A new haircut can change your life

Michaela Hesse and Lukas Radbruch, Department of Palliative Medicine, University Hospital Bonn, Germany, talk about a recent study week they delivered on volunteering in hospice and palliative care, and the key issues it raised.

Lukas Radbruch

Prof Lukas Radbruch

Michaela Hesse

Michaela Hesse

This is the experience of a hospice volunteer worker who told us her story. At the hairdresser she met a woman who talked so vividly and enthusiastically about her idea to help HIV patients that she said spontaneously, “I want to help.” The woman she talked to was Irmgard Wester, the founder of ‘Bonn Lighthouse’, an organisation caring for patients with HIV/AIDS. That was 14 years ago and since then she has worked as a volunteer in a number of different activites in the Lighthouse. In the beginning, she cooked for the patients, then she took charge of a weekly coffee hour in an inpatient unit at the hospital, and later she started to care for patients with intellectual disabilities in a specialised nursing home. She still says that being a volunteer makes her life rich and makes her happy.

We got to know her, and other volunteers from the Lighthouse and the local voluntary hospice service of Rheinbach, during a study and research week funded by the German Ministry of Education and Research (Bundesministerium für Bildung und Forschung BMBF). The study week, ‘Volunteer work in hospice and palliative care – sustainable concepts for the future?’, was held from 31 March to 4 April at the Malteser Hospital Bonn.

Study week on volunteer work in hospice and palliative care

Study week on volunteer work in hospice and palliative care at Malteser Hospital, Bonn

We invited the volunteers to talk about their work and their experiences. The study week aimed to provide the opportunity to identify challenges, exchange experiences, elicit needs for research and open up international discussion. Thirteen scholars from five countries participated and presented their projects dealing with different aspects of volunteering, such as the challenge of an ageing society; motivation, attitudes and characteristics of volunteers and how volunteers cope with grief and spirituality. In addition, eight renowned international experts gave talks, enriched the discussions and enabled an open discourse with the participants: Fatia Kiyange (APCA – African Palliative Care Association), Werner Schneider (professor of sociology, University of Augsburg, Germany), John Ellershaw (professor of palliative medicine, University of Liverpool, UK), Piotr Krakowiak (director, Hospice Gdansk, Poland), Yvonne Engels (assistant professor, Radboud University Nijmegen Medical Centre, the Netherlands), Thomas Klie (professor of public law and administration, University of Freiburg, Germany), Ros Scott (EAPC Task Force on Volunteering) and Leena Pelttari (EAPC Task Force on volunteering, Hospice Austria).

The discussions throughout the week, and across the continents and settings, demonstrated that there is a need to focus on at least three fields of interest:

  • Terminology – What does it mean when we talk about volunteers, voluntary work, professional volunteers, civic engagement?
  • Guidelines – There seems to be a need for guidance, for example with the definition of standards and guidelines – but how much do standards impede the flexibility that is a core element of volunteer work in hospice and palliative care?
  • Core competencies – What are the core competencies of volunteers in hospice and palliative care – across settings and healthcare systems?

Experts and participants of the study week will work on these topics as part of the work of the EAPC Task Force on Volunteering. Meanwhile, treasure your local hairdresser – it could be a valuable source of potential volunteers!

Find out more…

  • Click here to read more EAPC blog posts about volunteering in hospice and palliative care. 

Coming up…
Later this week on the EAPC blog, a school pupil explains how a volunteer placement in a UK hospice changed her mind about palliative care.

 

Posted in Education and training, Volunteering and palliative care | Tagged , | 1 Comment

From Austria to Armenia: Palliative care is sharing

Dr Avetis Babakhanyan, Hospital of Police of Armenia, Masis Medical Center, Armenia, explains the value of small training seminars that make a big difference.

Dr Avetis Babakhanyan

Dr Avetis Babakhanyan

Recently I attended a seminar in Salzburg, Austria, dedicated to Palliative Care in Neurology and Neuro-Oncology (23 February-1 March 2014). The seminar was organised by Open Society Foundations (Soros Foundation) together with Austrian-American Foundation (AAF). Thirty-seven participants attended (neurologists, oncologists, anesthesiologists, GPs and palliative care workers) from Albania, Armenia, Georgia, Moldova, Mongolia, Kazakhstan, Latvia, Estonia, Czech Republic and Macedonia. The faculty included distinguished specialists from Memorial Sloan-Kettering Cancer Center (New York, USA) led by Kathleen Foley and Alan Carver.

The one-week intensive educational course was very useful and productive. The course covered important topics of palliative care mainly related to neurological problems, including: strategies for communicating bad news, caregiver burnout, grief and bereavement.

Faculty leader, Dr Kathleen Foley, with Dr Avetis Babakhanyan

Faculty leader, Dr Kathleen Foley, with Dr Avetis Babakhanyan

The sessions were interactive enabling both participants and faculty members to ask questions and make comments. A bonus was that faculty members encouraged us to ask any questions relating to palliative care, even those beyond the discussed themes. I am sure that we all got a lot of information that will certainly help us to provide better palliative care in our own countries. Particularly, for me, there were many ‘take home’ messages and approaches that will help me in my everyday practice: headache differential diagnosis, worrisome headache ‘red flags’, seizures and delirium management, advance care planning and the seven-step protocol to negotiate goals of care, and sedation at the end of life guidelines.We also appreciated the role-plays performed by the faculty members and participants.

Another source of ideas to take home to Armenia was the Salzburg Hospice– a well-furnished and equipped institution that provides the best possible support to terminally ill patients. I was impressed by two simple but very meaningful initiatives that the hospice implements. First, there is an archive (storage) corner where they keep papers with pictures, writings and paintings of every patient who has died in the hospice. Second, there is a corner in the hospice where two huge candles are lit every time someone dies, and those candles are extinguished when the body is removed from the hospice.

During the course we all received some educational materials including CDs such as (EPEC-O – Education in Palliative and End-of-Life Care for Oncology and the ‘Life before death’ film http://www.lifebeforedeath.com).

I would like to express my gratitude to the organisers of this important event, especially to Mary Callaway, a woman who has devoted herself to palliative care development worldwide for many years.

Perhaps as a follow up, I think a seminar focusing on physical symptoms and management issues would be very useful…

Find out more…
The International Palliative Care Initiative Open Society Foundations

Click here to read other posts about Armenia on the EAPC blog. 

Posted in National and international events | Tagged | 1 Comment

Going back to basics: Everything is communication…

Clique aqui para ler a versão em português

Bárbara Antunes, Research Associate at Centro de Estudos e Investigação em Saúde da Universidade de Coimbra (CEISUC) Portugal   and Visiting Research Associate at Cicely Saunders Institute, King’s College London, UK.

Bárbara Antunes

Bárbara Antunes

Do you greet someone with a handshake, one kiss on the cheek, one kiss on each cheek or a total of three kisses on the cheeks? Having had the opportunity of being part of two EU-funded projects, PRISMA  and EUROIMPACT, these are some important issues to be aware of, as you start meeting international collaborators who will be your colleagues for a number of years.

So, if this simple cultural aspect is so variable, imagine working in an international European group: most people will not be English native speakers so they will not be working in their native language. They will, however, communicate mainly in writing, by email, possibly not having met all collaborators in person. As for face-to-face, real-time interaction, this will happen maybe twice a year during meetings and maybe through one or two Skype meetings, if the webcams are working properly! And people may find themselves asking questions such as, “Oh, sorry, were you asking or stating?” because the voice inflexion of a particular language used in another, in this case English, might cause a bit of confusion. They will be experts in different topics (under the broad topic of palliative care) with different backgrounds and disciplines, different perspectives and experiences, as well as researchers starting in the field.

And there are so many different institutions, contexts and ways of doing things, different interpretations on time/timings (there is a chance that the concept ‘deadline’ has as many definitions as there are cultures!), and different definitions for the same word or concept. There are unsuspected pitfalls and perhaps too many assumptions. Unconsciously, you tend to assume that rules in other institutions are the same as in your own institution, that everyone has the same resources, access to the same opportunities and shares the same logistical nightmares. “My reality must be their reality.”

So, if communication is the key to interaction with another human being – and don’t just think verbal/non-verbal, think concrete examples; after all, papers, abstracts, posters, presentations, reports, blogs, everything is communication – then, clarifying issues and concepts is the master key for a smoother international research experience.

If you are about to embark on an international collaborative project, “So, just to clarify…” should be part of your vocabulary and possibly even embedded in your new email signature!

It has been a very enriching experience to live outside my country and be part of such cultural diversity. I have had an exponential learning curve that is still on the rise! From methodological skills to networking and making friends for life, it has been a once-in-a-lifetime experience.

Good luck and enjoy. It goes by really fast…

If you’d like to share your experiences of being part of an international project please leave a comment below, send me an email  or Twitter: @B_CP_Antunes

Voltar ao básico: Tudo é comunicação…

Bárbara Antunes, Investigadora Colaboradora do Centro de Estudos e Investigação em Saúde da Universidade de Coimbra (CEISUC) Portugal e Investigadora Convidada no King’s College London, Instituto Cicely Saunders, Reino Unido.

Bárbara Antunes

Bárbara Antunes

Cumprimentam uma pessoa com um aperto de mãos, um beijo na cara, dois, ou um total de três beijos na cara? Tendo tido a oportunidade de fazer parte de dois projetos financiados pela União Europeia, PRISMA e EUROIMPACT  estas são algumas das importantes questões a considerar, quando se começa a conhecer os colaboradores internacionais que serão nossos colegas durante alguns anos.

Se este simples aspeto cultural é tão variável, imagine-se trabalhar num grupo internacional europeu: a maior parte das pessoas não tem inglês como primeira língua portanto, não estarão a trabalhar na sua língua materna. Irão, no entanto, comunicar principalmente por escrito, por mail, possivelmente não conhecendo todos os colaboradores pessoalmente. No que diz respeito a interação em tempo real, em pessoa, isto acontecerá talvez duas vezes por ano em reuniões do grupo, e talvez durante uma ou duas reuniões por skype, se as câmaras estiverem a funcionar como deve ser! E algumas pessoas irão fazer perguntas como, “Ah, desculpe, estava a perguntar ou a constatar?” porque as inflexões de voz de determinada língua usadas noutro idioma, neste caso o inglês, serão passíveis de causar alguma confusão. Os colaboradores são especialistas em diferentes tópicos (dentro do tema geral Cuidados Paliativos) com diferentes formações de base, diferentes perspetivas e experiências, alguns em início de carreira.

E há tantas instituições diferentes, contextos e maneiras de fazer as coisas, diferentes interpretações de tempo (é possível que o conceito “prazo final” tenha tantas definições quantas as culturas que existem!) e diferentes definições para a mesma palavra ou conceito. A armadilha inesperada? Demasiadas suposições! Inconscientemente, tende-se a assumir que as regras de outras instituições são as mesmas que as do próprio, que todos têm os mesmos recursos, acesso às mesmas oportunidades e partilha dos mesmos pesadelos logísiticos! “A minha realidade deve ser a realidade deles.”

Assim, se a comunicação é a chave para interagir com outro ser humano – e não se pense apenas em termos verbal/não-verbal, mas em exemplos concretos: afinal artigos, sumários, pósteres, apresentações, relatórios, blogs, tudo é comunicação – então, clarificar assuntos e conceitos é a chave-mestra para uma experiência internacional em investigação mais tranquila.

Se está prestes a iniciar um projeto de colaboração internacional as palavras “Então, só para clarificar…” devem fazer parte do seu vocabulário e possivelmente até da sua assinatura de email!

Para mim, viver noutros países e fazer parte desta diversidade cultural foi uma experiência muito enriquecedora. A curva exponencial de aprendizagem que tive continua a aumentar! Desde competências metodológicas, a criar e manter contactos de trabalho até fazer amigos para a vida, esta experiência foi única.

Boa sorte e aproveitem! Passa muito depressa…

Se quiser partilhar as suas experiências de fazer parte de um projeto internacional, por favor deixe o seu comentário abaixo, ou contacte via email: barbara.antunes@kcl.ac.uk ou Twitter: @B_CP_Antunes

Obrigada à Dra Sofia Vilar Soares pela revisão do texto em Português. 

Posted in Research | Tagged , , , | 2 Comments

Access to essential medicines for palliative care: Report from the 57th Commission on Narcotic Drugs

Katherine Pettus, PhD, represented the International Association for Hospice and Palliative Care (IAHPC) at the Vienna NGO Coalition on Drug Policy in Austria. She explains how the Commission on Narcotic Drugs is changing its view of access to essential medicines for palliative care.

United Nations buildings, Vienna

United Nations buildings, Vienna

The issue of lack of access to opioid analgesics in 80% of the world, drew unprecedented attention at the recent High Level Segment of the Commission on Narcotic Drugs (CND) and the annual (57th) session held on 13/14 March in Vienna. Although the WHO (World Health Organization) classifies opioids such as morphine, used for the relief of severe pain, and methodone used for dependency treatment, as “essential medicines,” access to both is internationally restricted, since they are “scheduled” under the three drug control treaties supervised by the CND. Palliative care physicians in lower and middle-income countries confront multiple legal and regulatory barriers in accessing controlled medicines.

Two side events and a series of speeches by member states in plenary sessions educated delegates on the harmful health effects of national and international drug control policies. Member states were urged to make public health the cornerstone of drug policy and to review the effects of harsh law enforcement on access to essential medicines for palliative care and harm reduction.

CND side event: panel discussion

Commission on Narcotic Drugs side event: panel discussion

Dr Vladimir Poznyak (WHO), called the inequity of access to pain medicines a “scandal” at the Informal Civil Society Hearing. Norway referenced the “tragedy” of inadequate access to essential medicines, while Switzerland pointed out that “we need to recognise the suffering this causes as an unintended and unacceptable side-effect of drug control.” Australia cited the “moral imperative” of ensuring that all doctors be able to access medicines for their patients needing pain relief. India referenced the recent passage of the amendment to the NDPS (Narcotic Drugs and Psychotropic Substances) Act,  and the essential role of civil society, including the palliative care community, in educating lawmakers.

Separate side events hosted respectively by Lithuania and Australia highlighted the issue of access to essential medicines. The first featured Vietnamese physician and policy advocate, Dr Khuat Thi Hai Oanh, and Dr Jim Cleary, Director of the Pain and Policy Studies Group. Dr Oanh discussed the multiple public health side effects of drug prohibition, comparing the costs of policies that neglect harm reduction and punish drug users to the number of lives lost in all the Indochina wars. Evidence-based needle and syringe exchange programmes and opioid substitution therapy that reduce HIV and HCV transmission are illegal in many countries. Dr Oanh concluded her presentation by saying that:  “As doctors, we try our best to save lives, one by one. A bad policy can kill massive amounts of people; a good policy can save millions.”  

Dr Cleary showed a painful film clip of a palliative care team trying to work without morphine in rural India, and then presented the European Society of Medical Oncology’s findings on barriers to opioid availability in the WHO regions, highlighting the successes and remaining structural challenges for palliative care physicians and patients.

Find out more…

  • Click here for information on the side events.
  • For video clips click here.

What you can do…
Sign the Prague Charter and support the petition for palliative care and access to essential medicines, including opioid analgesics, for all patients who need it. Prague Charter QR Avaaz

Posted in Advocacy, National and international events, Opioid access | Tagged , | 1 Comment

Palliative care research: Professor Jane Seymour wins lifetime achievement award

Professor Jane Seymour (Sue Ryder Care Professor of Palliative and End of Life Studies), talks to Professor Sheila Payne (President of the EAPC) about her career in palliative care research and her reaction to winning the International Journal of Palliative Nursing Lifetime Achievement Award, which was presented in London on 20 March 2014.

Professor Jane Seymour with her husband, Dr Jeremy Seymour, at the award ceremony.  (Photograph: Julian Dodd)

Professor Jane Seymour with her husband, Dr Gerry  Seymour, at the award ceremony. (Photograph: Julian Dodd)

Sheila Payne: You’ve worked as a clinical nurse and academic nurse researcher for many years in the United Kingdom. What inspired you to devote so much of your life to palliative care?

Prof Jane Seymour: I believe that the formative experiences I had during my clinical work as a nurse in non-specialist palliative care and as a child growing up in the ‘60s and the ‘70s led to my career choice. As a child, I lived through the very serious life-threatening and long-term illness of both my parents, who were wonderful role models in how to deal with death and dying; they did so by humour, love and sheer stoical endurance.

SP: Palliative care has been part of your life for many years now – tell me why you began to do a PhD in palliative care and how did it all begin?

JS: I completed a degree in Social Science before I became a nurse and then, when my children were tiny, managed to complete a part-time master’s degree during a short break from clinical practice. Once I re-established myself as an intensive care nurse, I started to think seriously about the problems of care of the dying. David Clark enabled me to gain a PhD from the University of Sheffield, and the rest is history as they say!

SP: You’re now working at the University of Nottingham, where you lead a research team. Tell me about your work here and the innovations you’ve made?

JS: After my PhD I spent some years working at the University of Sheffield and later became Professor of Palliative and End of Life Care Studies and developed the Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care, at the University of Nottingham. It has been a huge pleasure as well as a challenge to develop the Centre. We are located in a university hospital and now have quite a sizeable team of researchers and a wonderful group of PhD students. I have worked on building our links to clinical practice and policy and extending internationally, particularly in terms of PhD student preparation.

SP: How did you build up the team?

JS: I was very fortunate in that the Centre came with some core funding meaning that I was able to appoint two or three key staff, which meant that we could bring in some research funds relatively quickly and thus gradually build the team. Most recently, we appointed Professor Bridget Johnston, in December 2013.

SP: What has been your biggest achievement in palliative care research?

JS: I am most proud of the fact that I have learnt to be a good PhD supervisor, and that the Centre has students from many parts of the world as well as from the UK, including: Jordan, Thailand, Malawi, Kenya, India and Cameroon.

SP: Thinking about your own experiences in establishing a new research group, what three tips would you give to someone who is setting up a new palliative care research group today?

JS:

  • Don’t try to do too much but rather deliver on your promises and do what you do well.
  • Learn to be a good manager of your staff and a visible and approachable leader
  • Take a break sometimes and don’t neglect your own well being.

SP: What gives you hope for the future?

JS: In the 32 years or so since I qualified as a nurse, palliative care has emerged from the side lines to become a feasible solution to global suffering; the attention it is now receiving internationally gives me great hope for the future.

Coming up…
Next in our series of blog interviews, Irene Murphy, EAPC board member, will be talking to Dr Kathy McLoughlin from Ireland about her recent award, and Professor Lukas Radbruch, President of the International Association for Hospice and Palliative Care, will be talking to Dr Nora Elena Saldarriaga Cartagena abut her work in Colombia.

Find out more …

  • Click here for more information on the Sue Ryder Care Centre for the Study of Supportive, Palliative and End of Life Care. 
  • Click here to read other interviews on the blog. 
  • Click here for more information about this year’s International Journal of Palliative Nursing awards.

 

Posted in EAPC Board Members, Interviews and Tributes, Research | Tagged , , , | Leave a comment

The time for palliative care services in Kyrgyzstan is now… 

Guljahan Fazilovna Pirnazarova, Head of Family Nursing Education Department at the Kyrgyz State Medical Institute in Bishkek, describes a recent patient situation that relates to a longer article published in the March/April issue of the European Journal of Palliative Care.

Today, a woman came to me and asked for help.

Guljahan Fazilovna Pirnazarova

Guljahan Fazilovna Pirnazarova

Her daughter is 35 years old, divorced with two sons aged 17 and 11. Two years ago, a small tumour appeared on her right tibia. She lives in a small town where a surgeon removed the tumour; but very soon, new tumours grew in larger sizes. After that, the patient came to the capital (Bishkek) and was seen by an oncologist who diagnosed her with stage 4 cancer with metastasis. She was admitted to a hospital where she received several courses of chemotherapy.

Her condition has deteriorated, she has fallen into depression, and her parents and children are very worried. The patient does not want to believe that she has cancer in the final stages. She wants to be cured. When she was discharged from hospital she decided to seek the assistance of healers and ‘traditional medicine’ men. These healers charge exorbitant amounts of money for prescribing herbs and unknown solutions. This young woman received a three-week supply of an herbal tincture for 18,000 SOM (US$350).

Her mother told me that she really wants to help her daughter and has agreed to buy her any medication or herbal infusion. The daughter has severe pain for which her mother gives Ketonal (acetaminophen). When I asked her, “Why don’t you give opioids to your daughter?”  She said she knows that her daughter will die, but the daughter believes that ‘only the dying’ receive morphine….

How I can help this weeping, traumatised mother who will lose her child?

Here are the problems we face in our country:

Kyrgyzstan

Kyrgyzstan: A landlocked Central Asian state bordering China, Kazakhstan, Uzbekistan and Tajikistan

  • Information about the role of pain medication needs to be clarified among citizens and professionals alike.
  • There are many bureaucratic barriers to obtaining opioids. (If you live in the village, you have to go into town to find a doctor who will prescribe only a limited number of vials of medication. Then the patient must find a pharmacy to buy these medications. Even then, only injectable drugs are available; there are no oral forms of opioids.)
  • There is no support for the patient and family members at a time when they have difficulties, depression and are in a state of shock.
  • There are no specialists trained in providing palliative care.
  • There are limited hospice and palliative care beds.
  • When patients and family members do not receive help from medical professionals, they go to the scams and the charlatans who exhaust the dying patient and family of their small savings.

But changes are under way in Kyrgyzstan as dedicated clinicians strive to provide comfort for the dying. Governmental and non-governmental groups are working to open the doors to improved training for professionals, opioid access, models of care, and increased awareness of the need for palliative care. The barriers still exist, but hopefully comfort for the dying will be a reality in the near future.

Read the longer article in the March/April issue of the European Journal of Palliative Care

Read the longer article in the March/April issue of the European Journal of Palliative Care

To read a copy of the full article…
This blog post relates to a longer article, Access to palliative care and pain medication in Kyrgyzstan by Guljahan Pirnazarova and Jane Schlickau, published in the March/April 2014 issue of the European Journal of Palliative Care (vol. 21.2).  If you already have a web-based subscription to the European Journal of Palliative Care you will be able to download this issue, plus all articles in the journal archive. You can also browse the archive and download articles by taking a 10-minute or 30-minute subscription. Members of the EAPC receive discounted subscription rates to the journal – click here to subscribe online. 

 

Posted in European Journal of Palliative Care, National and international events, Opioid access, Publications | Tagged , | Leave a comment

Member awareness of the EAPC Framework on palliative sedation

Dr Ebun Abarshi, an experienced researcher on the EUROIMPACT Project, provides the background to an internet-based survey that is reported in the March/April issue of the European Journal of Palliative Care.

Dr Ebun Abarshi

Dr Ebun Abarshi

Symptom management at the end of life can be very challenging both for patients and practitioners. Palliative sedation is a ‘last resort’ treatment option that can be used in selected cases of unbearable and refractory suffering. There have been a lot of debates about the correctness of this practice. In 2009, a European Association for Palliative Care (EAPC) White Paper recommended a framework for the use of sedation in palliative care to address widespread concerns. A lot of work went into the preparation of this paper especially since it addressed a topical issue that cut across cultures, professional expertise and international boundaries.

There is some evidence that formulating guidelines on issues that are unclear such as these, can help to underscore important and appropriate treatment policies; increasing awareness and encouraging adherence to proven methods, thereby improving practice. The EAPC has demonstrated that it values the dissemination of this White Paper by encouraging its translation into other languages, e.g. German and Romanian.

How did we ascertain members’ awareness of this White Paper?
In August 2012, I conducted an Internet survey; I emailed questionnaires to individual and collective members of the EAPC, asking if they were aware of the EAPC’s recommended framework for palliative sedation. I also asked them about their own institutional or national guidelines on the same subject, and solicited copies of these. I reckoned that if these members were ‘aware’ of the White Paper, it was likely they had read the White Paper and were at least familiar with its recommendations.

What did the survey tell us?
Almost 100 members from 37 nations responded to our survey: physicians, nurses, researchers, pharmacists, and psycho-spiritual care providers (see Figure 1). Over two-thirds of them were aware of the White Paper: 18% and 58% reported their country had and had not adopted the White Paper for use respectively, while 24% did not know if that had been the case.

Figure 1.ebun chart

Was the survey beneficial?
The survey provided fresh information on member awareness of an EAPC White Paper, and useful feedback on the practice of palliative sedation from end users. Besides, members submitted their own guidelines and /or referred me to their palliative care national representatives. This was especially useful because I conducted a study appraising existing guidelines on palliative sedation – many of which were not listed on any website or database.

Unfortunately, it was difficult to know the exact number of members who did /did not receive my questionnaire (or reminder). Despite advances in information technology, I could not tell how many questionnaires were lost in transit or landed in spam boxes! I observed that several members were aware of this White Paper and the ongoing debates on the use of palliative sedation and therefore my survey served as a useful pilot study for doing further research. However, I think that there is some room for improving awareness, especially among non-clinicians and policy makers.

Read the longer article in the March/April issue of the European Journal of Palliative Care

Read the longer article in the March/April issue of the European Journal of Palliative Care

Download a free copy of the longer article from the EAPC website
This post relates to a longer article, ‘Awareness of the EAPC’s recommended framework for the use of sedation in palliative care: an internet-based survey’ by Ebun Abarshi and Sheila Payne, published in the March/April 2014 issue of the European Journal of Palliative Care (vol. 21.2). You can download a copy of the article here

If you already have a web-based subscription to the European Journal of Palliative Care you will be able to download this issue, plus all articles in the EJPC archive.You can also browse the archive and download articles by taking a 10-minute or 30-minute subscription.

DID YOU KNOW THAT YOU CAN NOW DOWNLOAD COPIES OF EAPC DOCUMENTS IN 23 OTHER LANGUAGES? Click here to find out more…

Posted in EAPC guidelines and recommendations, European Journal of Palliative Care, Publications | Tagged , | 1 Comment