Community specialist palliative care services in New Zealand: a survey of Aotearoa hospices.

Aim: Community specialist palliative care (SPC) in Aotearoa New Zealand is provided by independent hospices. Substantial increase in demand for palliative care is projected in the next 20 years. We aimed to describe the current landscape of SPC services across Aotearoa whilst incorporating an equity lens.

Palliative and end of life care in undergraduate medical education: a survey of New Zealand medical schools.

Background: In New Zealand, 34% of deaths occur in the hospital setting where junior doctors are at the frontline of patient care. The death rate in New Zealand is expected to double by 2068 due to the aging population, but many studies report that graduates feel unprepared to care for people near the end of life and find this to be one of the most stressful parts of their work. International guidelines recommend that palliative and end of life care should be a mandatory component of undergraduate medical education, yet teaching varies widely and remains optional in many countries.

Preparing nurses for palliative and end of life care: A survey of New Zealand nursing schools.

Background: Nurses play a vital role in the care of people with advanced life-limiting illnesses, so palliative and end of life care is an essential skill nurses need to learn. Despite numerous reports in the international literature about educational developments in this area, there are widespread inconsistencies in undergraduate education, and graduates continue to report feeling unprepared for this part of their work. Little is known about how New Zealand nursing students learn about this important area of clinical practice.

Social consequences of assisted dying: a case study.

Aim: To consider the possibility of consequences beyond the alleviation of perceived individual suffering, for families left behind, communities and society as a whole should the End of Life Choice Act gain public support in the September 2020 referendum in New Zealand.

Method: This study used the Yin case study approach to undertake a single semi-structured in-depth interview with a participant who self-identified as having first-hand experience of assisted dying from a relative's perspective (in a country where this is legal). Thematic analysis was used to identify themes and trends from the interview transcript.

Is the bereavement grief intensity of survivors linked with their perception of death quality?

Background: Some people experience exceptionally severe bereavement grief, and this level of post-death grief could potentially be the result of a low quality dying process.

Aims: A pilot study was conducted to determine if a relationship exists between perceived death quality and bereavement grief intensity.

Methods: A questionnaire was developed and posted online for data on bereavement grief intensity, perceived death quality, and decedent and bereaved person characteristics.

Funeral and interment practices of rural residents: A mixed methods study.

There are few studies on interment preferences and practices for people in remote and rural regions of developed countries. This mixed methods study in rural Australia collated data on funeral and interment practices with an ethnographic exploration of the post-death preferences of terminally-ill rural residents. In the region, between February 2015 and May 2016, 44% of decedents were cremated.

Educational needs of healthcare professionals and members of the general public in Alberta Canada, 2 years after the implementation of medical assistance in dying.

Medical assistance in dying (MAID) was implemented across Canada in June of 2016, after each Canadian province and territory had developed their own MAID processes. Over the first 2 years, just under 300 Alberta citizens received MAID services, a very small proportion (<0.5%) of all 52,000 decedents.

Place of death in the Snowy Monaro region of New South Wales: A study of residents who died of a condition amenable to palliative care.

Objective: To describe the place of death of residents in a rural region of New South Wales.

Design: Cross-sectional quantitative study using death data collected from local funeral directors (in person and websites), residential aged-care facilities, one multipurpose heath service and obituary notices in the local media (newspapers/radio).

Setting: Snowy Monaro region (New South Wales Australia).

Can specially trained community care workers effectively support patients and their families in the home setting at the end of life?

Surveys indicate that many Australians would prefer to die at home, but relatively few do. Recognising that patients and their families may not have the support they need to enable end-of-life care at home, a consortium of care providers developed, and received funding to trial, the Palliative Care Home Support Program (PCHSP) across seven health districts in New South Wales, Australia. The programme aimed to supplement end-of-life care in the home provided by existing multidisciplinary community palliative care teams, with specialist supportive community care workers (CCWs).

Bereavement grief: A population-based foundational evidence study.

Information is needed on the incidence and prevalence of bereavement grief, and factors associated with severe or prolonged grief. Among 1,208 representative Canadian adults, 96% had experienced bereavement grief and 78% were actively grieving at interview. Grief levels were higher among women, Protestants, and Catholics, when the death was under 2 years previously, when a spouse, parent, or child had died, and when the perceived death quality was lower.

Death Anxiety Among New Zealanders: The Predictive Roles of Religion, Spirituality, and Family Connection.

The aim of this cross-sectional study was to investigate attitudes of New Zealanders toward death and dying. We administered an online version of Collett-Lester Fear of Death Scale and Concerns about Dying Instrument subscales to a representative sample of the New Zealand population. One thousand one people responded to the survey, where the largest age-group lay between 30 and 39 years.

Differences in place of death between lung cancer and COPD patients: a 14-country study using death certificate data.

Unlabelled: Chronic obstructive pulmonary disease and lung cancer are leading causes of death with comparable symptoms at the end of life. Cross-national comparisons of place of death, as an important outcome of terminal care, between people dying from chronic obstructive pulmonary disease and lung cancer have not been studied before. We collected population death certificate data from 14 countries (year: 2008), covering place of death, underlying cause of death, and demographic information.

Spiritual beliefs, practices, and needs at the end of life: Results from a New Zealand national hospice study.

Objective: International studies have shown that patients want their spiritual needs attended to at the end of life. The present authors developed a project to investigate people's understanding of spirituality and spiritual care practices in New Zealand (NZ) hospices.

Method: A mixed-methods approach included 52 semistructured interviews and a survey of 642 patients, family members, and staff from 25 (78%) of NZ's hospices.

A scoping review of bereavement service outcomes.

Objective: This scoping literature review, through finding and assessing researched bereavement service outcomes, sought to determine the state of bereavement services evaluation, to catalogue service types, and to identify which service or services, if any, demonstrate clear evidence of effectiveness.

Method: Our methods included: (1) a literature search for published English-language research articles from 2005-2015; (2) critical appraisal of articles to identify findings; (3) compilation of findings; and (4) determination of the relevance of our findings.

Results: Some 38 papers were found, and all were retained to identify the outcomes researched and research findings.

A Cross-Sectional Comparison of Quality of Life Between Physically Active and Underactive Older Men With Prostate Cancer.

Men with prostate cancer experience many side effects and symptoms that may be improved by a physically active lifestyle. It was hypothesized that older men with prostate cancer who were physically active would report significantly higher levels of quality of life (QOL) as assessed by the WHOQOL-BREF and the WHOQOL-OLD. Of the 348 prostate cancer survivors who were invited to participate in the present postal survey, 137 men returned the questionnaires.

"It's not about treatment, it's how to improve your life": The lived experience of occupational therapy in palliative care.

Objectives: A key aim of palliative care is to improve the quality-of-life of people with a life-threatening illness. Occupational therapists are well positioned to contribute to this aim due to their broad range of interventions, client-centeredness and focus on occupation. However, there is a limited understanding of how occupational therapy contributes to the end-of-life experience, which is crucial to providing optimal care.

Indigenous people's experiences at the end of life.

Objective: The primary purpose of this metasynthesis study was to explore the end-of-life experiences of Indigenous peoples by synthesizing the findings of qualitative research.

Method: Sandelowski and Barroso's methodology for synthesizing qualitative research was used and included (a) a comprehensive search, (b) appraising reports of qualitative studies, (c) classification of studies, and (d) synthesis of the findings. Research team members guided this process.

Spirituality in Renal Supportive Care: A Thematic Review.

Chronic kidney disease is marked by a reduced life expectancy and a high symptom burden. For those who reach end-stage renal disease, the prognosis is poor, and this combined with the growing prevalence of the disease necessitates supportive and palliative care programmes that will address people's psychosocial, cultural and spiritual needs. While there is variation between countries, research reveals that many renal specialist nurses and doctors are reluctant to address spirituality, initiate end-of-life conversations or implement conservative treatment plans early.

Spiritual care and kidney disease in NZ: a qualitative study with New Zealand renal specialists.

Aim: People with chronic kidney disease have a shortened life expectancy and carry a high symptom burden. Research suggests that attending to renal patients' spiritual needs may contribute to an improvement in their quality of life. The aim of this qualitative study was to investigate the provision of spiritual care in New Zealand renal units from the perspective of specialists.

Spirituality: what is its role in pain medicine?

Background: For many years, spirituality has been regarded as an integral aspect of patient care in fields closely allied to pain medicine such as palliative and supportive care. Despite this, it has received relatively little attention within the field of pain medicine itself. Reasons for this may include a lack of understanding of what spirituality means, doubtfulness of its relevance, an uncertainty about how it may be addressed, or a lack of awareness of how addressing spirituality may be of benefit.

The spiritual environment in New Zealand hospice care: identifying organisational commitment to spiritual care.

Objectives: Spiritual matters naturally arise in many people who have either a serious illness or are nearing end-of-life. The literature shows many examples of spiritual assessments, interventions and care; however, there is a lack of focus on organisational support for spiritual care. We aimed to ascertain the structural and operational capacity of New Zealand's hospices to attend to the spiritual needs and concerns of patients, families and staff.

A population-based study on advance directive completion and completion intention among citizens of the western Canadian province of Alberta.

Determining what proportion of the public has completed an advance directive and which population subgroups complete or do not complete such a directive is crucially important for planning purposes. Our research objective was to examine and compare advance directive completion, intention to complete, and noncompletion rates among citizens of one Canadian province. A telephone survey was conducted with 1,203 Albertans who met gender, age, and other requirements for a representative sample.

Characteristics influencing location of death for children with life-limiting illness.

Objective: To determine whether demographic and diagnostic characteristics were associated with location of death in a series of children with life-limiting illnesses.

Design: A population-level case series was carried out by reviewing mortality records. Sociodemographic characteristics, diagnosis and referral to paediatric palliative care (PPC) were analysed for association with location of death.

The public's viewpoint on the right to hastened death in Alberta, Canada: findings from a population survey study.

A research study was conducted to determine public opinion in Alberta, a Canadian province, on the controversial topic of death hastening. Questions on the right to hastened death, end-of-life plans and end-of-life experiences were included in the Population Research Laboratory's annual 2010 health-care telephone survey, with 1203 adults providing results relatively representative of Albertans. Of all 1203, 72.