‘There’s this big fear around palliative care because it’s connected to death and dying’: A qualitative exploration of the perspectives of undergraduate students on the role of the speech and language therapist in palliative care

Background: Speech and language therapy in palliative care is a developing discipline of clinical practice. Research literature has highlighted that undergraduate palliative care education in speech and language therapy is inconsistent and inadequate. However, limited research has been carried out to date in relation to student speech and language therapists and palliative care. Aim: To explore the role of speech and language therapists in palliative care from the perspective of speech and language therapy students in Ireland. Design: A qualitative descriptive research study was conducted, involving focus group interviews. Setting/participants: Purposive sampling was used to recruit 12 student speech and language therapists from one university site for this study. Undergraduate second, third and fourth year students were eligible for inclusion. Results: This study revealed that undergraduate student speech and language therapists collectively agree that there is a role for speech and language therapy in palliative care. Although students acknowledged that speech and language therapists can make a positive difference to patients’ lives, and academic lectures were positively received, insufficient exposure to palliative care has resulted in fear, uncertainty and a lack of confidence amongst student speech and language therapists. Conclusions: A greater emphasis on palliative care is needed in undergraduate speech and language therapy education to ensure confidence and competency development. An exploration of student speech and language therapists’ experiences in a specialist palliative care unit would be advantageous to determine the appropriateness of this setting for clinical placements.

The Unspeakable Nature of Death & Dying During Childhood: A Silenced Phenomenon in Pediatric Care

In pediatric settings, the concept of hope is frequently positioned as a fundamental aspect of care and at odds with the possibility and proximity of death. This arguably fosters silence about death and dying in childhood despite evidence indicating the benefits of open communication at the end of life. In this paper, we describe the unspeakable nature of death and dying in childhood, including its conceptual and clinical causes and dimensions, its persistence, and the associated challenges for children and youth facing critical illnesses, their families, and society. We explore how the tension between hope and death can be reframed and apply our analysis to the context of medical assistance in dying for mature minors in Canada. Considering the lack of related literature, this paper offers initial reflections to form a framework for the unspeakable nature of death and dying in childhood and to advance the crucial need for research.

Preference for initiation of end-of-life care discussion in Indonesia: a quantitative study

Background Initiating discussion about death and dying is often considered a difficult topic for healthcare providers, thus there is a need for further research to understand this area, particularly in developing countries. The aim of this study was to describe preferences for the initiation of end-of-life care discussions in Indonesia, comparing the general population and health care professionals. Methods This cross-sectional, descriptive study analysed quantitative data from 368 respondents to an online questionnaire (255 general population (69%); 113 healthcare professionals (31%)) utilizing consecutive sampling and snowball sampling methods. Results Overall, most respondents (80%) stated that they would like to discuss end-of-life issues with a healthcare professional in the case of terminal illness. This was more marked amongst healthcare professionals compared with the general population (94% vs. 75%, respectively, p < 0,001). The preferred time for discussion was at first diagnosis (68% general population, 52% healthcare professionals, p = 0.017) and the preferred person to start the discussion was the doctor (59% general population, 71% healthcare professionals, p = 0.036). Fewer respondents wanted to know about prognosis compared to diagnosis (overall 76% v 93% respectively). Conclusion Doctors have vital role in end-of-life care discussion, and attempts should be made to encourage physicians to initiate these conversations and respond to patient’s requests when needed. These findings contribute to the existing body of knowledge in this area of practice, with focus on a developing country. The role of socio-cultural influences on these conversations warrants further research, in order to develop practical resources to support clinicians to appropriately conduct end-of-life care discussions with their patients and to provide data for policymakers to develop services.

Death and dying of newborns and children: relationships between nursing and family according to Travelbee

ABSTRACT Objective: Identify the nursing staff's perception of their relationship with families of newborns and children who are in the process of death and dying. Methods: Qualitative research, carried out in the Neonatal and Pediatric Intensive Care Unit of a public maternity hospital in Rio Grande do Norte, with 17 nursing professionals, through a semi-structured interview. After being transcribed, the data were subjected to Bardin's content analysis and interpreted in the light of the theory of Interpersonal Relations proposed by Travelbee. Results: Four categories emerged from the analysis: "Caring and welcoming people, feelings and stories"; "Reactions in the midst of pain: moving between acceptance and suffering"; "Communication of bad news: challenges and strategies"; "The weight of caring and suffering". Final considerations: Family assistance can be established using Travelbee's principles, as they offer timely theoretical support for nursing actions in the context of the process of death and dying.

Implicações da depressão na qualidade de vida do idoso: estudo seccional

Objective: To analyze the association between depressive symptoms and quality of life in older adults. Method: Cross-sectional study carried out between July and October, in 2020, with 596 older adults who answered three instruments, namely: bio-sociodemographic, Geriatric Depression Scale and WHOQOL-Old. Data were analyzed using Chi-square, Kruskal-Wallis, Spearman correlation and linear regression tests, considering a 95% confidence interval (p<0.05). Results: Depressive symptoms were negatively and statistically significantly associated with all facets of quality of life: sensory abilities (β= -1.922 [CI95%= -2.328 – -1.517]); autonomy (β= -2.410 [CI95%= -2.755 - -2.064]); past, present and future activities (β= -3.534 [CI95%= -3.879 – -3.189]); social participation (β= -3.436 [CI95%= -3.816 – -3.056]); death and dying (β= -2.260 [CI95%= -2.792 – -1.728]) and intimacy (β= -3.547 [CI95%= -3,900 – -3.194]). Conclusion: The presence of depressive symptoms is negatively associated with the quality of life of older adults, thus requiring interventions in this area. Objetivo: Analizar la asociación entre sintomatología depresiva y calidad de vida de adultos mayores.Método: Estudio transversal realizado entre julio y octubre de 2020 con 596 personas mayores que respondieron a tres instrumentos: biosociodemográfico, Escala de Depresión Geriátrica y WHOQOL-Old. Los datos se analizaron mediante pruebas de Chi-cuadrado, Kruskal-Wallis, correlación de Spearman y regresión lineal, considerando un intervalo de confianza del 95% (p<0,05).Resultados: La sintomatología depresiva se asoció de forma negativa y estadísticamente significativa con todas las facetas de la calidad de vida: habilidades sensoriales (β= -1,922 [IC95%= -2,328 – -1,517]); autonomía (β= -2,410 [IC95%= -2,755 – -2,064]); actividades pasadas, presentes y futuras (β= -3,534 [IC95%= -3,879 – -3,189]); participación social (β= -3,436 [IC95%= -3,816 – -3,056]); muerte y morir (β= -2,260 [IC95%= -2,792 – -1,728]) e intimidad (β= -3,547 [IC95%= -3,900 – -3,194]).Conclusión: La presencia de sintomatologías depresivas se asocia negativamente con la calidad de vida de las personas mayores, por lo que requiere intervenciones en este ámbito. Objetivo: Analisar a associação entre ecesitando ía ecesitan e qualidade de vida de idosos. Método: Estudo seccional realizado entre julho e outubro de 2020 com 596 idosos que responderam três instrumentos: biosociodemográfico, Escala de Depressão Geriátrica e WHOQOL-Old. Os dados foram analisados com os testes de Qui-quadrado, Kruskal-Wallis, correlação de Spearman e regressão linear, considerando um intervalo de confiança de 95% (p<0,05). Resultados: A sintomatologia depressiva se associou de forma negativa e estatisticamente significante com todas as facetas da qualidade de vida: habilidades sensoriais (β= -1,922 [IC95%= -2,328 – -1,517]); autonomia (β= -2,410 [IC95%= -2,755 – -2,064]); atividades passadas, presentes e futuras (β= -3,534 [IC95%= -3,879 – -3,189]); participação social (β= -3,436 [IC95%= -3,816 – -3,056]); morte e morrer (β= -2,260 [IC95%= -2,792 – -1,728]) e intimidade (β= -3,547 [IC95%= -3,900 – -3,194]). Conclusão: : A presença de sintomatologias depressivas está associada negativamente à qualidade de vida dos idosos, necessitando, portanto, de intervenções nessa área.

“Dying with a Smile, Just Knowing that Somebody’s Listened to Me”: End-Of-Life Care and Medical Assistance in Dying in Canadian Prisons

Medical assistance in dying (MAiD) has been legal in Canada since 2016 and some incarcerated patients who are at the end of their lives are eligible for the procedure. Interviews with nine incarcerated men at a federal penitentiary in Canada provide insight into some of the ways that people who are navigating aging and end-of-life in prison think about MAiD. Interview themes are organized around: experience with death and dying; possibilities and barriers related to applications for release from prison at end-of-life; experiences of peer-caregiving in a prison palliative care program; support for MAiD and the expansion of eligibility criteria; what a good death looks like. Themes are contextualized alongside federal guidelines related to end-of-life care (EOLC) and MAiD for prisoners, highlighting that sound policy requires both generalizable principles and attention to nuance. MAiD rests on patient voluntariness, and thus autonomy over EOLC decisions is paramount for prisoners.

Nauczyć umierania. Tanatopedagogika na lekcjach języka polskiego w liceum na przykładzie literatury najnowszej

The aim of this article is to present a didactic proposition on the introduction of thanatopedagogical themes in Polish language lessons in high school while discussing contemporary literature. The first part of the work presents the most important elements of thanatopedagogy as a science in the context of literary studies. The history of the concept is described in the context of changes in the cultural understanding of death, and the way of presenting the final things in the literature of children and adolescents — from didactic to personalistic — is discussed. In the following subsections, two texts from the latest Polish literature are interpreted: The Things I Didn’t Throw Out by Marcin Wicha and Mira Marcin’s Bezmatek. Proposals are made for using these works to introduce elements of reflection on the finality of things to Polish lessons (the subject of mourning, anthropology of death and dying, the language used for speaking about passing away). The text ends with a summary of the most crucial research conclusions: about the important role of recent literature in conversations on ultimate topics, the need for thanatopedagogical education for teachers, and the need for large psychological competences to conduct such conversations.