Barriers to Early Access of Palliative Care: Addressing Misconceptions and Stigma
Peter Necy
Student ID:
Introduction
Palliative care aims to improve quality of life for patients and families facing life-limiting illnesses through a holistic approach that addresses physical, psychological, social and spiritual needs (World Health Organization, 2022). Early integration of palliative care has been shown to benefit patients by effectively managing pain and other distressing symptoms, as well as supporting families during the illness trajectory and bereavement period (Temel et al., 2010). However, several barriers often prevent timely access and referral to palliative care services. Common misconceptions about the role and purpose of palliative care among patients and healthcare providers act as significant obstacles (Gott et al., 2013).
Literature Review
A frequent misconception is the perception that palliative care is only appropriate for end-of-life or hospice care (Gott et al., 2013; National Consensus Project for Quality Palliative Care, 2018). In reality, palliative care aims to improve quality of life throughout the illness experience, from initial diagnosis onwards (World Health Organization, 2022). Early involvement of palliative care teams has demonstrated benefits for patients living with chronic, life-limiting illnesses like cancer, heart failure, lung disease, and neurological disorders (Temel et al., 2010). Studies show early integration effectively manages pain and distressing symptoms while supporting psychological and spiritual wellbeing (National Institute for Health and Care Excellence, 2022; Temel et al., 2010).
Another barrier is the stigma associated with palliative care due to its historical connections with death and dying (Gott et al., 2013; Palliative Care Australia, 2018). This prevents open discussion about needs and values, delaying referrals according to individual preferences. Sensitive conversations are needed to clarify palliative care’s broader role in optimizing quality of life (National Consensus Project for Quality Palliative Care, 2018). Healthcare providers must also address their own misconceptions through ongoing education on current evidence-based palliative approaches (Palliative Care Australia, 2018).
Nurses’ Role
As frontline providers, nurses are well-positioned to promote early palliative care access by addressing common misconceptions (Palliative Care Australia, 2018). They should engage patients and families in non-threatening, stigma-free conversations to assess holistic needs proactively. By clarifying misconceptions about palliative care’s benefits throughout illness, nurses can make timely referrals according to individual communication preferences (National Consensus Project for Quality Palliative Care, 2018). They must also receive regular training to stay updated on palliative evidence and challenge their own preconceptions (Palliative Care Australia, 2018).
Conclusion
In summary, misconceptions regarding the role and purpose of palliative care act as barriers preventing early access and integration. Common misperceptions include associating palliative care only with end-of-life and the stigma surrounding discussions about death and dying. Nurses can help address this through sensitive conversations with patients and families to assess needs, clarify misconceptions, and make appropriate referrals according to individual values and preferences. Ongoing education is also required to ensure healthcare providers, including nurses, provide evidence-based, stigma-free palliative care according to current standards. With a holistic, patient-centered approach, barriers can be overcome to improve quality of life for those living with life-limiting illness and support their loved ones.
References
Gott, M., Ingleton, C., Bennett, M. I., & Gardiner, C. (2013). Transitions to palliative care in acute hospitals in England: qualitative study. BMJ, 347. https://doi.org/10.1136/bmj.f1773
National Consensus Project for Quality Palliative Care. (2018). Clinical practice guidelines for quality palliative care (4th ed.). National Coalition for Hospice and Palliative Care. https://www.nationalcoalitionhpc.org/ncp
National Institute for Health and Care Excellence. (2022, February 23). Palliative care for adults: Strong opioids for pain relief. https://www.nice.org.uk/guidance/ng140/chapter/Recommendations#strong-opioids-for-pain-relief
Palliative Care Australia. (2018). National palliative care standards (5th ed.). https://palliativecare.org.au/palliativecare-information/national-palliative-care-standards
Temel, J. S., Greer, J. A., Muzikansky, A., Gallagher, E. R., Admane, S., Jackson, V. A., Dahlin, C. M., Blinderman, C. D., Jacobsen, J., Pirl, W. F., Billings, J. A., & Lynch, T. J. (2010). Early palliative care for patients with metastatic non-small-cell lung cancer. New England Journal of Medicine, 363(8), 733–742. https://doi.org/10.1056/NEJMoa1000678
World Health Organization. (2022, August 23). WHO definition of palliative care. https://www.who.int/news-room/fact-sheets/detail/palliative-care
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NRSG374: Principles of Nursing Palliative Approach
NRSG374 _ Assessment 1: Professional Development Resource
ASSESSMENT INFORMATION
Assessment Title Assessment Task 1 – Professional Development Resource Narrated PowerPoint
Purpose This assessment enables students to demonstrate their understanding of the palliative approach and the promotion of best practice in the clinical area.
Due Date Wednesday 13th September, 2023
Time Due 14:00
Weighting 50%
Submission Submission of the assessment task is via the assessment 1 drop box in the NRSG374
LEO site on the ‘Assessment’ tile.
Length Narration length: 10 minutes (+/- 10%) (Video is not required)
PowerPoint slide deck length: 10 slides including a title page and reference slides.
Additional slides will not be accepted.
Rubric Appendix 1 of the NRSG374 unit outline.
The assessment will be marked using the criteria-based rubric.
LEO Resource A national pre-recorded lecture is available on the ‘Assessment’ tile in the NRSG374 LEO site, which provides students with an overview of the assessment as well as resources and advice on how to approach the task.
A national Q&A session will be held during week four (4) of the semester via zoom.
The Q&A session will provide students with the opportunity to clarify any questions,
but the expectation is that students will have viewed the pre-recorded national
lecture prior to attending. The date and a link for this session is available on the
Communication and Support tile on the NRSG374 LEO site.
Students are encouraged to post questions on the Assessment 1 Q&A forum on LEO
and to check for answers there as a first point of query.
LOs Assessed LO1, LO2, LO3, LO5, LO6
Task Students will develop a 10-minute narrated PowerPoint based on one (1) of the key topics discussed by the ‘Survivors Teaching Students’ program.
Three ‘Survivors Teaching Students’ sessions will occur in Week 3. All students are expected to attend at least one of the sessions. Dates and links for these sessions are available on the Survivors Teaching Students tile on the NRSG374 LEO unit. The sessions will also be recorded.
This narrated PowerPoint is to be a professional development resource. The resource is to provide education, information and learning opportunities for final year nursing students and/or graduate nurses about a palliative care topic, the nurse’s role and how the National Palliative Care Standards relate to the topic.
Application of the National Palliative Care Standards and other relevant contemporary evidence-based literature should be used to support the presentation.
Target Audience Final year nursing students and/or graduate registered nurses.
This is not a resource for the general consumer or community members. Therefore,
you are expected to use professional terminology.
NRSG374: Principles of Nursing Palliative Approach
NRSG374 _ Assessment 1: Professional Development Resource © Australian Catholic University 2023 _ Page 2 of 4
Topics Your professional development resource should focus on one of the following key
topics discussed by the ‘Survivors Teaching Students’ program:
1. Barriers to early access to palliative care, including misconceptions and stigma
2. Psychological and physical supports to improve quality of life in palliative care
3. Family centred care in the palliative environment
PowerPoint
Structure
Your Presentation should follow this format:
1. Slide One: Title Slide – State your name, student number and identify which one
of the three topics you have chosen to focus your presentation on.
2. Slide Two: Provide an introduction, including what you will discuss in the
presentation (refer to rubric). Outline the target audience and the learning
outcomes for your presentation. Learning outcomes are what your target
audience will have learnt/achieved by the end of your professional development
resource.
3. Slide Three: Provide an overview of palliative care and the principles of palliative
care, referring to high-quality evidence.
4. Slide Four: Provide an overview of the National Palliative Care Standards and
identify and introduce three standards that most relate to your topic. You will
then be incorporating the three chosen standards in Slides Five, Six and Seven.
5. Slides Five: Outline one key learning/point from the ‘Survivors Teaching
Students’ program, that relates to your chosen topic. Link to evidence and the
first of the three National Palliative Care Standards outlined on Slide Four, to
support why this is an important point.
6. Slide Six: Identify how the key learning/point identified in Slide Five can be
managed/assessed. Support your information by referring to high-quality
evidence and the second of the three National Palliative Care Standards outlined
on Slide Four.
7. Slide Seven: Outline the role of the registered nurse regarding the key
learning/point identified in Slide Five. Support your information by referring to
high-quality evidence and the third of the three National Palliative Care
Standards outlined on Slide Four.
8. Slide Eight: Conclusion – Restate your key points and summarise the information
presented.
9. Slide Nine: References
10. Slide Ten: References
FORMATTING
Recording your
PowerPoint
Instructions on how to record a PowerPoint with narration and slide timings can be
found here.
Recording your PowerPoint
1) Create your assessment in PowerPoint.
2) Record your audio assessment in PowerPoint – DO NOT record a video.
3) LEO tech support recommend that students record the PowerPoint in mono
single channel as this reduces the megabytes for a 10-minute recording from
100 megabytes down to 30.
Saving your assessment
When saving your assessment, you must save it in a format that corresponds to
NRSG374: Principles of Nursing Palliative Approach
NRSG374 _ Assessment 1: Professional Development Resource © Australian Catholic University 2023 _ Page 3 of 4
Turnitin. File types accepted by Turnitin include: .pptx, .ppt, .ppsx, .pps.
Do not submit pdf, MP4 or Mac files.
ACU has made Microsoft Office 365 available for students for either PC or Mac
versions.
If you experience technical difficulties, please review that you have recorded and saved your assessment as instructed above. If you continue to experience difficulties, please contact LEO tech support on Ph. 1800 246 442.
File to submit You are to submit one PowerPoint file. You are not required to submit your script.
Font Font size – no smaller than 18-point.
Minimum font size for the reference list is 12-point.
Font style – Calibri, Arial or Times New Roman.
Headings – you can use headings to support the delivery of information.
Images – you can include images, however, please ensure they support and add
value to your work. Images need to be referenced using APA7 referencing.
REFRENCING
Referencing Style APA 7
th edition – Please refer to the ACU APA7 Referencing guide for detailed
information and resources.
Intext
Referencing
The narrated PowerPoint presentation must include intext citations on the slides.
Intext citations should be placed next to their corresponding text, not at the bottom of the slide. It is a requirement that you reference the points on your slides.
Minimum
References
A minimum of 15 high quality resources are to be used. All arguments must be
supported using a variety of high-quality primary evidence. Avoid using any one
source repetitively.
Reference Age Published in the last 5 years unless using seminal text.
Order References are arranged alphabetically by author family name within the reference list.
Hanging Indent Second and subsequent lines of a reference have a hanging indent.
DOI Presented as functional hyperlink.
Spacing Single spacing within a reference. A space is required between references.
ADMINISTRATION
Late Penalties Late penalties will be applied from 14:01pm on the due date, incurring 5% penalty of
the maximum marks available up to a maximum of 15%. Assessment tasks received
more than three calendar days after the due or extended date will not be allocated a
mark.
Penalty Timeframe Penalty Marks Deducted
14:01 Wednesday to 14:00 Thursday 5% penalty 5 marks
14:01 Thursday to 14:00 Friday 10% penalty 10 marks
14:01 Friday to 14:00 Saturday 15% penalty 15 marks
Received after 14:00 Saturday No mark allocated
Example:
NRSG374: Principles of Nursing Palliative Approach
NRSG374 _ Assessment 1: Professional Development Resource
• Academic integrity will be monitored in all assessments submitted.
• Use APA7 referencing style and paraphrase adequately.
• Turnitin monitors the use of artificial intelligence.
• Be sure to submit your own work.
• Submit your assessment with enough time to obtain your similarity report from
Turnitin and review your citations and paraphrasing to see if they need to be
improved.
Extensions All extension request forms need to be submitted electronically to the extension
application drop box on the NRSG374 LEO site on the ‘Assessment’ tile.
This should normally occur at least 24 hours before the due date and time as
per ACU Assessment Procedures – Section 2 Student Responsibilities. If submitting
within 24hrs of the prescribed due date/time – the exceptional circumstances must
have arisen with the 24hrs leading up to the due date/time.
There is no need to email the LIC to notify them you have submitted an
extension request. The extension request drop box is checked Monday to Friday
during normal business hours for new extension requests. Staff will only review
applications received in office hours and not on a public holiday.
If your EIP contains provisions for extension to assessment tasks you must still, follow the standard university procedure to apply for an extension. If your reason for seekingan extension is unrelated to the condition identified in your EIP, you may be required to provide evidence of your circumstances.
Special
NRSG374 LEO site on the ‘Assessment’ tile.
If applying for special consideration across multiple units, the special consideration
form needs to be forwarded to your Course Coordinator for review.
Special consideration for one assessment task cannot be submitted before the
assessment due date and can only be submitted up to five working days after the
relevant assessment due date.
Assessment template project informed by ACU student forums, ACU Librarians and the Academic Skills Unit.
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