Journal of palliative care, Winter 2007, vol. 23, no. 4

Teaching interprofessional teamwork in palliative care--a values- based approach.
Full text available at ProQuest
p. 280-5, 45 refs

Pettifer-Annie, Cooper-Jan, Munday-Daniel.
Author affiliation
Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
Publication type
Journal-Article, Review.

Practising interprofessional team--work from the first day of class: a model for an interprofessional palliative care course.
Full text available at ProQuest

p. 273-9, 23 refs

Cadell-Susan, Bosma-Harvey, Johnston-Meaghen, Porterfield-Pat et al
Publication type
Journal-Article, Review.

Sustainable practice improvements: impact of the Comprehensive Advanced Palliative Care Education (CAPCE) program.
Full text available at ProQuest
p. 262-72

Harris-Diane, Hillier-Loretta-M, Keat-Nancy.
Abstract
This paper describes an education program designed to improve palliative care practice through the development of workplace hospice palliative care resources (PCRs), and its impact on knowledge transfer and longer-term changes to clinical practice. Evaluation methods included pre- and post-program questionnaires, and a survey of learners' (n=301) perceptions of program learning strategies. Interviews (n=21) were conducted with a purposeful sample of PCRs and representatives from their work sites. Ratings of the sessions indicated that they were relevant to learners' clinical practice. At follow up, the majority of learners (83%) continued to serve as PCRs. Many positive effects were identified, including enhanced pain and symptom management, staff education, and development of care policies and guidelines. Management support, particularly the prioritization of palliative care and staff development, were factors facilitating sustained implementation. These findings highlight the importance of multimodal learning strategies and supportive work environments in the development of PCRs to enhance palliative care practice.

Nurse-physician collaboration in pain management for terminally ill cancer patients treated at home in Japan.
Full text available at ProQuest
p. 255-61
Ishikawa-Hirono, Kawagoe-Koh, Kashiwagi-Masayo, Yano-Eiji.
Abstract
Collaboration between nurses and physicians is essential for successful pain management, especially in home care settings. This study describes how physicians collaborate with nurses for the pain management of terminally ill cancer patients treated at home in Japan, and evaluates the use of standing orders in pain management. Self-administered questionnaires were sent to all 565 institutions listed in a nationwide database of home care service providers for terminally ill cancer patients; 177 responding institutions were analyzed. In general, institutions caring for fewer patients per year were less likely to make specific efforts to collaborate with nurses and less likely to use standing orders in pain management. Given that many institutions provide home palliative care services on a small scale, a standard protocol for care should be developed and applied across all institutions to ensure the availability of quality home palliative care throughout the country.

Meta-analysis of survival prediction with Palliative Performance Scale.
Full text available at ProQuest
p. 245-52; discussion 252-4

Downing-Michael, Lau-Francis, Lesperance-Mary, Karlson-Nicholas, Shaw-Jack et al
Abstract
This paper aims to reconcile the use of Palliative Performance Scale (PPSv2) for survival prediction in palliative care through an international collaborative study by five research groups. The study involves an individual patient data meta-analysis on 1,808 patients from four original datasets to reanalyze their survival patterns by age, gender, cancer status, and initial PPS score. Our findings reveal a strong association between PPS and survival across the four datasets. The Kaplan-Meier survival curves show each PPS level as distinct, with a strong ordering effect in which higher PPS levels are associated with increased length of survival. Using a stratified Cox proportional hazard model to adjust for study differences, we found females lived significantly longer than males, with a further decrease in hazard for females not diagnosed with cancer. Further work is needed to refine the reporting of survival times /probabilities and to improve prediction accuracy with the inclusion of other variables in the models.