Browsing by Author "Thorpe, Lilian"

Now showing 1 - 9 of 9

Open Access
Care considerations in a patient-and family-centered medical assistance in dying program
(SAGE Publications, 2020) Brown, Janine; Goodridge, Donna; Harrison, Averi; Kemp, Jordan; Thorpe, Lilian; Weiler, Robert
Medical Assistance in Dying (MAID) became legal in Canada in June 2016. As part of a project designed to improve end-of-life care for those requesting MAID, qualitative data from patients, families, and providers were used to assess opportunities to enhance patient-and family-centered care (PFCC) in this program.
Open Access
Completion of Medical Certificates of Death after an Assisted Death: An Environmental Scan of Practices
(Longwoods, 2018-11) Brown, Janine; Thorpe, Lilian; Goodridge, Donna
Policies and practices have been developed to operationalize assisted dying processes in Canada. This project utilized an environmental scan to determine the spectrum of assisted death reporting practices and medical certificate of death (MCD) completion procedures both nationally and internationally. Findings suggest medically assisted dying (MAiD) is represented on the MCD inconsistently nationally and internationally. Related factors include the specifics of local assisted death legislation and variations in death-reporting legislation, variation in terminology surrounding assisted death and designated oversight agency for assisted dying reporting.
Open Access
A controlled investigation of continuing pain education for long-term care staff
(Hindawi, 2013) Ghandehari, Omeed, O; Hadjistavropoulos, Thomas; Williams, Jaime; Thorpe, Lilian; Alfano, Dennis P.; Dal Bello-Haas, Vanina; Malloy, David C.; Martin, Ronald, R.; Rahaman, Omar; Zwakhale, Sandra, M.G.; Carleton, R. Nicholas; Hunter, Paulette V.; Lix, Lisa M.
The underassessment and undertreatment of pain in residents of long-term care (LTC) facilities has been well documented. Gaps in staff knowledge and inaccurate beliefs have been identified as contributors.OBJECTIVES: To investigate the effectiveness of an expert-based continuing education program in pain assessment/management for LTC staff.METHODS: Participants included 131 LTC staff members who were randomly assigned to either an interactive pain education (PE) program, which addressed gaps in knowledge such as medication management, or an interactive control program consisting of general dementia education without a specific clinical focus. Participants attended three sessions, each lasting 3 h, and completed measures of pain-related knowledge and attitudes/beliefs before, immediately after and two weeks following the program. Focus groups were conducted with a subset of participants to gauge perception of the training program and barriers to implementing pain-related strategies.RESULTS: Analysis using ANOVA revealed that PE participants demonstrated larger gains compared with control participants with regard to pain knowledge and pain beliefs. Barriers to implementing pain-related strategies certainly exist. Nonetheless, qualitative analyses demonstrated that PE participants reported that they overcame many of these barriers and used pain management strategies four times more frequently than control participants.CONCLUSIONS: Contrary to previous research, the present study found that the interactive PE program was effective in changing pain beliefs and improving knowledge. Continuing PE in LTC has the potential to address knowledge gaps among front-line LTC providers.
Open Access
Factors contributing to practitioner choice when declining involvement in legally available care: A scoping protocol
(BMJ, 2018-07-27) Brown, Janine; Goodridge, Donna; Thorpe, Lilian; Chipanshi, Mary
As legislation addressing medical treatments continues to evolve, there are several circumstances (eg, abortion, assisted dying) in which health practitioners may choose to not provide legally available care options. It is not always clear what underlies practitioner choice, as some research has suggested non-participation in care provision is not always due to an ethical abstention but may represent other factors. This results in tension between a practitioner’s right to refrain from practices deemed morally objectionable by the practitioner, and the care recipient’s right to access legally available treatments. The aim of this systematic scoping review is to identify the current knowledge regarding all the factors influencing practitioner’s choices when declining involvement in legally available healthcare options.
Open Access
Factors influencing practitioners’ who do not participate in ethically complex, legally available care: scoping review
(BioMed Central (BMC), 2021-09-28) Brown, Janine; Goodridge, Donna; Thorpe, Lilian; Hodson, Alexandra; Chipanshi, Mary
Evolving medical technology, advancing biomedical and drug research, and changing laws and legislation impact patients’ healthcare options and influence healthcare practitioners’ (HCPs’) practices. Conscientious objection policy confusion and variability can arise as it may occasionally be unclear what underpins non-participation. Our objective was to identify, analyze, and synthesize the factors that influenced HCPs who did not participate in ethically complex, legally available healthcare.
Open Access
“I Am Okay With It, But I Am Not Going to Do It”: The Exogenous Factors Influencing Non-Participation in Medical Assistance in Dying
(SAGE Publications, 2021-07-08) Brown, Janine; Goodridge, Donna; Thorpe, Lilian; Crizzle, Alexander
Access to medical assistance in dying (MAID) is influenced by legislation, health care providers (HCPs), the number of patient requests, and the patients’ locations. This research explored the factors that influenced HCPs’ nonparticipation in formal MAID processes and their needs to support this emerging practice area. Using an interpretive description methodology, we interviewed 17 physicians and 18 nurse practitioners who identified as non-participators in formal MAID processes. Nonparticipation was influenced by their (a) previous personal and professional experiences, (b) comfort with death, (c) conceptualization of duty, (d) preferred end-of-life care approaches, (e) faith or spirituality beliefs, (f) self-accountability, (g) consideration of emotional labor, and (h) future emotional impact. They identified a need for clear care pathways and safe passage. Two separate yet overlapping concepts were identified, conscientious objection to and nonparticipation in MAID, and we discussed options to support the social contract of care between HCPs and patients.
Open Access
Medical Assistance in Dying in health sciences curricula: A qualitative exploratory study
(Canadian Medical Education Journal, 2020-09-03) Brown, Janine; Goodridge, Donna; Thorpe, Lilian
This paper offers insight into (1) the driving and restraining forces impacting the inclusion of medical assistance in dying (MAID) in health sciences curricula, (2) the required resources for teaching MAID, and (3) the current placement of MAID in health sciences curricula in relation to end-of-life care concepts.
Open Access
Medical Assistance in Dying: Patients', Families', and Health Care Providers' Perspectives on Access and Care Delivery
(Mary Ann Liebert, 2020) Brown, Janine; Goodridge, Donna; Harrison, Averi; Kemp, Jordan; Thorpe, Lilian; Weiler, Robert
Open Access
“What is right for me, is not necessarily right for you”: The endogenous factors influencing non-participation in medical assistance in dying
(SAGE Publications, 2021-05-03) Brown, Janine; Goodridge, Donna; Thorpe, Lilian; Crizzle, Alexander
Access to medical assistance in dying (MAID) is influenced by legislation, health care providers (HCPs), the number of patient requests, and the patients’ locations. This research explored the factors that influenced HCPs’ nonparticipation in formal MAID processes and their needs to support this emerging practice area. Using an interpretive description methodology, we interviewed 17 physicians and 18 nurse practitioners who identified as non-participators in formal MAID processes. Nonparticipation was influenced by their (a) previous personal and professional experiences, (b) comfort with death, (c) conceptualization of duty, (d) preferred end-of-life care approaches, (e) faith or spirituality beliefs, (f) self-accountability, (g) consideration of emotional labor, and (h) future emotional impact. They identified a need for clear care pathways and safe passage. Two separate yet overlapping concepts were identified, conscientious objection to and nonparticipation in MAID, and we discussed options to support the social contract of care between HCPs and patients.