A Qualitative Evaluation of the Provision of Bereavement Care Accessed by Service Users Living in a Health and Social Care Trust Area in Northern Ireland

Within the health and social care sector in the United Kingdom, the
management of death and bereavement has become increasingly
challenging. This service evaluation sought to explore the bereavement
care offered to individuals living in one Health and Social Care
Trust catchment area of Northern Ireland. Qualitative interviews
were conducted with key government and voluntary agency staff.
The findings indicated that much of the bereavement provision is
based on the interest and initiative of individual staff members, with
few processes to assess the level of bereavement care needed and those
best skilled to provide it. Recommendations are made for a bereavement
care strategy that outlines a bereavement needs assessment process,
identifying the scope of interventions and protocols for practice.

Bolivian health and social care professionals' experiences of decision-making in oncology and palliative care

In the UK, end-of-life care strategies recommend patients and families are involved in decision making around treatment and care. In Bolivia, such strategies do not exist, and access to oncology services depends on finance, geography, education and culture. Compared to more developed countries, the delivery of oncology services in Latin America may result in a higher percentage of patients presenting with advanced incurable disease. The objective of this study was to explore decision-making experiences of health and social care professionals who cared for oncology and palliative care patients attending the Instituto Oncológico Nacional, Cochabamba (Bolivia). Patients were predominantly from the Quechua tradition, which has its own ethnic diversity, linguistic distinctions and economic systems. Qualitative data were collected during focus groups. Data analysis was conducted using Interpretative Phenomenological Analysis. Three interrelated themes emerged: (i) making sense of structures of experience and relationality; (ii) frustration with the system; and (iii) the challenges of promoting shared decision making. The study uncovered participants' lived experiences, emotions and perceptions of providing care for Quechua patients. There was evidence of structural inequalities, the marginalisation of Quechua patients and areas of concern that social workers might well be equipped to respond to, such as accessing finances for treatment/care, education and alleviating psychological or spiritual suffering.

Service user perspectives on palliative care education for health and social care professionals supporting people with learning disabilities

Background and objectives
Evidence from European and American studies indicates limited referrals of people with learning (intellectual) disabilities to palliative care services. Although professionals’ perceptions of their training needs in this area have been studied, the perceptions of people with learning disabilities and family carers are not known. This study aimed to elicit the views of people with learning disabilities, and their family carers concerning palliative care, to inform healthcare professional education and training.

Methods
A qualitative, exploratory design was used. A total of 17 people with learning disabilities were recruited to two focus groups which took place within an advocacy network. Additionally, three family carers of someone with a learning disability, requiring palliative care, and two family carers who had been bereaved recently were also interviewed.

Results
Combined data identified the perceived learning needs for healthcare professionals. Three subthemes emerged: ‘information and preparation’, ‘provision of care’ and ‘family-centred care’.

Conclusions
This study shows that people with learning disabilities can have conversations about death and dying, and their preferred end-of-life care, but require information that they can understand. They also need to have people around familiar to them and with them. Healthcare professionals require skills and knowledge to effectively provide palliative care for people with learning disabilities and should also work in partnership with their family carers who have expertise from their long-term caring role. These findings have implications for educators and clinicians.

An evaluation of palliative care services for cancer patients in the Southern Health and Social Services Board of Northern Ireland.

An interview study of 55 lay carers of people who died from cancer in the Southern Board of Northern Ireland was undertaken using a combination of closed-format and open-ended questions. The aim of the study was to evaluate palliative care services delivered in the last six months of their lives to cancer patients who died either at home or in hospital. Two-thirds of the deaths (36) occurred in the domestic home, 45 of the deceased were admitted as hospital inpatients, and the great majority were in receipt of community nursing (53) and general practitioner (54) services. Open-ended questions were used to allow respondents to give their views about services in some detail and their views about good and bad aspects of services were sought. While they were generally satisfied with services specific areas of difficulty were identified in each aspect of care addressed by the study. The most favourable assessments were made of community nursing with the greatest number of negative comments being made about inpatient hospital care. Differing interests between some of those who were dying and their lay carers were found in two areas: the receipt of help from nonfamily members and the information that the deceased received about their terminal status.

Social Inequality and Social Policy outside the OECD

Almost all Latin American countries are still marked by extreme forms of social inequality – and to an extent, this seems to be the case regardless of national differences in the economic development model or the strength of democracy and the welfare state. Recent research highlights the fact that the heterogeneous labour markets in the region are a key source of inequality. At the same time, there is a strengthening of ‘exclusive’ social policy, which is located at the fault lines of the labour market and is constantly (re-)producing market-mediated disparities. In the last three decades, this type of social policy has even enjoyed democratic legitimacy. These dynamics challenge many of the assumptions guiding social policy and democratic theory, which often attempt to account for the specificities of the region by highlighting the purported flaws of certain policies. We suggest taking a different perspective: social policy in Latin American should not be grasped as a deficient or flawed type of social policy, but as a very successful relation of political domination. ‘Relational social analysis’ locates social policy in the ‘tension zone’ constituted by the requirements of economic reproduction, demands for democratic legitimacy and the relative autonomy of the state. From this vantage point, we will make the relation of domination in question accessible for empirical research. It seems particularly useful for this purpose to examine the recent shifts in the Latin American labour markets, which have undergone numerous reforms. We will examine which mechanisms, institutions and constellations of actors block or activate the potentials of redistribution inherent in such processes of political reform. This will enable us to explore the socio-political field of forces that has been perpetuating the social inequalities in Latin America for generations.

Health and social care. Level 2. BTEC First.

Recurso preparado para ayudar al alumno en el curso BTEC First, nivel 2 en salud y asistencia social. El programa de estudios BTEC ofrece una cualificación profesional o laboral. El contenido se divide en once unidades que proporcionan conocimientos específicos y habilidades para desarrollar este trabajo. Incluye actividades de evaluación en cada unidad que cubren todos los criterios de ésta para ofrecer a los estudiantes la oportunidad de practicar sus tareas y profundizar en el conocimiento y la comprensión de la materia.

Health and social care. Book 1. Level 3. BTEC National.

Recurso preparado para ayudar al alumno en el curso BTEC National, nivel 3 en salud y asistencia social. El programa BTEC, es un programa de estudios que permite obtener una cualificación profesional o laboral. Su contenido se divide en diez unidades, que abarcan temas como: el desarrollo de una comunicación eficaz en salud y asistencia social; igualdad, diversidad y derechos; perspectivas sociológicas y perspectivas psicológicas en salud y asistencia social; anatomía, fisiología y nutrición, y salud, protección y seguridad. Incluye actividades de evaluación en cada unidad que cubren todos los criterios de ésta para ofrecer a los estudiantes la oportunidad de practicar sus tareas y profundizar en el conocimiento y la comprensión de la materia.

Health and social care. Book 2. Level 3. BTEC National.

Recurso preparado para ayudar al alumno en el curso BTEC National, nivel 3 en salud y asistencia social. El programa BTEC, es un programa de estudios que permite obtener una cualificación profesional o laboral. Incluye las siguientes unidades: los valores y la planificación de la atención social; el cuidado de los niños y jóvenes; la protección de los adultos y la promoción de la independencia; salud pública; fisiología del balance de fluidos; desórdenes fisiológicos; aplicación de perspectivas sociológicas a la salud y asistencia social, y promoción de la educación sanitaria. Incluye actividades de evaluación en cada unidad que cubren todos los criterios de ésta para ofrecer a los estudiantes la oportunidad de practicar sus tareas y profundizar en el conocimiento y la comprensión de la materia.

Health and social care. Student book. Entry 3-level1.

Recurso preparado para ayudar al alumno en el curso BTEC, nivel 1 en salud y asistencia social. El programa BTEC, es un programa de estudios que permite obtener una cualificación profesional o laboral. Su contenido incluye las unidades: investigando los derechos y responsabilidades en el trabajo; la gestión de su salud en el trabajo; salud y necesidades de atención social; cuidado personal en atención sanitaria y social; actividades creativas para niños; experiencias de aprendizaje para niños y jóvenes; actividades creativas y de ocio para adultos en la atención sanitaria y social; promoción de una alimentación saludable; información a los adultos y niños en salud y asistencia social; oportunidades de trabajo y proyecto de grupo sobre salud y asistencia social.