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Call for papers – Palliative sedation

This Collection seeks to gather research on palliative sedation, addressing its ethical, clinical, and interpersonal dimensions. BMC Palliative Care invites submissions that explore the complexities of palliative sedation, including ethical considerations, clinical guidelines, and the perspectives of patients, families, and healthcare professionals. In doing so, we aim to advance our understanding of palliative sedation and its role in providing compassionate end-of-life care.

Read the full paper here.

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A Look into the PAL-CYCLES Train-the-Trainers Program

A Look into the PAL-CYCLES Train-the-Trainers Program 

In today’s rapidly evolving healthcare environment, the PAL-CYCLES project is at the forefront of enhancing transitional palliative care for patients with advanced cancer. This project is focused on developing, adapting, implementing, and evaluating a comprehensive palliative care program that ensures a seamless transition from hospital care to community-based care. The project recognizes the complex nature of patient care transitions, involving the coordinated and continuous movement of patients across different care settings, providers, and levels of care as their medical conditions and needs evolve. According to Coleman et al. (2003), this process is vital for maintaining the continuity of patient care and ensuring the best outcomes. 

The concept of “transition” in palliative care is not just about changing care settings but also about a shift in the patient’s care goals. While the initial focus may be on curing or managing a chronic illness, the transition to palliative care emphasizes maximizing the patient’s quality of life. This approach is particularly important for patients with advanced cancer, where the focus shifts from curative treatments to supportive care aimed at enhancing comfort and well-being. As Gott et al. (2011) have highlighted, this transition is essential for improving the overall patient experience and outcomes in palliative care settings. 

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Train-the-Trainer Program: Objectives and Participant Overview 

The PAL-CYCLES project hosted a comprehensive Train-the-Trainer (ToT) program from December 4-6, 2023, in Bucharest, Romania. The main objective of this program was to prepare future trainers from seven countries—the United Kingdom, Romania, Hungary, the Netherlands, Poland, Germany, and Portugal—to implement transitional palliative care programs in their respective clinical sites. Additionally, the ToT program aimed to refine and adapt training materials, making them relevant and accessible to clinical staff working with cancer patients in both hospital and community settings. 

Participants in the ToT program included 1-3 representatives from each consortium partner country, all of whom possessed expertise in delivering palliative care to cancer patients and experience in education. In total, 14 participants attended the face-to-face training sessions in Bucharest, while two participants from Spain joined the program online. This diverse group brought a wealth of knowledge and experience to the program, creating a rich and dynamic learning environment. 

Training Structure and Methodology 

The training program was carefully structured to align with the transitional education program, comprising five modules. Each module included one or more teaching units, resulting in a total of 12 teaching units. Each unit consisted of a one-hour instructional session followed by 30 minutes of discussion and feedback. These sessions provided participants with the opportunity to explore various teaching methods, share insights, and discuss the feasibility of implementing these methods in their respective countries. 

A significant aspect of the training involved feedback sessions, which highlighted the diversity of palliative care training experiences among the participants. This diversity underscored the need for a tailored approach to training that considers the unique needs and challenges of each country. To address this, the trainers agreed on a self-assessment pretest for clinicians and trainers, which would help them adapt the initial training to the specific needs of each clinical site. 

Post-Training Implementation and Evaluation 

Following the initial training, all five modules and 12 training sessions will be made available to clinicians throughout the intervention phase of the research. The consortium agreed on two compulsory sessions—”Identifying Patients with Palliative Care Needs” and “Discussing Goals of Care.” However, each country has the flexibility to decide how many additional sessions to incorporate based on their specific needs and contexts. This approach allows for a customized training experience that is responsive to the unique healthcare landscapes of each participating country. 

Reflections and Conclusions 

The Train-the-Trainer program received high praise for its effective organization, well-prepared sessions, and expert instructors. Participants found the group work process both challenging and rewarding, with the formation of country teams proving invaluable for discussing the application of sessions and overcoming potential challenges. These teams fostered a collaborative environment, enabling participants to share experiences, best practices, and innovative solutions for common challenges in palliative care. 

The PAL-CYCLES project demonstrates a strong commitment to advancing palliative care through education, collaboration, and innovation. By equipping healthcare professionals with the necessary knowledge and skills, the project is significantly improving the quality of life for patients with advanced cancer. 

References 

Gott, Merryn et al. “Transitions to palliative care in acute hospitals in England: qualitative study.” BMJ (Clinical research ed.) vol. 342 d1773. 29 Mar. 2011, doi:10.1136/bmj.d1773. 

Coleman, Eric A et al. “Improving the quality of transitional care for persons with complex care needs.” Journal of the American Geriatrics Society vol. 51,4 (2003): 556-7. doi:10.1046/j.1532-5415.2003.51186.x. 

 

This blog post aims to provide a comprehensive overview of the PAL-CYCLES training program, its objectives, and its significance in the field of palliative care. See the original article here and visit our website for more information. This blog was developed with chatgpt.com.  

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Newsletter second issue

Newsletter

People with advanced cancer and in need of palliative care deserve better care. But too often, they’re left to fend for themselves when they leave the hospital. Our new project aims to change that.

The Pal-Cycles team wishes you a Merry Christmas and a Happy New Year. 

Pal-Cycles Newsletter

December 2023, Issue 2

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Newsletter first issue

Newsletter

People with advanced cancer and in need of palliative care deserve better care. But too often, they’re left to fend for themselves when they leave the hospital. Our new project aims to change that.

Professor Jeroen Hasselaar invites us to read the first issue of the Pal-Cycles newsletter. 

Pal-Cycles Newsletter

May 2023, Issue 1

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To new beginnings, an introduction to Pal-Cycles​

To new beginnings, an introduction to Pal-Cycles​

In January 2023 I started as a PHD candidate on the Pal-Cycles project. With an educational background focusing on international policy making and healthcare organization and management, I developed a fascination for solving problems through policies or interventions, and what makes them effective or not. More specifically I am interested in what can be done from an organizational point of view to improve people’s quality of life.

Observed from an organizational point of view, a rocky road is often experienced by patients with advanced cancer moving from curative care to palliative care. Ineffective communication between the afore mentioned settings induces misunderstandings regarding for example the treatment goals or responsibilities. These misunderstandings often cause patients to experience adverse events and preventable hospital admissions, which have a negative impact on their quality of life.

In the Pal-Cycles research project we aim to develop a programme to improve the transition from curative care to palliative care for cancer patients, applicable in seven different European countries (The Netherlands, Germany, United Kingdom, Poland, Hungary, Romania, and Portugal).

The research team is developing the Pal-Cycles programme, based on the following five cornerstones.

  1. Identification of a patient with palliative and supportive care needs in collaboration with their oncologist and the hospital palliative care team.
  2. Compassionate communication towards the patient and their family.
  3. A collaborative multidimensional care plan and follow-up in the home care setting.
  4. Timely evaluation of the care plan with patients and relatives.
  5. Identification of the terminal phase (if reached) based on periodic evaluations, with appropriate intensification of care and end-of-life talks depending on local possibilities and habits, including consultation with patients and families about ethically and legally sensitive issues.

The Pal-Cycles programme will be tested for effectiveness using a stepped wedge clinical trial.  Patients will participate in the trial for five months. In addition to the effectiveness being tested, the implementation process and the ethics of the Pal-Cycles will also be evaluated. By doing this, we hope that in five years, we will be able to share whether the systemic changes made through the programme were effective in reducing unplanned admissions at the end of life and improving quality of life of patients and relatives.

team having dinner

Pippa van den Brand​

Radboudumc PhD candidate for the Pal-Cycles Project​

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