1,720,977 research outputs found
Commentary on McSherry, R., Mudd, D., Campbell, S. (2007) Evaluating the perceived role of the nurse consultant through the lived experience of health care professionals
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Review: a narrative review of the published ethical debates in palliative care research and an assessment of their adequacy to inform research governance
No full textThe quality of research, and the resulting quality of evidence available to guide palliative care, is dependent on the ethical decisions underpinning its design, conduct and report. Whilst much has been published debating the ethics of palliative care research, an assessment of the quality and synthesis of the central debates is not available. Such a review is timely to inform research governance. The methodology of this study is based on the principles of systematic reviews. Fifty-seven papers were reviewed following a thorough search, and were critically appraised for their literary quality, the knowledge on which they drew and the research standards they addressed. The debates identified address vulnerability, moral appropriateness, consent, gate-keeping and inclusion and research culture. The quality of debate and the sources of knowledge varied. The debate was rich in quality and knowledge with respect to the protection of the dignity, rights and safety of research participants, but less developed in relation to those of researchers and other staff. There is also little debate about the ethics of reporting of research and the ethics underpinning research leadership. A framework is offered that reconciles the ethical issues raised with potential methodological strategies identified from the review. <br/
Preferred place of care at the end of life for people in hospitals
No full textBackground: Achievement of a person’s preferences for end-of-life care is a moral and policy imperative. It is morally important as it demonstrates respect for people’s end of life choices and a policy imperative because it is recognized that many people die do not die in the place of their choice. Much has been written about the factors influencing preferred place of care (PPC) and where people die. Little attention has been paid to which interventions enhance achievement of PPC. Aim: This article reports on an audit assessing the impact of the interventions of an acute hospital discharge team (HDTNs) on the achievement of PPC. Methods: The audit was undertaken on a consecutive sample of 39 people, referred at the end of life to the HDTNs, over a 3-month period from May-July 2009. The data were analysed using Cohen’s Kappa statistic to test the degree to which PPC was achieved. Results: All but three people achieved their PPC. Conclusions: The results compare very favorably with studies assessing success in achieving preferred and actual place of end-of-life care. Key to the success of this intervention was the HDTNs’ knowledge of community services, imparted during conversations with patients and their families
The use of reflection in a palliative care programme: a quantitative study of the development of reflective skills over an academic year
No full textReflection has gained a reputation for encouraging the integration between theory and practice within professional education. However, this reputation is based on an evidence base that mostly consists of theoretical debate. The aim of this study was to test our experience that the ability to reflect is developmental and that some reflective skills are harder to achieve than others. The research was undertaken by assessing the degree to which registered nurses achieved reflective criteria within assignments submitted for a variety of palliative care undergraduate modules. A total of 160 assignments were analysed using a marking grid constructed from a literature review and the results were compared between students and across academic terms. The results suggest that students are able to describe their practice but find it harder to analyse knowledge, the context of care and to action plan. Nevertheless, reflective abilities developed over time with significant developments made between each term. However, the development of skills indicative of critical reflection was less evident and confined to the ability to raise implications for future learning. The lack of multivariate analysis limits the study. However, the findings build on previous research and prompt questions for future work, particularly with respect to the process of reflection and how this can be supported in order to encourage the development of critical reflective skills
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