Effects of spiritual care training for palliative care professionals

Little is known about the effects of spiritual care training for professionals in palliative medicine. We therefore investigated prospectively the effects of such training over a six-month period. All 63 participants of the three and a half-day training were asked to fill out three questionnaires: before and after the training, as well as six months later. The questionnaires included demographic data, numeric rating scales about general attitudes towards the work in palliative care, the Self-Transcendence Scale (STS), the spiritual subscale of the Functional Assessment of Chronic Illness Therapy (FACIT-Sp) and the Idler Index of Religiosity (IIR). Forty-eight participants (76) completed all three questionnaires (91 women, median age 49 years; 51 nurses, 16 hospice volunteers, 14 physicians).Significant and sustained improvements were found in self-perceived compassion for the dying (after the training: P =0.002; 6 months later: P=0.025), compassion for oneself (P < 0.001; P =0.013), attitude towards one's family (P =0.001; P =0.031), satisfaction with work (P < 0.001; P =0.039), reduction in work-related stress (P < 0.001; P =0.033), and attitude towards colleagues (P =0.039; P =0.040), as well as in the FACIT-Sp (P < 0.001; P =0.040). Our results suggest that the spiritual care training had a positive influence on the spiritual well-being and the attitudes of the participating palliative care professionals which was preserved over a six-month period

Algorithmic paranoia and the convivial alternative

In a time of big data, thinking about how we are seen and how that affects our lives means changing our idea about who does the seeing. Data produced by machines is most often 'seen' by other machines; the eye is in question is algorithmic. Algorithmic seeing does not produce a computational panopticon but a mechanism of prediction. The authority of its predictions rests on a slippage of the scientific method in to the world of data. Data science inherits some of the problems of science, especially the disembodied 'view from above', and adds new ones of its own. As its core methods like machine learning are based on seeing correlations not understanding causation, it reproduces the prejudices of its input. Rising in to the apparatuses of governance, it reinforces the problematic sides of 'seeing like a state' and links to the recursive production of paranoia. It forces us to ask the question 'what counts as rational seeing?'. Answering this from a position of feminist empiricism reveals different possibilities latent in seeing with machines. Grounded in the idea of conviviality, machine learning may reveal forgotten non-market patterns and enable free and critical learning. It is proposed that a programme to challenge the production of irrational preemption is also a search for the possibility of algorithmic conviviality

What nurses need to know about Buddhist perspectives of end-of-life care and dying

Palliative care professionals, particularly nurses, understand that it is crucial to deliver culturally and religiously appropriate care to the dying while attending to their physical needs. This article provides a brief overview of the different types of Buddhism and the major beliefs of Buddhists, particularly around suffering and death. It explores the impact of some of the current practices of end-of-life care from the Buddhist perspective, with an emphasis on Buddhist goals, beliefs, and practices at the time of death. It outlines the importance of advanced care planning, particularly with respect to the use of analgesia, palliative sedation, and any special dietary requirements. It notes that regardless of advanced care planning, nurses should continue to assess the needs of the patient, and in discussion with family, titrate medication and provide an environment that helps the Buddhist reach his/her spiritual goals. It outlines the importance of the environment in achieving this goal, particularly as the Buddhist practitioner will wish to use non-medication practices, such as meditation and chanting, to finish the last meditation before death. The paper provides guidance on how nurses can ensure a good death for the dying Buddhist, and their family or loved ones, especially in the area of choice in terminal pain management and palliative sedation therapy