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Connolly, Michael
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Connolly, Michael
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Connolly, Michael
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- PublicationEquity and the financial costs of informal caregiving in palliative care: a critical debateBackground: Informal caregivers represent the foundation of the palliative care workforce and are the main providers of end of life care. Financial pressures are among the most serious concerns for many carers and the financial burden of end of life caregiving can be substantial. Methods: The aim of this critical debate paper was to review and critique some of the key evidence on the financial costs of informal caregiving and describe how these costs represent an equity issue in palliative care. Results: The financial costs of informal caregiving at the end of life can be significant and include carer time costs, out of pocket costs and employment related costs. Financial burden is associated with a range of negative outcomes for both patient and carer. Evidence suggests that the financial costs of caring are not distributed equitably. Sources of inequity are reflective of those influencing access to specialist palliative care and include diagnosis (cancer vs non-cancer), socio-economic status, gender, cultural and ethnic identity, and employment status. Effects of intersectionality and the cumulative effect of multiple risk factors are also a consideration. Conclusions: Various groups of informal end of life carers are systematically disadvantaged financially. Addressing these, and other, determinants of end of life care is central to a public health approach to palliative care that fully recognises the value of carers. Further research exploring these areas of inequity in more depth and gaining a more detailed understanding of what influences financial burden is required to take the next steps towards meeting this aspiration. We will address the conclusions and recommendations we have made in this paper through the work of our recently established European Association of Palliative Care (EAPC) Taskforce on the financial costs of family caregiving.
103Scopus© Citations 16 - PublicationIntegrated care for children living with complex care needs: an evolutionary concept analysis(Springer Science and Business Media LLC, 2023-02-13)
; ; ; ; ; ; Children with complex care needs (CCNs) are in need of improved access to healthcare services, communication, and support from healthcare professionals to ensure high-quality care is delivered to meet their needs. Integrated care is viewed as a key component of care delivery for children with CCNs, as it promotes the integration of healthcare systems to provide family and child-centred care across the entire health spectrum. There are many definitions and frameworks that support integrated care, but there is a lack of conceptual clarity around the term. Furthermore, it is often unclear how integrated care can be delivered to children with CCNs, therefore reinforcing the need for further clarification on how to define integrated care. An evolutionary concept analysis was conducted to clarify how integrated care for children with CCNs is defined within current literature. We found that integrated care for children with CCNs refers to highly specialised individualised care within or across services, that is co-produced by interdisciplinary teams, families, and children, supported by digital health technologies. Conclusion: Given the variation in terms of study design, outcomes, and patient populations this paper highlights the need for further research into methods to measure integrated care.32Scopus© Citations 1 - PublicationNursing and Midwifery Workforce Readiness during a Global Pandemic: A Survey of the Experience of one hospital group in the Republic of Ireland(Wiley, 2022-01)
; ; ; ; ; Aim: To explore the mobilisation of nurses/midwives in a designated hospital group in Ireland during a global pandemic.Background: The recent global pandemic has resulted in the large-scale worldwide mobilisation of Registered Nurses and Midwives working in the acute care sector. There is a dearth of literature reporting the mobilisation of this professional workforce.Method: Mixed-methods design using an electronic survey and facilitated discussion across one Irish hospital group.Results: Eight of 11 hospitals responded to the survey. There was a 2% vacancy rate prior to the pandemic. Mobilisation included reconfiguration of clinical areas and redeployment of 9% of the nursing/midwifery workforce within two weeks of the pandemic. A total of 11% (n=343) of nurses/midwives were redeployed in three months. Nurses/midwives required re-skilling in infection prevention control, enhancement of critical care skills and documentation.Conclusions: Three key areas were identified to enable the nursing workforce readiness. These are referred to as the three ‘R’s’: Reconfiguration of specific resources; Redeployment of nurses to dedicated specialist areas and Re-skilling of nurses to safely care for the patients during the pandemic.Implications for Nursing Management: A centralised approach to Reconfiguration of clinical areas. Redeployment is enabled by closing non-essential departments. Hands-on re-skilling and reorientating staff are essential.356Scopus© Citations 1