What Do Palliative Care Professionals Understand as Spiritual Care? Findings from an EAPC Survey

From its inception palliative care has been understood as addressing four dimensions: physical, social, emotional/psychological, and spiritual/religious. However, the spiritual and/or religious element is poorly understood and under-researched, and little is known about palliative care professionals’ understandings of spiritual care, or how they seek to implement spiritual care in practice. Members of the European Association of Palliative Care (EAPC) Spiritual Care Taskforce (SCTF) designed and conducted a 28-item survey, supported by the EAPC Board, investigating palliative care professionals’ understandings and attempts to implement spiritual care. Following pilot-testing with 30 participants, the survey ran for a month. It was engaged with by 527 people from 67 countries and most regions of the world, with 502 answering at least two questions, 465 people answering at least one substantive questions, 228 providing examples of spiritual care at Q24, and 115 providing further comments at Q28. We analysed the sociodemographic data descriptively, thematically analysed the diverse, detailed spiritual care examples provided at Q24, and conducted a content analysis of Q28 responses. We identified nine themes from Q24 responses. Of these nine themes, five encompassed interactions between staff and patients, one of these five addressing the character, nature, or quality of care provided by staff; the other four specific content of that care: supporting patients’ wellbeing, supporting patients’ religious faiths, enabling reflection, and facilitating focused discussions. A sixth theme covered staff roles and responsibilities, including specific input from specialist providers. Three smaller themes addressed supporting others than patients: families before patients’ deaths, families during bereavement, and staff

The Challenges Facing Palliative Care Advocacy: What Is in a Name?

The need for Palliative Care (PC) continues to grow throughout the world, requiring continuous development, true to its “ethos.” As awareness grows so does the expectation for timely response and policies to potentiate its delivery. The scientific dimension of its philosophy, underpinned by research and scientific practice, looks to explain its nature, origin and concepts, models and theories within which it is delivered. The concept palliation is widely used; yet, it is understudied by academics and clinicians. Interestingly, it is increasingly questioned by society and other specialists, calling for it to “be debated and essentially contested”. Our aim is to contribute to society’s understanding of palliative care so that they can have a clear and truthful awareness of the complex implications of its mission. We approach the different concepts, scientific theories and structures can be achieved by following different pathways, including defining its “ethos”: personality or nature, manifest in the very formulae by which PC places itself before those who need it. What a fascinating topic it is to research and write on!, phenomenological in its base, it shows how different translations of the Anglo-Saxon PC influence its understanding and much needed expansion. Semiotics are at the base of the essence of how palliative care might be assumed and promoted. PC is, for sure, one of the most important, existential spheres to apply our knowledge today and a novel promising methodology to apply the semiotic and phenomenological approaches learning of different aspects of cultural transfer processes

Funding models in palliative care: Lessons from international experience

Background: Funding models influence provision and development of palliative care services. As palliative care integrates into mainstream health care provision, opportunities to develop funding mechanisms arise. However, little has been reported on what funding models exist or how we can learn from them. Aim: To assess national models and methods for financing and reimbursing palliative care. Design: Initial literature scoping yielded limited evidence on the subject as national policy documents are difficult to identify, access and interpret. We undertook expert consultations to appraise national models of palliative care financing in England, Germany, Hungary, Republic of Ireland, New Zealand, The Netherlands, Norway, Poland, Spain, Sweden, Switzerland, the United States and Wales. These represent different levels of service development and a variety of funding mechanisms. Results: Funding mechanisms reflect country-specific context and local variations in care provision. Patterns emerging include the following: Provider payment is rarely linked to population need and often perpetuates existing inequitable patterns in service provision. Funding is frequently characterised as a mixed system of charitable, public and private payers. The basis on which providers are paid for services rarely reflects individual care input or patient needs. Conclusion: Funding mechanisms need to be well understood and used with caution to ensure best practice and minimise perverse incentives. Before we can conduct cross-national comparisons of costs and impact of palliative care, we need to understand the funding and policy context for palliative care in each country of interest