African Journal of Primary Health Care & Family Medicine
Background: Basic palliative care teaching should be included in training curricula for health ca... more Background: Basic palliative care teaching should be included in training curricula for health care providers (HCPs) at all levels of the health service to ensure that the goal set by the South African (SA) National Policy Framework and Strategy for Palliative Care, to have an adequate number of appropriately trained HCPs in South Africa, is achieved. Furthermore, palliative learning objectives for nurses and doctors should be standardised. Many SA medical schools have integrated elements of Palliative Medicine (PM) teaching into undergraduate medical training programmes for doctors; however, the degree of integration varies widely, and consensus and standardisation of the content, structure and delivery of such PM training programmes are not yet a reality.Aim: This joint position paper aims to describe the current state of undergraduate medical PM teaching in South Africa and define the PM competencies required for an SA generalist doctor.Setting: Palliative Medicine programme lead...
Using communication skills for difficult conversations in palliative care 'Suffering is not a que... more Using communication skills for difficult conversations in palliative care 'Suffering is not a question which demands an answer, It is not a problem which demands a solution, It is a mystery which demands a "Presence". ' (Anonymous)
1. There are opportunities for children’s palliative care (CPC) teams to expand their skills and ... more 1. There are opportunities for children’s palliative care (CPC) teams to expand their skills and knowledge through ongoing learning and commitment to support the care needs of children living with life-limiting (LLC) and life-threatening conditions (LTCs) and their families. 2. Each member of the team plays a vital role in the interdependent nature of service delivery which requires that each member assumes responsibility for their own learning and development so as to promote team confidence and competence. 3. There are a range of CPC educational programmes available worldwide: learners may choose from face-to-face, online and blended training options. Clinical placement is recommended. 4. The importance of reflective practice and its role as an intrinsic tool to self-care. 5. There is an essential need for ongoing mentoring and supervision of individuals and teams working in the field of CPC.
Palliative care is a field that is rich with opportunity and the need for clear, unambiguous and ... more Palliative care is a field that is rich with opportunity and the need for clear, unambiguous and direct communication. The nature of the illness that brings a palliative care team into the management of a patient and family - the 'unit of care' - makes it all the more likely that difficult conversations will already have taken place. The breaking of bad news, such as the diagnosis of metastatic cancer or WHO stage 4 HIV/AIDS, has often taken place in suboptimal circumstances and the palliative care team sometimes has to revisit the conversation to assist the patient to come to terms with the diagnosis and the way the diagnosis was given.
Using communication skills for difficult conversations in palliative care 'Suffering is not a que... more Using communication skills for difficult conversations in palliative care 'Suffering is not a question which demands an answer, It is not a problem which demands a solution, It is a mystery which demands a "Presence". ' (Anonymous)
Chapter Ten Communicating with Children and their Families Janet Matthews 10 ABSTRACT This chapte... more Chapter Ten Communicating with Children and their Families Janet Matthews 10 ABSTRACT This chapter aims to ensure that the reader clearly understands the impact of communication on child development, daily living and health. The development of communication from ...
The World Health Organization (WHO) defines palliative care as 'an approach that improves the qua... more The World Health Organization (WHO) defines palliative care as 'an approach that improves the quality of life of patients and their families facing problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual'. [1] Palliative care is appropriate for illnesses such as cancer, HIV/AIDS, and heart and neurodegenerative diseases. Early referral at diagnosis to a palliative care service improves patient outcomes and saves costs. [2] In order to enable clinicians to focus on treatment and manage medical complications, critical clinical time points (triggers) need to be identified to draw in the palliative care team. [3] In 2014, the Global Atlas of Palliative Care [4] reported that of the 20 million people who need palliative care at the end of life every year, <10% receive it. Although most care is delivered in highincome countries, 80% of people who need palliative care are in low-and middle-income countries. [5] Thousands of South Africans are diagnosed with life-threatening illness every year, but there is no clear referral process to ensure access to palliative care. Although communication skills are essential to enable doctors to break bad news, assess patient and family needs, elicit preferences and establish realistic goals of care, little research has been conducted on this topic in low-and middle-income countries. Objectives To explore medical doctors' use of communication skills, identify their needs to improve communication when conveying a poor prognosis, and determine their understanding of palliative care. Methods Study design This was an exploratory, qualitative study using a grounded theory approach. Study setting This study was conducted at a tertiary hospital in the Western Cape Province, South Africa (SA). It is a referral centre for patients with various illnesses, including cancer, from community level, across the country and beyond.
African Journal of Primary Health Care & Family Medicine
Background: Basic palliative care teaching should be included in training curricula for health ca... more Background: Basic palliative care teaching should be included in training curricula for health care providers (HCPs) at all levels of the health service to ensure that the goal set by the South African (SA) National Policy Framework and Strategy for Palliative Care, to have an adequate number of appropriately trained HCPs in South Africa, is achieved. Furthermore, palliative learning objectives for nurses and doctors should be standardised. Many SA medical schools have integrated elements of Palliative Medicine (PM) teaching into undergraduate medical training programmes for doctors; however, the degree of integration varies widely, and consensus and standardisation of the content, structure and delivery of such PM training programmes are not yet a reality.Aim: This joint position paper aims to describe the current state of undergraduate medical PM teaching in South Africa and define the PM competencies required for an SA generalist doctor.Setting: Palliative Medicine programme lead...
Using communication skills for difficult conversations in palliative care 'Suffering is not a que... more Using communication skills for difficult conversations in palliative care 'Suffering is not a question which demands an answer, It is not a problem which demands a solution, It is a mystery which demands a "Presence". ' (Anonymous)
1. There are opportunities for children’s palliative care (CPC) teams to expand their skills and ... more 1. There are opportunities for children’s palliative care (CPC) teams to expand their skills and knowledge through ongoing learning and commitment to support the care needs of children living with life-limiting (LLC) and life-threatening conditions (LTCs) and their families. 2. Each member of the team plays a vital role in the interdependent nature of service delivery which requires that each member assumes responsibility for their own learning and development so as to promote team confidence and competence. 3. There are a range of CPC educational programmes available worldwide: learners may choose from face-to-face, online and blended training options. Clinical placement is recommended. 4. The importance of reflective practice and its role as an intrinsic tool to self-care. 5. There is an essential need for ongoing mentoring and supervision of individuals and teams working in the field of CPC.
Palliative care is a field that is rich with opportunity and the need for clear, unambiguous and ... more Palliative care is a field that is rich with opportunity and the need for clear, unambiguous and direct communication. The nature of the illness that brings a palliative care team into the management of a patient and family - the 'unit of care' - makes it all the more likely that difficult conversations will already have taken place. The breaking of bad news, such as the diagnosis of metastatic cancer or WHO stage 4 HIV/AIDS, has often taken place in suboptimal circumstances and the palliative care team sometimes has to revisit the conversation to assist the patient to come to terms with the diagnosis and the way the diagnosis was given.
Using communication skills for difficult conversations in palliative care 'Suffering is not a que... more Using communication skills for difficult conversations in palliative care 'Suffering is not a question which demands an answer, It is not a problem which demands a solution, It is a mystery which demands a "Presence". ' (Anonymous)
Chapter Ten Communicating with Children and their Families Janet Matthews 10 ABSTRACT This chapte... more Chapter Ten Communicating with Children and their Families Janet Matthews 10 ABSTRACT This chapter aims to ensure that the reader clearly understands the impact of communication on child development, daily living and health. The development of communication from ...
The World Health Organization (WHO) defines palliative care as 'an approach that improves the qua... more The World Health Organization (WHO) defines palliative care as 'an approach that improves the quality of life of patients and their families facing problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual'. [1] Palliative care is appropriate for illnesses such as cancer, HIV/AIDS, and heart and neurodegenerative diseases. Early referral at diagnosis to a palliative care service improves patient outcomes and saves costs. [2] In order to enable clinicians to focus on treatment and manage medical complications, critical clinical time points (triggers) need to be identified to draw in the palliative care team. [3] In 2014, the Global Atlas of Palliative Care [4] reported that of the 20 million people who need palliative care at the end of life every year, <10% receive it. Although most care is delivered in highincome countries, 80% of people who need palliative care are in low-and middle-income countries. [5] Thousands of South Africans are diagnosed with life-threatening illness every year, but there is no clear referral process to ensure access to palliative care. Although communication skills are essential to enable doctors to break bad news, assess patient and family needs, elicit preferences and establish realistic goals of care, little research has been conducted on this topic in low-and middle-income countries. Objectives To explore medical doctors' use of communication skills, identify their needs to improve communication when conveying a poor prognosis, and determine their understanding of palliative care. Methods Study design This was an exploratory, qualitative study using a grounded theory approach. Study setting This study was conducted at a tertiary hospital in the Western Cape Province, South Africa (SA). It is a referral centre for patients with various illnesses, including cancer, from community level, across the country and beyond.
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Papers by Linda Ganca