Paying clinicians to join clinical trials: a review of guidelines and interview study of trialists.

Background: The motivations of clinicians to participate in clinical trials have been little studied. This project explored the potential role of payment for participation in publicly funded clinical trials in the UK. The aims were to review relevant guidelines and to collate and analyse views of clinical trialists on the role of payments and other factors that motivated clinicians to join clinical trials.

A systematic review of the use and validation of health-related quality of life instruments in older cancer patients.

Aim: The aim of this paper is to systematically review the use and validation of HRQOL instruments in older cancer patients.

Method: A systematic review of 5 databases and 3 research registers identified studies reporting the use and validation of HRQOL instruments in cancer patients aged over 65 years from 1995 to mid 2007.

Results: Thirty-one studies reported the use of HRQOL measures in older people, using a range of generic and disease-specific instruments.

Experiences of end-of-life care in community hospitals.

Concerns remain that health and social care services often fail people dying of chronic illnesses other than those with cancer. British government policy aims to improve end-of-life care and to enable people to make choices about place of care near the end of life, with the assumption that home is often the preferred option. However, some elderly people may lack suitable social networks, family carers and other resources to remain at home.

Case study research methods in end-of-life care: reflections on three studies.

Aim: This paper is an evaluation of the use of case study methods, drawing on three research studies conducted by the authors in end-of-life care and bereavement.

Background: Case study methods have their origins in social anthropology and draw on the principles of naturalistic inquiry. They have been used in a number of disciplines, including qualitative sociology, management science, education and organizational psychology for the understanding and evaluation of complex social systems.

End-of-life care in community hospitals: the perceptions of bereaved family members.

Objectives: The perceptions of bereaved family members were obtained to evaluate the nature and quality of end-of-life care in community hospitals.

Design: During organizational case studies in six community hospitals in the South East and South West of England, bereaved family members were asked to participate in semi-structured interviews.

Participants: Fifty-one interviews were conducted with family members of patients who had received end-of-life care in a community hospital within the previous year.

Out-of-hours medical cover in community hospitals: implications for palliative care.

Background: The new General Medical Services contract in England means many GPs have transferred out-of hours work to their primary care organization, with implications for continuity of palliative care in community hospitals.

Aim: To examine existing arrangements for out-of-hours medical cover in community hospitals, focusing on palliative care.

Methods: Telephone survey of community hospital managers/senior nurses across England and Wales.

Nurse-led models of chemotherapy care: mixed economy or nurse-doctor substitution?

Aim: This paper reports a study exploring the perspectives of people affected by cancer (service users) and health care professionals' about current medical consultant-led services and the acceptability of a proposed nurse-led ambulatory chemotherapy service.

Background: A number of studies have evaluated a nurse-led model of cancer care delivery but little work has been undertaken in chemotherapy settings. Furthermore, many of these studies give little information on how the perspective of users was incorporated in the design and evaluation of these services.

Community hospitals: an under-recognized resource for palliative care.

In the UK there are concerns that, in certain groups of dying patients such as the old, those with non-cancer diagnoses and those in rural areas, the quality of care is unacceptably variable. There has been no systematic survey of the extent to which community hospitals provide general palliative care for such patients. Therefore, by means of a structured questionnaire we asked senior nurses/managers at all 478 community hospitals in the UK for information on staff expertise, facilities and specialist equipment, liaison arrangements with specialist palliative care providers, priorities, practice and policy in end-of-life care.

Appraising the evidence: reviewing disparate data systematically.

The authors describe a method of systematically reviewing research from different paradigms. They draw on the methods adapted, developed, and designed during a study concerned with the delivery of care across professional boundaries. Informed by the established method of systematic review, the authors undertook the review in distinct stages.

The communication of information about older people between health and social care practitioners.

Aim: to provide an evidence base for strategies, and effectiveness of the transfer of patient information between hospital and community for older people with physical illness.

Design: a systematic review of qualitative and quantitative literature.

Search Strategy: literature from medical, health-related and social science databases as well as work in progress from national databases, the Internet, British PhD theses and other grey literature and policy documents.