iPANEL Newsletter Issue 8

                                                                                                                                                                                                           

We are pleased to publish our latest iPANEL newsletter! To download this issue please click HERE. To view older issues of our newsletters please check out our Publications tab.

Conceptual foundations of a palliative approach: A knowledge synthesis

                                                                                                                                                                                                           

Sawatzky, R., Porterfield, P., Lee, J., Dixon, D., Lounsbury, K., Pesut, B., Roberts, D., Tayler, C., Voth, J., & Stajduhar, K. (2016). BMC Palliative Care, Volume 16 Issue 6. doi: 10.1186/s12904-016-0076-9

The iPANEL team is thrilled to announce the publication of "Conceptual foundations of a palliative approach: A knowledge synthesis" in BMC Palliative Care. Narrowing 190,204 search results to a final yield of 91 studies has produced a comprehensive understanding of a palliative approach to care for people with chronic, advancing, life-limiting illnesses.

This article is available open access HERE.

Abstract

Background

Much of what we understand about the design of healthcare systems to support care of the dying comes from our experiences with providing palliative care for dying cancer patients. It is increasingly recognized that in addition to cancer, high quality end of life care should be an integral part of care that is provided for those with other advancing chronic life-limiting conditions. A “palliative approach” has been articulated as one way of conceptualizing this care. However, there is a lack of conceptual clarity regarding the essential characteristics of a palliative approach to care. The goal of this research was to delineate the key characteristics of a palliative approach found in the empiric literature in order to establish conceptual clarity.

Methods

We conducted a knowledge synthesis of empirical peer-reviewed literature. Search terms pertaining to “palliative care” and “chronic life-limiting conditions” were identified. A comprehensive database search of 11 research databases for the intersection of these terms yielded 190,204 documents. A subsequent computer-assisted approach using statistical predictive classification methods was used to identify relevant documents, resulting in a final yield of 91 studies. Narrative synthesis methods and thematic analysis were used to then identify and conceptualize key characteristics of a palliative approach.

Results

The following three overarching themes were conceptualized to delineate a palliative approach: (1) upstream orientation towards the needs of people who have life-limiting conditions and their families, (2) adaptation of palliative care knowledge and expertise, (3) operationalization of a palliative approach through integration into systems and models of care that do not specialize in palliative care.

Conclusion

Our findings provide much needed conceptual clarity regarding a palliative approach. Such clarity is of fundamental importance for the development of healthcare systems that facilitate the integration of a palliative approach in the care of people who have chronic life-limiting conditions.

 

Congratulations to Naheed Dosani!

                                                                                                                                                                                                           

naheed-profile

The Equitable Access to Care (EAC) Study (PI Kelli Stajduhar) is thrilled to announce that co-investigator, Dr. Naheed Dosani, has been named a recipient of the 2015 Early Career Development award from the College of Family Physicians of Canada. The award acknowledges the efforts and outstanding contributions of new family physician leaders recognizing Dr. Dosani’s project leadership in Palliative Education and Care for the Homeless (PEACH) and research such as the EAC study.

Congratulations Naheed!

 

 

Congratulations to Erin Donald!

                                                                                                                                                                                                           

erin-profile

Congratulations go out to iPANEL research assistant and student Erin Donald! Erin is the recipient of three 2015 scholarships:

  • Discovery Program for Youth and Family Addiction Services Scholarship
  • Dr. David Chuenyan Lai Scholarship
  • Jessie H. Mantle Fellowship in Nursing

Erin is in the second year of her doctoral program with the School of Nursing at the University of Victoria. Her past clinical experience in long-term care and community palliative care led to her interest in caring for older adults with advanced life-limiting conditions. Under the guidance of Dr. Kelli Stajduhar, her dissertation research will focus on access to care for people with severe persistent mental illness who are approaching end of life. She hopes her research will help improve access to appropriate clinical care for this population.

These awards are well-deserved. Congratulations, Erin!

 

A PORT in the Storm

                                                                                                                                                                                                           

A PORT in the Storm: A day of education and discussion about equitable access in palliative care for structurally vulnerable people in Victoria

On Thursday, October 29, 2015 the University of Victoria Equitable Access to Care Study Team (PI Kelli Stajduhar), Victoria Hospice, and the Palliative Outreach Resource Team (PORT) hosted an interactive and educational event about palliative care for structurally vulnerable people. Structural vulnerability recognizes that particular groups of people are more vulnerable to harm as a result of intersecting factors (e.g., poverty, homelessness, gender, disability, race, illicit drug use, mental health issues, etc.). The intent of this day was to foster dialogue between formal palliative care providers (e.g., hospice personnel, home care workers, etc.) and downtown service providers (i.e., health, housing, faith and social service organizations) to identify challenges in our community with regards to palliative care access for these populations.

The day began with a welcome from City Councillor Marianne Alto who spoke about the significance of dignified palliative care services for Victoria's inner city population. Participants then heard about current research on palliative care and structurally vulnerable populations through presentations by Dr. Kelli Stajduhar, Lead Investigator with the University of Victoria's Equitable Access to Care study, and Dr. Ryan McNeil from the BC Centre for Excellence in HIV/AIDS, a leading researcher in the field.

A series of presentations followed on promising practices in palliative care from Dr. Naheed Dosani, lead physician with PEACH (Palliative Education and Care for the Homeless) in Toronto; Dr. Sue Burgess, a physician providing palliative care in Vancouver's Downtown Eastside; and Victoria's Palliative Outreach Resource Team. After lunch, a panel of practitioners from Pacifica Housing, Cool Aid Community Health, Victoria Hospice, the Dandelion Society, Our Place Society and AIDS Vancouver Island spoke about the challenges to providing and accessing palliative care for the people they serve.

The remainder of the event was spent in small group discussions where participants with diverse employment backgrounds, including front line workers, health care professionals, managers, executive directors, spiritual practitioners and people with lived experience of poverty and homelessness participated in discussions about challenges to palliative care access in Victoria. Finally, Dr. Dosani facilitated break-out groups where participants had the opportunity to discuss how 7 palliative care principles (i.e., flexible admission criteria; consistent and continuous case management; maximize flexibility of program policies; foster peer-support networks; employ diverse and holistic care models; prioritize client dignity; provide palliative care within intensive supportive housing) could be implemented in various organizations for a community-based response to this important issue.

The day was a great success and people left feeling inspired. We are currently in process of writing up the main findings of the day which will be made publicly available. The Equitable Access to Care study will continue with data collection until spring 2016. We plan to host another community forum with people who have lived experience of poverty and/or homelessness to seek feedback on findings as well as to contribute to project recommendations. For more information about the Equitable Access to Care study please contact Ashley Mollison, Project Coordinator at This email address is being protected from spambots. You need JavaScript enabled to view it..

Thanks to our generous funders and contributors: The Sovereign Order of St. John of Jerusalem Knights Hospitaller Victoria Commandery, Victoria Hospice, the Canadian Institutes of Health Research (CIHR) and the UVic Centre on Aging; and our presenters, panelists and facilitators.

Media links:

CFAX: Dr. Kelli Stajduhar's CFAX Interview with Terry Moore on October 29, 2015.

CBC: Dr. Kelli Stajduhar's interview with Robyn Burn's from All Points West on November 2, 2015 (recording unavailable)

Collage

Andrea Hofmeyr, Home & Community Care nurse

Beverley Cote, Home & Community Care nurse

Caite Meagher, Home & Community Care nurse

Kelli Stajduhar, Equitable Access to Care Study

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