• Attitudes of UK doctors towards euthanasia and physician-assisted suicide: a systematic literature review.

      McCormack, Ruaidhri; Clifford, Margaret; Conroy, Marian; Department of Palliative Medicine, Milford Care Centre, Castletroy, Limerick, Ireland. r.mccormack@kcl.ac.uk (2012-01)
      To review studies over a 20-year period that assess the attitudes of UK doctors concerning active, voluntary euthanasia (AVE) and physician-assisted suicide (PAS), assess efforts to minimise bias in included studies, determine the effect of subgroup variables (e.g. age, gender) on doctors' attitudes, and make recommendations for future research. Data sources: Three electronic databases, four pertinent journals, reference lists of included studies. Review methods: Literature search of English articles between January 1990 and April 2010. Studies were excluded if they did not present independent data (e.g. commentaries) or if they related to doctors outside the UK, patients younger than 18 years old, terminal sedation, withdrawing or withholding treatment, or double-effect. Quantitative and qualitative data were extracted.
    • Creating a spiritual tapestry: nurses' experiences of delivering spiritual care to patients in an Irish hospice.

      Bailey, Maria E; Moran, Sue; Graham, Margaret M; Department of Nursing and Midwifery, Health Science, University of Limerick, Castletroy, Limerick. maria.bailey@ul.ie (2009-01)
      This study aims to describe nurses' experiences of delivering spiritual support in a palliative care setting in the Republic of Ireland. The authors conducted semi-structured interviews with 22 nurses working in the area of specialist palliative care. A content analysis of the transcriptions revealed five sub-themes: understanding spirituality; the art of nursing in spiritual care; education and learning; the challenge of spiritual caring; and the dimensions of time. The resulting creation of a spiritual tapestry provided an overall theme. Nurses in this study were spiritually self-aware and placed a high value on the spiritual element of their caring role. Nurses described their individual understanding of spirituality and discussed how they recognized and addressed a patient's spiritual needs. Time was described as essential to the provision of spiritual support and appeared to be a significant resource challenge to the provision of spiritual care. The challenges of assessing spiritual needs and measuring outcomes of care were also reported. Participants in this study described the creation of a spiritual tapestry that 'weaves' together care and compassion with skills and knowledge in their nursing practice.
    • Improving palliative care.

      Moran, Sue; Milford Nursing Home, Limerick. (2009-05)
      Any service improvement project requires planning, action and evaluation. Using a recognised quality improvement framework can offer a structured approach to implementing and assessing changes to patient care. This article describes how use of the Deming Cycle has helped to identify nurses' learning needs.
    • Phenomenological and neuropsychological profile across motor variants of delirium in a palliative care unit

      Leonard, Maeve; Donnelly, Sinead; Conroy, Marion; Trzepacz, Paula; Meagher, David J; Dept of Adult Psychiatry, Midwestern Regional Hospital, Limerick; Milford Care Centre, Milford, Limerick; Lilly Research Laboratories, Indianapolis, IN, USA. (2011)
      Studies using composite measurement of cognition suggest that cognitive performance is similar across motor variants of delirium. The authors assessed neuropsychological and symptom profiles in 100 consecutive cases of DSM-IV delirium allocated to motor subtypes in a palliative-care unit: Hypoactive (N=33), Hyperactive (N=18), Mixed (N=26), and No-Alteration motor groups (N=23). The Mixed group had more severe delirium, with highest scores for DRS-R-98 sleep-wake cycle disturbance, hallucinations, delusions, and language abnormalities. Neither the total Cognitive Test for Delirium nor its five neuropsychological domains differed across Hyperactive, Mixed, and Hypoactive motor groups. Most patients (70%) with no motor alteration had DRS-R-98 scores in the mild or subsyndromal range even though they met DSM-IV criteria. Motor variants in delirium have similar cognitive profiles, but mixed cases differ in expression of several noncognitive features.
    • Quality-of-life assessment in advanced cancer.

      Donnelly, S; Milford Care Centre, Plassey Park Road, Castletroy, Limerick, Ireland. milford@milfordcare.ie (2000-07)
      In the past 5 years, quality-of-life (QOL) assessment measures such as the McGill, McMaster, Global Visual Analogue Scale, Assessment of QOL at the End of Life, Life Evaluation Questionnaire, and Hospice QOL Index have been devised specifically for patients with advanced cancer. The developers of these instruments have tried to respond to the changing needs of this specific population, taking into account characteristics including poor performance status, difficulty with longitudinal study, rapidly deteriorating physical condition, and change in relevant issues. Emphasis has been placed on patient report, ease and speed of completion, and the existential domain or meaning of life. Novel techniques in QOL measurement have also been adapted for palliative care, such as judgment analysis in the Schedule for the Evaluation of Individual Quality of Life. It is generally agreed that a single tool will not cover all QOL assessment needs.
    • A quantitative exploration of the subjective burden experienced by nurses when caring for patients with delirium.

      Mc Donnell, Siobhan; Timmins, Fiona; Milford Care Centre, Limerick, Ireland. (2012-09)
      The aim of this study is to examine the subjective burden experienced by nurses when they provide care for patients with acute delirium.
    • Use of dependency and prioritization tools by clinical nurse specialists in palliative care: an exploratory study.

      Bracken, Mairéad; McLoughlin, Kathleen; McGilloway, Sinéad; McMahon, Edith; National University of Ireland (NUI) Maynooth; Milford Care Centre (2011-12)
      The principal aim was to assess the utility of three needs assessment/dependency tools for use in community-based palliative care services. Specific objectives were to assess a sample of patients receiving specialist palliative care community nursing using these tools, to assess the predictive ability of each tool, and to explore the utility of prioritizing and measuring patient dependency from a clinical nurse specialist (CNS) perspective.