.
Building consensus
Authors: Downing Julia , Larkin Philip
Published: May 2014

Have you ever begun walking up a steep hill when it has been raining and misty, the route that you need to take is not clear, and the ground is wet and muddy underneath – you know that you need to reach the top but you are not sure how to get there. Then suddenly the mist clears, not only can you see the top where you are aiming for, but the path to reach it has become clear.
Atheism: online information and resources
Authors: Smyth Dion
Published: May 2014

The final part of the series, which explores the websites that explain the various world belief systems, examines websites relating to atheism. Atheism may be largely defined as the denial or disbelief in a deity and the rejection of a mystical God as an influence on Man. As such, it may seem out of place in a series that has mainly addressed faith and religious belief; nevertheless, as we enter an era of more secular sensibility and receptivity to the natural and not supernatural world, it is reasonable to consider resources for this aspect of life.
Implementation and evaluation of a palliative care resource scheme within a district general hospital
Authors: Rees Yvonne , Jones Sian , Parry Maria
Published: May 2014

This article explores the development, implementation and evaluation of a palliative care resource scheme in a district general hospital in Mid Gamorgan, Wales. The evolution of the resource scheme and how the hospital specialist palliative care team identified the need for improved patient care on hospital wards is discussed, in addition to how using their specialist role combined with education can implement change.

The project evolved from initially recruiting two nurses on an in-house educational programme, to what has since become a formal arrangement with the local university, whereby students can access taught palliative care modules at degree and diploma levels as part of a distance learning degree in cancer care and a distance learning post-graduate certificate in palliative care. The resource enhances the knowledge of the practitioners who have completed it and also formalizes and expands the working links between education and clinical practice. It is hoped to continue and develop the scheme to further enhance the collaborative partnerships.
Broadcasting death and the legality of assisted suicide: are they the antithesis to palliative care?
Authors: Smyth Dion
Published: May 2014

Perhaps one of the most famous published or performed meditations upon man’s mortality is ‘to be or not to be – that is the question’. Shakespeare’s Prince Hamlet is, depending on your interpretation of the text, contemplating a suicide that will end ‘the heartache and the thousand natural shocks that flesh is heir to’. Via the theatrical contrivance of the soliloquy, his contemplations are conveyed to the audience and through the dramatic device of this internal monologue we gain a deep insight into, and share confidence with, a complex personal perspective and the pain of the character.
Effecting positive change with bereaved service users in a hospice setting
Authors: Agnew Audrey , Duffy Joe
Published: May 2014

User involvement is now an internationally established feature of health and social care, service planning and delivery. This paper discusses the background context of user involvement as a prelude to describing the processes pursued in changing communication systems for bereaved service users. This qualitative study aimed to gain a deeper understanding of service user experiences of an adult bereavement group in a hospice setting in Northern Ireland. The key focus of the study was the development of a bereavement information leaflet. To achieve this, a one-off focus group meeting with seven users who were purposively selected based on their previous experience of bereavement services was held. The findings are presented using a thematic content analysis approach. These illustrate the experiences of service users and their recommendations, which informed the content and language of a new information leaflet. This paper demonstrates how service user participation can inform changes to service delivery in a manner that avoids the potential for consultation fatigue and tokenism.
Podcasts providing directory services: online information and resources
Authors: Smyth Dion
Published: May 2014

Last month, Web Words described some of the technical terms associated with podcasting and examined some of the major players in this field of media technology, as well as some of the attendant software issues. This month, we examine a couple of the websites that provide a directory service, which is where the content that is available on the internet and registered with the site is catalogued.
Book Reviews
Authors: O’Donnell Jane
Published: May 2014

This book describes a range of approaches to using the arts in a palliative care setting. It is written from the perspective of many different therapeutic approaches and disciplines, including the visual arts, poetry, creative writing, drama, and music; using many case studies as examples.
Podcasts providing indexing services: online information and resources
Authors: Smyth Dion
Published: May 2014

This month’s Web Words continues the review of some of the podcasting indexes that are available. There are a number of such websites available, each offering something different in terms of the content uploaded by contributors, how it is catalogued, the overall style of presentation, and additional subscription services.
Understanding the key areas of clinical decision making at the end of life
Authors: Simon Alfred
Published: May 2014

According to the World Health Organisation (2002), palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness. The prevention and relief of suffering, the treatment of pain and other problems, physical, psychosocial and spiritual, are aims which determine and motivate the actions of physicians, caregivers and other professionals working in palliative care. They are the core of what could be characterized as the ethos of palliative care.
The role of transdermal fentanyl patches in the effective management of cancer pain
Authors: Gibbs Margaret
Published: May 2014

Transdermal fentanyl patches first became available in the early 1990s and provided an innovative treatment for the management of cancer pain. Since then, they have become a familiar and convenient method for providing analgesia for patients with stable levels of cancer pain. Transdermal delivery is more complex than oral administration and some specific factors need to be taken into consideration for the patches to be used appropriately and to their best advantage. This article will review the use of transdermal fentanyl, looking at their place in the overall therapy plan, the use of appropriate adjunctive prescribing and some specific practical and safety issues.
Comfort care packs: a little bit of hospice in hospital?
Authors: Oliver Mark A , Hillock Sharon , Moore Carol , Goble Hannah , Asbury Nicky
Published: May 2014

The Comfort Care Pack initiative is an innovation designed to enhance the inpatient experience of end-of-life patients and their carers. The carer is given a pleasantly decorated box containing a variety of items for use by the patient or the carer themselves: snacks, toiletries and items to promote comfort. This project set out to evaluate the impact of these packs by reviewing the returns of the feedback questionnaires included with the packs. From the first 220 packs, 58 questionnaires were returned, giving quantitative and qualitative data. The response to the packs was overwhelmingly positive and they were much valued by the carers. This was the case despite the fact that relatively few of the items were actually used by the recipients. It is suggested that the value of the packs to recipients lies in the gesture of being thought about during what is a difficult time for them. The implications of this are discussed.
Psychological distress in Icelandic patients with repeated recurrences of cancer
Authors: Hjörleifsdóttir Elísabet , Óskarsson Guðmundur Kr.
Published: May 2014

Aim:

The main aim was to investigate differences between the psychological distress of patients with a first diagnosis of cancer, those experiencing their first recurrence, and those experiencing later recurrences. Little is known about the development of cancer patients' psychological distress and whether it becomes more severe with greater incidence of recurrence.

Method:

A total of 218 patients from 3 oncology outpatient clinics in Iceland were assessed with the Brief Symptom Inventory Scale 18 (BSI 18).

Results:

Several aspects of cancer patients' psychological distress seem to positively correlate with number of recurrences, and women experience a recurrence of cancer differently to men.

Conclusion:

Health-care professionals need to be aware of patients' likely distress levels at different stages of their illness and the ways in which their gender might affect their psychological state.
Thai Buddhist intensive care unit nurses’ perspective of a peaceful death: an empirical study
Authors: Kongsuwan Waraporn , Keller Kathryn , Touhy Theris , Schoenhofer Savina
Published: May 2014

Aim: To describe the concept of a peaceful death from Thai Buddhist intensive care unit (ICU) nurses’ perspectives. Method: A descriptive qualitative study of data generated from individual in-depth interviews of ten intensive care nurses who practiced in adult ICUs in the southern region of Thailand. Content analysis was used to analyse the data. Findings: Four core qualities of a peaceful death emerged as described by Thai Buddhist nurses who practised in the ICUs. These core qualities are: peaceful mind; no suffering; family’s acceptance of patient’s death; and being with others and not alone. Conclusion: Thai Buddhist nurses described a peaceful death as ‘a situation in which persons who are dying have peace of mind, and do not show signs and symptoms of suffering. Peaceful death occurs when family members declare acceptance of their loved one’s dying and eventual death. Such a death is witnessed by relatives and friends and the dying person is not alone.’ The findings encourage nurses to be with, and provide palliative care for, dying patients and families.
Book Reviews
Authors: Pennell Mary
Published: May 2014

The book is described by Beth Perry as an updated and revised version of her book, Moments in Time: Images of Exemplary Nursing that she published in 1998. The preface makes it clear that publishing the book in 2009 puts it in a health-care context that is very different from 10 years previously but is repeated in many countries, I am sure. She has allowed herself the opportunity to update the references and also update her own story, in a chapter entitled ‘The multi-layered landscape’. She does not lay claim to being an exemplary nurse but offers the chapter as a way of setting out her beliefs and philosophy regarding nursing. There is food for thought and also material for teaching in what she offers in vignettes and examples from her wide-ranging practice.
The development and audit of a spiritual care policy used across three hospices in England
Authors: Walters Geoffrey , Fisher Simon
Published: May 2014

Spiritual care may be said to be universally recognized as an important aspect of palliative care and yet its effectiveness is notoriously difficult to evaluate. This article traces the experience of a group of three hospice services in East Kent. It describes the formulation of a multidisciplinary policy for spiritual care based on the best available evidence. Clinical and non-clinical staff were encouraged through training to adopt an approach to spiritual care for all patients recognizing that their spiritual needs are broader than religious needs, The outcome of the training was audited and showed that the principles of the policy had been understood and put into practice. Lessons learned through the audit were then used to update the policy, adapt practice and plan a fresh round of training.
The development of a falls prevention and management toolkit for hospices
Authors: Fisher Simon
Published: May 2014

In 2008 a small group of people in the UK were brought together at the invitation of the charity Help the Hospices and with the support of the National Patient Safety Agency to create a falls prevention and management toolkit. The purpose of the toolkit was to assist hospices to manage and if possible prevent falls in their in-patient units and day care centres. This Falls Prevention Working Group put together a policy, care plan, and incident report form designed to enable an accurate and effective assessment of patients' needs and minimise harm while supporting patient independence. A draft version of the toolkit was trialled by nine hospices in 2009. Following revision, a final version was published on the Help the Hospices and Patient Safety First websites in 2010 and introduced with workshops in two separate locations in the UK. This paper provides an overview of the development process and presents evidence, albeit limited, that in-patient falls in hospices are reducing. The toolkit provides outcome measures of better patient care in falls management and prevention.
Politics and palliative care: Laos
Authors: Smyth Dion
Published: May 2014

Dion Smyth's review of the internet for palliative nursing
Politics and palliative care: Paraguay
Authors: Smyth Dion
Published: May 2014

Dion Smyth's review of the internet for palliative nursing
Can art therapy reduce death anxiety and burnout in end-of-life care workers? A quasi-experimental study
Authors: Potash Jordan S , Ho Andy HY , Chan Faye , Wang Xiao Lu , Cheng Carol
Published: May 2014

Background

The need for empathy and the difficulties of coping with mortality when caring for the dying and the bereaved can cause psychological, emotional, and spiritual strain.

Objective

The aim of this study was to examine the effectiveness of art-therapy-based supervision in reducing burnout and death anxiety among end-of-life care workers in Hong Kong.

Methods

Through a quasi-experimental design, 69 par ticipants enrolled in a 6-week, 18-hour art-therapy-based supervision group, and another 63 enrolled in a 3-day, 18-hour standard skills-based supervision group (n=132). Pre- and post-intervention assessments were carried out with three outcome measures: the Maslach Burnout Inventory—General Survey, the Five Facet Mindfulness Questionnaire, and the Death Attitude Profile—Revised. The data was analysed using paired sample t-tests.

Results

Significant reductions in exhaustion and death anxiety and significant increases in emotional awareness were observed for participants in the art-therapy-based supervision group.

Conclusion

This study provides preliminary evidence that art-therapy-based supervision for end-of-life care workers can reduce burnout by enhancing emotional awareness and regulation, fostering meaning-making, and promoting reflection on death.
A simple self-help exercise regimen for clients with back problems
Authors: Key Sarah
Published: May 2014

Understanding the value of specific back exercises and what they are meant to achieve is the essence of self help for clients with back problems. Broadly speaking, there are two categories of exercise for painful low backs: mobilizing and strengthening. Mobilizing exercises work to separate the spinal segments so that the lower spine is less compressed, while strengthening procedures give more power to the muscles that control the spinal segments and to the abdominal retaining wall at the front of the spine.
Book reviews
Authors: Bennett Rosalie
Published: May 2014

Despite the reference to ‘medicine’ rather than ‘health care’ in the title, this book provides relevant information for all health-care students and professionals who are interested in evidence-based patient management.
A review of the Wardmaster and Clinicmaster patient handling systems
Authors: Collins Fiona
Published: May 2014

There are many risks associated with transferring highly dependent patients from bed to chair, owing to their reduced functional ability and the various attachments, such as drips and ventilator tubes. Hoisting these patients can be very difficult.

This article considers the Wardmaster chair, a new patient handling system that can also be used as a trolley, thereby allowing lateral sliding transfers without the need for a hoist. The chair can be used in a critical care setting. The article also mentions the Clinicmaster patient handling transfer system; the Wardmaster's sister chair, which offers the same positional functions but without the electrical operation facility. Both systems are a novel approach to moving and handling patients in a variety of settings.
An audit of anticipated discharge planning for acute medical and orthopaedic admissions
Authors: Shiu Kin Yee , Radu Margaret , McFarlane Lindsay , Dooley John , Thomas David
Published: May 2014

The authors of this article audited an anticipated discharge survey on acute medical and orthopaedic admissions to a UK hospital over a 2-month period. An anticipated discharge form was filled in on admission by an experienced clinician and a discharge date set based on the patient's clinical condition, age and social circumstances. In total, 31 patients (51%) went home on the day planned or within one day of this date. The reasons for delays in discharge included failure of doctors to review patients, slow response to treatment and waiting for social services. Slow mobilization in eight patients accounted for the longest length of stays.

The authors found that discharge plans may break down at weekends and are exploring innovative ways of solving this problem.
The role of mentoring in continuing professional development
Authors: Harrison Deborah , Hong Chia Swee
Published: May 2014

In today's health- or social-care environment, a worker might have a manager, a supervisor and a mentor. Along with performance reviews, professional development plans and portfolios, it can get confusing as to who is doing what and why. It is important to have clarity to make the most of these different tools and mechanisms.
Language delay: Why do parents fail appointments?
Authors: Phillips Julie
Published: May 2014

Missed health-care appointments cost the NHS an estimated £300 million each year and occur across all booked services. Why appointments are not kept and what can be done to reduce non-attendance, are questions that concern NHS staff at all levels.
Physiotherapy in the management of TMD: A review of the literature part 1
Authors: Smith Toby Oliver
Published: May 2014

‘Temporomandibular disorders’ (TMD) is a generic term encompassing a group of musculoskeletal conditions that affect the temporomandibular joint, masticatory muscles and surrounding soft tissues. Physiotherapy is used to treat TMD. The first of this two-part article reviews the current literature to determine what TMD are and how effective physiotherapy is in their treatment. This section defines TMD and examines the evidence investigating the effectiveness of exercise, postural correction and acupuncture.

The author concludes from the studies reviewed that there is insufficient evidence to establish the effectiveness of exercise, postural correction or acupuncture in treating TMD. He recommends that a number of large, well designed blinded randomized controlled trials, with between-group comparison assessing individual treatment interventions, are required to evaluate the effectiveness of these three techniques in the treatment of TMD.
How important is physiotherapy in the treatment of ankylosing spondylitis?
Authors: Calin Andrei
Published: May 2014

Ankylosing spondylitis (AS) is a chronic, progressive, destructive and disabling rheumatic disease characterized by inflammation of the sacro-iliac joints, the entheses and the spine. It causes pain, stiffness and swelling, potentially leading to destruction and immobility of the structures affected.
The virtual office trainer: a teaching tool for people with learning disabilities
Authors: rose David , Brooks Barbara
Published: May 2014

In the past few years, the use of computer-generated interactive representations of real-life situations has become increasingly popular in fields as diverse as engineering, design, architecture, medicine and education. The immersive and interactive properties of virtual reality simulations are regularly used to supplement conventional training methods in such occupations as pilots, fire-fighters and soldiers, where real-life training is dangerous, expensive or difficult to monitor and control.
Use of self-applied TENS for low back pain in people with multiple sclerosis
Authors: Warke K , Al-Smadi J , Baxter GD , Walsh DM , Lowe-Strong AS
Published: May 2014

The aim of this study was to evaluate the use of self-applied transcutaneous electrical nerve stimulation (TENS) for low back pain in a population of people with multiple sclerosis (MS). In total, 15 participants diagnosed with MS (aged 37–71 years) presenting with low back pain were recruited and randomized into two active TENS groups and a placebo group under double-blind conditions (n=5 per group). Treatment involved self-application of TENS on a daily basis for 6 weeks. Outcome measures were recorded at weeks 1, 6, 10 and 32.

Statistical analysis indicated significant changes in the McGill Pain Questionnaire affective subsection (P=0.01) throughout the trial. However, trends observed seem to indicate an improvement in both active TENS groups during the treatment period, with differential improvement maintained into the follow-up period. The findings of this study thus warrant further investigation by means of a randomized, controlled clinical trial within this population.
Diversity matters: addressing the recruitment and retention problem
Authors: Finucane Caroline
Published: May 2014

Recruitment and retention of staff is currently a hot topic within health care. From 2001, the Department of Health (2000) committed itself to expanding the NHS workforce by 6500 more allied health professionals (AHPs) by 2004, which means 40% more NHS-funded students entering occupational therapy education and the funding of 149 new pre-registration occupational therapy education places. The scope of the governments targets, however, is not clear.
Quality of life issues for speech and language therapists
Authors: Brumfitt Shelagh
Published: May 2014

Quality of life issues are an increasingly important dimension in speech and language therapy practice. However, there is a lack of clarity about where this fits in the professional scope of practice and what factors affect the achievement of good quality of life for our clients. Quality of life is a difficult construct to define and measure. Originally relating to social conditions, it has been expanded to include individuals’ ‘perceptions of their position in life in the context of the culture and value system in which they live and in relation to their goals, expectations, standards and concerns’ (World Health Organization Quality of Life Group, 1998). Further, the concept of health-related quality of life has emerged, which describes the impact of an illness.