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