Publications by authors named "Lucy E Selman"

Background: Coronary artery bypass grafting (CABG) provides superior long-term outcomes to percutaneous coronary intervention (PCI) for complex multivessel coronary artery disease (CAD). People with chronic kidney disease (CKD) have increased prevalence of multivessel CAD, but also increased surgical risk. We investigated whether CKD predicted real-world use of CABG, versus PCI, in patients revascularized for acute coronary syndrome (ACS).

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Background: Advance care planning can improve patient and family outcomes; however, minoritised ethnic communities experience access barriers. Co-production offers a way to design culturally appropriate information and support, but evidence is needed to understand its implementation in palliative care.

Aim: To explore and describe how two charities used co-production to develop and deliver community-based advance care planning workshops for South Asian elders.

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Article Synopsis
  • The OSCAR study explored how clinicians communicate treatment options for advanced kidney disease to older patients, focusing on the impact of this communication on patient decision-making.
  • The research involved recording 110 outpatient consultations and analyzing how dialysis and conservative management options were presented, finding two dominant communication styles.
  • Results indicated that presenting both treatments equally encouraged more patient engagement, while presenting conservative management as secondary limited the patient's opportunity to ask questions and voice their opinions.
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Background: Grieving is a natural process, and many people adjust with support from family and friends. Around 40% of people would benefit from additional input. Online bereavement support interventions may increase access to support.

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Article Synopsis
  • A study analyzed data from over 10,000 patients with acute coronary syndrome (ACS) from 2010 to 2017 to explore the impact of reduced kidney function (eGFR) on treatment and mortality rates.
  • It found that lower eGFR levels were strongly linked to a decrease in invasive treatments like coronary angiography; patients with eGFR <30 were significantly less likely to receive these procedures compared to those with higher eGFR.
  • Additionally, there was a clear connection between lower eGFR and higher 30-day mortality rates, indicating that kidney function plays a critical role in treatment outcomes for ACS patients.
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Most older people with kidney failure choose between treatment with dialysis or conservative kidney management. The preferences underlying these decisions are poorly understood. Here, we performed a choice experiment, informed by qualitative research, to examine preferences for the characteristics of dialysis and conservative management among over-65-year-olds with eGFR of 20 mls or under/min/1.

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Article Synopsis
  • The Good Grief Weston festival, co-designed with the community, aimed to enhance death and grief literacy in Weston-super-Mare, attracting around 3000 attendees over 8 days in May 2023.
  • A mixed methods evaluation, including online surveys and focus groups, was conducted to assess participants' experiences and gather insights for future events.
  • Results showed that 71.3% of participants felt more confident discussing grief after attending, with many expressing positive feedback about the festival's impact on their understanding and sense of community.
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Article Synopsis
  • Poor prognosis communication between secondary and primary care is crucial for providing coordinated care based on patient preferences, but the process is not well understood.
  • A systematic review identified only 30 out of 23,853 studies that focused on this communication, revealing that prognosis information is rarely shared unless death is imminent, and identifying barriers and facilitators to such sharing.
  • GPs value receiving prognosis information for continuity of care, highlighting the need for further research to identify GPs' information needs and understand the obstacles faced by secondary care clinicians in sharing this critical information.
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Background: An ageing prison population with complex health needs combined with punitive sentencing practices means palliative care for incarcerated individuals is increasingly important. However, there is limited evidence regarding the models of care delivery in high-income countries, and their associated challenges and benefits.

Aim: To develop a typology of models of palliative care provision for incarcerated individuals, synthesise evidence of their outcomes and describe facilitators of and challenges in delivering different models of palliative and end-of-life care in prisons.

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Objectives: Early' specialist palliative care (SPC) has been shown to improve outcomes for patients with advanced cancer, yet patients are often referred late. 'Enhanced supportive care' (ESC) aims to facilitate earlier integrated supportive care for those with incurable cancer. This study aimed to explore clinicians' understanding of ESC/SPC delivery through description of current service provision.

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Objectives: Patients with advanced illness and their family caregivers can be mutually supportive. However, what facilitates and/or restricts supportive relationships between patients and family caregivers in palliative care remains unclear. We aimed to identify key barriers to and facilitators of supportive relationships between people with advanced illness and family caregivers in specialist palliative care.

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Background: The COVID-19 pandemic has been a devastating and enduring mass-bereavement event, with uniquely difficult sets of circumstances experienced by people bereaved at this time. However, little is known about the long-term consequences of these experiences, including the prevalence of Prolonged Grief Disorder (PGD) and other conditions in pandemic-bereaved populations.

Methods: A longitudinal survey of people bereaved in the UK between 16 March 2020 and 2 January 2021, with data collected at baseline ( = 711), c.

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Background: Good Grief Festival was originally planned as a face-to-face festival about grief and bereavement. Due to COVID-19, it was held online over 3 days in October 2020.

Objective: To evaluate the festival's reach and impact.

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We identified factors associated with higher levels of grief and support needs among 711 people bereaved during the COVID-19 pandemic in the UK (deaths 16 March 2020-2 January 2021). An online survey assessed grief using the Adult Attitude to Grief (AAG) scale, which calculates an overall index of vulnerability (IOV) (range 0-36), and practical and emotional support needs in 13 domains. Participants' mean age was 49.

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Background: Voluntary and community sector bereavement services are central to bereavement support in the UK.

Aim: To determine service providers' perspectives on access to their support before and during the COVID-19 pandemic.

Design: Mixed methods study using an explanatory sequential design: (1) Cross-sectional online survey of UK bereavement services; (2) Qualitative interviews with staff and volunteers at selected services.

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Background: During the COVID-19 pandemic, many children and young people have experienced the death of close family members, whilst also facing unprecedented disruption to their lives. This study aimed to investigate the experiences and support needs of bereaved children and young people from the perspective of their parents and guardians.

Methods: We analysed cross-sectional qualitative free-text data from a survey of adults bereaved in the UK during the pandemic.

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The evaluation of public engagement health festivals is of growing importance, but there has been no synthesis of its practice to date. We conducted a systematic review of evidence from the evaluation of health-related public engagement festivals published since 2000 to inform future evaluation. Primary study quality was assessed using the Mixed Methods Appraisal Tool.

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Background: The COVID-19 pandemic has been a devastating, mass bereavement event characterised by high levels of disruption to end-of-life, grieving and coping processes. Quantitative evidence is emerging on the effects of the pandemic on grief outcomes, but rich qualitative evidence on the lived experiences of people bereaved during these times is lacking.

Methods: We analysed qualitative data from two independent UK-wide online surveys to describe the experiences of 881 people bereaved during the pandemic.

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Background: Decision-making in palliative care usually involves both patients and family caregivers. However, how concordance and discordance in decision-making manifest and function between patients and family caregivers in palliative care is not well understood.

Objectives: To identify key factors and/or processes which underpin concordance and/or discordance between patients and family caregivers with respect to their preferences for and decisions about palliative care; and ascertain how patients and family caregivers manage discordance in decision-making in palliative care.

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Background: Experiences of end-of-life care and early bereavement during the COVID-19 pandemic are poorly understood.

Aim: To identify clinical and demographic risk factors for sub-optimal end-of-life care and pandemic-related challenges prior to death and in early bereavement, to inform clinical practice, policy and bereavement support.

Design: Online national survey of adults bereaved in the UK (deaths between 16 March 2020 and 2 January 2021), recruited via media, social media, national associations and organisations.

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Introduction: In 2020 England moved to an opt-out deceased donation law. We aimed to investigate the views of a mixed stakeholder group comprising people with kidney disease, family members and healthcare practitioners towards the change in legislation. We investigated the expected impacts of the new legislation on deceased-donor and living-donor transplantation, and views on media campaigns regarding the law change.

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Introduction: People dying in Britain spend, on average, 3 weeks of their last year of life in hospital. Hospital discharge presents an opportunity for secondary care clinicians to communicate to general practitioners (GPs) which patients may have a poor prognosis. This would allow GPs to prioritise these patients for Advance Care Planning.

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Background: While patient and public involvement (PPI) in clinical trials is beneficial and mandated by some funders, formal guidance on how to implement PPI is limited and challenges have been reported. We aimed to investigate how PPI is approached within a UK Clinical Trials Unit (CTU)'s portfolio of randomised controlled trials, perceived barriers to/facilitators of its successful implementation, and perspectives on the CTU's role in PPI.

Methods: A mixed-methods study design, involving (1) an online survey of 26 trial managers (TMs) and (2) Interviews with Trial Management Group members and public contributors from 8 case-study trials.

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Background: The COVID-19 pandemic is a mass bereavement event which has profoundly disrupted grief experiences. Understanding support needs and access to support among people bereaved at this time is crucial to ensuring appropriate bereavement support infrastructure.

Aim: To investigate grief experiences, support needs and use of formal and informal bereavement support among people bereaved during the pandemic.

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Background: Despite its ubiquity in academic research, the phrase 'ethical challenge(s)' appears to lack an agreed definition. A lack of a definition risks introducing confusion or avoidable bias. Conceptual clarity is a key component of research, both theoretical and empirical.

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