Place of death in the Czech Republic and Slovakia:a population based comparative study using death certificates data

Place of death represents an important indicator for end-of-life care policy making and is related to the quality of life of patients and their families. The aim of the paper is to analyse the place of death in the Czech Republic and Slovakia in 2011. Research questions were focused on factors influencing the place of death and specifically the likelihood of dying at home

The impact of the mySupport advance care planning intervention on family caregivers’ perceptions of decision-making and care for nursing home residents with dementia : pretest-posttest study in six countries

Background the mySupport advance care planning intervention was originally developed and evaluated in Northern Ireland (UK). Family caregivers of nursing home residents with dementia received an educational booklet and a family care conference with a trained facilitator to discuss their relative’s future care. Objectives to investigate whether upscaling the intervention adapted to local context and complemented by a question prompt list impacts family caregivers’ uncertainty in decision-making and their satisfaction with care across six countries. Second, to investigate whether mySupport affects residents’ hospitalisations and documented advance decisions. Design a pretest–posttest design. Setting in Canada, the Czech Republic, Ireland, Italy, the Netherlands and the UK, two nursing homes participated. Participants in total, 88 family caregivers completed baseline, intervention and follow-up assessments. Methods family caregivers’ scores on the Decisional Conflict Scale and Family Perceptions of Care Scale before and after the intervention were compared with linear mixed models. The number of documented advance decisions and residents’ hospitalisations was obtained via chart review or reported by nursing home staff and compared between baseline and follow-up with McNemar tests. Results family caregivers reported less decision-making uncertainty (−9.6, 95% confidence interval: −13.3, −6.0, P  Conclusions the mySupport intervention may be impactful in countries beyond the original setting

Important Aspects Influencing Delivery of Serious News in Pediatric Oncology: A Scoping Review

Delivering serious news presents a major challenge for clinical practice in pediatric oncology due to the complexity of the communication process and a number of aspects that influence how the serious news is delivered and received. This study aims to review and explore the aspects influencing the delivery of serious news in pediatric oncology from the perspective of physicians, parents, siblings and patients themselves. The MEDLINE, Embase, Scopus, Cochrane Library, PsycInfo and Medvik databases were systematically searched for relevant articles published from 1990 to 2017. Following the Preferred Reporting Items for Systematic Review and Meta-analysis extension for scoping reviews (PRISMA-ScR) guidelines, 36 original papers were included. Identified aspects of communication were categorized into six thematic groups: initial setting, physician’s approach, information exchange, parental role, illness related aspects and age of the ill child. The importance of the aspects is perceived differently by parents, patients, siblings and physicians. This scoping review highlights that delivering serious news requires an individualized approach towards the patient and the family. Ten key objectives built upon the results of the literature review offer guidance for daily clinical practice in communication with pediatric patients and their families

How to measure the international development of palliative care?:a critique and discussion of current approaches

CONTEXT: A number of research projects have been conducted that aim to gather data on the international development of palliative care. These data are important for policy makers and palliative care advocates. OBJECTIVES: The aim of this article was to provide a critical comparative analysis of methodological approaches used to assess the development and status of palliative care services and infrastructure at an international level. METHODS: A selective literature review that focused on the methodological features of eight identified reports was undertaken. RESULTS: Reviewed reports were found to differ in adopted methodologies and provided uneven amounts of methodological information. Five major methodological limitations were identified (lack of theory, use of experts as source of information, grey literature, difficulties in ranking, and the problematic nature of data on service provision). A set of recommendations on how to deal with these issues in future research is provided. CONCLUSION: Measuring the international development of palliative care is a difficult and challenging task. The results of this study could be used to improve the validity of future research in this field

Where do people not want to die?:A representative survey of views of general population and health care professionals in the Czech Republic

Introduction: Dying in the preferred place of death is considered to be one of indicators of quality of end-of-life care. Research into health care professionals’ knowledge of patients’ preferences for place of death is therefore important. The aim of this study was to assess the difference between health care professionals and the general public in their views on where do people not want to die. Methods: Secondary analysis of data from a representative survey of the general population and a convenience sample of health care professionals in the Czech Republic. Respondents from the general population were asked where they would not like to die and health care professionals were asked where they think the general population does not want to die. Sample consisted of 1095 respondents from the general population and 1006 health care professionals. Health care professionals were physicians (73.3%) and nurses (26.6%). Results: Long-term care facilities and hospitals were identified as the most undesirable settings for place of death. A significant difference in views on hospices was identified: 6% of health professionals compared to 42.2% of the general population (P < 0.001) indicated a preference for people to not die in hospice. Discussion: The most unwanted settings for place of death were places where most people die. More research is needed to understand the factors influencing preferences and should feed into policy making. Better promotion of hospice care should be developed to communicate to the general public the differences between hospices and other institutions

Self-reported knowledge, attitudes, and behaviour towards hospice care and how are these related to training in palliative care:An online survey among oncologists in the Czech republic and Slovakia

Oncologists have a central role as ‘gate keepers’ in terms of referring patients to palliative and hospice care. This role is even more important in countries such as the Czech Republic and Slovakia, where palliative care is still developing. The aim of this study was to assess the associations between self-reported knowledge, attitudes, and behaviour of Czech and Slovak oncologists towards hospice care and their attendance of palliative care training. Methods: The method was an anonymous online questionnaire created by the LimeSurvey software. All members of national Oncological Society in the Czech Republic and Slovakia were invited to participate. Eighty-four oncologists completed the survey. Results: Czech and Slovak oncologists’ attendance of palliative care training is significantly associated with their attitudes and behaviour towards hospice care. Respondents who had any additional palliative care training felt more knowledgeable and were more likely to discuss hospice care with their patients and families than oncologists without such training. Additionally, they also found delivering bad news less difficult and referred more terminal patients to hospice care than those with no training. Conclusion: Training in palliative care can influence how oncologists discuss hospice care and refer their patients to such care. This should be reflected in curricula for medical students and in postgraduate education for oncologists and other health care providers, especially in countries with less integrated palliative care such as the Czech Republic or Slovakia