RESUMO
BACKGROUND: Dying in Australia has been recognised as amongst the most institutionalised in the world. Discussion of death and dying is largely taboo in contemporary society, resulting in a lack of formal advance care planning or personal reflection on end-of-life considerations. To address this problem, a pilot study was developed as an innovative health promotion activity, drawing upon the Arts. AIM: To explore how an arts medium might influence public discussion on end of life issues in the community. METHODS: An action research approach was used to collect survey data from a community sample attending a Canberra marketplace. 54 participants completed a 14 item questionnaire, after viewing a photographic exhibition that provided international narratives on death and dying. Qualitative descriptors were elicited from participants to describe their reactions to viewing the exhibition, and quantitative data were analysed for frequency. RESULTS: Most participants agreed the exhibition effectively engaged members of the public in conversations about death and dying. After viewing the exhibition, they were more inclined to consider or prepare a legal will, enduring or medical power of attorney, or an advance care plan (ACP). CONCLUSION: From this pilot study, there are preliminary but encouraging data to suggest that the Arts are an effective medium for health promoting approaches. We propose further use of Arts-based activities in communities to promote public discussions about death and dying.
RESUMO
BACKGROUND: Palliative care services are increasingly identifying areas for improvement, then trying to create appropriate changes in response. Nurses in particular are often expected to take leading roles in quality improvement (QI) but are not necessarily trained or supported in these processes. METHODS: A framework approach to change was developed to guide services through a change cycle and delivered via workshops by representatives of three Australian national projects. Participants were predominantly nurses (80%), with the majority (63.7%) over the age of 50. FINDINGS: The workshops and the framework were positively evaluated, with participants feeling confident in a number of QI-related activities following workshop training. CONCLUSION: Recognising and addressing problems in clinical practice and service delivery is an important way for nurses to ensure quality care for patients; however, they need support in developing the skills and knowledge that are essential to successful QI activities.
