Barry Ashpole Media Watch #488

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 Region:

Giving sick children dignity in death

Giving sick children dignity in death CHINA | The China Daily (Beijing) – 16 November 2016 – Zhou Xuan, an oncologist at the Beijing Children’s Hospital, clearly remembers seeing a dying boy pressing his face against the window beside his bed. “He was about 2, and had acute myeloid leukemia. For most of the four months he stayed on the ward, he longed to go outside and play, a request repeatedly turned down by his mother who was worried about his physical condition,” she said. “Weeks later, I came across the boy’s mother at the hospital. She was traumatized by his death, and by the fact that she had refused his ‘one last wish.’” Zhou said. “Sadly, regrets are common among parents, who are focused too single-mindedly on seeking a cure for their dying child.” She said the success of children’s palliative care (PC) in China will depend on whether parents can accept that the process is not about “giving up,” but about “making peace with oneself while having a dignified, less-painful exit from life’s stage. In the West, this is done by specially trained teams of doctors, nurses and social workers who work together with a patient’s doctors to weave an extra layer of support for the patients and their families. In China now, my team of doctors and nurses have to undertake dual roles.” Strangely, this arrangement may better suit the current situation… https://goo.gl/6GJw9p

Experiences of healthcare professionals in providing palliative end-of-life care to patients in emergency departments: a systematic review protocol

JBI DATABASE OF SYSTEMATIC REVIEWS & IMPLEMENTATION REPORTS, 2016;14(10):9-14. The emergency department (ED) is increasingly recognized as a potential site to provide palliative care (PC) to patients at their end of life. Although the true incidence of patients with these health needs in ED remains unknown, it is expected to increase over time as the population ages. As such, all healthcare professionals working in the ED are likely to be expected to provide this care. However, such provision of care in the ED setting is not without concerns. The practice in emergency care is characterized by managing acute health problems, making critical decisions under pressure and with limited time to discuss treatment plans and preferences with patients and their families. This ED culture may not be conducive to providing quality PC. Indeed, healthcare professionals report mixed feelings about providing this type of care in the ED setting. Given that the provision of PC is increasing and that it has significant implications for the practice and wellbeing of healthcare professionals working in the ED, understanding the caring experience from their perspectives will add to the body of knowledge in this area. https://goo.gl/sr9MC4

Specialist Publications

Appropriate and inappropriate care in the last phase of life: An explorative study among patients and relatives

BMC HEALTH SERVICES | Online – 15 November 2016 – This study shows that patients and relatives interpret appropriate care in the last phase of life as a wide-ranging term, which can refer to supportive care, treatment decisions, location, the role of the patient’s wish and patient-physician communication. These findings are in line with earlier studies, that showed that patients in the last phase of life have multiple and diverse care needs. The five dimensions of appropriate care are similar to, but broader than those identified in studies on good palliative care (PC). For instance, the domains described in the ‘National Consensus Project Clinical Practice Guidelines for Quality Palliative Care’1 mostly fall under the dimension “supportive care,” while focusing little on treatment decisions and location. Apparently, patients and relatives perceive appropriate care in the last phase of life as broader than the presence of good quality PC. In many cases, inappropriate care could simply be defined as the absence or the opposite of appropriate care. In these cases, care was insufficient to meet the patients’ and relatives’ needs. However, the difference between appropriate care and inappropriate care was not always so clear-cut. While potentially curative or life-prolonging treatment was often described as inappropriate, there were also cases in which it was seen as appropriate. Accordingly, stopping potentially curative or life-prolonging treatment was described as appropriate as well as inappropriate (albeit less often). This illustrates how difficult decisions on starting, continuing or stopping potentially curative of life-prolonging treatment can be in advanced disease. Treatment can be appropriate by giving hope, a chance of prolonging life and it can be the patient’s wish. But in many cases, treatment is more likely to lead to false expectations, sideeffects and complications. https://goo.gl/VdQfa9