BMJ supportive & palliative care
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BMJ Support Palliat Care · Jun 2016
Palliative medicine specialists' causal explanations for depression in the palliative care setting: a qualitative in-depth interview study.
Medical practitioners have different causal explanations for depression, and may have greater difficulty in explaining causality of depression in the palliative care setting. The objective of this study was to investigate and describe the causal explanations of depression in the palliative care setting, from the perspective of palliative medicine specialists. ⋯ Palliative medicine specialists hold causal explanations of depression that align with the biopsychosocial and vulnerability-stress models. They use multiple individual explanations with diverse theoretical underpinnings, and largely view depression as multifactorial in causality. Given that causal explanations are linked to clinical interventions, these findings have implications for clinical practice and medical education.
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BMJ Support Palliat Care · Jun 2016
The provision of spiritual and pastoral care following stillbirth in Ireland: a mixed methods study.
The death of a baby is recognised as one of the most difficult bereavements with life-long impact for parents. How bereaved parents are cared for influences their grief journey. Optimal holistic care is provided when the physical, emotional, spiritual and social needs of parents are attended to. This study reviewed how spiritual care is provided to bereaved parents following stillbirth in maternity units in Ireland and the impact of stillbirth on healthcare chaplains. ⋯ The provision of spiritual care following stillbirth in Ireland is diverse. Spiritual care in this specialised area by chaplains who are not professionally trained and accredited potentially impacts quality and depth of care. Chaplains experience considerable impact and challenge to personal faith and belief as they provide care. Recommendations are made for ongoing education and greater support for chaplains.
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BMJ Support Palliat Care · Jun 2016
Developing a palliative care competence framework for health and social care professionals: the experience in the Republic of Ireland.
Competence-based education in health and social care has been promoted through the Tuning Process in Europe. This papers reports on the process of developing a Palliative Care Competence Framework for health and social care professionals working in the Republic of Ireland. ⋯ The framework describes universal core competences in palliative care while also detailing individual competences for each health and social care discipline. It is envisioned that the framework will inform academic curricula and professional development programmes, and so will enhance the care of people with life-limiting illness, fostering greater interprofessional and interorganisational collaboration in palliative care provision.
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BMJ Support Palliat Care · Jun 2016
Review Meta AnalysisA systematic review and meta-analysis of meditative interventions for informal caregivers and health professionals.
Burnout, stress and anxiety have been identified as areas of concern for informal caregivers and health professionals, particularly in the palliative setting. Meditative interventions are gaining acceptance as tools to improve well-being in a variety of clinical contexts, however, their effectiveness as an intervention for caregivers remains unknown. ⋯ Meditation provides a small to moderate benefit for informal caregivers and health professionals for stress reduction, but more research is required to establish effects on burnout and caregiver burden.
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BMJ Support Palliat Care · Jun 2016
Multicenter StudyMental disorders and the desire for death in patients receiving palliative care for cancer.
The desire for death in terminally ill patients is associated with depression and anxiety, but not all patients who report it meet criteria for mental disorders. We examined the characteristics of subgroups of palliative cancer patients who expressed a desire for death that occurred either with or without a concurrent depressive or anxiety disorder. ⋯ The expression of a desire for death by a terminally ill patient should raise a suspicion about mental health problems, but is not in itself clearly indicative of one. Nevertheless, it may serve as a catalyst to review the individual's physical symptom management and interpersonal concerns, and overall sense of suffering.