Nursing in Practice May/June 2020 (issue 114) | Page 15

ences are key
are planning
patient experience
itions (MCCs) such
betes or persistent
groups, prevalence
ltural factors infl uence
le are now living
ities, and there is
ents cope with the
can bring.
the experiences of
e adults diagnosed
ow they manage their
litative descriptive
tifi ed that, although
e actively while
onditions had an
ain themes emerged
g MCCs’, participants
ng’ of symptoms and
ddressing MCCs
demonstrated
s by employing
r prescribed
hinese treatments.
orking is held in high
, ‘fulfi lling social roles’
the impact of MCCs
r people with IDs
l disabilities (IDs) are
problems than those
in treatment and care
ated as long-term
illnesses resulting in
ore people with IDs
However, this is an
ith challenges that are
licy. Diffi culties arise
limited cognitive or
they are not always
ed care planning
express their wishes.
s aimed to explore
h people who have
alysing the
edical notes from
15 people who
gside this, telephone
30 with relatives and
nals. The fi ndings
f ACP for people with
tions often excluded
ult of known cognitive
on others and to maintain a routine life as far as
possible. ‘Maintaining psychological wellbeing’
involved efforts to reduce negative emotions,
including stress, anxiety and frustration.
The study highlights that people cope with
MCCs in a variety of ways, and that cultural
infl uences have a signifi cant impact.
A commentary notes that although this study
was undertaken in China, it carries important
messages for current UK practice. Good
communication is paramount; if health
professionals can understand the impact of
MCCs on quality of life, and acknowledge
cultural differences in coping strategies,
culturally sensitive care delivery for managing the
physical and psychological challenges of MCCs
can be implemented and evaluated.
Study reference
Cheng, C; Bai, J; Yang, C-Y; Inder, K; Chan SW-C. ‘Patients’
experiences of coping with multiple chronic conditions: A
qualitative descriptive study. J Clin Nurs. 2019, 28, pp.4400-
4411. doi.org/10.111/jocn.15022
Commentary reference
Zhan, X; Wenchung, W; Lin, H; Jingran, L; Li, B; Li, MT; Fu, RT;
Wu, Y; Wu, X; Shi, X; Lee, A; Shengxiao, X. ‘Coping with multiple
morbidities: Asian perspectives to inform culturally appropriate
caregiving.’ Evid Based Nurs. Published Online First: 09 January
2020. doi: 10.1136/ebnurs-2019-103211
or communication diffi culties. While Do Not
Attempt Resuscitate (DNAR) orders were usually
documented (93% of cases), the conversations
were often noted to take place in the month
before death, and as a result of declining health
as opposed to a case of advanced planning.
To avoid ‘last-minute’ conversations in this
patient group, a commentary highlights that
palliative care planning should be based on
personal preferences, and that a proactive
approach to ACP is required. In cases where
cognitive or communicative diffi culties hinder
conversations, narratives or life stories could be
used to include the views of people with ID, and
policy and procedure should refl ect this.
Study reference
Voss, H; Vogel, A; Wagemans, AMA; Francke, AL; Metsemakers,
JFM; Courtens, AM; de Veer, AJE. ‘Advance care planning in the
palliative phase of people with intellectual disabilities: analysis of
medical fi les and interviews.’ J Intellect Disabil Res. 2019;
63:1262–72. doi: 10.1111/jir.12664
Commentary reference
Johansson L. ‘Time to increase the involvement of persons with
intellectual disability in palliative care and research.’ Evid Based
Nurs. Published Online First: 04 March 2020. doi: 10.1136/
ebnurs-2019-103188