Author: Ms Michela Saretta STSM Period: 2019-09-25 – 2019-10-24
Hosting institution: Polibienestar Research Institute at the University of Valencia
From ITC: No
PURPOSE OF THE STSM
The purpose of this STSM has been to learn more about the Polibienestar Institute and to deepen its European scientific projects related to health, long-term care, chronic diseases and especially to older people, considering my background and my Master in Psychology of Aging. Specifically, the aim has been to study palliative care in aging and older people through a multidisciplinary context, a people-centred focus approach and a psychological perspective with the goal of contributing to the European project called “InAdvance”. This project has as its main objective the improvement of palliative care interventions for patients, families, informal caregivers and professionals, even in Spain settings, helping to develop results and guidelines for health and care systems. Specifically, this STSM aims at investigating psychological palliative care in older people patients and professionals, considering psychological and emotional wellbeing, self-esteem, social functioning, relationships and communication; using a holistic and integrative approach. To achieve these results the method of reviewing the literature has been used with the purpose of analyzing the scientific studies present in research nowadays. Currently, the focus is to complete the scientific paper that could be useful in both research and clinical contexts.
DESCRIPTION OF WORK CARRIED OUT DURING THE STSMS
For the specific purpose of this STSM, the work was carried out in several phases: the first step of this STSM was to meet the coordinator of the European project “InAdvance”. This project focuses on palliative care in different European contexts. The first aim was to outline the topic related to the main project for deepening it. During this step, it was relevant to make a general review of the literature on the subject to analyse the psychological palliative care and advance care planning with older people patients and professionals: what had already been explored, the gaps around the question of research in palliative care, with knowledge of the strengths, the obstacles and the barriers.
The second step, after that, focused on the decision of the research question about specific themes of palliative care such as well-being and communication, that could have been deepen, and on writing the proposal through the initial review of the literature. Furthermore, during this step it was important to decide which protocol to follow during the final review. The definition of the protocol, in this case PRISMA, is relevant to delineate the entire procedure for reviewing literature: the research questions, the main keywords for the study, the databases to be used, the tool to collect the outcomes like ZOTERO and the reviewers who will be involved.
The third step was to actually start the research using the different databases and the keywords chosen. It is important to include the results into Zotero to organize the outputs well. At this point, it is also relevant decide a methodology to eliminate duplicate outcomes and decide which procedure use to select the titles that they will be use to verify which abstracts will be evaluated with the other reviewers. After the revision of the titles, indeed, it is necessary analyse the chosen abstracts to decide which full texts studies read and evaluate.
Generally, during this STSM, there were weekly meetings with the other researchers from the Polibienestar Institute to explain the own work and progress.
This whole process, for me, was really important because it was a first time that I started a literature review.
DESCRIPTION OF THE MAIN RESULTS OBTAINED
The literature review has not been completed yet, considering that a month is not always sufficient to do it. However, it is significant to observe that through the initial review of the literature with the Google Scholar database, some obtained results are really interesting. These results sustain the gaps still present in psychological palliative care and advance care planning considering older people, with the need for further research and studies. By specifically analyzing a component of psychological palliative care as the communication, it is possible to find the presence of the phenomena called “ageism”, by the professionals towards older people yet. These results are really important because, especially in Europe, older people are becoming more and more long-lived and with more illnesses in multimorbidity. Therefore, these results are intended to enhance the focus on having more discussions and conversations about death and dying earlier. This, indeed, could help older people and their families to address their wishes and preferences for treatments when they do not have much pain, severe cognitive impairment and not too close to death. Palliative care, in fact, is not only bad news and immediate death, but could be consider as a path where patients and professionals talk together with kindness, compassion and support. These aspects are very significant due they could help the quality of life about the older people and also the quality of life about the professionals, decreasing their probability of burnout. At the same time, the outcomes claimed that it is very difficult to have more conversations about death and dying; there are many barriers from boht patiens and professionals. For the reason, research in this field with older people could give the contribution in clinical settings, improving the guidelines and analyzing this process with more attention, as this work wants to do. Therefore, these initial results confirmed, once again, the importance and the usefulness of holistic and integrative care, and the people-centred focus approach for enhancing the healthcare and psychological component of older people.
The future collaborations have been scheduled at the end of the STSM with the aim of continuing to work to conclude the literature review and the ongoing scientific paper on this specific review. The draft of the paper is scheduled to be prepared within three months. At the moment, it is really relevant to make a precise evaluation of the titles with other two researches from Polibienestar Institute, to obtain coherent abstracts and full texts to be analysed. The abstract selection procedure and the assessment of study quality have been decided.