A5010614354- Palliative Care and End-of-Life Issues
- Geriatric Care and Nursing Homes
- Grief, Bereavement, and Mental Health
- Family and Patient Care in Intensive Care Units
- Dementia and Cognitive Impairment Research
- Interprofessional Education and Collaboration
- Intergenerational Family Dynamics and Caregiving
- Pain Management and Opioid Use
- Patient Dignity and Privacy
- Childhood Cancer Survivors' Quality of Life
- Frailty in Older Adults
- Ethics in medical practice
- Mental Health and Patient Involvement
- Palliative and Oncologic Care
- Health Systems, Economic Evaluations, Quality of Life
- Migration, Aging, and Tourism Studies
- Chronic Disease Management Strategies
- Primary Care and Health Outcomes
- Pharmaceutical Practices and Patient Outcomes
- Clinical practice guidelines implementation
- Health Policy Implementation Science
- Health, Medicine and Society
- Family Support in Illness
- Healthcare Systems and Technology
- Patient Safety and Medication Errors
University of Edinburgh
2015-2024
Edinburgh Napier University
2021
Primary Health Care
2020
Lancaster University
2018-2019
St Christopher's Hospice
2008-2018
University of East Anglia
2010
Western General Hospital
1994-1999
South London Healthcare NHS Trust
1998
King's College Hospital
1998
Eastman Dental Hospital
1998
In economically developed countries there is a rapidly increasing number of older people living and dying in care homes. The relative isolation nursing homes from the development palliative care, poor retention recruitment staff, lack medical cover, hinder provision quality end-of-life care. End-of-life strategies internationally highlight benefit using tools to help improve All seven private within one district Scotland undertook implement, as package, two tools, namely, Gold Standards...
<h3>Importance</h3> High-quality evidence on how to improve palliative care in nursing homes is lacking. <h3>Objective</h3> To investigate the effect of Palliative Care for Older People (PACE) Steps Success Program resident and staff outcomes. <h3>Design, Setting, Participants</h3> A cluster-randomized clinical trial (2015-2017) 78 7 countries comparing PACE (intervention) with usual (control). Randomization was stratified by country median number beds each a 1:1 ratio....
The care given to 26 dying patients, and their families, being nursed in a hospital where there was no specific terminal facility studied. These patients were from both malignant non-malignant disease. Anorexia, sleeplessness, coated or infected mouths, pain, pressure sores seen half of the patients. Fear about caring for patient at home lack information problems most frequently identified by relatives. As result this study multidisciplinary team specialising symptom control supportive has...
Method: study participants were residents who had died within 38 nursing care homes in southeast England over a 3-year period. The been recruited to take part cluster randomised controlled trial looking at different models of facilitation while implementing the Gold Standards Framework Care Homes (GSFCH) programme. Two researchers examined notes and daily records all each these between 1 June 2008 31 May 2011.
a large and increasing number of older people in the UK are living care homes. Dementia is frequent reason underlying admission determining needs, but prevalence data becoming increasingly outdated reliant on brief screening instruments.to describe severity dementia, depression, behavioural problems relevant medication use representative sample residential nursing home residents.a survey conducted 15 randomly selected South East London Consensus clinical dementia diagnoses were made from...
Increasing numbers of older people with advanced dementia are cared for in care homes. No cure is available, so research focused on improving quality life and needed to support them live die well. The Namaste Care programme a multi-dimensional program sensory, psycho-social spiritual components intended enhance dementia. aim the study was establish whether can be implemented UK homes; what effect has residents dementia, their families staff. This article explores qualitative findings study,...
Aim: This paper explores the barriers that needed to be overcome during process of implementing an integrated care pathway for last days life as a way developing quality end-of-life in nursing homes. Methods: An action research methodology underpinned study. Qualitative and quantitative data were collected eight homes before, after implementation pathway. Findings: Six main identified: lack knowledge palliative drugs control symptoms at end life; preparation approaching death; not knowing...
The objective of this study was to evaluate the key components services for people with advanced heart failure from multiple perspectives and recommend how care might be delivered in line UK policies on long-term conditions, palliative end-of-life care. Serial interviews were conducted over 2 years patients, case-linked family carers professionals (n =162); followed by four focus groups involving =32). There 36 patients failure, 30 62 included a health region various models. Participants...
Objective The objective of the study was to evaluate effects Namaste Care programme on behavioural symptoms residents with advanced dementia in care homes and their pain management. Methods Six collaborated an action research study—one withdrew. Inclusion criteria were a diagnosis Bedford Alzheimer's Nursing Severity Scale score >16. Primary measures Neuropsychiatric Inventory—Nursing Homes (NPI‐NH) Doloplus‐2 assessment scale for elderly. Measures recorded at baseline three 1–2 monthly...
Background: The provision of quality end-of-life care is increasingly on the national agenda in many countries. In United Kingdom, Gold Standards Framework for Care Homes programme has been promoted as a framework improving care. While its implementation recommended, there are no guidelines facilitators to follow undertake this role. Aim: It was hypothesised that action learning alongside high facilitation when implementing will result reduced proportion hospital deaths residents and...
Several studies have highlighted the need for improvement in palliative care delivered to older people long-term facilities. However, available evidence on how improve these settings is weak, especially Europe. We describe protocol of PACE trial aimed 1) evaluate effectiveness and cost-effectiveness 'PACE Steps Success' intervention facilities, 2) assess implementation process identify facilitators barriers different countries. will conduct a multi-facility cluster randomised controlled...
The purpose of this study was to promote quality end-of-life care in eight independent nursing homes using an ‘integrated pathway (ICP) for the last days life’ document. Action research methodology underpinned design order collaboration between staff and team, empower practice care, sustainable development once finished. Considerable barriers within home context highlighted initial difficulties. This is reported elsewhere (Watson et al., press) (Bridges Initiative, 2004). However, key...
Background: In the UK, implementation of Gold Standards Framework in Care Homes (GSFCH) programme is being promoted to develop quality end-of-life care for frail older people living and dying homes. Advance planning (ACP) discussions are an integral part this. This study explored experiences initiating completing these homes undertaking GSFCH. Methods: A qualitative descriptive was carried out three nursing implementing GSFCH programme. Following ACP discussion, 28 semi-structured interviews...
Background Nursing care homes are increasingly the place where frail older people die. However, training in end‐of‐life is not statutory. Aims and objectives To develop strategies to promote quality nursing homes. Design Action research was used work collaboratively with managers staff two care. Methods There were three overarching phases: an exploratory phase, feedback/planning of actions a summative evaluation. Two main inductively derived. One actions, reflective debriefing groups...
Abstract Background The PACE ‘Steps to Success’ programme is a complex educational and development intervention for staff improve palliative care in long-term facilities (LTCFs). In cluster randomized controlled trial, this has been implemented 37 LTCFs 7 European countries. Alongside an effectiveness study, process evaluation study was conducted. This paper reports on the results of evaluation, which aim provide more detailed understanding implementation Programme across within Methods...
Abstract Patient and public involvement engagement (PPIE) is an increasingly important component of research conduct to enhance processes potential for impact, yet rarely critically interrogated. This paper draws on Foucauldian analysis highlight the disciplinary powers tensions arising in PPIE. The a nested evaluation interview study with three PPIE members eight academics, who had been involved implementation science focused palliative care. were whole are co‐authors this article. Through...
The global population is changing with an increasing percentage of the oldest old, many whom in UK are looked after care homes. Care homes now provide for a fifth who die each year. However, most nursing privately owned and not part NHS, which exposes staff to lack skills/knowledge relation end-of-life care.To implement Gold Standards Framework Homes Programme audit outcomes within across five Clinical Commissioning Groups over 7-year period using research-based model facilitation.The...
Action research is beginning to be utilized within palliative care address questions concerned with practice and organizational change. An understanding of appropriate evaluation practices required in order ensure that high-quality action conducted.The aim this paper present an account participatory illustrate the way which approaches are integrated methodology.Participatory will described identifying its origins, principles relationship frameworks. The key features process regard...