The Cicely Saunders International PhD Training Fellowship Programme will contribute to the overall aims of the BuildCARE IARE study and help generate information to improve the access, rights and empowerment of people who need end-of-life and palliative care. There are two Cicely Saunders International PhD Training Fellows, and two Cicely Saunders International PhD Clinical Training Fellows. Details of their research interests are detailed below.
Clare Ellis-Smith joined the BuildCARE team as a Cicely Saunders International PhD Training Fellow in July 2012. Clare is currently developing an assessment tool to be used in care homes for people with dementia or cognitive impairment to aid care home staff to identify, assess and communicate symptoms and problems to GPs and community nurses. The study has three phases. The POS-DemA Version Two has been developed based on the results of the first two phases, which are now completed.
Cognitive interviews involving the POS-DemA have begun. It is proposed that this assessment tool will enable symptoms and problems to be identified and addressed for people with dementia or cognitive impairment living in care homes. Her study aims to improve the rights of, and access to palliative care, for those who traditionally have been neglected from such services.
Dr Barbara Daveson, Dr Catherine Evans and Professor Irene J Higginson.
A holistic assessment tool to improve the detection and management of problems and symptoms experienced by people with dementia in residential care homes: development and evaluation of utility in care
Dr. Mendwas Dzingina joined the BuildCARE team as a Cicely Saunders International PhD Training Fellow in August 2012. The aim of his study is to develop a preference-based measure of health-related quality of life (HRQoL) for use in economic evaluations of palliative care interventions.
He developed a function for mapping the 10-item Palliative Outcome Scale (POS) questionnaire to the EuroQol Group’s EQ-5D utility index. He then examined the comparability and performance of the POS to the EQ-5D. He is now entering the final phase of the PhD, which involves the development of a questionnaire for the valuation survey. This is the first valuation survey in palliative care patients. Once ethical approval for the questionnaire has been granted, he will conduct a valuation survey, and in turn will estimate a preference-based measure of health (with which Quality Adjusted Life Years – QALYs – can be calculated) from the POS. His study will aid in the provision of access to the most cost-effective services for patients and their families. He has had the followed paper accepted for publication:
Public Health and Palliative Care in 2015. Mendwas D. Dzingina, Irene J. Higginson. Clin Geriatr Med, Feb 20, 2015 http://dx.doi.org/10.1016/j.cger.2015.01.002 (article in press)
Dr Fliss Murtagh, Professor Paul McCrone and Professor Irene Higginson.
Development of a preference-based outcome measure for use in economic evaluations of palliative care services
Dr Lesley Henson joined the BuildCARE team as a Cicely Saunders International PhD Clinical Training Fellow in September 2012. Her study will provide an understanding of the factors associated with emergency department attendance by patients with advanced cancer towards the end of life. She is analysing data from the Office for National Statistics and Hospital Episode Statistics to develop an empirical model of how the factors interrelate. She is exploring specific aspects of this model using qualitative in-depth interviews with patients with advanced cancer and their carers.
This study is an important first stage in the future development of interventions aimed at supporting palliative care cancer patients in the community, as well as addressing current and future emergency department capacity issues. She has had the following paper published in the Journal of Clinical Oncology:
Emergency Department Attendance by Patients With Cancer in Their Last Month of Life: A Systematic Review and Meta-Analysis. Henson, L. A., Gao, W., Higginson, I. J., Smith, M., Davies, J. M., Ellis-Smith, C. & Daveson, B. A. Feb 2015 In : Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 33, 4, p. 370-376
Policy brief 'Palliative Care: part of the solution to the Accident & Emergency Crisis?
Dr Barbara Daveson, Dr Gao Wei and Professor Irene Higginson.
Emergency Department Attendance towards the End of Life by People with Cancer: A Mixed Methods Study
Dr. Pauline Kane joined the BuildCARE team as a Cicely Saunders International PhD Clinical Training Fellow in October 2012. Her study involves the development of an intervention to identify the palliative care symptoms and concerns experienced by patients with advanced heart failure. The intervention involves a patient reported outcome measure, the Integrated Palliative care Outcome Scale (IPOS) with integrated healthcare professional education and training. The intervention will be introduced into nurse-led heart failure clinics in two tertiary referral hospitals in Dublin, Ireland.
It is proposed that this intervention will improve patient-centred care for patients with advanced heart failure by enabling patients and healthcare professionals to participate in a process of shared decision making. This study will explore the feasibility of using the IPOS in this population with qualitative interviews with both the patients and healthcare professionals involved. She has had the following paper published in the Journal of Pain and Symptom Management:
Kane PM, Daveson BA, Ryan K, McQuillan R, Higginson IJ, Murtagh FE on behalf of BuildCARE. The Need for Palliative Care in Ireland: A Population-Based Estimate of Palliative Care Using Routine Mortality Data, Inclusive of Nonmalignant Conditions. J Pain Symptom Manage. 2015 Jan 26. [Epub ahead of print]
Dr Fliss Murtagh, Dr Barbara Daveson and Professor Irene Higginson.
A longitudinal study of the feasibility of a patient-reported outcome measure to improve the assessment and management of palliative symptoms and concerns in heart failure