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Facilitators and barriers of implementing end-of-life care volunteering in a hospital in five European countries:the iLIVE study
No full textBackgroundEnd-of-life (EoL) care volunteers in hospitals are a novel approach to support patients and their close ones. The iLIVE Volunteer Study supported hospital volunteer coordinators from five European countries to design and implement an EoL care volunteer service on general wards in their hospitals. This study aimed to identify and explore barriers and facilitators to the implementation of EoL care volunteer services in the five hospitals.MethodsVolunteer coordinators (VCs) from the Netherlands (NL), Norway (NO), Slovenia (SI), Spain (ES) and United Kingdom (UK) participated in a focus group interview and subsequent in-depth one-to-one interviews. A theory-inspired framework based on the five domains of the Consolidated Framework for Implementation Research (CFIR) was used for data collection and analysis. Results from the focus group were depicted in radar charts per hospital.ResultsBarriers across all hospitals were the COVID-19 pandemic delaying the implementation process, and the lack of recognition of the added value of EoL care volunteers by hospital staff. Site-specific barriers were struggles with promoting the service in a highly structured setting with many stakeholders (NL), negative views among nurses on hospital volunteering (NL, NO), a lack of support from healthcare professionals and the management (SI, ES), and uncertainty about their role in implementation among VCs (ES). Site-specific facilitators were training of volunteers (NO, SI, NL), involving volunteers in promoting the service (NO), and education and awareness for healthcare professionals about the role and boundaries of volunteers (UK).ConclusionEstablishing a comprehensive EoL care volunteer service for patients in non-specialist palliative care wards involves multiple considerations including training, creating awareness and ensuring management support. Implementation requires involvement of stakeholders in a way that enables medical EoL care and volunteering to co-exist. Further research is needed to explore how trust and equal partnerships between volunteers and professional staff can be built and sustained
Discussing Humanism part 3
No full textThis is the introduction to the summer issue on Humanism in Journal for Humanistic Studies, Waardenwer
Dutch Therapists’ Professional Autonomy and Moral Agency After the Marketization and Bureaucratization of Mental Healthcare: Between Impracticalities and Impossibilities
No full textOver the last decades, western mental healthcare has increasingly been governed by market and bureaucratic principles. As a consequence, therapists are faced with conflicting demands and decreased autonomy. This study examines how they cope and whether their strategies suffice. Drawing on the direct experience of therapists through interviews, we demonstrate that psychologists have become quite skilled at balancing and navigating bureaucratic and market demands that were at odds with professionalism. However, when they were structurally faced with bureaucratic and market demands that were already irreconcilable with each other, these skills fell short. Trying to meet all requirements took up so much of their resources that sometimes, professional reasoning and agency disappeared altogether. In some cases, this led to detachment, burnout, and patient neglect. Our findings suggest that the public interest in having a well-functioning mental healthcare system requires more room for professional autonomy
Introduction of Spiritual Psychotherapy for Inpatient, Residential, and Intensive Treatment (SPIRIT) in The Netherlands: Translation and Adaptation of a Psychotherapy Protocol for Mental Health Care
No full textThe perceived value of the integration of spirituality and religion (SR) in mental health care is growing. This study aimed to adapt an SR intervention developed in the USA (SPIRIT) for use in the Netherlands and to explore its applicability. Employing a participatory practice-based action research design, professionals, clients, and an advisory board collaborated in iterative cycles of translation, adaptation, discussion, and testing. The ongoing interfaith dialog during the adaptation process broadened the perspectives incorporated into the existing handouts. We added the term “meaning” (M) alongside SR to accommodate patients who do not identify with religion or spirituality. Additionally, several handouts were added to the original protocol: autonomy, responsibility, and liberty; loneliness and belonging; inspiring persons in the past and present; and grief and loss. Moreover, the existing handout on sacred verses was expanded to encompass versions from various outlooks on life: philosophical/humanistic, Judeo-Christian, Buddhist, Islamic, and Hindu. Finally, layout modifications and diverse exercise formats were introduced. A qualitative examination revealed that the adapted SPIRIT protocol was well received by professionals and patients, and quantitative studies on its applicability and usefulness are recommended
Spiritual conversation model for patients and loved ones in palliative care: a validation study.
No full textObjectives: In palliative care, validated tools for professionals that facilitate day-to-day spiritual conversations with patients and loved ones are scarce. The objective of this study was to validate the Diamond spiritual conversation model across different palliative care settings as well as professional and educational levels. Methods: An online survey was filled in by 387 professionals providing palliative care for patients in hospice, home care, hospital and nursing home settings. The five polarities of the Diamond model: holding on-letting go, doing-undergoing, remembering-forgetting, me-the other and believing-knowing were operationalised and evaluated on reported occurrence. Results: In conversations with patients, palliative care professionals reported letting go of loved ones (81.8%), dealing with pain and suffering (88.1%), dealing with issues from the past (67.2%), dealing with own versus loved one's wishes (69.4%) and giving meaning to death (66.7%) as themes occurring regularly to very often. In conversations with loved ones, this was 70.8%, 78.5%, 55.4%, 68,8% and 62%, respectively. Respondents working in hospices reported these themes significantly more than those working in home care settings, nursing homes or hospitals. Nurse assistant respondents reported the themes significantly less than nurses or chaplains. Conclusion: From the perspective of professionals providing palliative care in different palliative care settings, the Diamond model offers a validated framework for addressing relevant spiritual themes for patients and loved ones
Brief Eclectic Psychotherapy for Prolonged and Traumatic Grief Following Drug-Related Death
No full textThe loss of a loved one due to drug-related death may have emotional and sociocultural implications that influence meaning attribution to the loss, thereby complicating the grief process and increasing the risk of prolonged grief disorder (PGD). Brief Eclectic Psychotherapy for Prolonged and Traumatic Grief (BEPPTG) can be tailored to the needs of individuals facing complex meaning attribution following drug-related death bereavement. BEPPTG consists of information and motivation, grief-focused exposure, symbolic interactions, and meaning attribution and activation. A case description shows the application of BEPPTG for the treatment of PGD and post-traumatic stress disorder (PTSD) following drug-related death bereavement. Through cognitive, behavioural, and experiential techniques, BEPPTG enables the patient to deal with traumatic and ambiguous aspects of drug-related death and to involve the patient’s social, cultural, and spiritual context to support adaptive meaning attribution and to reshape the relationship with the deceased
Patient perspectives and experiences with psilocybin treatment for treatment-resistant depression: a qualitative study.
No full textPsilocybin is the most researched classic psychedelic for Treatment-Resistant Depression (TRD). While optimizing set and setting are considered essential for efficacy and safety, patient perspectives on these aspects have rarely been investigated. To address this knowledge gap, the current paper explored the experiences of 11 TRD patients (8 women, 3 men) participating in a double-blind randomized clinical trial with a single session of oral (1, 10 or 25 mg) psilocybin treatment. After qualitative analysis, three major themes were identified: (1) challenges with trust-building and expectation management; (2) navigating the experience; and (3) the need for a more comprehensive treatment. Subthemes of the first theme include a general distrust in mental healthcare, trust in study therapists, limited time for preparation, and managing expectations. The second theme included the following subthemes: trusting to surrender, profound and overwhelming experiences, and music as a guide. The third theme addressed a desire for multiple psilocybin sessions, and challenges with sensemaking. Patients’ perspectives provided important insights into potential optimization of psilocybin treatment of TRD, including individualized preparation, investment in trust-building, offering additional psilocybin sessions, providing access to sustained (psycho)therapy with trusted therapists, and personalizing treatment approaches, which may also enhance real-world adaption of these treatments
Vriendschappelijkheid als vruchtbare houding in langdurig onderzoek en zorg!?
No full textTwaalf jaar geleden ontmoette Gustaaf Bos een bijzondere, creatieve, ondernemende man van 75 jaar met een verstandelijke beperking. De vriendschap die tussen hen ontstond leverde een heleboel stof tot nadenken op over vriendschap