Tuesday, July 18, 2006
NICE guidelines, bereavement and information.
Some abstracts from the 6th Palliative Care Congress in Sheffield 5-7th April 2006
Payne S, Reid D, Field D, Relf M
Adult hospice bereavement support: “NICE ” or not quite “NICE” yet?
Palliative Medicine 2006 v20 no2 p141
NICE guidance on palliative and supportive care recommends a three tier model of bereavement support. This paper explores the extent to which five hospice services in the UK fulfil these criteria. Qualitative data was collected and analysed using a variety of methods, mainly with hospice staff and bereaved services users. The total sample involved 301 people.
All the services appeared to provide NICE Level 1 services, including pre-death family care by nurses and other staff. All services provided a mixture of social and therapeutic activities at NICE Level 2 which bereaved people had a choice to take up. However, there was little evidence of NICE Level 3 provision for those with complex needs and access to external services was not readily available.
It appears that these hospice bereavement services were fulfilling Levels 1 and 2 but do not have the capacity to provide Level 3 support.
Another presentation was not explicit about adhering to the NICE guidelines. Chowns G, Bassey S, Jones A “It’s the truth, so keep it in”: researching collaboratively with children of seriously ill parents . (Palliative Medicine v20 no 2 p133-4). The findings indicated that children wanted to know the truth about parental illness, but wanted to be told earlier rather than later. Factual information was also prized. Thus this would appear to be providing the Level 1 tier on bereavement service provision of the NICE guidelines. It has a link with both the previous and following abstract.
McNulty A
Is the NICE guidance on bereavement support setting the bar too low?
Palliative Medicine 2006 v20 no2 p152-3
This forms part of a larger study on comparing bereavement support after home or hospice death. This study looks at Level 1 - that of information provision - of the 3 tier model for bereavement service provision in the NICE guidance, it being the minimal objective of all supportive and palliative care providers. There are various strands to the study. However, 5 focus groups (number 20 people ) revealed complex information needs including the pattern of grief, funeral arrangements and benefits advice. Written information was supportive. However, participants greatly valued personal contact as a source of information. This included discussions with staff involved in patient care through to sharing experiences with others. Conversely poor/absent information resulted in stress and anxiety.
The conclusion emphasised that information is one of the immediate and wide ranging needs for the bereaved. Nevertheless provision differs across services. Hospices appear consistently to offer information, yet written information is impersonal, compared to verbal contact. However, both service types offered far more than this single intervention. For this reason, the NICE guidance is a step in the right direction, but has the potential to develop further.
Reference: Chapter 12 in http://www.nice.org.uk/page.aspx?o=csgspfullguideline
Payne S, Reid D, Field D, Relf M
Adult hospice bereavement support: “NICE ” or not quite “NICE” yet?
Palliative Medicine 2006 v20 no2 p141
NICE guidance on palliative and supportive care recommends a three tier model of bereavement support. This paper explores the extent to which five hospice services in the UK fulfil these criteria. Qualitative data was collected and analysed using a variety of methods, mainly with hospice staff and bereaved services users. The total sample involved 301 people.
All the services appeared to provide NICE Level 1 services, including pre-death family care by nurses and other staff. All services provided a mixture of social and therapeutic activities at NICE Level 2 which bereaved people had a choice to take up. However, there was little evidence of NICE Level 3 provision for those with complex needs and access to external services was not readily available.
It appears that these hospice bereavement services were fulfilling Levels 1 and 2 but do not have the capacity to provide Level 3 support.
Another presentation was not explicit about adhering to the NICE guidelines. Chowns G, Bassey S, Jones A “It’s the truth, so keep it in”: researching collaboratively with children of seriously ill parents . (Palliative Medicine v20 no 2 p133-4). The findings indicated that children wanted to know the truth about parental illness, but wanted to be told earlier rather than later. Factual information was also prized. Thus this would appear to be providing the Level 1 tier on bereavement service provision of the NICE guidelines. It has a link with both the previous and following abstract.
McNulty A
Is the NICE guidance on bereavement support setting the bar too low?
Palliative Medicine 2006 v20 no2 p152-3
This forms part of a larger study on comparing bereavement support after home or hospice death. This study looks at Level 1 - that of information provision - of the 3 tier model for bereavement service provision in the NICE guidance, it being the minimal objective of all supportive and palliative care providers. There are various strands to the study. However, 5 focus groups (number 20 people ) revealed complex information needs including the pattern of grief, funeral arrangements and benefits advice. Written information was supportive. However, participants greatly valued personal contact as a source of information. This included discussions with staff involved in patient care through to sharing experiences with others. Conversely poor/absent information resulted in stress and anxiety.
The conclusion emphasised that information is one of the immediate and wide ranging needs for the bereaved. Nevertheless provision differs across services. Hospices appear consistently to offer information, yet written information is impersonal, compared to verbal contact. However, both service types offered far more than this single intervention. For this reason, the NICE guidance is a step in the right direction, but has the potential to develop further.
Reference: Chapter 12 in http://www.nice.org.uk/page.aspx?o=csgspfullguideline
