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1. Development of a palliative paramedicine framework to standardise best practice: A Delphi study.

Author

Juhrmann, Madeleine L, Butow, Phyllis N, Simpson, Paul, Boughey, Mark, Makeham, Meredith, and Clayton, Josephine M

Subjects
*MEDICAL protocols, *CONSENSUS (Social sciences), *PALLIATIVE treatment, *RESEARCH funding, *BENCHMARKING (Management), *MEDICAL care, *QUESTIONNAIRES, *EMERGENCY medical services, *DESCRIPTIVE statistics, *CONCEPTUAL structures, *PALLIATIVE medicine, *PARAMEDICINE, *DELPHI method
Abstract

Background: Growing global demand for palliative care services has prompted generalist clinicians to provide adjunct support to specialist teams. Paramedics are uniquely placed to respond to these patients in the community. However, embedding palliative care principles into their core business will require multifactorial interventions at structural, healthcare service and individual clinician and consumer levels. Aim: To develop a palliative paramedicine framework suitable for national implementation, to standardise best practice in Australia. Design: Delphi study utilising questionnaire completion; each round informed the need for, and content of, the next round. Free text comments were also sought in Round 1. Two rounds of Delphi were undertaken. Setting/participants: Sixty-eight participants took part in Round 1, representing six countries, and 66 in Round 2. Participants included paramedics, palliative care doctors and nurses, general practitioners, researchers and carers with lived experience and expertise in palliative paramedicine. Results: Seventeen of the original 24 components gained consensus; 6 components were modified; and 9 new components arose from Round 1. All modified and new components gained consensus in Round 2. Only one original component did not gain consensus across both rounds and was excluded from the final 32-component framework. Conclusion: This study has developed a comprehensive national framework addressing the macro-, meso- and micro-level interventions required to standardise palliative paramedicine across Australia. Future research ought to engage a multidisciplinary team to create an implementation strategy, addressing any perceived barriers, facilitators and challenges for applying the framework into policy and practice. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Paramedics delivering palliative and end-of-life care in community-based settings: A systematic integrative review with thematic synthesis.

Author

Juhrmann, Madeleine L, Vandersman, Priyanka, Butow, Phyllis N, and Clayton, Josephine M

Subjects
PSYCHOLOGY information storage & retrieval systems, CINAHL database, TERMINAL care, TERMINALLY ill, SYSTEMATIC reviews, COMMUNITY health services, HOSPITAL admission & discharge, LABOR supply, MEDICAL protocols, RESEARCH funding, MEDLINE, PALLIATIVE treatment
Abstract

Background: There is a growing demand for community palliative care and home-based deaths worldwide. However, gaps remain in this service provision, particularly after-hours. Paramedicine may help to bridge that gap and avoid unwanted hospital admissions, but a systematic overview of paramedics' potential role in palliative and end-of-life care is lacking. Aim: To review and synthesise the empirical evidence regarding paramedics delivering palliative and end-of-life care in community-based settings. Design: A systematic integrative review with a thematic synthesis was undertaken in accordance with Whittemore and Knafl's methodology. Prospero: CRD4202119851. Data sources: MEDLINE, CINAHL, PsycINFO and Scopus databases were searched in August 2020 for primary research articles published in English, with no date limits applied. Articles were screened and reviewed independently by two researchers, and quality appraisal was conducted following the Mixed-Methods Appraisal Tool (2018). Results: The search retrieved 5985 articles; 23 articles satisfied eligibility criteria, consisting of mixed-methods (n = 5), qualitative (n = 7), quantitative descriptive (n = 8) and quantitative non-randomised studies (n = 3). Through data analysis, three key themes were identified: (1) Broadening the traditional role, (2) Understanding patient wishes and (3) Supporting families. Conclusions: Paramedics are a highly skilled workforce capable of helping to deliver palliative and end-of-life care to people in their homes and reducing avoidable hospital admissions, particularly for palliative emergencies. Future research should focus on investigating the efficacy of palliative care clinical practice guideline implementation for paramedics, understanding other healthcare professionals' perspectives, and undertaking health economic evaluations of targeted interventions. [ABSTRACT FROM AUTHOR]

Published
2022
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14. CONTRIBUTORS

Author

Aberg, Judith A., primary, Abernethy, Amy P., additional, Abrahm, Janet L., additional, Adolph, Michael, additional, Aherne, Michael, additional, Allsopp, K., additional, Altisent, Rogelio, additional, Alvarez, Carmen Fernandez, additional, Amigo, Pablo, additional, Anderson, Wendy G., additional, Ang, Sik Kim, additional, Antonelli, Tiziana, additional, Armstrong, John, additional, Armstrong, Wendy S., additional, Arnold, Robert M., additional, Arranz, Pilar, additional, Augustyns, Koen, additional, Sáenz-Diez, Isabel Barreiro-Meiro, additional, Barreto, Pilar, additional, Barton, Debra, additional, Bates, Ursula, additional, Fernandez-Creuchet Santos, Maria B., additional, Bátiz, Jacinto, additional, Benedetti, Costantino, additional, Bennani-Baiti, Nabila, additional, Bennett, Michael I., additional, Berger, Kevin, additional, Bhatnagar, Mamta, additional, Bicanovsky, Lesley, additional, Blue, Lynda, additional, Bobb, Barton, additional, Body, Jean-Jacques, additional, Borasio, Gian Domenico, additional, Borreani, Claudia, additional, Bozzetti, Federico, additional, Bozzetti, Valentina, additional, Braybrooke, Jason, additional, Breitbart, William, additional, Bresnihan, Barry, additional, Broeckaert, Bert, additional, Bruera, Eduardo, additional, Brune, Kay, additional, Buckhout, Bradley, additional, Butow, Phyllis N., additional, Byock, Ira, additional, Byrne, Anthony, additional, Byrne, Clare, additional, Cable-Williams, Beryl E., additional, Callin, Sarah E., additional, Casarett, David, additional, Casper, David, additional, Cassell, Eric J., additional, Cassileth, Barrie, additional, Castagno, Emanuele, additional, Centeno, Carlos, additional, Ceranski, Walter, additional, Ceulemans, Lucas, additional, Chadha, Meghna, additional, Chamberlain, Bruce H., additional, Chang, Eric L., additional, Chang, Victor T., additional, Chochinov, Harvey Max, additional, Chow, Edward, additional, Christ, Grace, additional, Clark, Katherine, additional, Clarke, Stephen, additional, Clayton, Josephine M., additional, Cleary, James F., additional, Clein, Lawrence J., additional, Clemens, Katri Elina, additional, Clemens, Libby, additional, Colebunders, Robert, additional, Connor, Steven R., additional, Conraads, Viviane, additional, Cooney, Colm, additional, Costantini, Massimo, additional, Couceiro, Azucena, additional, Covington, Holly, additional, Cowan, John D., additional, Coyne, Patrick, additional, Crawford, Garnet, additional, Creedon, Brian, additional, Cronin, Hilary, additional, Cullen, Garret, additional, Cummings, Jennifer E., additional, Currow, David C., additional, Daeninck, Paul J., additional, Dalinis, Pamela, additional, Das, Prajnan, additional, Davis, Mellar P., additional, Davison, Sara N., additional, Deamant, Catherine, additional, de Lima, Liliana, additional, Delany, Conor P., additional, Demeulenaere, Peter, additional, Dergham, Lena, additional, Derycke, Noël, additional, Dhupar, Rajeev, additional, Dicato, Mario, additional, Dickerson, Edwin D., additional, Dickman, Andrew, additional, Dietrich, Maria, additional, Dixon, Pamela, additional, Dodd, Philip C., additional, D'Olimpio, James T., additional, Dombernowsky, Per, additional, Dooley, Michael, additional, Dudgeon, Deborah, additional, Dunn, Geoffrey P., additional, Dunwoodie, David, additional, Eades, Jane, additional, El Osta, Badi, additional, Elbert-Avila, Katja, additional, Ellershaw, John, additional, Estfan, Bassam, additional, Exton, Louise, additional, Fairchild, Alysa, additional, Farrelly, Matthew, additional, Fassbender, Konrad, additional, Faulhaber, Jason, additional, Fearon, Kenneth C.H., additional, Fenelon, Lynda E., additional, Ferson, Peter F., additional, Feyer, Petra, additional, Filbet, Marilene, additional, Firth, Pam, additional, FitzGerald, Susan F., additional, Flood, Hugh D., additional, Floriani, Francesca Crippa, additional, Ford, Paul J., additional, Fortner, Barry, additional, Foth, Darlene, additional, Fowler, Bridget, additional, Frame, Karen, additional, Fraser, Thomas G., additional, Frost, Fred, additional, Fulham, Michael J., additional, Gagnon, Pierre R., additional, Gallagher, Lisa M., additional, Gambles, Maureen, additional, Giri, Subhasis K., additional, Glare, Paul, additional, Goh, Cynthia R., additional, Gómez-Batiste, Xavier, additional, Gramlich, Leah, additional, Grassi, Luigi, additional, Grauer, Phyllis A., additional, Green, Claire, additional, Griffiths, Gareth, additional, Griffo, Yvona, additional, Groninger, Hunter, additional, Gruenewald, David A., additional, Gubili, Jyothirmai, additional, Gutgsell, Terence L., additional, Gwyther, Elizabeth, additional, Haber, Paul S., additional, Haemers, Achiel, additional, Haley, Mindi C., additional, Hanna, Mazen A., additional, Hardy, Janet R., additional, Haselkorn, Jodie, additional, Hauser, Katherine, additional, Heaven, Cathy, additional, Herman, Michael, additional, Herrstedt, Jørn, additional, Higgins, Stephen, additional, Higginson, Irene J., additional, Hilden, Joanne M., additional, Hillenbrand, Kathryn L., additional, Hinz, Burkhard, additional, Homsi, Jade, additional, Hood, Kerry, additional, Hou, Juliet Y., additional, Hubens, Guy, additional, Hudson, Peter, additional, Hughes, John G., additional, Hunt, John, additional, Hurwitz, Craig A., additional, Ibinson, James, additional, Janjan, Nora, additional, Jaspers, Birgit, additional, Jehser, Thomas, additional, Joffe, A. Mark, additional, John, Laurence, additional, Johnstone, Jennie, additional, Jones, J. Stephen, additional, Kane, Javier R., additional, Karafa, Matthew T., additional, Keaveny, Andrew P., additional, Keefe, Dorothy M.K., additional, Kelso, Catherine McVearry, additional, Kenny, Rose Anne, additional, Kern, Martina, additional, Khoshknabi, Dilara Seyidova, additional, Kirkova, Jordanka, additional, Kirsh, Kenneth L., additional, Kissane, David W., additional, Klaschik, Eberhard, additional, Komurcu, Seref, additional, Kottke-Marchant, Kandice, additional, Kozell, Kathryn M., additional, Krishnan, Sunil, additional, Kuban, Deborah, additional, Laber, Damian A., additional, Lagman, Ruth L., additional, Lalla, Rajesh V., additional, Lane, Deforia, additional, Larkin, Philip J., additional, Lasheen, Wael, additional, Lawlor, Peter, additional, LeGrand, Susan B., additional, Lens, Vincent, additional, Leskuski, Dona, additional, Levack, Pamela, additional, Levetown, Marcia, additional, Lewandowski, Jeanne G., additional, Lewis, William R., additional, Librach, S. Lawrence, additional, Lichtenthal, Wendy G., additional, Lickiss, J. Norelle, additional, Lijoi, Stefano, additional, Lin, Edward, additional, Lipman, Arthur G., additional, Livrozet, Jean-Michel, additional, Lloyd-Williams, Mari, additional, Logan, Richard M., additional, Martín, Francisco López-Lara, additional, Loprinzi, Charles L., additional, Loughnane, John, additional, Lucey, Michael, additional, Lyckholm, Laurie, additional, Macmillan, Carol, additional, Mair, Frances, additional, Makoni, Stephen N., additional, Malik, Bushra, additional, Malone, Kevin, additional, Maltoni, Marco, additional, Mani, Aruna, additional, Marchand, Lucille R., additional, Mareiniss, Darren P., additional, Marsland, Anna L., additional, Marston, Joan, additional, Martinez, Julia Romero, additional, Martínez de Ubago, Isabel, additional, Martins, Lina M., additional, Maughan, Timothy S., additional, Mayland, Catriona, additional, McClement, Susan E., additional, McCutcheon, Ian, additional, McGee, Michael F., additional, McGill, Neil, additional, McNamara, Stephen, additional, McPherson, Mary Lynn, additional, McQuay, Henry, additional, McQuillan, Regina, additional, McQuown, Robert E., additional, Meiring, Michelle, additional, Mercadante, Sebastiano, additional, Meyer, Elaine C., additional, Miller, Randy D., additional, Millerick, Yvonne, additional, Miniero, Roberto, additional, Mohamed, Armin, additional, Mooka, Busi, additional, Morrison, Helen M., additional, Muir, J. Cameron, additional, Mulcahy, Fiona, additional, Mulcahy, Hugh E., additional, Muller, Monica, additional, Müller-Busch, H. Christof, additional, Murray, Scott A., additional, Nauck, Friedemann, additional, Neasham, Katherine, additional, Nkosi, Busisiwe, additional, Noble, Simon, additional, Noguera, Antonio, additional, Nowak, Anna K., additional, Nuñez-Olarte, Juan, additional, Obbens, Eugenie A.M.T., additional, O'Brien, Tony, additional, Olden, Megan, additional, O'Leary, Norma, additional, Oliver, David, additional, Oliviere, David, additional, Omlin, Aurelius G., additional, Osenga, Kaci, additional, O'Shea, Diarmuid, additional, Ostgathe, Christophe, additional, Ottery, Faith D., additional, Ouellette, Michel, additional, Overton, Edgar Turner, additional, Palacios, Moné, additional, Palmer, Robert, additional, Palmer, Teresa, additional, Paradis, Carmen, additional, Parala, Armida G., additional, Pascual-López, Antonio, additional, Passik, Steven D., additional, Pawlik, Timothy M., additional, Payne, Malcolm, additional, Payne, Sheila, additional, Paz, Silvia, additional, Pereira, José, additional, Perkins, George, additional, Peschardt, Karin, additional, Pessin, Hayley, additional, Peterson, Douglas E., additional, Podichetty, Vinod K., additional, Pollens, Robin, additional, Pontifex, Eliza, additional, Poole, Susan, additional, Porta-Sales, Josep, additional, Poston, Graeme, additional, Powazki, Ruth D., additional, Powderly, William, additional, Pozuelo, Leopoldo, additional, Prommer, Eric, additional, Puchalski, Christina M., additional, Radbruch, Lukas, additional, Raes, David F.J., additional, Read, Jane, additional, Reddy, Anantha, additional, Reger, Steven I., additional, Rehm, Susan J., additional, Reich, Stephen G., additional, Rocafort, Javier, additional, Rosenblatt, Adam, additional, Rushton, Cynda Hylton, additional, Russell, K. Mitchell, additional, Ryan, Karen, additional, Rybicki, Lisa A., additional, Sacerdote, Paola, additional, Sahgal, Vinod, additional, Ann Sammon, Mary, additional, Sandrock, Dirk, additional, Sands, Mark, additional, Schilling, Denise L., additional, Schulz, Valerie Nocent, additional, Schum, Lisa N., additional, Selwyn, Peter, additional, Shadd, Joshua, additional, Shapiro, Charles L., additional, Sharif, Aktham, additional, Sharp, Helen M., additional, Shepard, Kirk V., additional, Sherwood, J. Timothy, additional, Shrestha, Nabin K., additional, Skipworth, Richard J.E., additional, Smith, Howard S., additional, Solomon, Mildred Z., additional, de Prado Otero, Diego Soto, additional, Spencer, Denise Wells, additional, Spice, Ron, additional, Spiegel, David, additional, Srivastava, Manish, additional, Staffurth, John N., additional, Starling, Randall, additional, Stewart, Grant D., additional, Stjernswärd, Jan, additional, Strasser, Florian, additional, Strauss, Edna, additional, Strohscheer, Imke, additional, Summey, Brett Taylor, additional, Sutton, Graham, additional, Sykes, Nigel P., additional, Taege, Alan J., additional, Tamburini, Marcello, additional, Tarumi, Yoko, additional, Tassinari, Davide, additional, Tattersall, Martin H.N., additional, Theil, Karl S., additional, Thomas, Keri, additional, Tookman, Adrian, additional, Torrubia, María P., additional, Towers, Anna, additional, Tsoi, Daphne, additional, Tucker, Rodney O., additional, Tulsky, James A., additional, Tunick, Rachel A., additional, Turner, Claire, additional, Twaddle, Martha L., additional, Twomey, Marie, additional, Ullrich, Christina, additional, Urch, Catherine E., additional, Vachon, Mary L.S., additional, Van den Eynden, Bart, additional, Vigano, Antonio, additional, Vlieghe, Erika, additional, Volandes, Angelo E., additional, Voltz, Raymond, additional, Walker, Paul W., additional, Watanabe, Sharon, additional, Weber, Michael A., additional, Weinstein, Elizabeth, additional, Weinstein, Sharon M., additional, Weise, Kathryn L., additional, Weisenfluh, Sherri, additional, Welsh, John, additional, White, Clare, additional, Wilson, Donna M., additional, Wolfe, Joanne, additional, Yavuzsen, Tugba, additional, Yee, Albert J.M., additional, Yerian, Lisa M., additional, and Zucchetti, Elena, additional

Published
2009
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19. Doctors discussing religion and spirituality: A systematic literature review.

Author

Best, Megan, Butow, Phyllis, and Olver, Ian

Subjects
*CINAHL database, *COMMUNICATION, *INFORMATION storage & retrieval systems, *MEDICAL databases, *MEDICAL information storage & retrieval systems, *PSYCHOLOGY information storage & retrieval systems, *MEDLINE, *PHYSICIANS, *RELIGION, *SPIRITUALITY, *SYSTEMATIC reviews, *THEMATIC analysis, *PHYSICIANS' attitudes, *DESCRIPTIVE statistics
Abstract

Background: Discussion of religion and/or spirituality in the medical consultation is desired by patients and known to be beneficial. However, it is infrequent. We aimed to identify why this is so. Aim: We set out to answer the following research questions: Do doctors report that they ask their patients about religion and/or spirituality and how do they do it? According to doctors, how often do patients raise the issue of religion and/or spirituality in consultation and how do doctors respond when they do? What are the known facilitators and barriers to doctors asking their patients about religion and/or spirituality? Design: A mixed qualitative/quantitative review was conducted to identify studies exploring the physician’s perspective on discussion of religion and/or spirituality in the medical consultation. Data sources: We searched nine databases from inception to January 2015 for original research papers reporting doctors’ views on discussion of religion and/or spirituality in medical consultations. Papers were assessed for quality using QualSyst and results were reported using a measurement tool to assess systematic review guidelines. Results: Overall, 61 eligible papers were identified, comprising over 20,044 physician reports. Religion and spirituality are discussed infrequently by physicians although frequency increases with terminal illness. Many physicians prefer chaplain referral to discussing religion and/or spirituality with patients themselves. Such discussions are facilitated by prior training and increased physician religiosity and spirituality. Insufficient time and training were the most frequently reported barriers. Conclusion: This review found that physician enquiry into the religion and/or spirituality of patients is inconsistent in frequency and nature and that in order to meet patient needs, barriers to discussion need to be overcome. [ABSTRACT FROM AUTHOR]

Published
2016
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20. Evaluation of a novel individualised communication-skills training intervention to improve doctors’ confidence and skills in end-of-life communication

Author

Clayton, Josephine M, primary, Butow, Phyllis N, additional, Waters, Amy, additional, Laidsaar-Powell, Rebekah C, additional, O’Brien, Angela, additional, Boyle, Frances, additional, Back, Anthony L, additional, Arnold, Robert M, additional, Tulsky, James A, additional, and Tattersall, Martin HN, additional

Published
2012
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22. Doctors discussing religion and spirituality: A systematic literature review

Author

Megan Best, Phyllis Butow, Ian N. Olver, Best, Megan, Butow, Phyllis, and Olver, Ian

Subjects
Medical consultation, Attitude of Health Personnel, physician–patient relations, Chaplaincy Service, Hospital, education, neoplasms, review, Terminally ill, Original research, 03 medical and health sciences, 0302 clinical medicine, Nursing, Physicians, Spirituality, Humans, Terminally Ill, Medicine, 030212 general & internal medicine, Practice Patterns, Physicians', Referral and Consultation, Physician-Patient Relations, business.industry, Communication, Communication Barriers, Religion and Medicine, Perspective (graphical), General Medicine, Databases, Bibliographic, spirituality, humanities, Anesthesiology and Pain Medicine, Systematic review, spiritual care, religion, 030220 oncology & carcinogenesis, Research questions, Spiritual care, business
Abstract

Background: Discussion of religion and/or spirituality in the medical consultation is desired by patients and known to be beneficial. However, it is infrequent. We aimed to identify why this is so. Aim: We set out to answer the following research questions: Do doctors report that they ask their patients about religion and/or spirituality and how do they do it? According to doctors, how often do patients raise the issue of religion and/or spirituality in consultation and how do doctors respond when they do? What are the known facilitators and barriers to doctors asking their patients about religion and/or spirituality? Design: A mixed qualitative/quantitative review was conducted to identify studies exploring the physician’s perspective on discussion of religion and/or spirituality in the medical consultation. Data sources: We searched nine databases from inception to January 2015 for original research papers reporting doctors’ views on discussion of religion and/or spirituality in medical consultations. Papers were assessed for quality using QualSyst and results were reported using a measurement tool to assess systematic review guidelines. Results: Overall, 61 eligible papers were identified, comprising over 20,044 physician reports. Religion and spirituality are discussed infrequently by physicians although frequency increases with terminal illness. Many physicians prefer chaplain referral to discussing religion and/or spirituality with patients themselves. Such discussions are facilitated by prior training and increased physician religiosity and spirituality. Insufficient time and training were the most frequently reported barriers. Conclusion: This review found that physician enquiry into the religion and/or spirituality of patients is inconsistent in frequency and nature and that in order to meet patient needs, barriers to discussion need to be overcome.

Published
2015

23. The doctor's role in helping dying patients with cancer achieve peace: a qualitative study

Author

Phyllis Butow, Megan Best, Ian N. Olver, Best, Megan, Butow, Phyllis, and Olver, Ian

Subjects
Adult, Male, medicine.medical_specialty, peace, Attitude to Death, physician–patient relations, Grounded theory, terminal care, Nursing, Neoplasms, Surveys and Questionnaires, Spirituality, Advanced disease, Terminal care, Medicine, cancer, Humans, Terminally Ill, Meaning (existential), Physician's Role, Qualitative Research, Aged, Aged, 80 and over, Physician-Patient Relations, Terminal Care, business.industry, Communication, Cancer, Patient Preference, General Medicine, Middle Aged, medicine.disease, spirituality, Variety (cybernetics), Anesthesiology and Pain Medicine, Family medicine, Grounded Theory, doctor–patient relations, Quality of Life, Female, business, Qualitative research
Abstract

Background: Being at peace is important for the quality of life of dying cancer patients, but its features, and the role of the doctor in facilitating peace, are unclear. Aim: We sought to understand the features of a peaceful patient, and patients’ preferences regarding the role of the doctor in facilitating a sense of peace. Design: A grounded theory approach was used with semi-structured interviews. Patients were asked about the things that gave their life meaning and a sense of peace and how the doctor could support their spiritual well-being. Patients were also questioned about their concerns for their future. Setting/participants: In total, 15 cancer patients with advanced disease were interviewed in a variety of care settings. Results: Patients were observed to be along a spectrum between having peace and not having peace. Features of the two extreme positions are described. Doctors could facilitate peace by developing a good relationship with cancer patients and supplying clear and honest information about what patients could expect as they approached their death. Conclusion: Spiritual well-being in cancer patients can be promoted by communication from doctors regarding prognosis, which allows them time to prepare for death, and recognition of their fears. However, acceptance of death does not always lead to the patient experiencing peace.

Published
2014

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