Audrey Roulston

Exploring public awareness and perceptions of palliative care: a qualitative study.

Background: Research suggests that the public appear to be confused about the meaning of palliative care. Given the ageing population and associated increase in the number of patients requiring palliative care, it is vital to explore the public’s understanding of this concept. Health-promoting palliative care seeks to translate hospice and palliative care ideals into broader public health practice. Aim: To explore public perceptions of palliative care and identify strategies to raise awareness. Design: An exploratory qualitative approach. Participants: Semi-structured telephone interviews were undertaken (N = 50) with members of the public who volunteered to participate in the study. The interviews focused on knowledge and perceptions of palliative care, expectations of palliative care services and the identification of strategies to raise public awareness of palliative care. The interviews were audio recorded and content analysed. Results: Most participants had a general knowledge of palliative care, largely influenced by their own personal experience. They identified that palliative care was about caring for people who were dying and maintaining comfort in the last days of life. Participant’s expectations of services included the following: holistic support, symptom management, good communication and practical support to enable choice and carer support. Key aspects identified for promoting palliative care were the development of understanding and use of the term itself and targeted educational strategies. Conclusion: Experience of palliative care generates understanding in the general public who also have ideas for increasing knowledge and awareness. The findings can inform policymakers about strategies to raise public awareness of palliative care.

Bereavement outcomes: A quantitative survey identifying risk factors in informal carers bereaved through cancer.

Background: Enabling patients to die in their preferred place is important but achieving preferred place of death may increase the informal carer’s risk into bereavement. Aim: To determine risk factors of family carers bereaved through cancer in Northern Ireland. Design: These results form part of a larger QUALYCARE-NI study which used postal questionnaires to capture quantitative data on carer’s bereavement scores using the Texas Revised Inventory of Grief. Setting/participants: Participants were individuals who registered the death of a person between 1 December 2011 and 31 May 2012; where cancer (defined by ICD10 codes C00-D48) was the primary cause; where the deceased was over 18 years of age and death occurred at home, hospice, nursing home or hospital in Northern Ireland. Participants were approached in confidence by the Demography and Methodology Branch of the Northern Ireland Statistics and Research Agency. Those wishing to decline participation were invited to return the reply slip. Non-responders received a second questionnaire 6 weeks after initial invitation. Results indicated that risk factors positively influencing bereavement outcomes included patients having no preference for place of death and carers remaining in employment pre- or post-bereavement. In contrast, patients dying in hospital, carers stopping work, being of lower socio-economic status and close kinship to the deceased negatively affected bereavement scores. Family carers should be adequately supported to continue in employment; priority should be given to assessing the financial needs of families from lower socio-economic areas; and bereavement support should focus on close relatives of the deceased.

Exploring the impact of mindfulnesss on mental wellbeing, stress and resilience of undergraduate social work students

Abstract Mindfulness is becoming more popular as emerging research demonstrates its benefits for self-care, by cultivating calmness and decreasing stress or anxiety. This pilot study aimed to measure the impact of a six-week Mindfulness course, modelled on the manualised treatment programme developed by Kabat-Zinn on the mental well-being, stress and resilience of undergraduate social work students in Northern Ireland. This was a mixed methods study involving two groups: (1) intervention group participants who attended a six-week Mindfulness course (April–May 2016) and (2) control group participants. Basic socio-demographic data were collected from all participants and all were invited to complete the Warwick-Edinburgh Mental Well-being Scale, the Perceived Stress Scale and the Resilience Scale during weeks 1 and 6. Statistical tests were used to compare mean scores from the scales, and qualitative data were manually analysed using thematic content analysis. Findings indicated significant changes in the scores for well-being, stress and resilience for the intervention group, but not for the control group. Mindfulness may not appeal to all students so it should not be a mandatory component of training, but may be offered as one of the wider approaches to self-care for undergraduate social work degree students.

Promoting readiness to practice: which learning activities promote competence and professional identity for student social workers during practice learning?

ABSTRACT Practice learning is integral to the curriculum for qualifying social work students. Accreditation standards require regular student supervision and exposure to specific learning activities. Most agencies offer high-quality placements, but organizational cutbacks may affect supervision and restrict the development of competence and professional identity. Undergraduate social work students in Northern Ireland universities (n=396) were surveyed about the usefulness of the learning activities they received on placement for developing practice competence and professional social work identity. Results suggest that students most valued regular supervision, constructive feedback, observing social workers, and thinking critically about the social work role. Differences were reported across placements with students feeling disadvantaged in agencies where there was no clear social work role.

Bereavement support standards and bereavement care pathway for quality palliative care provision

ABSTRACTObjective:Provision of bereavement support is an essential component of palliative care service delivery. While bereavement support is integral to palliative care, it is typically insufficiently resourced, under-researched, and not systematically applied. Our aim was to develop bereavement standards to assist palliative care services to provide targeted support to family caregivers. METHOD We employed a multiple-methods design for our study, which included: (1) a literature review, (2) a survey of palliative care service providers in Australia, (3) interviews with national (Australian) and international experts, (4) key stakeholder workshops, and (5) a modified Delphi-type survey. RESULTS A total of 10 standards were developed along with a pragmatic care pathway to assist palliative care services with implementation of the standards. SIGNIFICANCE OF RESULTS The bereavement standards and care pathway constitute a key initiative in the evolution of bereavement support provided by palliative care services. Future endeavors should refine and examine the impact of these standards. Additional research is required to enhance systematic approaches to quality bereavement care.

An examination of the role of observation in supervised access and its implications for child protection work

Abstract A pre-requisite to all social work with children is an understanding of their physical, emotional and educational needs. In the area of child protection work there is always the dilemma of ensuring that these key needs are adequately met.