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Source
J Palliat Care. 2010;26(1):5
Publication Type
Article
Date
2010

An integrative framework for conducting palliative care research with First Nations communities.

https://arctichealth.org/en/permalink/ahliterature144141
Source
J Palliat Care. 2010;26(1):47-53
Publication Type
Article
Date
2010
Author
Holly Prince
Mary Lou Kelley
Author Affiliation
Centre for Education and Research on Aging and Health, and School of Social Work, Lakehead University, 955 Oliver Road, Thunder Bay, Ontario, Canada P7B 5E1. hprince@lakeheadu.ca
Source
J Palliat Care. 2010;26(1):47-53
Date
2010
Language
English
Publication Type
Article
Keywords
Community-Based Participatory Research
Community-Institutional Relations
Cultural Competency
Ethics, Research
Health Services, Indigenous - organization & administration
Humans
Indians, North American
Ontario
Palliative Care - organization & administration
Program Development
Notes
Erratum In: J Palliat Care. 2011 Autumn;27(3):preceding 187
PubMed ID
20402186 View in PubMed
Less detail

Barriers to providing palliative care in long-term care facilities.

https://arctichealth.org/en/permalink/ahliterature164918
Source
Can Fam Physician. 2006 Apr;52:472-3
Publication Type
Article
Date
Apr-2006
Author
Kevin Brazil
Michel Bédard
Paul Krueger
Alan Taniguchi
Mary Lou Kelley
Carrie McAiney
Christopher Justice
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada. brazilk@mcmaster.ca
Source
Can Fam Physician. 2006 Apr;52:472-3
Date
Apr-2006
Language
English
Publication Type
Article
Keywords
Clinical Competence - statistics & numerical data
Cross-Sectional Studies
Education, Medical, Continuing - statistics & numerical data
Female
Health Care Surveys
Health Facility Environment - statistics & numerical data
Health Knowledge, Attitudes, Practice
Health Manpower
Humans
Long-Term Care - organization & administration - statistics & numerical data
Male
Ontario
Palliative Care - organization & administration - statistics & numerical data
Physician Executives - statistics & numerical data
Principal Component Analysis
Professional Practice - statistics & numerical data
Residential Facilities - organization & administration - statistics & numerical data
Abstract
To assess challenges in providing palliative care in long-term care (LTC) facilities from the perspective of medical directors.
Cross-sectional mailed survey. A questionnaire was developed, reviewed, pilot-tested, and sent to 450 medical directors representing 531 LTC facilities. Responses were rated on 2 different 5-point scales. Descriptive analyses were conducted on all responses.
All licensed LTC facilities in Ontario with designated medical directors.
Medical directors in the facilities.
Demographic and practice characteristics of physicians and facilities, importance of potential barriers to providing palliative care, strategies that could be helpful in providing palliative care, and the kind of training in palliative care respondents had received.
Two hundred seventy-five medical directors (61%) representing 302 LTC facilities (57%) responded to the survey. Potential barriers to providing palliative care were clustered into 3 groups: facility staff's capacity to provide palliative care, education and support, and the need for external resources. Two thirds of respondents (67.1%) reported that inadequate staffing in their facilities was an important barrier to providing palliative care. Other barriers included inadequate financial reimbursement from the Ontario Health Insurance Program (58.5%), the heavy time commitment required (47.3%), and the lack of equipment in facilities (42.5%). No statistically significant relationship was found between geographic location or profit status of facilities and barriers to providing palliative care. Strategies respondents would use to improve provision of palliative care included continuing medical education (80.0%), protocols for assessing and monitoring pain (77.7%), finding ways to increase financial reimbursement for managing palliative care residents (72.1%), providing educational material for facility staff (70.7%), and providing practice guidelines related to assessing and managing palliative care patients (67.8%).
Medical directors in our study reported that their LTC facilities were inadequately staffed and lacked equipment. The study also highlighted the specialized role of medical directors, who identified continuing medical education as a key strategy for improving provision of palliative care.
Notes
Cites: J Palliat Care. 1997 Autumn;13(3):13-79354036
Cites: Clin Geriatr Med. 2004 Nov;20(4):717-34, vii15541622
Cites: J Palliat Med. 2003 Apr;6(2):293-612854949
Cites: J Am Med Dir Assoc. 2003 May-Jun;4(3):145-5112854988
Cites: J Am Med Dir Assoc. 2004 Mar-Apr;5(2):114-2214984624
Cites: J Am Med Dir Assoc. 2004 May-Jun;5(3):147-5515115574
Cites: J Am Med Dir Assoc. 2004 May-Jun;5(3):197-20615115582
Cites: J Palliat Med. 2004 Aug;7(4):533-4415353097
Cites: J Am Geriatr Soc. 1993 May;41(5):541-48486889
Cites: Clin Geriatr Med. 1995 Aug;11(3):343-587585383
Cites: Clin Geriatr Med. 1995 Aug;11(3):531-457585395
Cites: Am J Hosp Palliat Care. 1999 Jul-Aug;16(4):573-8210661065
Cites: Gerontologist. 2000 Feb;40(1):5-1610750309
Cites: Clin Geriatr Med. 2000 May;16(2):225-3710783426
Cites: J Palliat Med. 2001 Spring;4(1):9-1311291400
Cites: JAMA. 2001 Apr 25;285(16):208111311096
Cites: Gerontologist. 2001 Apr;41(2):153-6011327480
Cites: Med Health R I. 2001 Jun;84(6):195-811434148
Cites: J Palliat Med. 2002 Feb;5(1):117-2511839234
Cites: Gerontologist. 2003 Apr;43(2):259-7112677083
Cites: J Am Med Dir Assoc. 2003 Jul-Aug;4(4):231-4312837146
PubMed ID
17327890 View in PubMed
Less detail

Building capacity to provide palliative care in rural and remote communities: does education make a difference?

https://arctichealth.org/en/permalink/ahliterature176323
Source
J Palliat Care. 2004;20(4):308-15
Publication Type
Article
Date
2004
Author
Mary Lou Kelley
Sonja Habjan
Joanna Aegard
Author Affiliation
Northern Educational Centre for Aging and Health, Lakehead University, Thunder Bay, Ontario, Canada.
Source
J Palliat Care. 2004;20(4):308-15
Date
2004
Language
English
Publication Type
Article
Keywords
Analysis of Variance
Attitude of Health Personnel
Clinical Competence - standards
Curriculum
Education, Continuing - organization & administration
Health Knowledge, Attitudes, Practice
Health Personnel - education - psychology
Humans
Medically underserved area
Models, Educational
Needs Assessment - organization & administration
Ontario
Organizational Objectives
Palliative Care - organization & administration
Patient Care Team - organization & administration
Program Development
Program Evaluation
Questionnaires
Rural health services - organization & administration
Self Efficacy
Total Quality Management - organization & administration
Abstract
One strategy for improving access to palliative care services in rural and remote communities is to educate community-based health professionals in the knowledge and skills required to provide end-of-life care. It is, therefore, important to evaluate palliative care educational initiatives. This article provides an evaluation of the interdisciplinary education program at Lakehead University which aims to: improve the knowledge and skills of individual providers; contribute to the development of palliative care programs in rural communities; and develop palliative care trainers to educate their co-workers in the workplace. A survey of 353 providers who participated in the education program was completed after eight years of providing education. Results confirm that the goals of the education program were met, and that rural and remote communities reported a greater capacity to deliver palliative care. Nevertheless, respondents identified a lack of resources, especially home care visits, as an obstacle to improving care.
PubMed ID
15690834 View in PubMed
Less detail

Caregiving for elders in first nations communities: social system perspective on barriers and challenges.

https://arctichealth.org/en/permalink/ahliterature124245
Source
Can J Aging. 2012 Jun;31(2):209-22
Publication Type
Article
Date
Jun-2012
Author
Sonja Habjan
Holly Prince
Mary Lou Kelley
Author Affiliation
Lakehead University, Thunder Bay, ON, Canada.
Source
Can J Aging. 2012 Jun;31(2):209-22
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Aging
Caregivers - supply & distribution
Data Collection
Focus Groups
Health Services Accessibility
Health Services, Indigenous - supply & distribution
Humans
Indians, North American
Ontario
Public Policy
Residence Characteristics
Social Support
Abstract
This research examined the perspectives and experiences of First Nations community members regarding health and social support for elderly people living in 13 First Nations communities in northwestern Ontario. Surveys (n = 216) and focus groups (n = 70) were conducted in 2005 and 2006 with elderly Aboriginal people and their formal and informal caregivers. Results indicated a strong preference (69%) for helping people to age and die at home; however, barriers and challenges existed at the family, community, health system, and social policy levels. Barriers included a lack of family caregivers and shortage of health care providers and programs; changing community values; and limited access to provincial health services and culturally relevant and safe care, all of which hindered social policy and community empowerment. Enabling elderly people to age within First Nations communities will require multi-level and multi-sectoral system changes.
PubMed ID
22608239 View in PubMed
Less detail

Care provider perspectives on end-of-life care in long-term-care homes: implications for whole-person and palliative care.

https://arctichealth.org/en/permalink/ahliterature141476
Source
J Palliat Care. 2010;26(2):122-9
Publication Type
Article
Date
2010
Author
Joanie Sims-Gould
Elaine Wiersma
Lise Arseneau
Mary Lou Kelley
Jean Kozak
Sonja Habjan
Michael MacLean
Author Affiliation
Department of Family Practice, Faculty of Medicine, Centre for Hip Health and Mobility, University of British Columbia, 315-2647 Willow Street, Vancouver, BC V5Z 1M9. simsg@interchange.ubc.ca
Source
J Palliat Care. 2010;26(2):122-9
Date
2010
Language
English
Publication Type
Article
Keywords
Aged
Anthropology, Cultural
Attitude of Health Personnel
Attitude to Health
Dementia - therapy
Holistic Nursing
Homes for the Aged
Humans
Long-Term Care
Nursing Homes
Ontario
Palliative Care
Professional-Patient Relations
Terminal Care
Workload
Abstract
This study holistically explores the experience of dying and end-of-life care for older persons with dementia in long-term care (LTC) from the perspective of care providers. Using a focused ethnography methodology, seven researchers interviewed LTC staff, residents' families, volunteers, management staff, and spiritual advisers/clergy over a five-day period. Research was guided by two key questions: What is the dying experience of people living in LTC from the perspective of different care providers? and, What are the salient issues in providing palliative care for elderly people dying in LTC? Based on a thematic analysis of verbatim data, three common themes were identified: tension between completing job tasks on time and "being there" for residents; the importance of family-like bonds between front-line staff and residents; and the importance of communication among staff and between staff and residents and their families at the end of life. Findings are discussed in relation to their implications for policies and practices that can support whole-person care and ultimately a good death for residents of LTC facilities.
PubMed ID
20718397 View in PubMed
Less detail

Creating social work competencies for practice in hospice palliative care.

https://arctichealth.org/en/permalink/ahliterature147832
Source
Palliat Med. 2010 Jan;24(1):79-87
Publication Type
Article
Date
Jan-2010
Author
Harvey Bosma
Meaghen Johnston
Susan Cadell
Wendy Wainwright
Ngaire Abernethy
Andrew Feron
Mary Lou Kelley
Fred Nelson
Author Affiliation
School of Social Work, University of British Columbia, Vancouver, BC, Canada. bosmah@shaw.ca
Source
Palliat Med. 2010 Jan;24(1):79-87
Date
Jan-2010
Language
English
Publication Type
Article
Keywords
Adult
Canada
Child
Clinical Competence
Delphi Technique
Educational Measurement - standards
Health Knowledge, Attitudes, Practice
Hospice Care
Humans
Interprofessional Relations
Palliative Care
Professional Role
Social Work - education
Abstract
Social workers play an important role in the delivery of Hospice Palliative Care in many diverse settings. The profession brings a unique perspective to end-of-life care that reflects and supports the holistic philosophy of Hospice Palliative Care. Despite the prominent and longstanding position of social work in this area, the role and functions of social workers had not been clearly defined. A Canadian task group of social work practitioners and educators utilized a modified Delphi process to consult front line clinicians nationally, and thereby achieved consensus regarding the identification and description of eleven core competencies in Hospice Palliative Care. These competencies are relevant for social workers at different experience levels across care settings. They can be used to inform social work practice, as well as professional development and educational curricula in this area.
PubMed ID
19843621 View in PubMed
Less detail

Defining and measuring a palliative approach in primary care.

https://arctichealth.org/en/permalink/ahliterature106146
Source
Can Fam Physician. 2013 Nov;59(11):1149-50
Publication Type
Article
Date
Nov-2013
Author
Joshua D Shadd
Fred Burge
Kelli I Stajduhar
S Robin Cohen
Mary Lou Kelley
Barbara Pesut
Author Affiliation
Centre for Studies in Family Medicine, Western Centre for Public Health and Family Medicine, London, ON N6A 3K7. joshua.shadd@schulich.uwo.ca.
Source
Can Fam Physician. 2013 Nov;59(11):1149-50
Date
Nov-2013
Language
English
Publication Type
Article
Keywords
Canada
Humans
Palliative Care - methods - organization & administration
Primary Health Care - methods - organization & administration
Notes
Cites: J Palliat Care. 2006 Summer;22(2):115-617265665
Cites: Palliat Med. 2002 Nov;16(6):457-6412465692
Cites: CMAJ. 2012 Sep 4;184(12):E643-422847965
Cites: Palliat Med. 2007 Jul;21(5):409-1517901100
Cites: Can Fam Physician. 2001 Oct;47:2009-12, 2015-611723595
PubMed ID
24235182 View in PubMed
Less detail

Developing palliative care programs in Indigenous communities using participatory action research: a Canadian application of the public health approach to palliative care.

https://arctichealth.org/en/permalink/ahliterature291803
Source
Ann Palliat Med. 2018 Apr; 7(Suppl 2):S52-S72
Publication Type
Journal Article
Date
Apr-2018
Author
Mary Lou Kelley
Holly Prince
Shevaun Nadin
Kevin Brazil
Maxine Crow
Gaye Hanson
Luanne Maki
Lori Monture
Christopher J Mushquash
Valerie O'Brien
Jeroline Smith
Author Affiliation
School of Social Work, Centre for Education and Research on Aging & Health, Lakehead University, Thunder Bay, Ontario, Canada. mlkelley@lakeheadu.ca.
Source
Ann Palliat Med. 2018 Apr; 7(Suppl 2):S52-S72
Date
Apr-2018
Language
English
Publication Type
Journal Article
Abstract
The Indigenous people of Canada include First Nations, Inuit and Metis. This research focused on four diverse First Nations communities located in Ontario and Manitoba. First Nations communities have well-established culturally-based social processes for supporting their community members experiencing dying, loss, grief and bereavement. However, communities do not have formalized local palliative care (PC) programs and have limited access to medical services, especially pain and symptom management.
Researchers conducted participatory action research (PAR) in partnership with four First Nations communities to create local PC programs. A conceptual framework for community capacity development (Kelley model) and an integrative framework for PC research with First Nations communities guided the research over 6 years. Based on a community assessment, Elders and Knowledge Carriers, community leaders and First Nations health care providers created PC programs grounded in the unique social, spiritual and cultural practices of each community, and integrated them into local health services. Maintaining local control, community members engaged external health care organizations to address gaps in health services. Strategies such as journey mapping clarified roles and strengthened partnerships between community and external health care providers. Finally, community members advocated for needed funding, medication and equipment to provide palliative home care. The research team provided mentorship, facilitation, support, education and resources to the community leaders and documented and evaluated their capacity development process.
Our findings contribute to PC practice, policy and research. Four unique PC programs were created that offered First Nations people the choice to receive PC at home, supported by family, community and culture. A workbook of culturally relevant resources was developed for use by interested First Nations communities across Canada, including resources for program development, direct care, education, and engaging external partners. Policy recommendations and a policy framework to guide PC program development in First Nations communities were created. All research outcomes were published on a website and disseminated nationally and internationally. Our work also contributes to furthering discussions of research methods that can advance public health and PC initiatives. We demonstrated the achievements of PAR methods in strengthening community action, developing the personal skills of community health care providers and creating more supportive environments for First Nations people who wish to die at home. The Kelley model was adapted for use by First Nations communities. We also identified keys to success for capacity development.
This research provides a Canadian example of implementing a public health approach to PC in an Indigenous context using PAR. It provides evidence of the effectiveness of a community capacity development as a strategy and illustrates how to implement it. This approach, fully grounded in local culture and context, has potential to be adapted to Indigenous communities elsewhere in Canada and internationally.
PubMed ID
29764173 View in PubMed
Less detail

Developing palliative care programs in Indigenous communities using participatory action research: a Canadian application of the public health approach to palliative care.

https://arctichealth.org/en/permalink/ahliterature295136
Source
Ann Palliat Med. 2018 Apr; 7(Suppl 2):S52-S72
Publication Type
Journal Article
Date
Apr-2018
Author
Mary Lou Kelley
Holly Prince
Shevaun Nadin
Kevin Brazil
Maxine Crow
Gaye Hanson
Luanne Maki
Lori Monture
Christopher J Mushquash
Valerie O'Brien
Jeroline Smith
Author Affiliation
School of Social Work, Centre for Education and Research on Aging & Health, Lakehead University, Thunder Bay, Ontario, Canada. mlkelley@lakeheadu.ca.
Source
Ann Palliat Med. 2018 Apr; 7(Suppl 2):S52-S72
Date
Apr-2018
Language
English
Publication Type
Journal Article
Keywords
Canada
Community Health Services - organization & administration
Health Services, Indigenous - organization & administration
Humans
Palliative Care - organization & administration
Public Health
Abstract
The Indigenous people of Canada include First Nations, Inuit and Metis. This research focused on four diverse First Nations communities located in Ontario and Manitoba. First Nations communities have well-established culturally-based social processes for supporting their community members experiencing dying, loss, grief and bereavement. However, communities do not have formalized local palliative care (PC) programs and have limited access to medical services, especially pain and symptom management.
Researchers conducted participatory action research (PAR) in partnership with four First Nations communities to create local PC programs. A conceptual framework for community capacity development (Kelley model) and an integrative framework for PC research with First Nations communities guided the research over 6 years. Based on a community assessment, Elders and Knowledge Carriers, community leaders and First Nations health care providers created PC programs grounded in the unique social, spiritual and cultural practices of each community, and integrated them into local health services. Maintaining local control, community members engaged external health care organizations to address gaps in health services. Strategies such as journey mapping clarified roles and strengthened partnerships between community and external health care providers. Finally, community members advocated for needed funding, medication and equipment to provide palliative home care. The research team provided mentorship, facilitation, support, education and resources to the community leaders and documented and evaluated their capacity development process.
Our findings contribute to PC practice, policy and research. Four unique PC programs were created that offered First Nations people the choice to receive PC at home, supported by family, community and culture. A workbook of culturally relevant resources was developed for use by interested First Nations communities across Canada, including resources for program development, direct care, education, and engaging external partners. Policy recommendations and a policy framework to guide PC program development in First Nations communities were created. All research outcomes were published on a website and disseminated nationally and internationally. Our work also contributes to furthering discussions of research methods that can advance public health and PC initiatives. We demonstrated the achievements of PAR methods in strengthening community action, developing the personal skills of community health care providers and creating more supportive environments for First Nations people who wish to die at home. The Kelley model was adapted for use by First Nations communities. We also identified keys to success for capacity development.
This research provides a Canadian example of implementing a public health approach to PC in an Indigenous context using PAR. It provides evidence of the effectiveness of a community capacity development as a strategy and illustrates how to implement it. This approach, fully grounded in local culture and context, has potential to be adapted to Indigenous communities elsewhere in Canada and internationally.
PubMed ID
29764173 View in PubMed
Less detail

24 records – page 1 of 3.