Barry Ashpole Media Watch #498

Barry Ashpole Media Watch

The latest issue of Media Watch, compiled and annotated by Barry R. Ashpole (Ontario, Canada) can now be downloaded here. More reports can be found at IPCRC.NET

Articles from Asia Pacific regions:

Branding palliative care units by avoiding the terms “palliative” and “hospice”: A nationwide study in Taiwan

INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION & FINANCING | Online – 24 January 2017 – The term “palliative care” has a negative connotation and may act as a barrier to early patient referrals. Rebranding has thus been proposed as a strategy to reduce the negative perceptions associated with palliative care. In this study, the authors found that words reflecting the themes of “kindness and love”, “peace” and “religion” were frequently used. This finding suggests the hypothesis that less stigmatising names were used to generate more positive impressions, higher perceived need, and more referrals.

End-of-life care and opioid use in India: Challenges and opportunities

JOURNAL OF GLOBAL ONCOLOGY | Online – 25 January 2017 – Ease of access to opioid pain medications is an integral component of palliative care service. In India, poppy plants are grown only in three states, under strict government licensing, with only two factories processing them into morphine sulfate powder. Awareness of opioid medications increased during the early 1980s, which in turn increased morphine use, raising concerns regarding diversion of the medication. Balancing these virtues and vices in a cost-effective setting, within this multicultural society is a gargantuan task that the Indian government and palliative care community has currently undertaken. The palliative care community is optimistic about the new NDPS amendment, which may help make pain relief accessible to millions.

Specialist Publications:

Promoting end-of-life discussions in advanced cancer: Effects of patient coaching and question prompt lists

JOURNAL OF CLINICAL ONCOLOGY | Online – 30 January 2017 – Most patients with advanced cancer say they want honest, sensitive communication about end-of-life issues. These conversations help patients and their families prepare, make informed decisions, and avoid potentially burdensome aggressive medical treatments near death. Yet, patients are often misinformed about cancer survival and curability, and those with over-optimistic prognosis estimates are more likely to die in a hospital and receive burdensome aggressive care. Patients often do not disclose their concerns and vary in the amount of information they want about the disease, prognosis, and treatment options, whereas physicians often do not know or enact patient preferences about end-of-life issues. . Interventions to promote communication in cancer settings have targeted patients and physicians. Randomized controlled trials in early cancer and palliative care have shown that question prompt lists (QPLs) – structured lists of questions given to patients before consultations – help patients with cancer and their caregivers ask more questions, particularly if the physician also encourages and endorses the QPL. In addition, a tailored pre-visit educational coaching intervention (that did not involve QPLs) helped patients with cancer communicate concerns about pain.

A matter of life and death: Knowledge about the body and concept of death in adults with intellectual disabilities

JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, 2017;61(1):89-98. An increased awareness of how people with intellectual disabilities (ID) understand death and dying is necessary in supporting life-long learning, post-bereavement support and planning end-of-life care. However, the assumption that adults with ID have no concept of death and therefore are unable to grieve, has been discredited, and it is now widely accepted that an incomplete understanding of death is not necessarily a barrier to experience grief. The analysis of participants’ responses shows that those individuals who are able to reason about the human body were more likely to achieve significantly higher concepts of death scores. Clearly, there is a need for focused interventions aimed at developing further this embryonic biological understanding.

Funding models in palliative care: Lessons from international experience

PALLIATIVE MEDICINE | Online – 3 February 2017 – Funding models influence provision and development of palliative care services. As palliative care integrates into mainstream health care provision, opportunities to develop funding mechanisms arise. Variation in the palliative care services exists not only in the type and content of services provided but also in the ways that palliative care services are funded. One of the implications of variability in funding mechanisms is the ability to conduct large-scale health economics research on palliative care is dependent on having a clear signal of palliative care provision in the administrative data generated, and the strength of the data signal is driven by the funding model.

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