Community Specialist Palliative Care Nurses Research Articles

P19 Widening access to hospice services: The development of a 7/7 community specialist palliative care nurse service and a rapid response service pilot

Background and ContextIn response to national Peer Review Standards and NICE Guidance to offer 7 day face to face visiting an opportunity to pilot a service within a hospice based...

‘Made to fit’: filling critical gaps with a hospice at home service

BackgroundPromoting the choice to die at home is central to UK policies and strategies. Nationally, various models of Hospice at Home service support this choice. Locally a service was developed...

Widening the definition of palliative care

International Journal of Palliative NursingVol. 17, No. 4 CorrespondenceWidening the definition of palliative careHelen MacMahonHelen MacMahonSearch for more papers by this authorHelen MacMahonPublished Online:28 Sep 2013https://doi.org/10.12968/ijpn.2011.17.4.203AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Andrews N, Seymour J (2011) Factors influencing the referral of non-cancer patients to community specialist palliative care nurses. Int J Palliat Nurse 17(1): 35–41 Link, Google Scholar World Health Organisation (2002) WHO definition of palliative care. www.who.int/can-cer/palliative/definition/en/ (accessed 15 March 2011) Google Scholar FiguresReferencesRelatedDetailsCited byPalliative Care, Toward a More Responsive Definition13 April 2019Palliative Care, Toward a More Responsive Definition4 June 2018 1 April 2011Volume 17Issue 4ISSN (print): 1357-6321ISSN (online): 2052-286X Metrics History Published online 28 September 2013 Published in print 1 April 2011 Information© MA Healthcare LimitedPDF download

Factors influencing the referral of non-cancer patients to community specialist palliative care nurses

To understand why non-cancer patients are under-represented on the caseloads of community Macmillan specialist palliative care nurses by exploring what influences community health professionals' referral patterns of non-cancer patients in one locality of a primary care trust. The study adopted a qualitative design, making use of semi-structured interviews with a purposive sample of community health professionals comprising three GPs, three district nurses, and three community matrons. The framework approach was used for analysis. The classification of patients, the perception of the palliative care service, the existence of different pathways of care for cancer and non-cancer patients, and the role of other specialist nurses all seem to influence the referral patterns of community health professionals. Although further research is required to fully understand all of the relevant viewpoints, in particular those of patients and carers, it appears that innovative new models of service delivery could be developed that address the engrained perception of the Macmillan nursing service as being for dying cancer patients only, as well as the blurred boundaries between Macmillan nurses and other senior clinical nurses.

Valued aspects of palliative care community nurse specialist role

Community palliative care nurses provide a range of services for patients who have complex needs and their carers in the midst of terminal illness. Patients often prefer to be looked after at home when they are terminally ill because home represents a place where they feel safe and where they have most control over decisions. The author works as a clinical nurse specialist within a community palliative care team. Her professional experience led her to be interested in identifying the aspects of palliative care patients and their families value most. Consequently, a literature search was carried out to identify those aspects of care provided by community specialist palliative care nurses deemed invaluable to patients and their families. The two most important elements of care, as identified by patients and carers, were found to be the provision of emotional support and having expertise in the management of symptoms. This article discusses these elements with regard to the community specialist palliative care nurse’s role, highlighting where the community palliative care service fails to meet the needs of patients and families. Conflicts of interest: none

Dying at home: community nurses' views on the impact of informal carers on cancer patients' place of death

Giving patients with cancer a choice in where they want to die including the choice to die at home if they so wish, underpin the recent UK government policies and is embedded in the End of Life Care Programme. However, this presents increasing challenges for the informal carers particularly with an increasingly aging population. Despite the policy initiatives, there remain a persistent number of patients with cancer who had chosen to die at home being admitted to hospital in the last days and hours of life. A qualitative study using two focus group interviews with community nurses (district nurses and community specialist palliative care nurses) was undertaken across two primary care trusts in the north-west of England. Data were analysed using a thematic analysis approach. The results indicated that informal carer burden was a key reason for prompting hospital admission. Recommendations for the development of a carer assessment tool with appropriate supportive interventions are made.

Barriers to dying at home: the impact of poor co-ordination of community service provision for patients with cancer

For patients dying of cancer, there is an emphasis on giving choice regarding preferred location for care, with the option of dying at home, which is integral to UK government health initiatives such as the End of Life Care Programme. However, patients continue to be admitted to hospital in the terminal phase of their illness when they have expressed a desire to die at home. A qualitative study, using two audio tape-recorded focus group interviews, with a purposive sample of district nurses and community specialist palliative care nurses (19) was undertaken across two primary care trusts in the north west of England. Data were analysed using a thematic analysis approach. From a service provision perspective, the results reveal that poor discharge planning and co-ordination, difficulty in establishing additional equipment and services together with inadequate out of hours medical provision were all factors contributing to hospital admissions for patients with cancer in the last hours and days of life, and thus were barriers to dying at home.

Which terminally ill cancer patients in the United Kingdom receive care from community specialist palliative care nurses?

This study investigates how cancer patients who receive care from community specialist palliative care (CSPC) nurses differ from those who do not. This was achieved by secondary data analyses from the Regional Study of Care for the Dying, a retrospective interview survey of deaths in 1990 in 20 nationally representative health districts. Interviews were obtained for 2,074/2,915 (71%) of randomly selected cancer deaths; 574 (27.8%) were reported to have received care from a Macmillan nurse, hospice home-care nurse, or other community specialist palliative care nurse. Using logistic regression analysis 10 factors were found to predict independently CSPC use. Being dependent with dressing/undressing, needing help at night, having constipation, experiencing vomiting/nausea, being mentally confused, having breast cancer and being under the age of 75 years increased the likelihood of receiving CSPC. Having a lymphoma, leukaemia or myeloma, a brain tumour and being dependent on others for help with self-care for more than 1 year decreased the likelihood. The use of CSPC nurses to provide expertise in symptom control and to support families of dependent patients is consistent with the aims of palliative care, and therefore appears appropriate. Further research is, however, needed to investigate the apparent age bias in access to these services, and to ensure that CSPC services are provided on the basis of need, irrespective of patient age.

Which terminally ill cancer patients in the United Kingdom receive care from community specialist palliative care nurses?

Which terminally ill cancer patients in the United Kingdom receive care from community specialist palliative care nurses?