Rehabilitative palliative care is a developing field integrating rehabilitation, enablement, self-management and self-care into the holistic model of palliative care. A growing evidence-base suggests that rehabilitation not only delays or prevents deterioration in function but can actively improve physical function irrespective of advance disease. The drive towards rehabilitative palliative care has led to an increase in the application of self-management techniques within hospices but there appears to be a gap in the empirical evidence specific to palliative care.
The challenges, possible solutions and anticipated patient benefits of hospices being research active have also been highlighted.
In response, palliative care professionals across five hospices formed a collaborative group and planned a phased approach to research.
Phase 1: A literature review (March – May 2016) to establish the evidence-base for self-management in palliative care. This identified a significant gap in evidencing the outcomes of self-management in the palliative population.
Phase 2: A collaborative service evaluation (April – May, 2016) identifying self-management opportunities for patients within the hospices followed by a patient survey on the exercise groups they attended.
This suggested that promoting self-management through exercise was both acceptable and beneficial in a palliative population. Patient responses showed exercise:
Enabled patients to cope better with their illness
Increased their confidence in maintaining/improving activity levels
Provided a focus for independent goal setting
Facilitated independent activity outside of the organisation.
Phase 3: The work is being written up for publication to contribute to the evidence-base supporting the beneficial effects of self-management through exercise and the potential this has to improve patients’ quality of life.
Phase 4: Moving forward the group aims to seek funding to extend this work into a research project and ultimately to drive further research through a dedicated research post.
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