At a time when hospice care is being scrutinised by commissioners this small study evaluates the implementation of an education programme in a Day Hospice and the impact this had on patients living with life limiting illness.
Education for patients near end of life appears to have received minimal research attention. Wider investigation of the needs of these patients reveals that the impact of illness robs them of their sense of self and autonomy (Johnston 2004), and opportunities to self-care and self-manage can be limited by paternalism (Cottrell 2008, Jackson 2006).
This programme offered patients the opportunity to attend facilitated educational discussion groups such as medicine management, coping with anxiety and breathlessness, and planning ahead for death and to participate in group relaxation and exercise sessions
A case study methodology allowed the use of mixed methods to collect data from three sources; patients, using diaries and transcribed interviews; staff delivering the programme using a focus group; and professionals referring to the service using a questionnaire.
Findings revealed that patients had motivation and capacity to participate and learn however ill they were, demonstrating their desire to be acknowledged as ‘active and participating citizens’ (Kendall et al 2007:524). Patients also experienced an increase in self-esteem and confidence resulting from the programme.
Staff delivering the programme reported an increase in their confidence through facilitating discussion groups and were challenged in relation to their preconceived ideas about what individual patients may want to learn.
Other findings related to the ability to promote the service to a wider group of potential patients.
This small study demonstrates the potential for increased ‘self-care’ when an education programme is introduced within a Day Hospice setting. This may positively influence potential commissioners to the service and raise the profile of Day Services as part of Hospice Care.
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