Patients with advanced renal failure experience a symptom burden and impairment of quality of life similar to that of patients with terminal malignancy.

This pilot study aimed to assess the benefits of hypnotherapy in the management of anxiety and other symptoms, including depression and sleep disturbance, in palliative care patients with cancer. Eleven hospice patients received four sessions of hypnotherapy and completed the Hospital Anxiety and Depression Scale, the Edmonton Symptom Assessment System, and the Verran and Snyder-Halpern Scale at set time points. Wrist actigraphy also provided an objective assessment of sleep quality. After the second hypnotherapy session there was a statistically significant reduction in mean anxiety and symptom severity, but not in depression or sleep disturbance. After the fourth session there was a statistically significant reduction in all four patient-reported measures but not in actigraphy. These results offer evidence that hypnotherapy can reduce anxiety in palliative care patients, as well as improving sleep and the severity of psychological and physical symptoms. Further studies are needed to explore whether the observed benefits were a direct result of the hypnotherapy and how the intervention could most benefit this patient population.

usual setting (hospital or community) to another (the hospice) to learn. Methods Qualitative semi-structured interviews were conducted with ten purposively recruited healthcare professionals who were visiting Meadow House Hospice for experiential learning. Data analysis involved a framework approach to recognise themes confirming the visitors as educational tourists. Interview data was then used to generate themes to inform an educational programme. Results Four student nurses, 2 medical students, a district nurse, a GP trainee, a hospital specialist breast nurse and an advanced medical practitioner visiting the hospice showed characteristics common to educational tourists: travelling to learn, a desire to learn, wishing to experience something different, wishing to experience something in context and a preference for experiential learning. Visitors considered their experience to be beneficial to their future practice and three main themes about how to improve the hospice educational programme were established; personalising learning; continuing to see and experience authentic hospice activities; and the presence of a facilitator guide. Conclusion This study confirms that educational tourism occurs in the hospice, substantiating the application of educational tourism models. Using the pre-visit, visit, post-visit educational tourism model, improvements could include: pre-visit personalisation and planning of the learning experience by clarifying objectives, giving information and establishing visitor preferences about educational activities; postvisit debriefing/reflection and outcome measurement while maintaining the current authentic learning experience with a facilitator guide. Using an educational tourism model may offer an opportunity to improve learning experiences in the hospice within the educational resources already available.

Conclusion The palliative care team were referred patients with Covid-19 at a later stage in their illness. The symptom burden and medication requirements at the end of life were however similar across all groups. It is helpful to be aware of these findings so that we can care for patients dying of Covid-19 effectively.

No abstract