Objectives Psychological distress is common among palliative care patients. Despite this, little is known about the availability of psychological services to support palliative care patients within Australia. This study aimed to determine the level of psychological support services available within Australian Palliative Care Services. The study was based on a similar study in Australia by Crawford in 1999, allowing differences over time to be examined. Methods A 12-item online survey was distributed to adult Palliative Care Services throughout Australia from November 2021 to January 2022. Quantitative and qualitative analysis of responses was conducted, with comparisons made with the 1999 study using a 2-proportions z-test. Results Social workers were the most available professionals delivering psychological care (prevalence of 94.1%), followed by spiritual care workers (62.5%), creative therapists (43.8%), counselors (36.4%), psychiatrists (31.3%), complementary therapists (28.1%), and psychologists (25.0%). Nearly 60% of services had no access to a psychiatrist or a psychologist. The proportion of Palliative Care Services that had access to a psychiatrist, psychologist, or counselor was significantly less in 2021/22 compared to 1999, with differences of 29.4% (p = 0.002), 23.4% (p = 0.015), and 26.1% (p = 0.006), respectively. Significance of results Lack of access to psychiatrists, psychologists, and counselors in Australian Palliative Care Services remains a significant issue and has become more prevalent since 1999. Ongoing advocacy and increased government funding to enable psychological health professionals to be readily employed in Palliative Care Services is vital.
IntroductionAgitation is a common manifestation of the behavioural and psychological symptoms of dementia (BPSD). Pharmacotherapy is not the first-line management because of its potential harms, particularly in the elderly. Music as a non-pharmacological intervention for agitation has been explored in residential aged-care facilities, but few studies have been situated in hospitals. This pilot aims to evaluate the feasibility of a personalised music listening intervention for reducing agitation in hospitalised patients with dementia in a metropolitan Geriatric Evaluation and Management (GEM) unit.MethodsTwo-arm randomised control feasibility trial. Eligible patients were assigned to the music intervention or control group, with the intervention group receiving music daily between 15:00–16:00, and agitation levels measured in both groups hourly based on the Pittsburgh Agitation Score (PAS) over 5 days of hospitalisation. Post-trial semi-structured interviews assessed feasibility of the intervention.ResultsTwenty-one patients were recruited over 8 months. Interviews with staff involved indicated that the music intervention was manageable to deliver, assisted engagement with patients which increased efficiency of some clinical tasks, and challenged staff mindset around using psychotropic medication to address agitation. PAS results were inconclusive, because of underpowered numbers in this pilot study.ConclusionIt is feasible for nursing staff to deliver a personalised music listening intervention to patients with dementia in a geriatric unit of a tertiary hospital, without compromising on usual clinical care.
The hospice recognised the need to maximise the talent and expertise of Band 5 palliative care nurses. Funding was set aside in annual budget planning to reward the equivalent of one increment on Agenda for Change NHS pay scale (band 5) to nurses undertaking a project for one year. We later diversified the plan to also allow band 3 healthcare assistants to be eligible which again rewards the equivalent of one increment on Agenda for Change NHS pay scale (band 3).Through setting up a project, nurses could be recognised for the additional work they do, over and above caring for the patients. As a hospice we know we are providing the best evidence based care, whilst in turn upskilling staff.Staff create a project plan with a number of outcomes, often including increasing staff awareness of a current evidence on their topic and creating resources for staff to use.We support staff by offering dedicated study time, access to study days and ongoing project support from our advanced nurse practitioner. In return they deliver current evidence based resources and teaching to the in patient unit staff.On launch of project uptake was low with three projects being submitted, once these projects were in action and visible on the wards, we opened a second round of application, to utilise the funding allocated. There was increased interest, generating many applications from staff. This highlights staff clearly value the project and are keen to get involved.We currently have five projects running covering topics including, Motor Neurone Disease, Wound care, Outcome Measures and Infection Prevention. We are planning poster displays to celebrate nursing achievements in the hospice to highlight the work being undertaken and how this is influencing our practice.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.