The following lists palliative care research primarily conducted by Australian research groups. The list is based on application of the CareSearch search filter for palliative care to identify articles held within the PubMed database and corresponding to the strongest evidence. Articles have been selected based on relevance and new articles are added on a weekly basis.
Whilst not an exhaustive list, the aim is to keep the community informed by providing a snapshot of recent research findings and planned studies in the Australian setting.
Zhai J, Mooney C, Hamilton O, Vesty G, Millar R, Runacres F, et al.
Aim: To describe patient outcomes for patients at high risk of mortality (with a prognosis of three months or less to live) where a Palliative Care Nurse Consultant (PCNC) was embedded in a General Medicine team. To explore patients and/or their carers feedback and allied health, nursing professionals' perspectives on integrating a palliative care approach in the General Medicine ward.
Design: Prospective exploratory study.
Methods: SQUIRE reporting guidelines was adopted for the study reporting. This study was conducted over six weeks in a general medicine ward at Monash Medical Centre in Melbourne, Australia. Participants were 20 patients aged > 65 years with non-malignant, chronic conditions at high risk of mortality within three months and had 18 nursing and allied health professionals involved in their care. Quantitative data were analysed descriptively and qualitative survey data were analysed thematically.
Results: Twenty patients participated, with an average age of 87 years. 55% spoke a language other than English. PCNC interventions, focused on care coordination and family liaison, were found to facilitate timely referrals to other support services, improve communication and better address end-of-life care needs. Healthcare professionals recognised the benefits of PCNC involvement; however, a key qualitative theme was staff reluctance to raise palliative care needs due to perceived role boundaries and limited confidence. While PCNC presence improved communication and advocacy, barriers included time constraints and patient/family resistance.
Conclusion: Embedding a PCNC in a general medicine team appears to enhance care coordination and support timely palliative care integration. Addressing barriers and optimising workflow can improve patient, carer and clinician experience as well as improve resource utilisation.
Implications for the profession and/ or patient care: The model has the potential to enhance patient-centred care and clinician support in acute general medicine settings.
Impact: The research will have an impact on acute care settings, particularly general medicine units, by informing models of integrated palliative care for patients with complex needs and enhancing staff capability and confidence in providing timely, person-centred care.
Patient or public contribution: Patients or members of the public were not involved in the design, conduct, analysis or manuscript preparation of this study. The project was a prospective observational study with limited scope and resources, which did not include a formal patient or public involvement component.
Lamba G, Vellar K, Burgess CP, La Brooy C, Komesaroff PA.
Abstract: Voluntary assisted dying (VAD) legislation has now been passed in all Australian jurisdictions, except for the Northern Territory. The Voluntary Assisted Dying Independent Expert Advisory Panel led public consultations in the NT to inform development of NT VAD legislation, submitting their report to the Chief Minister in July 2024, which has been publicly released. This perspective article reflects on the VAD implementation challenges highlighted in this public report. We discuss the unique demographics of the NT, including a significant Aboriginal population living in remote areas coupled with a high burden of chronic disease, which poses difficulties for equitable access to end-of-life services (respecting NT cultural protocols, “First Nations” in this perspective article are referred to as “Aboriginal peoples”, which is inclusive of Torres Strait Islanders). “Cultural safety” is critical for Aboriginal peoples but application is contextual. Telehealth, which may help increase access, also presents challenges.
Haining CM, Willmott L, White BP.
Abstract: Patients seeking to access voluntary assisted dying (VAD) are necessarily at the end of their lives. Hence, they are likely to be concurrently receiving care from institutions (community nursing services, health services, palliative care services, and aged care facilities) with different levels of participation in VAD. This article reports on the various institutional approaches to VAD based on eighteen semi-structured interviews with regulators from Victoria and Western Australia, representing fifteen institutions with varying levels of support for VAD. We generated five main themes from reflexive thematic analysis of the interview data: settling on a position; operationalizing a position and determining level of involvement; local policy decisions on specific VAD activities; transparency; and navigating pluralism and accommodating diverse views. Overall, our findings revealed significant diversity in how institutions approached various VAD activities and that an institution's position on VAD (whether it supports it or not) does not necessarily indicate the extent to which it will facilitate access to VAD. These findings may have relevance for institutions seeking to implement (or revise) their approach to VAD and suggest that greater transparency about institutional approaches to VAD is needed to enable people to make informed decisions about where to seek care.
Last updated 30 April 2024