PhD in Palliative Care - Student Projects

Our PhD students engage in a wide range of research projects, some of which are listed below.

Current student projects

An exploratory study into the perceptions of Respiratory Specialist Physiotherapists (RSPs) in the end of life care of people with severe Chronic Obstructive Pulmonary Disease (COPD)
For more information contact: Jackie Malone
Jackie Malone photograph

Jackie Malone

As a Physiotherapy lecturer with a clinical background in respiratory care, I am particularly interested in the end of life care of those with severe COPD, and the involvement of physiotherapists with this client group. There is a significant lack of palliative care provision for this client group, partly due to difficulties in predicting end of life (Gore, Brophy et al. 2000). This study seeks to further investigate the perceptions of RSP’s as to their role in the management of COPD at the end of life through a mixed methods approach including e-survey and focus groups.

Phase 1 of the study aims to undertake a nation-wide e-survey with RSPs to begin to identify the perceptions of those caring for this client group.
Phase 2 aims to further understand these perceptions through the use of focus groups in the West Yorkshire and Morecambe Bay areas.

The study aims to:

  • evaluate how RSP's perceive their skill set in caring for those in the final six months of life with severe COPD
  • identify the involvement of RSP’s in Advance Care Planning in those with severe COPD
  • assess issues of professional discomfort around emergency treatment of those with severe COPD in the final six months of life
  • identify future research priorities in this under-researched field

Gore, J., C. J. Brophy, et al. (2000). How well do we care for patients with end stage chronic obstructive pulmonary disease (COPD)? a comparison of palliative care and quality of life in COPD and lung cancer. Thorax 55(12): 1000.

Academic Supervisors: Dr Nancy Preston, Professor Carol Thomas
Funded by: Self-funded
Project start date: September 2012
Project end date: September 2015
Resources:  
Service user Involvement in the governance of independent voluntary hospices: Trustee attitudes
For more information contact: Katrina Poulson
Katrina Poulson photograph

Katrina Poulson

Involving service users in health service development has been progressing in the NHS since 1990, but has been slower to evolve in independent voluntary hospices. As hospice leaders the Trustees may impact this initiative at a time when inclusion of users within hospice governance is likely to be targeted for development. This study aims to ascertain, through the use of in-depth semi-structured interviews, the attitudes of trustees to service user involvement in hospice governance in order to anticipate potential barriers and aid the successful implementation of training and support. Chairs of Trustees of independent voluntary hospices will be invited to participate in audio-recorded interviews lasting 30-60 minutes. It is anticipated that between 15 and 25 interviews will be required to reach the point where no new data emerges. Interviews will be transcribed, and subjected to qualitative thematic analysis using a Framework approach (Ritchie and Lewis, 2003).

RITCHIE, J. & LEWIS, J. (Eds.) (2003) Qualitative Research Practice: A Guide for Social Science Students and Researchers, London, SAGE.

Academic Supervisors: Dr Mary Turner, Professor Carol Thomas
Funded by: Self-funded
Project start date: September 2012
Project end date: June 2015
Resources:  
Understanding the Lived Experience of Family Caregivers of Lung Cancer Patients Participating in a Palliative Care Educational Intervention
For more information contact: Shirley Otis-Green
Shirley Otis-Green photograph

Shirley Otis-Green

The goal of this qualitative, interpretive phenomenological study is to understand the lived experience of family caregivers of lung cancer patients participating in a tailored, interdisciplinary palliative care educational intervention. A purposive sample of 10 family caregivers will participate in semi-structured interviews, with findings leading to the development of content for a future feasibility proposal exploring the delivery of customized psychoeducational support services for this population.

Academic Supervisors: Professor Sheila Payne, Professor Carol Thomas
Funded by: Self-funded
Project start date: October 2012
Project end date: December 2013
Resources:  
Paediatric Palliative Care Service Underutilisation: A Mixed Methods Study Exploring Accessibility and Caregiver Coping
For more information contact: Andrea Postier
Andrea Postier photograph

Andrea Postier

My PhD Palliative Care research is funded by an institutional research grant from Children's Hospitals and Clinics of Minnesota, USA.

Paediatric palliative care (PPC) is a rapidly growing field, yet data is scarce around referral patterns, parental perspectives or family coping. Children with life-threatening or life-limiting conditions benefit from early referral to PPC services, yet many of these children are referred later in the course of their disease when symptoms are advanced or end of life is near.

Children's Department of Homecare, Pain Medicine, Palliative Care & Integrative Medicine cares for a high volume of patients and is uniquely positioned to study these patients to identify barriers to PPC referral. The Homecare program provides in-home skilled nursing services to approximately 1,300 infants and children annually, many of whom qualify for, but are not referred for PPC services for unknown reasons. I am interested in learning more about why these children and their families are not referred directly to the PPC service.

Approximately 80 parents from each program (Homecare and PPC) will be invited to share information about their child's referral, their knowledge of PPC, and their stress and coping status at the time of enrolment and three months later. Questionnaires, chart review, and a validated scale will be used to capture family experiences.

To my knowledge, this study is the first study to examine parent perspectives on PPC underutilisation; to describe associations between caregiver perspectives and institutional, clinical, and family characteristics; and to learn how caregivers handle stress associated with their child's condition. I hope results from this study will encourage better access and earlier psychosocial assessment and support for distressed parents, as well as improve processes and programming.

Academic Supervisors: Dr Anne Grinyer, Dr Sarah Brearley
Funded by: Institutional Research Grants Program, Children's Hospitals and Clinics Of Minnesota, USA
Project start date: Summer 2012
Project end date: Summer 2014
Resources:
Delivery of Palliative Care by Non-western Trained International Medical Graduates in Remote and Rural Newfoundland and Labrador, Canada
For more information contact: Fiona O'Shea
Fiona O'Shea photograph

Fiona O'Shea

Background:
Non-western trained international medical graduates (IMGs) provide the majority of medical care in remote and rural NL, Canada. Many non-western IMGs in the province have received undergraduate medical education in countries that do not provide palliative care as a core component of undergraduate curricula. Traditionally most IMGs remain in remote and rural areas for one to two years before relocating to urban centres. The high turn-over of IMGs is theorised to have a negative impact on patients and families living with life limiting diseases.

Aim and Objectives:
To examine how palliative care delivery is experienced by non-western trained international medical graduates in remote and rural NL and to understand how palliative care delivery is received by patients, families and carers in remote and rural NL.

Methods/Design:
This is a qualitative, naturalistic, interpretative, embedded design, multiple case study. The case study will consist of eight cases. Each case will include a physician (non-western trained IMG or, a western-trained physician) and up to four others from a recognized, connected circle of care. Members from the circle of care may be drawn from the following group: palliative patient, family, nurse, pastoral care provider, social worker, pharmacist, volunteer, home care worker, physiotherapist and occupational therapist. Interviews, archival records and observations will be used to collect data. Data will be analysed using grounded theory. Outcomes will be described in terms of an explanatory theory of the experience of palliative care in remote and rural NL.

Discussion:
Outcomes will inform care providers, educators and policy makers of the experience of palliative care in remote and rural NL and identify areas for improvement within the Public Health mandate.

Keywords:
Case study, palliative care, international medical graduate, remote, rural.

Academic Supervisors: Professor Sheila Payne, Dr Anne Grinyer
Funded by: Self-funded
Project start date: Not started
Project end date: May 2015 (approx)
Resources:  

 

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