Patient reported outcomes of pastoral care in a hospital setting

This study aimed to establish whether Pastoral Care (PC) visits were an effective component of a hospitalized patient’s overall health experience. Outcomes of PC visits were reported by 369 patients in 7 sites across Australia. The patient reported outcomes of PC visits included: the patients felt they could be honest with themselves, with a sense of peace, a better perspective of their illness, less anxiety, and felt more in control. Five factors of the PC visit significantly related to higher patient’s overall outcomes: (a) having more Pastoral Care visits (p \u3c 0.5 0 R 0.778, CI 0.17–1.38); (b) the patient was able to talk about what was on their mind (p \u3c 0.01, OR1.48, CI 0.58–2.37); (c) they had something to be hopeful about (p \u3c 0.01 OR1.18, CI 0.51–1.85); 4); the visit focused on decisions about the patient’s health care (p \u3c 0.05, OR0.70, CI 0.05–1.35); and (d) a belief in God/Higher Being (p \u3c 0.01, OR 1.01, CI 0.43–1.71)

Culturally and linguistically diverse palliative care patients\u27 journeys at the end-of-life

Objective: To understand the clinical and psychosocial journey of culturally and linguistically diverse (CALD) palliative care patients. Method: This study was conducted at a subacute hospital with a specialist palliative care unit and a community palliative care service in a metropolitan region of New South Wales, Australia. Medical records of 100 deceased patients from CALD backgrounds over a 12-month period from 2014 to 2015 were recorded on a data mining tool. The cohort had transitioned to either community or inpatient palliative care services with a life-limiting illness. We used descriptive statistical analyses to identify the patients’ end-of-life journeys in the physical, psychological, spiritual, and social palliative care domains. Staff case notes were used to enrich the quantitative data. Result: The most common symptoms burdening the patients were decreased mobility (82%), pain (76%), and poor appetite (60%). The majority of patients (87%) were diagnosed with cancer. Language was a major barrier to the assessment and management of symptoms. The vast majority of patients were born in Europe and Asia. Twenty-nine percent of the patients preferred to use English. However, among patients who required an interpreter on admission, only 9% used professional interpreters. Family distress around patients’ lack of food consumption was prominent, along with provider concern when this led to families “force feeding” patients. Only 5% of files documented patients’, and 21% of files documented families’, cultural wishes or needs. Care of the body after death was only documented in 20% of files. Significance of results: The increasing cohort of older people from CALD backgrounds will have significant implications for the planning and delivery of palliative care services. There is an emerging need to address the physical, psychological, spiritual, and social palliative care domains in the end-of-life journeys of patients from CALD backgrounds to ensure the provision of quality care

Socio-cultural dimension of gendered wellbeing of older persons in Lampung, Indonesia

Women's experiences of ageing are markedly different from men's. The sex-difference in older age is predominantly a result of enduring inequalities across the life course, apparent in many areas, including education, labour force participation, public programs for health and income security, national legal system as well as cultural practices. The Indonesian government has provided only limited fully-funded programs for select older Indonesians. This study examines the wellbeing of the older Indonesians using a multi-level strategy including: (1) examination at national level of the socio-economic background of older Indonesians; (2) exploration of sex-differences in the wellbeing of two ethnic groups, Lampungese and Javan-migrants, using an ethnographic approach in Whyanda, Lampung in 2009-2010. The thesis analyses three key dimensions of the lives of older persons in Lampung. These are: (1) sex differences in the physical wellbeing of the older persons, measured by self-rated health; (2) sex differences in the economic wellbeing of older persons, measured by individual income, home ownership and ownership of household items; and (3) sex differences in the vulnerability of older persons, measured by "doubly-poor" characteristics, a composite of low self-rated health and low economic wellbeing. By and large, older women experience lower physical and economic wellbeing compared with older men; the lower wellbeing is significantly related to their lower status within the family. With regard to physical wellbeing, the main finding is that an older person's status within the family is a significant factor related to health, but the direction of the relations depended on the sex and ethnicity of the person. The high status does signify a better health, but only for older men. However, Javan-migrants (men and women) report better health when they have relatively equal status within the family, which is in accordance with Javan cultural norms. Six significant socio-demographic variables related to the older persons' health are lifestyle, inter-generational monetary and in-kind transfers, time spent on unpaid and paid work, and involvement in religious groups. In terms of economic wellbeing, education is the strongest positive indicator of income and ownership of household items. As an indicator of home ownership, education is second after ethnicity. Income is also positively related to living in urban area, being a Javan-migrant, working more than 35 hours weekly and monetary transfers between parents and children. Home ownership is related to ethnicity, the number of living children and age. Access to household goods is linked positively to income, health and number of living children. Among vulnerable older persons, women seem to be more vulnerable than men. However, among the 'most vulnerable' no significant sex-differences are observed. This research demonstrates that the mainstream cultural convention may assign men to higher status within the family compared with women, but this sex-difference in status is mitigated by ethnic norms. Putting relatively equal value on men's and women's contributions to the family, means a husband and wife have a relatively equal status, which in turn has a positive effect on the wellbeing of both men and women in their later life

Patient reported outcomes of pastoral care in a hospital setting

This study aimed to establish whether Pastoral Care (PC) visits were an effective component of a hospitalized patient’s overall health experience. Outcomes of PC visits were reported by 369 patients in 7 sites across Australia. The patient reported outcomes of PC visits included: the patients felt they could be honest with themselves, with a sense of peace, a better perspective of their illness, less anxiety, and felt more in control. Five factors of the PC visit significantly related to higher patient’s overall outcomes: (a) having more Pastoral Care visits (p \u3c 0.5 0 R 0.778, CI 0.17–1.38); (b) the patient was able to talk about what was on their mind (p \u3c 0.01, OR1.48, CI 0.58–2.37); (c) they had something to be hopeful about (p \u3c 0.01 OR1.18, CI 0.51–1.85); 4); the visit focused on decisions about the patient’s health care (p \u3c 0.05, OR0.70, CI 0.05–1.35); and (d) a belief in God/Higher Being (p \u3c 0.01, OR 1.01, CI 0.43–1.71)