Forensic nursing and the palliative approach to care: an empirical nursing ethics analysis

Wright, David; Vanderspank‐Wright, Brandi; Holmes, Dave; Skinner, Elise

doi:10.12968/ijpn.2017.23.8.378

Cited by 5 publications

(4 citation statements)

References 13 publications

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“…Alienation from friends and family members places people with SPMI at a disadvantage in palliative care settings that rely on lay caregivers, such as community-based hospice care (Baker, 2005; Craun et al, 1997). Special populations, such as those who are homeless or incarcerated, are reported to experience additional complexities from systems that are not prepared to care for them (Baker, 2005; Wright et al, 2017). According to Baker's (2005) literature review, follow-up and continuity of care are particularly challenging for people with SPMI who are homeless, and those suffering from SPMI and terminal illness who are incarcerated are increasingly vulnerable to the harsh environment founds in prisons, where adequate pain and symptom management is often not provided.…”

Section: Resultsmentioning

confidence: 99%

“…Mental health and palliative care are divided by siloing, yet share many similarities in treatment philosophy and approaches to caring (McGrath & Holewa, 2004; Terpstra & Terpstra, 2012; Wright et al, 2017). Both mental health and palliative care are person-centered (McGrath & Holewa, 2004; Wright et al, 2017), focused on the therapeutic relationship (Baker, 2005; McGrath & Holewa, 2004; Picot et al, 2015; Sweers et al, 2013), share hope for a good outcome regardless of prognosis (Wright et al, 2017), and are centered on compassionate and holistic care (McGrath & Holewa, 2004; Picot et al, 2015). Respect for autonomy is important in both mental health and a palliative care (McGrath & Holewa, 2004; Webber, 2012) as is concern for quality of life as defined by the person receiving care (Griffith, 2007a; McGrath & Holewa, 2004).…”

Section: Resultsmentioning

confidence: 99%

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A scoping review of palliative care for persons with severe persistent mental illness

Donald

Stajduhar

2019

Pall Supp Care

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ObjectivePeople with severe persistent mental illness (SPMI) experience a greater burden and severity of chronic disease, late diagnosis, and premature death compared with the general population. Those with SPMI also receive fewer medical treatments, poor quality of care, and are less likely to receive palliative care. A systematic scoping review was undertaken to determine the extent, range, and nature of research activity about people with SPMI requiring palliative care, and to identify gaps and opportunities for future research.MethodA systematic scoping review was undertaken in September 2017 and updated in May 2018 to map literature on this topic, determine the extent and range of what has been published, and report the findings. This five-stage framework was conducted by (1) identifying the research question; (2) identifying relevant studies; (3) determining study selection; (4) charting the data; and 5) collating, summarizing, and reporting the results. A narrative approach to analysis was used to synthesize and interpret findings. A search of multidisciplinary healthcare databases resulted in 46 included articles.ResultFour major themes were identified from the included studies: complexity of care; limited access to care (both through systems and healthcare providers); competence and autonomy; and the potential for relationships between mental health and palliative care.Significance of resultsThis review reveals a highly vulnerable population with complex needs that are not reliably being met by the healthcare system and providers. Research in this area must continue to develop using rigorous qualitative and quantitative study designs, and interventions should be developed and tested based on existing knowledge to inform care. The voices of people with SPMI in need of palliative care must be represented in future studies to address gaps. To expand a body of literature addressing mainly individuals, system perspectives and sociocultural analysis can bring much to contextualizing the experience of living with SPMI in the palliative phase of care. Adoption of a palliative approach, which promotes the principles of palliative care across nonspecialized care settings provided by nonspecialist palliative providers, has the potential to increase access to high-quality palliative treatment for people with SPMI.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A scoping review of palliative care for persons with severe persistent mental illness

Donald

Stajduhar

2019

Pall Supp Care

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“…As part of the interviews, participants were asked to describe a typical day as a nurse on their unit, to speak to the overall role of nursing in this environment, to elaborate on the nurse–patient relationship, and to reflect on their vision of “ideal” nursing care. Findings from a subset of these interviews (forensic nurses only), as well as further detail about the methods employed in our study, are reported elsewhere (Wright et al, 2017). Our focus is to elucidate how nurses in forensic and geriatric psychiatry engage values that underpin the palliative approach in the care of aging patients.…”

Section: Methodsmentioning

confidence: 99%

Ethics of Finitude: Nursing and the Palliative Approach in Geriatric and Forensic Psychiatry

Skinner

Jacob

Vanderspank‐Wright

et al. 2020

Global Qualitative Nursing Research

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There is a called-for shift to an upstream provision of palliative care as an overall care approach within a health equity perspective. Our research explored how nurses in psychiatry engage with aging patients and mortality to discern enactment of ethical dimensions of care. Drawing from tenets of interpretative phenomenological analysis, forensic and geriatric psychiatry registered nurses working at a mental health facility in eastern Ontario completed interviews for analysis. Nurses engaged with mortality through a process of recognition and through the affirmation of their values. The affirmed values are aligned with the palliative care approach and within an ethics of finitude lens in that their enactment is partly premised on the recognition of patients’ accumulated losses related to human facticities (social, temporal, mortal). This research underscores preliminary insights on a process identifying care practices aligned with the palliative approach and possibilities for expanding upon an ethics of finitude lens.

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“…Forensic mental health services provide care for people with serious mental illness (service users) who are detained through the criminal justice system (Hörberg, 2018). There has been a rise internationally in the number of people who are incarcerated and, subsequently, the number of forensic mental health inpatients who are dying in secure facilities (Turner et al, 2018; Wright et al, 2017). Similar to other western countries, Aotearoa, New Zealand has seen an increase in incarcerated persons: over 10,000 in 2017 compared with over 5,000 in 2000 (Department of Corrections Policy and Legislation, 2017).…”

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confidence: 99%

Forensic Mental Health Care Staff Experiences of Providing Palliative Care

Matthew¹,

Collier

McKenna³

2022

Journal of Forensic Nursing

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Background There is a steady increase in the number of people dying within the walls of forensic institutions across the world. This escalation is, to a large extent, because of an aging population. There is a need to explore how palliative care can be delivered in these settings where, historically, security has been the main focus. Objective The aims of this study were to explore staff experiences of providing palliative care in a forensic mental health unit and to establish the subjective significance of those experiences. Method A qualitative, descriptive, case study approach was used. This study examined staff perspectives of provision of palliative care to a long-term service user who had been diagnosed with a life-limiting illness and who subsequently died. Interviews were analyzed using codebook thematic analysis. Results There were nine in-depth interviews with staff who were involved in the service user's care. Analysis resulted in five main themes: intrinsic dignity, “It was out of our depth,” “It's just the way these places are,” “Hospital was the practical place,” and specialist services. Conclusion If equitable access to palliative care is a human right, then it is essential that individuals in secure care with mental illness are able to access palliative care services that are responsive to their needs. Forensic mental health services need to be proactively prepared for the inevitability that people will die in their care.

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Forensic nursing and the palliative approach to care: an empirical nursing ethics analysis

Cited by 5 publications

References 13 publications

A scoping review of palliative care for persons with severe persistent mental illness

A scoping review of palliative care for persons with severe persistent mental illness

Ethics of Finitude: Nursing and the Palliative Approach in Geriatric and Forensic Psychiatry

Forensic Mental Health Care Staff Experiences of Providing Palliative Care

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