Media Watch 544

Attached is the current issue of Media Watch (#544).


Of particular interest in this week's "double" issue:

Informal caregivers’ views on the division of responsibilities between themselves and professionals: A scoping review


HEALTH & SOCIAL CARE IN THE COMMUNITY | Online – 18 December 2017 – In Europe, the normative discourse on informal care has changed. Retreating governments and decreasing residential care increase the need to enhance the collaboration between informal caregivers and professionals. Professionals are assumed to adequately address the needs and wishes of informal caregivers, but little is known about informal caregivers’ views on the division of care responsibilities. Based on the opinion of informal caregivers, the authors conclude that professionals do not seem to explicitly take into account the views of informal caregivers about the division of responsibilities during their collaboration with them. Roles of the informal caregivers and professionals are not always discussed and the division of responsibilities sometimes seems unclear. Acknowledging the role and expertise of informal caregivers seems to facilitate good collaboration, as well as attitudes such as professionals being open and honest, proactive and compassionate. Inflexible structures and services hinder good collaboration. Asking informal caregivers what their opinion is about the division of responsibilities could improve clarity about the care that is given by both informal caregivers and professionals and could improve their collaboration. Educational programs in social work, health and allied health professions should put more emphasis on this specific characteristic of collaboration. 


Family conference in palliative care: Concept analysis

REVISTA BRASILEIRA DE ENFERMAGEM, 2018;71(1):206-213. A family conference (FC), a therapeutic instrument used by the palliative care (PC) team, emerges as a moment of planned dialogue between patient, family and team. Although it is of particular importance, the FC is still less widespread among health professionals. In addition to the scarcity of studies, it can be seen that there is no single definition in the literature about FCs. For some authors, FC is defined as an intervention aimed at sharing information, clarifying doubts about patient and family concerns, and communicating “bad news” in order to allow the family not only to understand the dynamics of the care that is being provided to their loved one in the process of dying, but also establish an affective connection so that it is possible to reach a consensus in the resolution of problems. One study states that the FC reflects a planned intervention with the family with the goal of helping to alleviate suffering. It is an effective means of communication and should be structured to enable nurses and other health professionals to provide information, assess patient and family needs, and create opportunities for shared decision-making for interaction within the family. It is necessary to develop a concept analysis about the FC in the context of PC, aiming at a better understanding and of the concept, and enabling a practical systematization of this therapeutic family instrument.Full text:

Respecting Choices and related models of advance care planning: A systematic review of published evidence


AMERICAN JOURNAL OF HOSPICE & PALLIATIVE MEDICINE | Online – 18 December 2017 – Eighteen articles from 16 studies were included, of which 9 were randomized controlled trials, 6 were observational, and one was a prepost test study. Only two specifically included a minority population (African American). Fourteen were conducted in the U.S., primarily in the Wisconsin/Minnesota region. Seven studies examined the RC model, whereas 9 examined derivative models. There was significant heterogeneity of outcomes examined. The authors found that there is a low level of evidence that RC and derivative models increase the incidence and prevalence of advance directive and Physician Orders for Life-Sustaining Treatment completion. There is a high level of evidence that RC and derivative models increase patient–surrogate congruence in Caucasian populations. The evidence is mixed, inconclusive, and too poor in quality to determine whether RC and derivative models change the consistency of treatment with wishes and overall health-care utilization in the end of life. The authors urge further studies be conducted, particularly with minority populations and focused on the outcomes of preference-congruent treatment and health-care utilization.