Downloaded from http://spcare.bmj.com/ on November 18, 2015 - Published by group.bmj.com
Abstracts REFERENCE 1
Dying Matters Survey http://www.comres.co.uk/polls/Dying_Matters_Public_April 12. pdf
Aim . .
PA18
HEART OF GOLD. INTEGRATING CROSS BOUNDARY CARE ACROSS DIFFERENT SECTORS WITH PATIENTS AT THE HEART OF CARE – A POPULATION-BASED PUBLIC HEALTH PERSPECTIVE
Keri Thomas, Maggie Stobbart Rowlands, Julie Armstrong Wilson. The Gold Standards Framework, UK 10.1136/bmjspcare-2015-000906.78
Background In response to the growing challenge of over-hospitalisation and fragmentation of care for people nearing the endof-life, a key factor is to develop an integrated cross-boundary care approach to meet the population’s needs. Gold Standards Framework (GSF) quality improvement programmes are widely used in the UK in primary care, care homes, hospitals, domiciliary care and hospices. By working together to a common plan, GSF can help be a vehicle for improvement with patients at the heart of care. Aim To explore using GSF programmes in different settings to develop an integrated whole-system approach, with patients at the heart of care – the ‘heart of gold’ projects. Method A description of GSF used in different settings as a common language to develop better integrated cross-boundary care, with peoples’ wishes and preferences at the heart of care. GSF improves the early identification, Advance Care Planning discussions and coordination of care reducing unnecessary hospital admissions. Results Findings from different sectors are presented from each setting, looking at whole-systems, and practical and qualitative measures of progress. Conclusion Real improvements are being seen across whole areas using GSF as a vehicle for better co-ordinated care. ‘Gold patients’ and their families feel many benefits and there is greater openness and ‘cultural change’ in end-of-life-care, especially for the frail elderly. GSF can be part of the solution in developing such integrated care by developing a common ‘vocabulary’ of care for all people in any setting with any condition in the final years of life.
PA19
‘CLOSING THE GAP’: A COMMUNITY ENGAGEMENT PROJECT
George Obita, Anna Wolkowski, Linda Johnson, Sarah Cash, Matthew Blagojevic, All other members of the project group are acknowledged: Briony Ming, Dave Carrick, Diane Dinning, Elaine Lord, Karinda Jones, Tania Wilson, Tania Wood. Dove House Hospice, UK 10.1136/bmjspcare-2015-000906.79
Background Dove House Hospice serves a population of about 600,000 covering Hull and East Riding. About 42% of people in Hull and East Riding die in their usual residence. Dove House Hospice’s vision is to provide excellent specialist palliative care and support to patients, their families and carers in the locality. Despite excellent services provided, there was evidence of lack of awareness. A project, using a community engagement approaches, was therefore developed to close this gap.
SPCare 2015;5(Suppl 1):A1–A32
.
Raise awareness about death, dying, loss and care; and services provided by Dove House Hospice Improve partnerships between Dove House Hospice and the community. Increase social supports to those who experiences death, dying, loss and caregiving.
Methods Approach: Two postcode areas, namely Cottingham and Bransholme, were initially selected for two-week community engagement activities. The key approaches used were: direct engagement with the public, participation in community activities, engagement with local primary health care services and distribution of information leaflets. Evaluation approach: Use of pre and post activities questionnaire and feedback meetings with key community members. Results Leaflets were distributed to a total of about 18,000 addresses. Immediate result include: Increased donation, increased application for volunteering and increased referrals. Community involvement in end of life care waits to be evaluated. Conclusion This is an on-going project. Early indications are that there has been improved awareness of the hospice services and interest in the hospice’s activities. The project has also contributed to the hospice being included in the pathfinder charter community.
PA20
VIEWS ON TALKING ABOUT DEATH, DYING AND LOSS
Katharine Abba, Siobhan Horton, Mari Lloyd-Williams. Academic Palliative and Supportive Care Studies Group, UK 10.1136/bmjspcare-2015-000906.80
Background Societal barriers to open discussion of personal feelings and preferences relating to death may hinder planning for end of life and supporting people who are dying or bereaved. Aim To explore views about talking about death, dying and loss. Method Semi-structured interviews were conducted with 31 people; age range 30 to 83 years. Results Making wills and communicating end of life wishes were considered very important; mostly for the sake of the family left behind. Participants also valued confidence to discuss other people’s end of life wishes and support them appropriately if they were dying or bereaved. Many participants were very comfortable talking about their own death. Identified barrier to talking about end of life wishes included not wanting to upset others; others not listening; not being about to find an appropriate moment; not knowing enough about the options available; and fear of death, especially of the unknown. Financial costs were seen as a barrier to making a will. Participants talked of the importance of raising awareness of what death and dying involves; what end of life options available; and the importance of communication. Information on the process of normal grieving and how to support somebody who has been bereaved were also suggested. Conclusion Being able to talk about end of life wishes and know how to support people who are dying or bereaved are important to many people, and they would welcome interventions to facilitate this at a societal level.
A25
Downloaded from http://spcare.bmj.com/ on November 18, 2015 - Published by group.bmj.com
Abstracts PA21
COMMUNITY PARTICIPATION IN SETTING UP PALLIATIVE CARE CLUBS FOR CHRONICALLY ILL AIDS PATIENTS IN LAGOS
research is needed to understand the nature and impact of creative interventions.
Olanrewaju Onigbogi. Department of Community Health and Primary Care, College of Medicine, Nairobi 10.1136/bmjspcare-2015-000906.81
Background With the introduction of Highly Active Anti-retroviral Therapy, more HIV/AIDS patients live longer in our communities. Aim This study was conducted to assess the willingness of people in Lagos to participate in setting up palliative care clubs for these patients. Methodology Self administered questionnaires were completed by 261 respondents with age ranging from 21–61 years. SPSS version 16 data editor was used to analyse data. Univariate odds ratios and 95% confidence intervals (95% CI) were used to evaluate the correlates of willingness to participate (WTP). Results A total of 62% of the respondents reported that they will be willing to participate in palliative care for the HIV patients. Higher willingness was associated with prior contact with higher education (OR = 1.13, 95% CI: 1.02–1.53), present employment (OR = 1.65, 95% CI: 1.45–1.72) and a potential for financial incentives (OR = 1.59, 95% CI: 1.32–1.77). Decreased WTP was associated with concerns about social stigmatisation (OR = 0.35, 95% CI: 0.13–0.71) and possibility of rejection by the patients (OR = 0.83, 95% CI: 0.56–0.93). Conclusion The high level of WTP indicates that such programmes would be better successful if organisers provide incentives as a part of the take-off of this program.
PA22
THE ARTS OF CONNEXION
Jackie Brooks, Rebecca Maher, Kathy Armour, Lucinda Jarrett. Marie Curie Hospice West Midlands, UK
PA23
Aditya Manna, SK Sarkar, LK Khanra. Narikeldaha Prayas, India 10.1136/bmjspcare-2015-000906.83
Background Due to financial incapability and absence of manpower poor families often fail to carry their advanced cancer patients to the nodal centres. This pilot study will explore whether communication by mobile phone can lessen this burden. Aim To identify and try to solve to the extent possible the main difficulties in giving palliative care to the terminal cancer patients of the area. Method Initially a plan was generated regarding management of an advanced cancer patient in a nodal centre at District Head Quarters. Subsequently every two weeks, a trained social worker attached to the nodal centre will follow up and give necessary advice and emotional support to the patients and their families through their registered mobile phone number. Patient’s family were also encouraged to communicate with the team by phone in case of fresh complaints and urgency. Results Since initiation, cancer patients were contacted by mobile phone every two weeks to enquire about their difficulties. In 76% of the situations, trained social workers could give necessary advice by phone regarding management of their physical symptoms. Moreover patient’s family were really overwhelmed by the emotional support offered by the team over phone. Only 24% of cancer patients had to attend the nodal centre for expert advice from Palliative Care specialists. Conclusion This novel approach helped . .
10.1136/bmjspcare-2015-000906.82
Background There is growing evidence that creative arts interventions improve perceived physical and mental. However, there is little research into arts interventions in relation to palliative care and the published studies in arts and health have focussed on visual arts with little attention to dance. Aim A one year clinical audit was followed by a ten week pilot research study explored whether creative movement enabled people to feel more connected to themselves and each other, whether it supported the development of their collective voice and their ability to advocate for themselves and their peers. The service was offered on a group basis in Day Therapy and on a one-to-one basis for patients in the in patient unit. Method Dance sessions were run weekly and evaluated at each session on a simple scale measuring connectedness to oneself and each other in the group, and the joy derived from attendance. Results Healthcare professionals reported that the sessions offered patients a chance to reconnect with the memories of their physicality, whilst also offering an experience that proferred joy, the opportunity to participate in a social group and focussed on sharing support. A patient’s daughter who co-participated in a session reported “Two days before {my mother} died we had a movement session together; we have never felt so together as we did after that session”. Conclusion Whilst palliative care has long recognised the arts, there are benefits to be gained from collaborating and further A26
ALTERNATIVE METHOD TO PROVIDING PALLIATIVE CARE WHERE THERE ARE CAREGIVER SHORTAGES
.
In providing regular physical and emotional support to the patients and their families. In significantly reducing the financial and manpower problems of carrying patients to the nodal units. In improved quality of life of patients by continuous guidance. More and more team members can take help of this new strategy for better communication and uninterrupted care.
PA24
A GROUNDED THEORY ANALYSIS TO EXPLORE THE IMPACT OF GROUP WORK AS A METHOD OF SERVICE DELIVERY BY COMMUNITY MATRONS TO SUPPORT THOSE LIVING WITH MULTIPLE LONG-TERM CONDITIONS
Abigail Barkham. Southern Health NHS Foundation Trust, UK 10.1136/bmjspcare-2015-000906.84
Background The role of the Community Matron was introduced in 2005 (DoH 2005a) to case-manage those patients deemed as very high intensity service users to prevent and reduce unscheduled admission to secondary care. Related studies on the effectiveness of managed care indicated the need to manage the demand of high service users who had multiple longterm conditions (LTCs). Little evidence exists as to how the role should be delivered to enhance disease self-management and levels of self-efficacy for the service users. Aim Reviewing the role of Community Matrons in regard to their work with patients with multiple long-term conditions.
SPCare 2015;5(Suppl 1):A1–A32
Downloaded from http://spcare.bmj.com/ on November 18, 2015 - Published by group.bmj.com
PA21 Community participation in setting up palliative care clubs for chronically ill aids patients in lagos Olanrewaju Onigbogi BMJ Support Palliat Care 2015 5: A25-A26
doi: 10.1136/bmjspcare-2015-000906.81 Updated information and services can be found at: http://spcare.bmj.com/content/5/Suppl_1/A25.4
These include:
Email alerting service
Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
Abstracts REFERENCE 1
Dying Matters Survey http://www.comres.co.uk/polls/Dying_Matters_Public_April 12. pdf
Aim . .
PA18
HEART OF GOLD. INTEGRATING CROSS BOUNDARY CARE ACROSS DIFFERENT SECTORS WITH PATIENTS AT THE HEART OF CARE – A POPULATION-BASED PUBLIC HEALTH PERSPECTIVE
Keri Thomas, Maggie Stobbart Rowlands, Julie Armstrong Wilson. The Gold Standards Framework, UK 10.1136/bmjspcare-2015-000906.78
Background In response to the growing challenge of over-hospitalisation and fragmentation of care for people nearing the endof-life, a key factor is to develop an integrated cross-boundary care approach to meet the population’s needs. Gold Standards Framework (GSF) quality improvement programmes are widely used in the UK in primary care, care homes, hospitals, domiciliary care and hospices. By working together to a common plan, GSF can help be a vehicle for improvement with patients at the heart of care. Aim To explore using GSF programmes in different settings to develop an integrated whole-system approach, with patients at the heart of care – the ‘heart of gold’ projects. Method A description of GSF used in different settings as a common language to develop better integrated cross-boundary care, with peoples’ wishes and preferences at the heart of care. GSF improves the early identification, Advance Care Planning discussions and coordination of care reducing unnecessary hospital admissions. Results Findings from different sectors are presented from each setting, looking at whole-systems, and practical and qualitative measures of progress. Conclusion Real improvements are being seen across whole areas using GSF as a vehicle for better co-ordinated care. ‘Gold patients’ and their families feel many benefits and there is greater openness and ‘cultural change’ in end-of-life-care, especially for the frail elderly. GSF can be part of the solution in developing such integrated care by developing a common ‘vocabulary’ of care for all people in any setting with any condition in the final years of life.
PA19
‘CLOSING THE GAP’: A COMMUNITY ENGAGEMENT PROJECT
George Obita, Anna Wolkowski, Linda Johnson, Sarah Cash, Matthew Blagojevic, All other members of the project group are acknowledged: Briony Ming, Dave Carrick, Diane Dinning, Elaine Lord, Karinda Jones, Tania Wilson, Tania Wood. Dove House Hospice, UK 10.1136/bmjspcare-2015-000906.79
Background Dove House Hospice serves a population of about 600,000 covering Hull and East Riding. About 42% of people in Hull and East Riding die in their usual residence. Dove House Hospice’s vision is to provide excellent specialist palliative care and support to patients, their families and carers in the locality. Despite excellent services provided, there was evidence of lack of awareness. A project, using a community engagement approaches, was therefore developed to close this gap.
SPCare 2015;5(Suppl 1):A1–A32
.
Raise awareness about death, dying, loss and care; and services provided by Dove House Hospice Improve partnerships between Dove House Hospice and the community. Increase social supports to those who experiences death, dying, loss and caregiving.
Methods Approach: Two postcode areas, namely Cottingham and Bransholme, were initially selected for two-week community engagement activities. The key approaches used were: direct engagement with the public, participation in community activities, engagement with local primary health care services and distribution of information leaflets. Evaluation approach: Use of pre and post activities questionnaire and feedback meetings with key community members. Results Leaflets were distributed to a total of about 18,000 addresses. Immediate result include: Increased donation, increased application for volunteering and increased referrals. Community involvement in end of life care waits to be evaluated. Conclusion This is an on-going project. Early indications are that there has been improved awareness of the hospice services and interest in the hospice’s activities. The project has also contributed to the hospice being included in the pathfinder charter community.
PA20
VIEWS ON TALKING ABOUT DEATH, DYING AND LOSS
Katharine Abba, Siobhan Horton, Mari Lloyd-Williams. Academic Palliative and Supportive Care Studies Group, UK 10.1136/bmjspcare-2015-000906.80
Background Societal barriers to open discussion of personal feelings and preferences relating to death may hinder planning for end of life and supporting people who are dying or bereaved. Aim To explore views about talking about death, dying and loss. Method Semi-structured interviews were conducted with 31 people; age range 30 to 83 years. Results Making wills and communicating end of life wishes were considered very important; mostly for the sake of the family left behind. Participants also valued confidence to discuss other people’s end of life wishes and support them appropriately if they were dying or bereaved. Many participants were very comfortable talking about their own death. Identified barrier to talking about end of life wishes included not wanting to upset others; others not listening; not being about to find an appropriate moment; not knowing enough about the options available; and fear of death, especially of the unknown. Financial costs were seen as a barrier to making a will. Participants talked of the importance of raising awareness of what death and dying involves; what end of life options available; and the importance of communication. Information on the process of normal grieving and how to support somebody who has been bereaved were also suggested. Conclusion Being able to talk about end of life wishes and know how to support people who are dying or bereaved are important to many people, and they would welcome interventions to facilitate this at a societal level.
A25
Downloaded from http://spcare.bmj.com/ on November 18, 2015 - Published by group.bmj.com
Abstracts PA21
COMMUNITY PARTICIPATION IN SETTING UP PALLIATIVE CARE CLUBS FOR CHRONICALLY ILL AIDS PATIENTS IN LAGOS
research is needed to understand the nature and impact of creative interventions.
Olanrewaju Onigbogi. Department of Community Health and Primary Care, College of Medicine, Nairobi 10.1136/bmjspcare-2015-000906.81
Background With the introduction of Highly Active Anti-retroviral Therapy, more HIV/AIDS patients live longer in our communities. Aim This study was conducted to assess the willingness of people in Lagos to participate in setting up palliative care clubs for these patients. Methodology Self administered questionnaires were completed by 261 respondents with age ranging from 21–61 years. SPSS version 16 data editor was used to analyse data. Univariate odds ratios and 95% confidence intervals (95% CI) were used to evaluate the correlates of willingness to participate (WTP). Results A total of 62% of the respondents reported that they will be willing to participate in palliative care for the HIV patients. Higher willingness was associated with prior contact with higher education (OR = 1.13, 95% CI: 1.02–1.53), present employment (OR = 1.65, 95% CI: 1.45–1.72) and a potential for financial incentives (OR = 1.59, 95% CI: 1.32–1.77). Decreased WTP was associated with concerns about social stigmatisation (OR = 0.35, 95% CI: 0.13–0.71) and possibility of rejection by the patients (OR = 0.83, 95% CI: 0.56–0.93). Conclusion The high level of WTP indicates that such programmes would be better successful if organisers provide incentives as a part of the take-off of this program.
PA22
THE ARTS OF CONNEXION
Jackie Brooks, Rebecca Maher, Kathy Armour, Lucinda Jarrett. Marie Curie Hospice West Midlands, UK
PA23
Aditya Manna, SK Sarkar, LK Khanra. Narikeldaha Prayas, India 10.1136/bmjspcare-2015-000906.83
Background Due to financial incapability and absence of manpower poor families often fail to carry their advanced cancer patients to the nodal centres. This pilot study will explore whether communication by mobile phone can lessen this burden. Aim To identify and try to solve to the extent possible the main difficulties in giving palliative care to the terminal cancer patients of the area. Method Initially a plan was generated regarding management of an advanced cancer patient in a nodal centre at District Head Quarters. Subsequently every two weeks, a trained social worker attached to the nodal centre will follow up and give necessary advice and emotional support to the patients and their families through their registered mobile phone number. Patient’s family were also encouraged to communicate with the team by phone in case of fresh complaints and urgency. Results Since initiation, cancer patients were contacted by mobile phone every two weeks to enquire about their difficulties. In 76% of the situations, trained social workers could give necessary advice by phone regarding management of their physical symptoms. Moreover patient’s family were really overwhelmed by the emotional support offered by the team over phone. Only 24% of cancer patients had to attend the nodal centre for expert advice from Palliative Care specialists. Conclusion This novel approach helped . .
10.1136/bmjspcare-2015-000906.82
Background There is growing evidence that creative arts interventions improve perceived physical and mental. However, there is little research into arts interventions in relation to palliative care and the published studies in arts and health have focussed on visual arts with little attention to dance. Aim A one year clinical audit was followed by a ten week pilot research study explored whether creative movement enabled people to feel more connected to themselves and each other, whether it supported the development of their collective voice and their ability to advocate for themselves and their peers. The service was offered on a group basis in Day Therapy and on a one-to-one basis for patients in the in patient unit. Method Dance sessions were run weekly and evaluated at each session on a simple scale measuring connectedness to oneself and each other in the group, and the joy derived from attendance. Results Healthcare professionals reported that the sessions offered patients a chance to reconnect with the memories of their physicality, whilst also offering an experience that proferred joy, the opportunity to participate in a social group and focussed on sharing support. A patient’s daughter who co-participated in a session reported “Two days before {my mother} died we had a movement session together; we have never felt so together as we did after that session”. Conclusion Whilst palliative care has long recognised the arts, there are benefits to be gained from collaborating and further A26
ALTERNATIVE METHOD TO PROVIDING PALLIATIVE CARE WHERE THERE ARE CAREGIVER SHORTAGES
.
In providing regular physical and emotional support to the patients and their families. In significantly reducing the financial and manpower problems of carrying patients to the nodal units. In improved quality of life of patients by continuous guidance. More and more team members can take help of this new strategy for better communication and uninterrupted care.
PA24
A GROUNDED THEORY ANALYSIS TO EXPLORE THE IMPACT OF GROUP WORK AS A METHOD OF SERVICE DELIVERY BY COMMUNITY MATRONS TO SUPPORT THOSE LIVING WITH MULTIPLE LONG-TERM CONDITIONS
Abigail Barkham. Southern Health NHS Foundation Trust, UK 10.1136/bmjspcare-2015-000906.84
Background The role of the Community Matron was introduced in 2005 (DoH 2005a) to case-manage those patients deemed as very high intensity service users to prevent and reduce unscheduled admission to secondary care. Related studies on the effectiveness of managed care indicated the need to manage the demand of high service users who had multiple longterm conditions (LTCs). Little evidence exists as to how the role should be delivered to enhance disease self-management and levels of self-efficacy for the service users. Aim Reviewing the role of Community Matrons in regard to their work with patients with multiple long-term conditions.
SPCare 2015;5(Suppl 1):A1–A32
Downloaded from http://spcare.bmj.com/ on November 18, 2015 - Published by group.bmj.com
PA21 Community participation in setting up palliative care clubs for chronically ill aids patients in lagos Olanrewaju Onigbogi BMJ Support Palliat Care 2015 5: A25-A26
doi: 10.1136/bmjspcare-2015-000906.81 Updated information and services can be found at: http://spcare.bmj.com/content/5/Suppl_1/A25.4
These include:
Email alerting service
Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article.
Notes
To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://group.bmj.com/subscribe/
