BackgroundHospital admissions are common in the last phase of life. However, palliative care and advance care planning (ACP) are provided late or not at all during hospital admission.AimTo provide insight into the perceptions of in-hospital healthcare professionals concerning current and ideal practice and roles of in-hospital palliative care and advance care planning.MethodsAn electronic cross-sectional survey was send 398 in-hospital healthcare professionals in five hospitals in the Netherlands. The survey contained 48 items on perceptions of palliative care and ACP.ResultsWe included non-specialists who completed the questions of interest, resulting in analysis of 96 questionnaires. Most respondents were nurses (74%). We found that current practice for initiating palliative care and ACP was different to what is considered ideal practice. Ideally, ACP should be initiated for almost every patient for whom no treatment options are available (96.2%), and in case of progression and severe symptoms (94.2%). The largest differences between current and ideal practice were found for patients with functional decline (Current 15.2% versus Ideal 78.5%), and patients with an estimated life expectancy <1 year (Current 32.6% versus ideal 86.1%). Respondents noted that providing palliative care requires collaboration, however, especially nurses noted barriers like a lack of inter-professional consensus.ConclusionsThe differences between current and ideal practice demonstrate that healthcare professionals are willing to improve palliative care. To do this, nurses need to increase their voice, a shared vision of palliative care and recognition of the added value of working together is needed.
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At a time when the population is ageing and most people choose to live in their own home for as long as possible, it is important to consider various aspects of supportive and comfortable environments for housing. This study, conducted in South Australia, aims to provide information about the links between the type of housing in which older people live, the weather and occupants’ heating and cooling behaviours as well as their health and well-being. The study used a Computer-Assisted Telephone Interviewing (CATI) system to survey 250 people aged 65 years and over who lived in their own home. The respondents were recruited from three regions representing the three climate zones in South Australia: semi-arid, warm temperate and temperate. The results show that while the majority of respondents reported being in good health, many lived in dwellings with minimal shading and no wall insulation and appeared to rely on the use of heaters and coolers to achieve thermally comfortable conditions. Concerns over the cost of heating and cooling were shared among the majority of respondents and particularly among people with low incomes. Findings from this study highlight the importance of providing information to older people, carers, designers and policy makers about the interrelationships between weather, housing design, heating and cooling behaviours, thermal comfort, energy use and health and well-being, in order to support older people to age in place independently and healthily. https://doi.org/10.1016/j.buildenv.2019.03.023 LinkedIn: https://www.linkedin.com/in/jvhoof1980/
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