DESIGN:A multi-methods, single-centre pilot comprising a quasi-experimental pre-/post-test design and an exploratory qualitative study. SETTING:A rural Australian hospital and health service. PARTICIPANTS:Men newly diagnosed with localised prostate cancer who were scheduled to undergo, or had undergone, radical or robotic prostatectomy surgery within the previous 3 months. INTERVENTION:The intervention comprised a 12-week virtual care program delivered via teleconference by a specialist nurse, using a pre-existing connected care platform. The program was tailored to the post-operative recovery journey targeting post-operative care, psychoeducation, problem-solving and goal setting. MAIN OUTCOME MEASURES:Primary outcome: program acceptability. SECONDARY OUTCOMES:quality of life; prostate cancer-related distress; insomnia severity; fatigue severity; measured at baseline (T1); immediately post-intervention (T2); and 12 weeks post-intervention (T3). RESULTS:Seventeen participants completed the program. The program intervention showed very high levels (≥4/5) of acceptability, appropriateness and feasibility. At T1, 47% (n = 8) of men reported clinically significant psychological distress, which had significantly decreased by T3 (p = 0.020). There was a significant improvement in urinary irritative/obstructive symptoms (p = 0.030) and a corresponding decrease in urinary function burden (p = 0.005) from T1 to T3. CONCLUSIONS:This pilot has shown that a tailored nurse-led virtual care program, incorporating post-surgical follow-up and integrated low-intensity psychosocial care, is both acceptable to rural participants and feasible in terms of implementation and impact on patient outcomes.

Background: As the number of people ageing in prison with complex healthcare needs continues to increase, so does the need for palliative care in the restrictive prison context. Palliative care for people in prison is facilitated by correctional officers, and prison- and hospital-based clinicians. A collective analysis of existing research to identify common experiences of these stakeholders globally has not been completed.Aim: To explore the perceptions and experiences of correctional officers and prison- and hospital-based clinicians who facilitate palliative care for people in prison.Design: A systematic review and meta-synthesis.Data sources: Keywords and subject headings related to palliative care and prisons were used to search seven databases with no time limitations. Peer-reviewed research in English, containing qualitative data from stakeholders facilitating palliative care for people in prison were included, and appraised using the CASP tool.Results: Two analytical themes emerged: (i) a prison lens on a palliative approach and (ii) coping complexities. Palliative care is 'translated' into the prison setting according to security and environmental constraints. Stakeholders experienced ethical, personal and professional difficulties, because prison-based palliative care did not align with community norms. Ambiguous policy and expectations regarding prioritising care needs and balancing custodial rules led to role stress.Conclusions: Providing palliative care for people in prison is complex and impacts stakeholders and people in prison with palliative care needs. Supporting person-centred care through a multi-service approach, stakeholder education and standards will improve the quality and accessibility of care.

ObjectiveTo assess the acceptability of a nurse-led prostate cancer survivorship intervention adapted for virtual delivery and tailored to post-surgical care, in a regional Australian hospital and health service. MethodsA qualitative exploratory study using the Theoretical Framework of Acceptability (TFA). ResultsTwenty-two participants took part in a semistructured interview comprising men who had completed the program (n = 16) and health professionals/service stakeholders involved in program delivery (n = 6). Acceptability of this virtual prostate cancer survivorship care program was very high across all constructs of the TFA, from the perspectives of both program recipients and those delivering the program. The quality of care received was seen as superior to what men had experienced previously (burden, opportunity costs). The time afforded by the regularly scheduled video-consultations allowed men to come to terms with the recovery process in their own time (self-efficacy), and provided an ongoing sense of support and access to care outside the consultation (ethicality). Clinically, the program improved care co-ordination, expedited identification of survivorship care needs, and met service priorities of providing quality care close to home (burden, perceived effectiveness). ConclusionsFindings from this study suggest virtual post-surgical care delivered via videoconferencing is highly acceptable to prostate cancer survivors in a regional setting. Future research exploring virtual program implementation at scale and long-term patient and service outcomes is warranted.

Purpose: Accessible cancer survivorship care is a key tenet of quality cancer care. However, prostate cancer survivorship care is often fragmented with best practice models of care largely undefined. The Prostate Cancer Survivorship Essentials Framework (“Essentials Framework”) was developed to guide the provision of integrated quality prostate cancer survivorship care. This process analysis reports the application of the Essentials Framework for mapping a current clinical model of prostate cancer survivorship care and identifying actions to facilitate translation of the framework into clinical practice.Methods: A five-phase mixed-methods participatory research study undertaken in an Australian multi-disciplinary prostate cancer clinic. All occasions of prostate cancer care over a two-year period were extracted from the patient database. Data from online surveys (patients) and semi-structured interviews (service stakeholders) were integrated and mapped to each domain of the Essentials Framework to identify areas of alignment and translational priorities.Results: Data from 326 patients representing 4232 occasions of care, online patient surveys (n = 61) and stakeholder interviews (n = 14) informed the mapping process. There was strong alignment between the service model and Essentials Framework largely due to the co-location of 13 multidisciplinary survivorship care services, and a dedicated focus on continuity of care and clinical surveillance across the prostate cancer survivorship care trajectory. Priority actions for translation included development of integrated survivorship care pathways across all treatment streams, integration of a survivorship care plan into the patient management system and embedding routine distress screening into survivorship care across disciplines. The five study phases formed the basis of a mapping template. This process analysis provides a starting point for services who wish to incorporate the principles of the Essentials Framework into their settings, through explicit description of research methods, tools and processes. An exemplar of mapping outcomes and translational priorities aligned with the Essentials Framework is detailed. This analysis shows the Essentials Framework articulates clearly to current clinical practice and serves as a model to guide the development and evaluation of prostate cancer survivorship care.Conclusions: By adopting a participatory research approach, and prioritizing clinical stakeholder experience, this study demonstrates evidence of the ecological validity of the Essentials Framework. Cross-disciplinary partnerships emerged as critical in identifying service-relevant translational priorities and supporting quality care.

Palliative care is increasingly important in the prison setting, but information about the quality and accessibility of this care is extremely limited. Developing and implementing standardised quality indicators will provide transparency, accountability, and a platform for quality improvement at both local and national levels.

Background: Globally, the prison population is growing and ageing, as is the need for palliative care. Yet, little is known about how people in prison perceive palliative care provision in this setting. Aims: To identify the: (i) perceptions of palliative care provision and dying in custody by people in prison; and (ii) perceived barriers and facilitators of person-centred palliative care provision in prison. Design: A systematic review and meta-synthesis was registered and undertaken in accordance with the reporting guidelines. Data Sources: Keywords and MeSH headings encompassing (i) palliative care, end-of-life care, death; and (ii) prison; were used to search Pubmed, Medline, CINAHL, PsycINFO, Web of Science, CINCH and ProQuest Central. Articles published in English, from high income countries, and containing qualitative data exploring perceptions of people in prison of palliative care in custody were included. Findings were reporting using the ENTREQ guidelines. Findings: Of the 2193 articles identified, 12 were included. Experiences of people in prison regarding palliative care related to two themes: (1) expectations versus experiences of palliative care; and (2) prison context complicates access to and provision of palliative care. People in prison with palliative care needs want to feel safe, cared for, and acknowledged as they face an expected death. The prison environment can severely restrict access to palliative care, leaving people in prison feeling isolated and powerless. Conclusions: People in prison expect to receive high-quality palliative care, but their experiences often do not match their expectations. Numerous structural and organisational challenges complicate the provision of palliative care in prisons, limiting accessibility of care.

International Journal of Palliative NursingVol. 27, No. 6 EditorialDying an expected death in prison: a growing realityJane L Phillips, Isabelle SchaeferJane L PhillipsHead School of Nursing, Queensland University of Technology, Brisbane and Professor Emerita Nursing (Palliative Care) IMPACCT, Faculty of Health, University of Technology Sydney, AustraliaSearch for more papers by this author, Isabelle SchaeferPalliative Care in Prisons Project, National Palliative Care Project and Doctoral Candidate, IMPACCT, Faculty of Health, University of Technology SydneySearch for more papers by this authorJane L Phillips; Isabelle SchaeferPublished Online:28 Aug 2021https://doi.org/10.12968/ijpn.2021.27.6.278AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Ambitions for Palliative and End of life Care Partnership. Dying well in custody charter: a national framework for local action. 2018. https://pdf4pro.com/amp/cdn/dying-well-in-custody-charter-endoflifecareambitions-org-uk-4fab9b.pdf (accessed 23 July 2021) Google ScholarAustralian Healthcare Association. Exploratory analysis of barriers to palliative care: issues report on people who are incarcerated. 2020. www.health.gov.au/sites/default/files/documents/2020/01/exploratory-analysis-of-barriers-to-palliative-care-issues-report-on-people-who-are-incarcerated.pdf (accessed 23 July 2021) Google ScholarBaidawi S. Managing the health of an ageing prison population: a review of the challenges to be addressed by effective models of care. 2015. https://www.academia.edu/35744043/Managing_the_health_of_an_ageing_prison_population_a_review_of_the_challenges_to_be_addressed_by_effective_models_of_care_an_Evidence_Check_rapid_review_brokered_by_the_Sax_Institute_www_saxinstitute_org_au_for_the_Justice_Health_and_Forensic_Mental_Health_Network_January_2015 (accessed 23 July 2021) Google ScholarCloyes KG, Rosenkranz SJ, Supiano KP, et al.. Caring to learn and learning to care: inmate hospice volunteers and the delivery of prison end-of-life care. J Correction Health Care 2017; 23:43–55. https://doi.org/10.1177%2F1078345816684833 Crossref, Medline, Google ScholarHer Majesty's Inspectorate of Prisons for Scotland. Standard 9: health and wellbeing. 2018. https://www.prisonsinspectoratescotland.gov.uk/publications/inspecting-and-monitoring-standard-9-health-and-wellbeing (accessed 23 July 2021) Google ScholarTurner M, Payne S, Barbarachild Z. Care or custody? An evaluation of palliative care in prisons in North West England. Palliat Med. 2011; 25(4):370–377. https://doi.org/10.1177/0269216310393058 Crossref, Medline, Google Scholar FiguresReferencesRelatedDetails 2 August 2021Volume 27Issue 6ISSN (print): 1357-6321ISSN (online): 2052-286X Metrics History Published online 28 August 2021 Published in print 2 August 2021 Information© MA Healthcare LimitedPDF download

Background A primary brain cancer diagnosis is a distressing, life changing event. It adversely affects the quality of life for the person living with brain cancer and their families (‘carers’). Timely access to evidence-based information is critical to enabling people living with brain cancer, and their carers, to self-manage the devastating impacts of this disease. Method A systematic environmental scan of web-based resources. A depersonalised search for online English-language resources published from 2009 to December 2019 and designed for adults (> 25 years of age), living with primary brain cancer, was undertaken using the Google search engine. The online information was classified according to: 1) the step on the cancer care continuum; 2) self-management domains (PRISMS taxonomy); 3) basic information disclosure (Silberg criteria); 4) independent quality verification (HonCode); 5) reliability of disease and treatment information (DISCERN Sections 1 and 2); and readability (Flesch-Kincaid reading grade). Results A total of 119 online resources were identified, most originating in England ( n = 49); Australia ( n = 27); or the USA ( n = 27). The majority of resources related to active treatment ( n = 76), without addressing recurrence ( n = 3), survivorship ( n = 1) or palliative care needs ( n = 13). Few online resources directly provided self-management advice for adults living with brain cancer or their carers. Just over a fifth ( n = 26, 22%) were underpinned by verifiable evidence. Only one quarter of organisations producing resources were HonCode certified ( n = 9, 24%). The median resource reliability as measured by Section 1, DISCERN tool, was 56%. A median of 8.8 years of education was required to understand these online resources. Conclusions More targeted online information is needed to provide people affected by brain cancer with practical self-management advice. Resources need to better address patient and carer needs related to: rehabilitation, managing behavioural changes, survivorship and living with uncertainty; recurrence; and transition to palliative care. Developing online resources that don’t require a high level of literacy and/or cognition are also required.

Background: Access to palliative care in the community enables people to live in their preferred place of care, which is often home. Community palliative care services struggle to provide timely 24-h services to patients and family. This has resulted in calls for 'accessible and flexible' models of care that are 'responsive' to peoples' changing palliative care needs. Digital health technologies provide opportunities to meet these requirements 24-h a day. Aim: To identify digital health technologies that have been evaluated for supporting timely assessment and management of people living at home with palliative care needs and/or their carer(s), and the evidence-base for each. Design: A systematic review of systematic reviews ('meta-review'). Systematic reviews evaluating evidence for virtual models of palliative or end-of-life care using one or more digital health technologies were included. Systematic reviews were evaluated using the Risk of Bias Tool for Systematic Reviews. A narrative approach was used to synthesise results. Data sources: Medline, Embase, Web of Science, CINAHL and Cochrane Database of systematic reviews were searched for English-language reviews published between 2015 and 2020. Results: The search yielded 2266 articles, of which 12 systematic reviews met criteria. Sixteen reviews were included in total, after four reviews were found via handsearching. Other than scheduled telehealth, video-conferencing, or after-hours telephone support, little evidence was found for digital health technologies used to deliver virtual models of palliative care. Conclusions: There are opportunities to test new models of virtual care, beyond telehealth and/or video conferencing, such as 24-h command centres, and rapid response teams. Systematic review registration number: Prospero CRD42020200266

Fragestellung: Im Inselspital Bern wird bei allen Patienten der Reanimationsstatus mit „CPR ja“ oder „CPR nein“ in der Pflegedokumentation festgehalten. Eigene Erfahrungen in unserem Zentrum deuten an, dass der Reanimationsstatus für Pflegende eine wichtige Rolle spielt hinsichtlich palliativer Handlungsoptionen. Bei zwei qualitativen Studien wurde eine Sekundäranalyse durchgeführt zu folgender Frage: Ändert der Reanimationsentscheid „CPR nein“ für Pflegende die weitere Patientenversorgung?