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Professor Jane Phillips


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Professor Jane Phillips is a professor of nursing with experience in delivering evidenced-based palliative care across diverse settings, including rural and regional Australia. She has led and evaluated complex health service reforms and has led a number of major cancer and palliative care reform initiatives at the local and national levels. Jane's research aims to improve care outcomes for people in the last year of their life by strengthening the nexus between research, policy and practice. She is currently evaluating non-pharmacological interventions to improve pain, breathlessness and delirium; looking at health services that can improve care for older people with cancer, and; undertaking translational research in the areas of pain management and symptom management.  She has developed and evaluated nurse-coordinated models of palliative care and has extensive experience in cancer and chronic disease nursing and research. Jane is the Director of the Centre for Cardiovascular and Chronic Care at UTS.


  • Member International Society Nursing Cancer Care
  • Member Sigma Theta Tau International, Honour Society of Nursing, Xi Omicron Chapter
  • Member Royal Australian College of Nursing
  • Member Palliative Care Nurses Australia
  • Member Cancer Nurses Society Australia
  • Member NSW Palliative Care Association
  • Member Clinical Oncology Society of Australia
Image of Jane Phillips
Director, Centre for Cardiovascular & Chronic Care, Faculty of Health
Director, Centre for Cardiovascular and Chronic Care
Director, Centre for Cardiovascular and Chronic Care (CCCC)
Core Member, CHSP - Health Services and Practice
Post Graduate Diploma Health Promotion, Nursing, Nursing
+61 2 9514 4822

Research Interests

Research expertise:

  • Cancer and palliative care
  • Pain and symptom management
  • Non-pharmacological interventions for pain management
  • Geriatric Oncology
  • Palliative care
  • Non-communicable diseases
  • Care of older peoples
  • Mixed methods
  • Translational research


Ingham, J.M., Moore, H., Phillips, J.L. & Portenoy, R.K. 2014, 'Measurement of, and tools for, pain and other symptoms' in Cherny, N., Fallon, M., Kaasa, S., Portenoy, R., Currow, C.D. & Morita, J. (eds), Oxford Textbook of Palliative Medicine, Oxford University Press, Oxford.
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Currow, D.C. & Phillips, J.L. 2014, 'Models of care in palliative medicine' in Wichmann, M. & Maddern, G. (eds), Palliative Surgery, Springer-Verlag, Berlin, pp. 9-17.
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Palliative surgery can greatly contribute to improving symptom control and quality of life for terminal cancer patients. Owing to the advanced stage of the disease, however, this type of surgery is also associated with significant morbidity and mortality. It is therefore important for surgeons to have a sound understanding of the medical and scientific background underlying treatment decisions in palliative surgery, a foundation that this book provides. The opening chapters examine the relationship between palliative medicine and palliative surgery and address general issues including pain management and anesthesiological considerations. The role of palliative surgery in a wide range of disease settings is then thoroughly explored, including detailed information on surgical techniques and their indications and outcomes. This book will be an invaluable resource for all who wish to learn more about the emerging role of palliative surgery.
Phillips, J.L. 2014, 'Palliative Care in the Nursing Home' in Cherny, N., Fallon, M., Kaasa, S., Portenoy, R., Currow, C.D. & Morita, J. (eds), Oxford Textbook of Palliative Medicine, Oxford University Press, Oxford, p. INPRESS.
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Agar, M. & Phillips, J.L. 2014, 'Palliative medicine and care of the elderly' in Cherny, N., Fallon, M., Kaasa, S., Portenoy, R., Currow, C.D. & Morita, J. (eds), Oxford Textbook of Palliative Medicine, Oxford University Press, Oxford, pp. In press-In press.
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Phillips, J.L., Ingham, J. & McLeod, R. 2014, 'The development of palliative medicine in Australia and New Zealand' in Bruera, E. & Higginson, I. (eds), Palliative Medicine, Hodder Arnold, UK, pp. In press-In press.
Davidson, P.M. & Phillips, J.L. 2012, 'Palliative Care in Chronic Illness' in O'Connor, M., Lee, S. & Aranda, S. (eds), Palliative Care Nursing A Guide to Practice 3rd Edition, AUSMED Publications Pty Ltd, North Melbourne, VIC Australia, pp. 291-307.
Chronic illnesses are a major cause of death and disability globally. Many people now live for an extended period of time with a life-limiting illness. This is particularly pronounced in the context of population ageing. This chapter focuses on the issues involved in providing a palliative approach to care for individuals with chronic life-threatening illnesses other than cancer.
Davidson, P.M. & Phillips, J.L. 2010, 'Focus Group Methodology: Being Guided on a Journey from Novice to Expert' in Minichiello, V. & Kottler, J.A. (eds), Qualitative Journeys: Student and Mentor Experiences with Research, SAGE, Thousand Oaks, California, pp. 255-276.
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Phillips, J. & Davidson, P.M. 2009, 'Action Research as a Mixed Methods Design: A Palliative Approach in Residential Aged Care' in Mixed Methods Research for Nursing and the Health Sciences, pp. 195-216.
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Hickman, L., Phillips, J.L., Newton, P. & Davidson, P.M. 2015, 'Montreal cognitive assessment tool: feasibility in a heart failure population group', Australian Cardiac Nurses Conference, Sydney.
Phillips, J.L. 2015, 'The importance of undertaking and publishing feasibility studies: the results from a randomized controlled pilot trial of The Pink Women's Wellness Program', MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY, pp. 921-922.
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Lovell, M., Luckett, T., Phillips, J., Agar, M., Ryan, L., Lam, L., McCaffrey, N., Boyle, F., Stubbs, J., Shaw, T., Currow, D., Hosie, A. & Davidson, P. 2015, 'Clinical Trial Protocol - Implementing Clinical Practice Guidelines For Cancer Pain In Adults To Ensure Equitable, Cost-Effective, Evidence-Based, Person-Centred Care: A Phase III Pragmatic Stepped Wedge Cluster Randomised Controlled Trial Of Guidelines And Screening With Implementation Strategies Versus Guidelines And Screening Alone To Improve Pain In Adults With Cancer Attending Outpatients Oncology And Palliative Care Centres', Asia-Pacific Journal of Clinical Oncology, pp. 162-162.
Phillips, J.L., Heneka, N., Lam, L.T. & Shaw, T. 2014, 'Multi-Centre Pre-Post Test Trial of a complex Qstream (C) pain assessment intervention on cancer nurses' pain screening and assessment practices', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, pp. 206-206.
Phillips, J.L., Heneka, N., Lam, L. & Shaw, T. 2014, 'A complex Qstream (R) pain assessment intervention on cancer nurses' pain screening and assessment practices: results from a quasi-experimental study', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, pp. 136-136.
Phillips, J.L., Heneka, N. & Hickman, L. 2014, 'Impact of a Qstream online learning module on palliative care nurses' pain assessment competencies and patients' report on pain: Results from a quasi-experimental pilot study', Asia Pacific Journal of Clinical Oncology, Wiley: 12 months.
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Phillips, J.L., Heneka, N., Hickman, L., Lam, L. & Shaw, T. 2013, 'The impact of a novel, online learning module on specialist palliative care nurses' pain assessment knowledge and practices', European Journal of Palliative Care, European Palliative Care Association Conference, Prague.
Phillips, J.L., Heneka, N., Hickman, L., Lam, L. & Shaw, T. 2013, 'Can a novel on-line pain assessment learning module improve specialist palliative care nurse's pain assessment knowledge?: Results from a pilot Spaced Education initiative', 16th CNSA Winter Congress, Brisbane Convention and Exhibition Centre, Queensland.
Phillips, J.L., Heneka, N., Hickman, L., Lam, L. & Shaw, T. 2012, 'Spaced Education in the Specialist Palliative Care Setting: exploring it's potential to improve pain management', 4th Biennial Palliative Care Nurses Australia Conference, Melbourne.
Phillips, J.L., Andrews, L. & Hickman, L. 2012, 'Factors predicting stays of over 30 days in patients dying in a specialist palliative care unit', 19th International Congress on Women's Health, Mahidol University Bangkok, Thailand.
Phillips, J.L., Hickman, L., Heneka, N. & Shaw, T. 2012, 'Can a novel on-line CPD program increase specialist palliative care nurses pain assessment capabilities and reduce patients' reported pain scores?', WA Palliative Care Conference, Perth, WA.
Phillips, J.L., Heneka, N., Hickman, L., Lam, L. & Shaw, T. 2012, 'Enhancing interdisciplinary team pain assessment communication: Can Spaced Education improve comprehensive pain assessment practices in the specialist palliative care setting?', Palliative Care NSW State Conference, Dubbo.
Hickman, L., Kelly, H. & Phillips, J.L. 2012, 'EVITECH: a pilot study exploring ways to optimise the uptake of evidence-based practice to undergraduate nurses', 23rd Research Conference, Sigma, Theta Tau International, Brisbane, QLD.
Phillips, J.L., Hickman, L., Heneka, N. & Shaw, T. 2012, 'Assessing specialist palliative care nurses pain assessment capabilities: identifying opportunities to improve patient outcomes', 16th Cancer Nurses Society Australia Conference, Hobart.
Phillips, J.L., Ramadge, J., Evans, R. & Currow, D. 2009, 'CanNET a new service model: linking regional and metropolitan cancer services into single networks', 10th National Rural Health Conference, National Rural Health Conference, National Rural Health Alliance, Cairns, Australia, pp. 1-11.
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Background: The treatment for cancer is often complex, involving many disciplines and therapies, which makes it difficult for Australians living in rural and remote areas to access the full range of care required within their local community. Aim: The Cancer Service Networks National Demonstration Program (CanNET) is a Commonwealth initiative which aimed to improve access to cancer care by linking regional and metropolitan cancer services. Method: Up to $7 million was made available across seven jurisdictions over a two year period from 2007 to 2009. This funding was to assist the development of sustainable links between cancer specialists and other leading health professionals in metropolitan cancer services and their colleagues in rural and regional centres. Each jurisdiction also made a contribution to the development of the cancer service networks. The cancer service network model is underpinned by: active consumer involvement; the development of agreed referral pathways; a multidisciplinary approach to cancer control; involvement of primary care and allied health professionals; championing of evidence-based practice; access to continuing professional development and training; and integration of rural and regional cancer services into a broad practice network.

Journal articles

Currow, D.C., Abernethy, A.P., Allcroft, P., Banzett, R.B., Bausewein, C., Booth, S., Carrieri-Kohlman, V., Davidson, P., Disler, R., Donesky, D., Dudgeon, D., Ekstrom, M., Farquhar, M., Higginson, I., Janssen, D., Jensen, D., Jolley, C., Krajnik, M., Laveneziana, P., McDonald, C., Maddocks, M., Morelot-Panzini, C., Moxham, J., Mularski, R.A., Noble, S., O'Donnell, D., Parshall, M.B., Pattinson, K., Phillips, J., Ross, J., Schwartzstein, R.M., Similowski, T., Simon, S.T., Smith, T., Wells, A., Yates, P., Yorke, J. & Johnson, M.J. 2016, 'The need to research refractory breathlessness', EUROPEAN RESPIRATORY JOURNAL, vol. 47, no. 1, pp. 342-343.
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Phillips, J.L. & Agar, M.R. 2016, 'Exemplary nursing leadership is central to improving care of the dying', Journal of Nursing Management, vol. 24, no. 1, pp. 1-3.
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Davidson, P.M., Phillips, J.L., Dennison-Himmelfarb, C., Thompson, S.C., Luckett, T. & Currow, D.C. 2016, 'Providing palliative care for cardiovascular disease from a perspective of sociocultural diversity: a global view', CURRENT OPINION IN SUPPORTIVE AND PALLIATIVE CARE, vol. 10, no. 1, pp. 11-17.
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Hosie, A., Lobb, E., Agar, M., Davidson, P., Chye, R., Lam, L. & Phillips, J. 2016, 'Measuring delirium point-prevalence in two Australian palliative care inpatient units.', International journal of palliative nursing, vol. 22, no. 1, pp. 13-21.
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Internationally, delirium prevalence in palliative care is reported to range between 26-88%, yet little is known about the occurrence of delirium in Australian palliative care inpatient populations.To: 1) ascertain 24-hour delirium point-prevalence in an Australian palliative care inpatient population; 2) test the feasibility and acceptability of the delirium measurement methodology.This was a prospective cross-sectional study. Delirium was measured in patients of two palliative care units using the Nursing Delirium Screening Scale, Memorial Delirium Assessment Scale and DSM-5 diagnostic criteria. Descriptive statistics were used to report patient demographics, palliative care phase, function, delirium measure completion, and proportion of patients with a positive screen and diagnosis.Patients (n=47) had a mean age of 74 years (SD+10) and mostly malignant diagnoses (96%). All patients were screened for delirium, but few were capable of completing the Memorial Delirium Assessment Scale (n=2). One-third of patients (34%) screened positive for delirium and 19% were diagnosed as delirious according to the DSM-5.The Nursing Delirium Screening Scale and physician application of DSM-5 proved feasible and acceptable, while the Memorial Delirium Assessment Scale did not. Patients' advanced age and proportions screening positive for delirium and diagnosed as delirious attest to the need to rapidly recognise, assess and respond to patients experiencing this distressing disorder while being cared for in palliative care inpatient settings.
Johnson, M.J., Booth, S., Currow, D.C., Lam, L.T. & Phillips, J.L. 2016, 'A Mixed-Methods, Randomized, Controlled Feasibility Trial to Inform the Design of a Phase III Trial to Test the Effect of the Handheld Fan on Physical Activity and Carer Anxiety in Patients With Refractory Breathlessness.', Journal of pain and symptom management, vol. 51, no. 5, pp. 807-815.
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The handheld fan is an inexpensive and safe way to provide facial airflow, which may reduce the sensation of chronic refractory breathlessness, a frequently encountered symptom.To test the feasibility of developing an adequately powered, multicenter, multinational randomized controlled trial comparing the efficacy of a handheld fan and exercise advice with advice alone in increasing activity in people with chronic refractory breathlessness from a variety of medical conditions, measuring recruitment rates; data quality; and potential primary outcome measures.This was a Phase II, multisite, international, parallel, nonblinded, mixed-methods randomized controlled trial. Participants were centrally randomized to fan or control. All received breathlessness self-management/exercise advice and were followed up weekly for four weeks. Participants/carers were invited to participate in a semistructured interview at the study's conclusion.Ninety-seven people were screened, 49 randomized (mean age 68 years; 49% men), and 43 completed the study. Site recruitment varied from 0.25 to 3.3/month and screening:randomization from 1.1:1 to 8.5:1. There were few missing data except for the Chronic Obstructive Pulmonary Disease Self-Efficacy Scale (two-thirds of data missing). No harms were observed. Three interview themes included 1) a fan is a helpful self-management strategy, 2) a fan aids recovery, and 3) a symptom control trial was welcome.A definitive, multisite trial to study the use of the handheld fan as part of self-management of chronic refractory breathlessness is feasible. Participants found the fan useful. However, the value of information for changing practice or policy is unlikely to justify the expense of such a trial, given perceived benefits, the minimal costs, and an absence of harms demonstrated in this study.
Vongmany, J., Hickman, L.D., Lewis, J., Newton, P.J. & Phillips, J.L. 2016, 'Anxiety in chronic heart failure and the risk of increased hospitalisations and mortality: A systematic review.', European Journal of Cardiovascular Nursing.
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Anxiety is a serious affective mood disorder that affects many chronic heart failure patients. While there is ample evidence that depression increases hospitalisations and mortality in chronic heart failure patients, it is unclear whether this association also exists for anxiety.The purpose of this study was to report on prospective cohort studies investigating anxiety in chronic heart failure patients and its association with hospitalisations and mortality rates. This systematic review aims to improve the current knowledge of anxiety as a potential prognostic predictor in chronic heart failure populations.This systematic review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Studies were identified by accessing electronic databases Embase, Medline, Cumulative Index to Nursing and Allied Health Literature and PsycINFO. Studies were included if they: employed a prospective cohort study design, included chronic heart failure participants with a confirmed clinical diagnosis plus anxiety confirmed by a validated anxiety assessment tool and/or clinical diagnosis and reported longitudinal hospitalisation rates and mortality data in chronic heart failure.Six studies were identified for inclusion. A study investigating hospitalisations and mortality rates found a significant (p<0.05) association solely between hospitalisation and anxiety. Of four studies reporting on hospitalisations alone, only two reported significant associations with anxiety. One study reported rates of mortality alone and identified no significant associations between mortality and anxiety. There was some variation in quality of the studies in regards to their methodology, analysis and reported measures/outcomes, which may have affected the results reported.It is possible that anxiety does predict hospitalisations in chronic heart failure populations, however further research is required to confirm this observation.
Heneka, N., Shaw, T., Rowett, D. & Phillips, J.L. 2016, 'Quantifying the burden of opioid medication errors in adult oncology and palliative care settings: A systematic review', Palliative Medicine, vol. 30, no. 6, pp. 520-532.
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Bhattarai, P., Hickman, L. & Phillips, J. 2016, 'Pain among hospitalized older people with heart failure and their preparation to manage this symptom on discharge: A descriptive-observational study.', Contemporary nurse, pp. 1-22.
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Globally, Heart Failure (HF) is one of the major health issues faced by many older people. It causes significant symptom burden that require ongoing management. This paper reports on an descriptive observational study undertaken to: 1) describe the prevalence of pain and analgesic prescription usage in hospitalized older HF patients; 2) determine the degree to which these patients are provided with a pain self-management strategy prior to discharge; and 3) determine if the patients' pain self-management strategy has been detailed in the discharge summary. A total of 122 older HF patients were included in this study. Results indicated that moderate to serve pain (Numeric rating scale (NRS) score 4) is experienced by a substantial number of older people hospitalized with HF. There is little documented evidence that older people are provided with adequate analgesic prescriptions and the instructions required to effectively manage their pain on discharge to the community.
Athari, F., Davidson, P.M., Hillman, K.M. & Phillips, J. 2016, 'Implementing a palliative approach in the intensive care unit: an oxymoron or a realistic possibility?', International journal of palliative nursing, vol. 22, no. 4, pp. 163-165.
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Currow, D.C., Phillips, J. & Clark, K. 2016, 'Using opioids in general practice for chronic non-cancer pain: An overview of current evidence', Medical Journal of Australia, vol. 204, no. 8, pp. 305-309.e2.
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&copy; 2016 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved. * Chronic non-cancer pain (lasting more than 3months) is highly prevalent in Australia (17% of males and 20%of females) and its optimal management is crucial to the health and wellbeing of the community. For 5% of the population, such pain interferesmarkedly with daily function. Part of the treatment for acute non-cancer pain for many people will include opioid analgesics at least for days to weeks. However, as pain becomes chronic, evidence to support ongoing prescription of opioids is lacking. There is increasing pressure to ensure that prescribing opioid analgesics is minimised to reduce not only the risk of dependence and illicit diversion but also the potential harms associated with tolerance, side effects and complications. * Frameworks for considering opioid prescribing include assessing suitability of the patient for opioids; initiating a trial of therapy; and monitoring long term use. There is limited evidence of the long term efficacy of opioids for chronic non-cancer pain, and documented clinical consequences beyond addiction include acceleration of loss of bone mineral density, hypogonadism and an association with increased risk of acute myocardial infarction. * Careful clinical selection of patients can help optimise the evidence-based use of opioids for chronic non-cancer pain: only treat pain that has been as well defined as possible when non-opioid therapies have not been effective; consider referral to specialist services for assessment if doses are above 100mg oral morphine equivalent per 24 hours or the duration of therapy is longer than 4 weeks; limit prescribing to only one practitioner; seek an agreement with the patient for the initiation and potential withdrawal of opioids if the therapeutic trial is not effective.
McGregor, D., Rankin, N., Butow, P., York, S., White, K., Phillips, J., Stone, E., Barnes, D., Jones, R. & Shaw, T. 2016, 'Closing evidence-practice gaps in lung cancer: Results from multi-methods priority setting in the clinical context.', Asia-Pacific journal of clinical oncology.
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To establish priorities for implementation research to reduce evidence-practice gaps in lung cancer care.A modified Nominal Group Technique was used to prioritize evidence-practice gaps in lung cancer care with oncology professionals at three clinical study sites: one rural and two metropolitan. A multimethods design was used to gather quantitative and qualitative data. Quantitative data were analyzed with descriptive statistics, while qualitative data were thematically analyzed.Forty-two health professionals participated, representing a multidisciplinary spread across the care trajectory. A standout priority was identified: reducing the time from first presentation of symptoms to diagnosis and referral for treatment (gap 1), as well as significant focus on a number of presented priorities, including: utilization of active treatments; timely referral to palliative care services; screening as a potential diagnostic tool; and focusing on the care needs of our vulnerable population groups. We describe emerging themes from the qualitative analysis, including: patient help-seeking behavior, provider knowledge about lung cancer, service factors, patient and provider factors in not receiving treatment, the "flow on" effect of variations from optimal care, vulnerable populations of patients, psychosocial needs and early referral to palliative care services.This study is an example of a priority setting partnership between clinicians and health researchers. The priorities highlighted by this study guide future decision making for collaborative implementation of research in lung cancer care.
Rao, A., Hickman, L.D., Phillips, J.L. & Sibbritt, D. 2016, 'Prevalence and characteristics of Australian women who use prayer or spiritual healing: A nationally representative cross-sectional study', Complementary Therapies in Medicine, vol. 27, pp. 35-42.
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&copy; 2016 Elsevier Ltd.Objectives: To determine the prevalence and characteristics of users of prayer or spiritual healing among Australian women aged 31-36 years. Design and setting: This cross-sectional study was conducted as a part of the Australian Longitudinal Study on Women's Health (ALSWH). The sample used in the current sub-study were participants from the 'young' cohort (1973-78) (n = 8180) aged between 31 and 36 years. Main outcome measure: Use of prayer or spiritual healing. Results: Prayer or spiritual healing was used on a regular basis by 20% of women aged between 31 and 36 years in 2009. Women who had symptoms of chronic illnesses (p = 0.001), women who had never smoked (p = 0.001) and women who used other forms of CAM (p < 0.001) were significantly more likely to use prayer or spiritual healing. Conclusion: A signifibasis. Further research is required to better understand their rationale for using prayer or spiritual healing and its perceived impact on health related outcomes and general well-being.cant proportion of women use prayer or spiritual healing on a regular basis. Further research is required to better understand their rationale for using prayer or spiritual healing and its perceived impact on health related outcomes and general well-being.
Luckett, T., Disler, R., Hosie, A., Johnson, M., Davidson, P., Currow, D., Sumah, A. & Phillips, J. 2016, 'Content and quality of websites supporting self-management of chronic breathlessness in advanced illness: a systematic review.', NPJ primary care respiratory medicine, vol. 26, p. 16025.
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Chronic breathlessness is a common, burdensome and distressing symptom in many advanced chronic illnesses. Self-management strategies are essential to optimise treatment, daily functioning and emotional coping. People with chronic illness commonly search the internet for advice on self-management. A review was undertaken in June 2015 to describe the content and quality of online advice on breathlessness self-management, to highlight under-served areas and to identify any unsafe content. Google was searched from Sydney, Australia, using the five most common search terms for breathlessness identified by Google Trends. We also hand-searched the websites of national associations. Websites were included if they were freely available in English and provided practical advice on self-management. Website quality was assessed using the American Medical Association Benchmarks. Readability was assessed using the Flesch-Kincaid grades, with grade 8 considered the maximum acceptable for enabling access. Ninety-one web pages from 44 websites met the inclusion criteria, including 14 national association websites not returned by Google searches. Most websites were generated in the USA (n=28, 64%) and focused on breathing techniques (n=38, 86%) and chronic obstructive pulmonary disease (n=27, 61%). No websites were found to offer unsafe advice. Adherence to quality benchmarks ranged from 9% for disclosure to 77% for currency. Fifteen (54%) of 28 written websites required grade 9 reading level. Future development should focus on advice and tools to support goal setting, problem solving and monitoring of breathlessness. National associations are encouraged to improve website visibility and comply with standards for quality and readability.
DiGiacomo, M., Hatano, Y., Phillips, J., Lewis, J., Abernathy, A. & Currow, D. 2016, 'Caregiver characteristics and bereavement needs: findings from a population study', Palliative Medicine.
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Background: Globally, the majority of care for people with life-limiting illnesses is provided by informal caregivers. Identifying characteristics of caregivers that may have unmet needs and negative outcomes can enable provision of better support to facilitate their adjustment. Aim: We compared characteristics, expressed unmet needs, and outcomes for spousal caregivers, with other caregivers at the end of life, by gender and age. Design: The South Australian Health Omnibus is an annual, random, face-to-face, cross-sectional survey wherein respondents are asked about end-of-life care. Setting/Participants: Participants were aged over 15, resided in households in South Australia, and had someone close to them die from a terminal illness in the last five years. Results: Of the 1,540 respondents who provided hands-on care for someone close at the end of life, 155 were widows/widowers. Bereaved spousal caregivers were more likely to: be older, female, better educated, have lower incomes, less full-time work, English as second language, sought help with grief, and provided more day-to-day care for longer periods. Spousal caregivers were less likely to be willing to take on caregiving again, less able to 'move on' with life, and needed greater emotional support and more information about the illness and services. The only difference between widows and widowers was older age of spouse in women. Younger spousal caregivers perceived greater unmet emotional needs and were significantly less likely to be able to 'move on'. Conclusions: Spousal caregivers are different from other caregivers, with more intense needs that are not fully met. These have implications for bereavement, health, and social services.
Forber, J., DiGiacomo, M., Carter, B., Davidson, P.M., Phillips, J. & Jackson, D. 2016, 'In pursuit of an optimal model of undergraduate nurse clinical education: an integrative review', Nurse Education in Practice.
Agar, M.R., Quinn, S.J., Crawford, G.B., Ritchie, C.S., Phillips, J.L., Collier, A. & Currow, D.C. 2016, 'Predictors of Mortality for Delirium in Palliative Care.', Journal of palliative medicine.
Delirium has a high mortality rate. Understanding predictors of prognosis in patients with delirium will aid treatment decisions and communication. This study aimed to explore variables associated with death during an established episode of delirium in palliative care when haloperidol treatment had been commenced.A consecutive cohort of palliative care patients, from 14 centers across four countries, is reported. The outcome of interest was death within 14 days from commencement of haloperidol treatment for delirium. Clinicodemographic variables explored were delirium severity, age, gender, primary life limiting illness, body mass index (BMI), total daily haloperidol dose at baseline (mg), functional status, and comorbidities.One hundred and sixteen palliative care patients where vital status was known were included in the analysis; 45% (n=52) died within 10 days, and 56% (n=65) died within 14 days. In multivariate analyses no clinical or demographic variables predicted death, apart from lower BMI in noncancer patients.This study has shown a very high mortality rate within two weeks of commencing haloperidol for delirium in palliative care, with no clear clinical predictors for those with a higher chance of dying. Having a higher BMI offered some benefit in survival, but only in noncancer patients. When delirium occurs in advanced illness, discussion should be initiated about the gravity of the clinical situation.
Phillips, J.L., Lovell, M., Luckett, T., Agar, M., Green, A.R. & Davidson, P.M. 2015, 'Australian survey of current practice and guideline use in adult cancer pain assessment and management: The community nurse perspective', Collegian, vol. 22, no. 1, pp. 33-41.
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Cancer pain remains a major public health concern. Despite effective treatmentsbeing available to manage the majority of cancer pain, this debilitating symptom is frequentlyunder treated. As cancer has becomes a chronic disease a range of health professionals, includ-ing community nurses in Australia are increasingly caring for people living with cancer relatedpain. Yet, little is known about community nurses capacity to assess and manage cancer painin accordance with best available evidence.
Virdun, C., Brown, N., Phillips, J.L., Luckett, T., Agar, M., Green, A.R. & Davidson, P.M. 2015, 'Elements of optimal paediatric palliative care for children and young people: An integrative review using a systematic approach', Collegian, vol. 22, no. 4, pp. 421-431.
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Background: Models of palliative care need to address the unmet needs of children, youngpeople and families.Objective: To undertake an integrative review to identify the key elements of optimal paediatric palliative care from the perspectives of children and young people with palliative care needs and their parents.
Koch, J., Everett, B., Phillips, J. & Davidson, P.M. 2015, 'Is there a relationship between the diversity characteristics of nursing students and their clinical placement experiences? A literature review', Collegian, vol. 22, no. 3, pp. 307-318.
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Background: There has been an increase in ethno-cultural, linguistic, and socio-demographical diversity in students enrolling in undergraduate nursing programs. Diversity also involves other characteristics, but little is known about how diversity impacts on the clinical experiences of nursing students. Aim: The aim of this review is to identify studies which describe the clinical placement experiences of nursing students who have a broad range of diversity characteristics. Methods: Major databases were searched and original studies published from 2003 to 30 June 2013 were eligible for inclusion. An expanded definition of diversity was used to include characteristics such as ethnicity, language, age, religion, gender, socioeconomic status, carer responsibilities, sexual orientation and special needs/disability. Findings: Male gender and speaking English as a second language are diversity characteristics associated with a less positive clinical experience. These students are also more likely to leave their nursing program. Mature-aged students and those from ethnic minority groups were also noted to have a less positive clinical experience and in some cases, this also increased attrition. However, it was difficult to determine the impact of these characteristics alone as they appeared to be linked with other characteristics such as financial difficulties and carer responsibilities in the case of mature-aged students, and language and international student status in the case of ethnicity. Conclusions: Given the significant benefits associated with preparing a diverse nursing workforce, it is an imperative to better understand the impact of diversity on nursing students to ensure that every placement becomes a positive and valuable learning experience. &copy; 2014 Australian College of Nursing Ltd.
Phillips, J., Dal Grande, E., Ritchie, C., Abernethy, A.P. & Currow, D.C. 2015, 'A population-based cross-sectional study that defined normative population data for the Life-Space Mobility Assessment-composite score.', Journal of pain and symptom management, vol. 49, no. 5, pp. 885-893.
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Mobility is linked to health status and quality of life. Life-Space Mobility Assessment (LSMA; range 0-120) measures the spatial extent of people's excursion and physical support needs over the preceding month.The aim of this study was to generate normative population data for an LSMA-Composite (LSMA-C) score, irrespective of age or health service contact and explore the LSM of people with diabetes, current asthma, arthritis, and osteoporosis.LSMA questions were included in the 2011 South Australian Health Omnibus Survey, a multistage, systematic, and clustered sample of household face-to-face interviews. Sociodemographic and clinical variables were explored in relation to LSMA scores using descriptive, univariable, and multivariable analyses and receiver operator curves.For the 3032 respondents, the mean LSMA score was 98.3 (SD 20.3; median 100; interquartile range 34 [86-120]; range 6-120). Five percent of respondents scored <60, 11% scored between 60 and 79, 27% scored between 80 and 99, and the remainder scored between 100 and 120. After 55 years of age, LSMA-C scores declined, more so in females. In multivariable analysis, declining scores were associated with being female, being older, living in rural areas, lower educational attainment, not working, lower household income, and higher numbers of chronic conditions (R(2) = 0.35, P < 0.001). The receiver operator curve demonstrated a highly specific but relatively insensitive measure.Having controlled for known confounders, the male/female difference cannot be easily explained. These data will help to contextualize studies in the future that use the LSMA-C score.
Lovell, M.R., Phillips, J., Luckett, T. & Agar, M. 2015, 'Improving the system for managing cancer pain', INTERNAL MEDICINE JOURNAL, vol. 45, no. 3, pp. 361-362.
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Virdun, C. & Phillips, J. 2015, 'Commentary on Jack B, Baldry C, Groves K, Whelan A, Sephton J and Gaunt K (2013) Supporting home care for the dying: an evaluation of healthcare professionals' perspectives of an individually tailored hospice at home service. Journal of Clinical Nursing 22, 2778-2786', JOURNAL OF CLINICAL NURSING, vol. 24, no. 7-8, pp. 1147-1148.
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Currow, D.C., Clark, K., Kamal, A., Collier, A., Agar, M.R., Lovell, M.R., Phillips, J.L. & Ritchie, C. 2015, 'The Population Burden of Chronic Symptoms that Substantially Predate the Diagnosis of a Life-Limiting Illness', JOURNAL OF PALLIATIVE MEDICINE, vol. 18, no. 6, pp. 480-485.
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Collier, A., Phillips, J.L. & Iedema, R. 2015, 'The meaning of home at the end of life: A video-reflexive ethnography study', PALLIATIVE MEDICINE, vol. 29, no. 8, pp. 695-702.
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DiGiacomo, M., Lewis, J., Phillips, J., Nolan, M. & Davidson, P.M. 2015, 'The business of death: a qualitative study of financial concerns of widowed older women', BMC Women's Health, vol. 15, pp. 36-36.
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Background The feminisation of ageing and increasing number of widowed women in contemporary society has significant implications. Older women are at risk of poor health, social, and economic outcomes upon widowhood. The aim of the study was to describe women's experiences in the period soon after their husbands' death, including their financial issues and concerns, and the ways in which these experiences impacted on the transition to widowhood late in life. Methods This was a longitudinal study using serial in-depth semi-structured interviews with 21 community-dwelling women over the age of 65 in Australia. Verbatim transcripts underwent Interpretive Phenomenological Analysis. Results Thematic analysis revealed: 1) administrative burden increases vulnerability; 2) gender roles impact on transitions; and 3) financial adjustments render housing insecurity and health risk. High administrative burden within the context of significant grief and mourning was a defining feature of the early bereavement period. Complicated protracted administrative processes, insensitive interactions, and reminders of loss contributed to distress, anxiety and feelings of demoralisation. Several women identified assumption of household financial management as the most difficult aspect of coping with their husband's death. Conclusions Older women may have unmet needs for assistance with administrative, financial, and legal issues immediately following spousal death and potentially for years afterward. Lack of familiarity and absence of instrumental support with financial and legal issues signal the need for policy reform, resources to improve financial literacy in women throughout the life course, increased advocacy, and consideration of different support and service models.
Lovell, M., Luckett, T., Boyle, F., Stubbs, J., Phillips, J., Davidson, P.M., Olver, I., von Dincklage, J. & Agar, M. 2015, 'Adaptation of international guidelines on assessment and management of cancer pain for the Australian context', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, vol. 11, no. 2, pp. 170-177.
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Virdun, C., Luckett, T., Davidson, P.M. & Phillips, J. 2015, 'Dying in the hospital setting: A systematic review of quantitative studies identifying the elements of end-of-life care that patients and their families rank as being most important.', Palliative Medicine, vol. 29, no. 9, pp. 774-796.
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BACKGROUND: The majority of expected deaths occur in hospitals where optimal end-of-life care is not yet fully realised, as evidenced by recent reviews outlining experience of care. Better understanding what patients and their families consider to be the most important elements of inpatient end-of-life care is crucial to addressing this gap. AIM AND DESIGN: This systematic review aimed to ascertain the five most important elements of inpatient end-of-life care as identified by patients with palliative care needs and their families. DATA SOURCES: Nine electronic databases from 1990 to 2014 were searched along with key internet search engines and handsearching of included article reference lists. Quality of included studies was appraised by two researchers. RESULTS: Of 1859 articles, 8 met the inclusion criteria generating data from 1141 patients and 3117 families. Synthesis of the top five elements identified four common end-of-life care domains considered important to both patients and their families, namely, (1) effective communication and shared decision making, (2) expert care, (3) respectful and compassionate care and (4) trust and confidence in clinicians. The final domains differed with financial affairs being important to families, while an adequate environment for care and minimising burden both being important to patients. CONCLUSION: This review adds to what has been known for over two decades in relation to patient and family priorities for end-of-life care within the hospital setting. The challenge for health care services is to act on this evidence, reconfigure care systems accordingly and ensure universal access to optimal end-of-life care within hospitals.
Luckett, T., Bhattarai, P., Phillips, J., Agar, M., Currow, D., Krastev, Y. & Davidson, P.M. 2015, 'Advance care planning in 21st century Australia: a systematic review and appraisal of online advance care directive templates against national framework criteria', AUSTRALIAN HEALTH REVIEW, vol. 39, no. 5, pp. 552-560.
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Chroinin, D.N., Goldsbury, D., O'Connell, D.L., Beveridge, A., Davidson, P., Girgis, A., Ingham, N., Phillips, J.L., Wilkinson, A. & Ingham, J. 2015, 'Patterns of hospital-based healthcare use amongst dementia patients in their last year of life in New South Wales (NSW)', AUSTRALASIAN JOURNAL ON AGEING, vol. 34, pp. 22-22.
Rao, A., Sibbritt, D., Phillips, J.L. & Hickman, L.D. 2015, 'Prayer or spiritual healing as adjuncts to conventional care: a cross sectional analysis of prevalence and characteristics of use among women', BMJ Open, vol. 5, no. 6, pp. e007345-e007345.
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Hosie, A., Lobb, E., Agar, M., Davidson, P.M., Chye, R. & Phillips, J. 2015, 'Nurse perceptions of the Nursing Delirium Screening Scale in two palliative care inpatient units: a focus group study', JOURNAL OF CLINICAL NURSING, vol. 24, no. 21-22, pp. 3276-3285.
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Hickman, L.D., Phillips, J.L., Newton, P.J., Halcomb, E.J., Al Abed, N. & Davidson, P.M. 2015, 'Multidisciplinary team interventions to optimise health outcomes for older people in acute care settings: A systematic review', Archives of Gerontology and Geriatrics, vol. 61, no. 3, pp. 322-329.
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Agar, M., Beattie, E., Luckett, T., Phillips, J., Luscombe, G., Goodall, S., Mitchell, G., Pond, D., Davidson, P.M. & Chenoweth, L. 2015, 'Pragmatic cluster randomised controlled trial of facilitated family case conferencing compared with usual care for improving end of life care and outcomes in nursing home residents with advanced dementia and their families: the IDEAL study protocol', BMC Palliative Care, vol. 14, no. 63.
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Halkett, G.K.B., Lobb, E.A., Miller, L., Phillips, J.L., Shaw, T., Moorin, R., Long, A., King, A., Clarke, J., Fewster, S., Hudson, P., Agar, M. & Nowak, A.K. 2015, 'Protocol for the Care-IS Trial: a randomised controlled trial of a supportive educational intervention for carers of patients with high-grade glioma (HGG)', BMJ OPEN, vol. 5, no. 10.
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Heneka, N., Phillips, J.L., Rowett, D. & Shaw, T. 2015, 'Identifying opioid medication error types, incidence and patient impact in adult oncology and palliative care settings: a systematic review', Asia-Pacific Journal of Clinical Oncology, vol. 11, pp. 128-128.
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Agar, M., Luckett, T. & Phillips, J. 2015, 'Role of palliative care in survivorship', Cancer Forum, vol. 39, no. 2, pp. 90-94.
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There is consensus that survivorship care should be integrated, risk or needs stratified, individualised, coordinated and multidisciplinary. But further research is needed to determine the service models that can best deliver optimal outcomes in the most cost-effective way. Model heterogeneity and diversity is needed to address issues that are disease, treatment or symptom specific, and account for other modifying influences such as comorbid illness and lifestyle. Further work is needed to determine the key elements within models of care configured to support cancer survivors that positively influence outcomes, and how these elements can be best delivered across a diverse range of care settings. In the meantime, adopting a needs based approach to care at the individual patient level will ensure that those in most need have access to relevant support and care from specialist palliative care services. Fortunately, current Australian health reforms provide a climate of plasticity and innovation that is conducive to the paradigm shifts required.
Goldsbury, D.E., O'Connell, D.L., Girgis, A., Wilkinson, A., Phillips, J.L., Davidson, P.M. & Ingham, J.M. 2015, 'Acute hospital-based services used by adults during the last year of life in New South Wales, Australia: a population-based retrospective cohort study', BMC HEALTH SERVICES RESEARCH, vol. 15.
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Phillips, J. 2015, 'The challenge of off-label prescribing.', International journal of palliative nursing, vol. 21, no. 9, p. 419.
Phillips, J. 2015, 'Implementing evidence-based palliative care.', International journal of palliative nursing, vol. 21, no. 2, p. 55.
Phillips, J.L., Johnson, M. & Currow, D. 2015, 'Heart failure and palliative care: Are we there yet?', Cardiology Today, vol. 5, no. 1, pp. 13-16.
Luckett, T., Phillips, J.L., Agar, M., Virdun, C., Green, A.R. & Davidson, P.M. 2014, 'Elements of effective palliative care models: a rapid review', BMC Health Services Research, vol. 14, no. 136.
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Background: Population ageing, changes to the profiles of life-limiting illnesses and evolving societal attitudes prompt a critical evaluation of models of palliative care. We set out to identify evidence-based models of palliative care to inform policy reform in Australia.
Hosie, A., Agar, M., Lobb, E., Davidson, P.M. & Phillips, J.L. 2014, 'Palliative care nurses' recognition and assessment of delirium symptoms: a qualitative study using Critical Incident Technique.', International Journal of Nursing Studies, vol. Online.
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Delirium is prevalent in palliative care inpatient settings and management is often challenging. Despite nurses integral patient care role, little is known about palliative care nurses capacity to recognise, assess and respond to patients delirium symptoms.
Phillips, J.L., Andrews, L. & Hickman, L. 2014, 'Role ambiguity, role conflict or burnout: are these areas of concern for Australian palliative care volunteers?', American Journal of Hospice and Palliative Medicine, vol. In press.
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To determine whether burnout, role ambiguity, or conflict affects Australian hospice volunteers.
Phillips, J.L., Heneka, N.A., Hickman, L., Lam, L. & Shaw, T. 2014, 'Impact of a novel online learning module on specialist palliative care nurses' pain assessment competencies and patients' reports of pain: Results from a quasi-experimental pilot study', Palliative Medicine, vol. 28, no. 6, pp. 521-529.
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Background: Pain is a complex multidimensional phenomenon moderated by consumer, provider and health system factors. Effective pain management cuts across professional boundaries, with failure to screen and assess contributing to the burden of unrelieved pain.
O'Connell, D.L., Goldsbury, D.E., Davidson, P.M., Girgis, A., Phillips, J.L., Piza, M., Wilkinson, A. & Ingham, J.M. 2014, 'Acute hospital-based services utilisation during the last year of life in New South Wales, Australia: methods for a population-based study', BMJ Open, vol. Online (4), no. 3.
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The aim of this study is to describe healthcare utilisation in the last year of life for people in Australia, to help inform health services planning. The methods and datasets that are being used are described in this paper.
Phillips, J.L., Chan, R. & Currow, D.C. 2014, 'Do palliative care health professionals settle for low level evidence?', Palliative Medicine, vol. 28, no. 1.
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Invited editorial
Phillips, J.L., Lam, L., Luckett, T., Agar, M. & Currow, D. 2014, 'Is the Life Space Assessment applicable to a palliative care population? : A brief methodological report on its relationship to measures of performance and quality of life. Brief Methodological Report.', Journal of Pain and Symptom Management, vol. 47, no. 6, pp. 1121-1127.
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The spatial environments that palliative care patients frequent for business and leisure constrict as their disease progresses and their physical functioning deteriorates. Measuring a persons movement within his or her own environment is a clinically relevant and patient-centered outcome because it measures function in a way that reflects actual and not theoretical participation.
Clark, K., Byfieldt, N., Green, M., Saul, P., Lack, J. & Phillips, J.L. 2014, 'Dying in two acute hospitals: would usual care meet Australian national clinical standards?', Australian Health Review, vol. 38, no. 2, pp. 223-229.
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The Australian Commission for Quality and Safety in Health Care (ACQSHC) has articulated 10 clinical standards with the aim of improving the consistency of quality healthcare delivery. Currently, the majority of Australians die in acute hospitals. But despite this, no agreed standard of care exists to define the minimum standard of care that people should accept in the final hours to days of life. As a result, there is limited capacity to conduct audits that focus on the gap between current care and recommended care. There is, however, accumulating evidence in the end of life literature to define which aspects of care are likely to be considered most important to those people facing imminent death. These themes offer standards against which to conduct audits. This is very apt given the national recommendation that healthcare should be delivered in the context of considering peoples wishes while always treating people with dignity and respect. This work describes a gap analysis undertaken to explore if issues defined as important by people facing imminent death would have been addressed by usual care of the dying in general hospital wards. The specific issues examined included the documentation that was available to define that this person was likely to die soon and how engaged the person dying seemed to be in discussions, how the person was monitored to ensure distressing symptoms were addressed when necessary and what investigations were considered necessary after the time the person was identified as dying.
Lovell, M.R., Luckett, T., Boyle, F.M., Phillips, J., Agar, M. & Davidson, P.M. 2014, 'Patient Education, Coaching, and Self-Management for Cancer Pain', JOURNAL OF CLINICAL ONCOLOGY, vol. 32, no. 16, pp. 1712-+.
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Hosie, A., Lobb, E., Agar, M., Davidson, P.M. & Phillips, J. 2014, 'Identifying the barriers and enablers to palliative care nurses' recognition and assessment of delirium symptoms: a qualitative study.', Journal of pain and symptom management, vol. 48, no. 5, pp. 815-830.
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CONTEXT: Delirium is underrecognized by nurses, including those working in palliative care settings where the syndrome occurs frequently. Identifying contextual factors that support and/or hinder palliative care nurses' delirium recognition and assessment capabilities is crucial, to inform development of clinical practice and systems aimed at improving patients' delirium outcomes. OBJECTIVES: The aim of the study was to identify nurses' perceptions of the barriers and enablers to recognizing and assessing delirium symptoms in palliative care inpatient settings. METHODS: A series of semistructured interviews, guided by critical incident technique, were conducted with nurses working in Australian palliative care inpatient settings. A hypoactive delirium vignette prompted participants' recall of delirium and identification of the perceived factors (barriers and enablers) that impacted on their delirium recognition and assessment capabilities. Thematic content analysis was used to analyze the qualitative data. RESULTS: Thirty participants from nine palliative care services provided insights into the barriers and enablers of delirium recognition and assessment in the inpatient setting that were categorized as patient and family, health professional, and system level factors. Analysis revealed five themes, each reflecting both identified barriers and current and/or potential enablers: 1) value in listening to patients and engaging families, 2) assessment is integrated with care delivery, 3) respecting and integrating nurses' observations, 4) addressing nurses' delirium knowledge needs, and 5) integrating delirium recognition and assessment processes. CONCLUSION: Supporting the development of palliative care nursing delirium recognition and assessment practice requires attending to a range of barriers and enablers at the patient and family, health professional, and system levels.
Hickman, L.D., Kelly, H. & Phillips, J.L. 2014, 'EVITEACH: A study exploring ways to optimise the uptake of evidence-based practice to undergraduate nurses', NURSE EDUCATION IN PRACTICE, vol. 14, no. 6, pp. 598-604.
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Hosie, A. & Phillips, J. 2014, 'Editorial: Nurses' role in improving interdisciplinary delirium care in inpatient settings: Steps for action', Journal of Clinical Nursing, vol. 23, no. 21-22, pp. 2995-2997.
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Koch, J., Everett, B., Phillips, J. & Davidson, P.M. 2014, 'Diversity characteristics and the experiences of nursing students during clinical placements: A qualitative study of student, faculty and supervisors' views', Contemporary Nurse, vol. 49, pp. 15-26.
&copy; eContent Management Pty Ltd. Background: Little is known about which diversity characteristics if any, impact on nursing students' clinical placements or how these may affect the quality of their learning experiences. There is therefore a need to better understand these effects not only from the student's perspective but also from the perspective of the staff who supervise them, in order to ensure students obtain maximal benefit from their placements. Aim: To describe the clinical experiences of nursing students and the diversity characteristics that affect this learning experience. Methods: Data were collected from a series of open-ended questions embedded within a larger anonymous web-based survey, from August 2011 to March 2012. Participants included first, second and third year undergraduate Bachelor of Nursing students (N = 704) and faculty members involved in the clinical learning environment (N = 165) from seven Australian universities. Findings: Qualitative findings were clustered into three main themes: differences, difficulty and discrimination, each with three subthemes. Conclusion: Findings suggest a need to offer appropriate support for nursing students who feel different because of diversity characteristics. Whilst some of the participant perceptions are confronting they provide valuable insights for universities developing curricula and the clinical placement facilities where students obtain their experience.
Phillips, J. 2014, 'A service versus an approach: the importance of building primary palliative care.', International journal of palliative nursing, vol. 20, no. 10, p. 471.
Ni, P., Zhou, J., Wang, Z.X., Nie, R., Phillips, J. & Mao, J. 2014, 'Advance Directive and End-of-Life Care Preferences Among Nursing Home Residents in Wuhan, China: A Cross-Sectional Study', Journal of the American Medical Directors Association, vol. 15, no. 10, pp. 751-756.
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&copy; 2014 AMDA - The Society for Post-Acute and Long-Term Care Medicine. Objectives: To describe Chinese nursing home residents' knowledge of advance directive (AD) and end-of-life care preferences and to explore the predictors of their preference for AD. Design: Population-based cross-sectional survey. Settings: Nursing homes (n= 31) in Wuhan, Mainland Southern China. Participants: Cognitively intact nursing home residents (n= 467) older than 60 years. Measures: Face-to-face questionnaire interviews were used to collect information on demographics, chronic diseases, life-sustaining treatment, AD, and other end-of-life care preferences. Results: Most (95.3%) had never heard of AD, and fewer than one-third (31.5%) preferred to make an AD. More than half (52.5%) would receive life-sustaining treatment if they sustained a life-threatening condition. Fewer than one-half (43.3%) chose doctors as the surrogate decision maker about life-sustaining treatment, whereas most (78.8%) nominated their eldest son or daughter as their proxy. More than half (58.2%) wanted to live and die in their present nursing homes. The significant independent predictors of AD preference included having heard of AD before (odds ratio [OR] 9.323), having definite answers of receiving (OR 3.433) or rejecting (OR 2.530) life-sustaining treatment, and higher Cumulative Illness Rating Scale score (OR 1.098). Conclusions: Most nursing home residents did not know about AD, and nearly one-third showed positive attitudes toward it. AD should be promoted in mainland China. Education of residents, the proxy decision maker, and nursing home staff on AD is very important. Necessary policy support, legislation, or practice guidelines about AD should be made with flexibility to respect nursing home residents' rights in mainland China.
Chan, R.J., Webster, J., Phillips, J. & Currow, D.C. 2014, 'The withdrawal of the Liverpool Care Pathway in the United Kingdom: what are the implications for Australia?', The Medical journal of Australia, vol. 200, no. 10, p. 573.
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Lovell, M., Forster, B. & Phillips, J.L. 2014, 'Assessing pain in people with cancer', Pain Management Today, vol. 1, no. 2, pp. 35-37.
Luckett, T., Davidson, P.M., Lam, L., Phillips, J.L., Currow, D. & Agar, M. 2013, 'Do Community Specialist Palliative Care Services That Provide Home Nursing Increase Rates of Home Death for People with Life-Limiting Illnesses? A Systematic Review and Meta-Analysis of Comparative Studies', Journal of Pain and Symptom Management, vol. 45, no. 2, pp. 279-297.
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Context. Systematic reviews and meta-analyses suggest that community specialist palliative care services (SPCSs) can avoid hospitalizations and enable home deaths. But more information is needed regarding the relative efficacies of different models. Family caregivers highlight home nursing as the most important service, but it is also likely the most costly.
Hosie, A., Davidson, P.M., Agar, M., Sanderson, C.R. & Phillips, J.L. 2013, 'Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: A systematic review', Palliative Medicine, vol. 27, no. 6, pp. 486-498.
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Background: Delirium is a serious neuropsychiatric syndrome frequently experienced by palliative care inpatients. This syndrome is under-recognized by clinicians. While screening increases recognition, it is not a routine practice. Aim and design: This systematic review aims to examine methods, quality, and results of delirium prevalence and incidence studies in palliative care inpatient populations and discuss implications for delirium screening.
Phillips, J.L., West, P., Davidson, P.M. & Agar, M. 2013, 'Does case conferencing for people with advanced dementia living in nursing homes improve care outcomes: Evidence from an integrative review?', International Journal of Nursing Studies, vol. 50, no. 8, pp. 1122-1135.
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Objective: This integrative review aimed to appraise the evidence for case conferencing as an intervention to improve palliative care outcomes for older people living with advanced dementia in nursing homes.
DiGiacomo, M., Lewis, J., Nolan, M., Phillips, J.L. & Davidson, P.M. 2013, 'Transitioning From Caregiving to Widowhood', Journal of Pain and Symptom Management, vol. 46, no. 6, pp. 817-825.
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Older women commonly assume a caregiving role for their husbands at the end of life and are more vulnerable to poorer health, well-being, and social and economic challenges. The aim of this study was to ascertain older women's experiences of spousal caregiving at the end of life and the ways in which this experience impacts on the transition to widowhood.
Prouse, J. & Phillips, J.L. 2013, 'Care of older people living with cancer: The role of the specialist nurse and allied health professionals', Cancer Forum, vol. 37, no. 3, pp. 226-239.
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Older people with cancer have unique physiological, psychological and social needs. This article has identified several key actions that can readily be integrated into existing cancer care services to improve care outcomes for older people referred for cancer treatment, namely: embedding an integrated assessment into the initial visit to ensure early identification of symptoms and unmet needs; monitoring the effectiveness of cancer treatment and changing needs; optimising function through early and appropriate referral; maintaining GP contact; ensuring the provision of well-coordinated care; addressing psychosocial, emotional and financial needs; and minimising caregiver burden.
Crawford, G., Agar, M., Quinn, S., Phillips, J.L., Litster, C., Michael, N., Doogue, M., Rowett, D. & Currow, D. 2013, 'Pharmacovigilance in hospice/palliative care. Net effect of haloperidol for delirium', Journal Of Palliative Medicine, vol. 16, no. 11, pp. 1335-1341.
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Prescribing practice in hospice/palliative care is largely extrapolated from other areas of clinical practice, with few studies of net medication effects (benefits and harms) in hospice/palliative care to guide prescribing decisions. Hospice/palliative care patients differ in multiple ways from better studied participant groups, hence the applicability of studies in other participant groups is uncertain. Haloperidol, a butyrophenone derivative and dopamine antagonist, is commonly prescribed for nausea, vomiting, and delirium in hospice/palliative care. Its frequent use in delirium occurs despite little evidence of the effect of antipsychotics on the untreated course of delirium. The aim of this study was to examine the immediate and short-term clinical benefits and harms of haloperidol for delirium in hospice/palliative care patients. METHOD: A consecutive cohort of participants from 14 centers across four countries who had haloperidol commenced for delirium were recruited. Data were collected at three time points: baseline, 48 hours (clinical benefits), and day 10 (clinical harms). Investigators were also able to report clinical harms at any time up to 14 days after it was commenced. RESULTS: Of the 119 participants included, the average dose was 2.1?mg per 24 hours; 42 of 106 (35.2%) reported benefit at 48 hours. Harm was reported in 14 of 119 (12%) at 10 days, the most frequent being somnolence (n=11) and urinary retention (n=6). Seven participants had their medication ceased due to harms (2 for somnolence and 2 for rigidity). Approximately half (55/119) were still being treated with haloperidol after 10 days. CONCLUSION: Overall, 1 in 3 participants gained net clinical benefit at 10 days.
Currow, D. & Phillips, J.L. 2013, 'Evolution of palliative care in Australia 1973-2013', Cancer Forum, vol. 37, no. 1, pp. 38-42.
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In parallel with the rapid development of oncology in Australia, palliative and supportive care has evolved rapidly. The sponsorship for such development was largely generated by oncology services in response to unmet needs that were encountered daily. Development of state, territory and national strategies has mirrored the professional development in service delivery, education (of existing practitioners and tomorrows clinicians) and research. More recently, national programs are delivering better outcomes for palliative care patients and their families, world-leading clinical research, improved access to essential medications in the community and the ability to access quality evidence to inform practice and policy. These initiatives provide a valuable foundation for continuing to improve access to high quality clinical care wherever people live.
Steer, C. & Phillips, J.L. 2013, 'Geriatric Oncology: Current State of the Science - Invited Editorial', Cancer Forum, vol. 33, no. 3, pp. 199-200.
Invited editorial
Breaden, K., Phillips, J.L., Agar, M., Grbich, C., Abernethy, A. & Currow, D. 2013, 'The clinical and social dimension of prescribing home oxygen for the relief of refractory dyspnea', Journal Of Palliative Medicine, vol. 16, no. 3, pp. 268-273.
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Background: Chronic breathlessness is a significant problem in palliative care and oxygen is often prescribed in an attempt to ameliorate it. Often, this prescription falls outside the current funding guidelines for long-term home oxygen use. The aim of this qualitative study was to understand the factors that most influence Australian specialist palliative care nurses' initiation of home oxygen for their patients. Methods: A series of focus groups were held across three states in Australia in 2011 involving specialist palliative care nurses. The invitation to the nurses was sent by e-mail through their national association. Recorded and transcribed data were coded for themes and subthemes. A summary, which included quotes, was provided to participants to confirm. Results: Fifty-one experienced palliative care nurses participated in seven focus groups held in three capital cities. Two major themes were identified: 1) logistic/health service issues (not reported in this paper as specific to the Australian context) involving the local context of prescribing and, 2) clinical care issues that involved assessing the patient's need for home oxygen and ongoing monitoring concerns. Palliative care nurses involved in initiating or prescribing oxygen often reported using oxygen as a second-line treatment after other interventions had been trialed and these had not provided sufficient symptomatic benefit. Safety issues were a universal concern and a person living alone did not emerge as a specific issue among the nurses interviewed. Conclusion: The role of oxygen is currently seen as a second-line therapy in refractory dyspnea by specialist palliative care nurses.
DiGiacomo, M., Lewis, J., Nolan, M.T., Phillips, J. & Davidson, P.M. 2013, 'Health transitions in recently widowed older women: a mixed methods study', BMC Health Services Research, vol. 13, no. 143.
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Yee, J., Davis, G.M., Beith, J.M., Wilcken, N., Hui, R., Harrison, M.L., Currow, D., Emery, J., Phillips, J., Martin, A., Segelov, E. & Kilbreath, S.L. 2013, 'Physical activity and fitness in women with metastatic breast cancer.', JOURNAL OF CLINICAL ONCOLOGY, vol. 31, no. 26.
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Phillips, J. 2013, 'What will it take to put talking about death on our agenda?', Collegian (Royal College of Nursing, Australia), vol. 20, no. 4, pp. 205-206.
Heneka, N. & Phillips, J.L. 2013, 'Spaced Education', The Hive, vol. 1, pp. 32-33.
Disler, R.T., Currow, D., Phillips, J.L. & Davidson, P.M. 2012, 'Interventions to support a palliative care approach in patients with chronic obstructive pulmonary disease: An integrative review.', International Journal of Nursing Studies, vol. 49, no. 11, pp. 1443-1458.
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End-stage chronic obstructive pulmonary disease (COPD) is a debilitating, life-limiting condition. A palliative approach is appropriate for individuals with end-stage COPD, yet currently few interventions embrace this holistic, multidisciplinary and inclusive perspective.
Phillips, J.L., Rolley, J.X. & Davidson, P.M. 2012, 'Developing Targeted Health Service Interventions Using the PRECEDE-PROCEED Model: Two Australian Case Studies', Nursing Research and Practice, vol. 2012, pp. 1-8.
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Aims and Objectives. This paper provides an overview of the applicability of the PRECEDE-PROCEED Model to the development of targeted nursing led chronic illness interventions. Background. Changing health care practice is a complex and dynamic process that requires consideration of social, political, economic, and organisational factors. An understanding of the characteristics of the target population, health professionals, and organizations plus identification of the determinants for change are also required. Synthesizing this data to guide the development of an effective intervention is a challenging process. The PRECEDE-PROCEED Model has been used in global health care settings to guide the identification, planning, implementation, and evaluation of various health improvement initiatives. Design. Using a reflective case study approach, this paper examines the applicability of the PRECEDE-PROCEED Model to the development of targeted chronic care improvement interventions for two distinct Australian populations: a rapidly expanding and aging rural population with unmet palliative care needs and a disadvantaged urban community at higher risk of cardiovascular disease. Results. The PRECEDE-PROCEED Model approach demonstrated utility across diverse health settings in a systematic planning process. In environments characterized by increasing health care needs, limited resources, and growing community expectations, adopting planning tools such as PRECEDE-PROCEEDModel at a local level can facilitate the development of the most effective interventions. Relevance to Clinical Practice. The PRECEDE-PROCEED Model is a strong theoretical model that guides the development of realistic nursing led interventions with the best chance of being successful in existing health care environments.
Agar, M., Draper, B., Phillips, P., Phillips, J., Collier, A., Harlum, J. & Currow, D. 2012, 'Making Decisions About Delirium: A Qualitative Comparison Of Decision Making Between Nurses Working In Palliative Care, Aged Care, Aged Care Psychiatry, And Oncology', Palliative Medicine, vol. 26, no. 7, pp. 887-896.
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Background: Delirium has a significant impact on nursing practice from diagnosis and management, with under-detection and variable management of delirium being international problems. This study aimed to explore nurses' assessment and management of delir
Phillips, J.L., Piza, M. & Ingham, J.M. 2012, 'Continuing professional development programmes for rural nurses involved in palliative care delivery: an integrative review', Nurse Education Today, vol. 32, no. 4, pp. 385-392.
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Purpose To review published studies evaluating the impact of continuing professional development (CPD) programmes on rural nurses palliative care capabilities in order to inform the development of targeted learning activities for this population. Design An integrative review. Methods Searches of key electronic databases and the World Wide Web was undertaken using key words, followed by hand searching for relevant articles. All studies were reviewed by two authors using a critical appraisal tool and level of evidence hierarchy. Results The search strategies generated 74 articles, with 10 studies meeting the inclusion criteria. All of these studies evaluated palliative care CPD programmes involving rural nurses which focused on increasing palliative care capabilities. The evidence generated by this review was limited by the absence of randomised controlled trials. A level III-1 study, with a small sample size provided the highest level of evidence, but the lack of control negated the investigators' capacity to confirm causality. Few studies measured the impact of CPD on the quality of care or utilised novel technology to address the tyranny of distance. Despite, these limitations valuable insights into the barriers and facilitators to engaging rural nurses in palliative care learning opportunities were identified.
Davidson, P.M., Jiwa, M., Goldsmith, A.J., McGrath, S., DiGiacomo, M., Phillips, J.L., Agar, M., Newton, P.J. & Currow, D. 2011, 'Decisions for lung cancer chemotherapy: the influence of physician and patient factors', Supportive Care in Cancer, vol. 19, no. 8, pp. 1261-1266.
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Purpose The purpose of this study is to review the literature examining how the beliefs and behaviours of physicians and patients influence clinical communication, doctor-patient interaction and treatment decisions for lung cancer treatment. Methods Literature was obtained via electronic database searches and hand searching of journals from 1990 to 2011. Results Wide variability in perceptions of the value of chemotherapy in lung cancer is present among both physicians and patients. There is a mismatch in the degree patients and physicians weigh survival, such that patients value survival benefits highly whilst physicians strongly emphasize toxicity and associated symptoms. This lack of congruence between patients and clinicians is influenced by a range of factors and has implications for treatment decisions, long-term survival and quality of life in people affected by lung cancer. Conclusion The divergence of treatment priorities indicates a need for improved communication strategies addressing the needs and concerns of both patients and clinicians. Patients should understand the benefits and risks of treatment options, while clinicians can gain a greater awareness of factors influencing patients' decisions on treatments. Reflecting these perspectives and patient preferences for lung cancer treatment in clinical guidelines may improve clinician awareness.
Phillips, J.L., Halcomb, E. & Davidson, P.M. 2011, 'End-of-Life Care Pathways in Acute and Hospice Care: An Integrative Review', Journal of Pain and Symptom Management, vol. 41, no. 5, pp. 940-955.
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Context. Over the past decade, there has been widespread adoption of end-of life care pathways as a tool to better manage care of the dying in a variety of care settings. The adoption of various end-of-life care pathways has occurred despite lack of robust evidence for their use. Objectives. This integrative review identified published studies evaluating the impact of an end-of-life care pathway in the acute and hospice care setting from January 1996 to April 2010. Methods. A search of the electronic databases Scopus and Cumulative Index of Nursing and Allied Health Literature as well as Medline and the World Wide Web were undertaken. Articles were reviewed by two authors using a critical appraisal tool. Results. The search revealed 638 articles. Of these, 26 articles met the inclusion criteria for this integrative review. No randomized controlled trials were reported. The majority of these articles reported baseline and post implementation pathway chart audit data, whereas a smaller number were local, national, or international benchmarking studies. Most of the studies emerged from the United Kingdom, with a smaller number from the United States, The Netherlands, and Australia. Conclusion. Existing data demonstrate the utility of the end-of-life pathway in improving care of the dying. The absence of randomized controlled trial data, however, precludes definitive recommendations and underscores the importance of ongoing research.
Phillips, J.L., Salamonson, Y. & Davidson, P.M. 2011, 'An instrument to assess nurses' and care assistants' self-efficacy to provide a palliative approach to older people in residential aged care: A validation study', International Journal of Nursing Studies, vol. 48, no. 9, pp. 1096-1100.
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Objective: This study investigated the psychometric properties of the 'Palliative care self-efficacy scale', an instrument designed to assess clinicians' degree of confidence in engaging in patient and family interactions at the end-of-life. Design: The
Phillips, J.L. 2011, 'A population based approach to palliative care', Primary Times: Supporting Nurses in Primary Care, vol. 11, no. 3, pp. 30-31.
Care at the end of life is not just the responsibility of the palliative care community, but rather `everyones business. The role of the general practitioner (GP) and primary health care nurse is fundamental to the provision of high quality care for people living in the community who are approaching the end of their life.
Hosie, A., Fazekas, B., Shelby-James, T., Mills, E., Byfieldt, N., Margitanovic, V., Hunt, J. & Phillips, J.L. 2011, 'Palliative Care Clinical Trials: How nurses are contributing to ethical, integrated and evidence based care of palliative care patients participating in clinical trials', International Journal of Palliative Nursing, vol. 17, no. 5, pp. 224-230.
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The aim of this paper is to describe the emerging role of the palliative care clinical trials nurse in an era of evidence-based practice and increasing clinical trial activity in palliative care settings across Australia. An overview of the current clinical trials work is provided, with a focus on three aspects of clinical trials nursing practice that have significant implications for patients: managing the consent process, integrating clinical trials into multidisciplinary care, and establishing and building the evidence base to inform practice in palliative care settings. Clinical trials roles provide palliative care nurses with an opportunity to contribute to clinical research, help expand palliative care's evidence base, and develop their own research capabilities.
Currow, D., Burns, C., Agar, M., Phillips, J.L., McCaffrey, N. & Abernethy, A. 2011, 'Palliative caregivers who would not take on the role again', Journal of Pain and Symptom Management, vol. 41, no. 4, pp. 661-672.
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Abstract Context Health and social services rely heavily on family and friends for caregiving at the end of life. Objectives This study sought to determine the prevalence and factors associated with an unwillingness to take on the caregiving role again by interviewing former caregivers of palliative care patients. Methods The setting for this study was South Australia, with a population of 1.6 million people (7% of the Australian population) and used the South Australian Health Omnibus, an annual, face-to-face, cross-sectional, whole-of-population, multistage, systematic area sampling survey, which seeks a minimum of 3000 respondents each year statewide. One interview was conducted per household with the person over the age of 15 who most recently had a birthday. Using two years of data (n = 8377; 65.4% participation rate), comparisons between those who definitely would care again and those who would not was undertaken.
Phillips, J. 2011, 'Narrowing the palliative care gap for Aboriginal and Torres Strait Islanders: the Practice Nurse Role.', Primary Times: Supporting Nurses in Primary Care, vol. 11, no. 4, pp. 19-21.
Phillips, J.L. 2011, 'Exploring the practice nurse role in palliative care', Primary Times: Supporting Nurses in Primary Care, vol. 11, no. 1, pp. 6-7.
Phillips, J.L. 2011, 'Managing dying in the acute care setting – the role of the end-of-life care pathway', Health Matters, vol. 57, pp. 14-15.
Davidson, P.M. & Phillips, J.L. 2010, 'Facing the inevitable - death from chronic illness', EoL-Towards quality care at the end of life, vol. 2, no. 1, pp. 14-15.
Globally there is an epidemic of chronic illnesses challenging individuals, health care providers and systems.9 In contemporary society, many people live for extended periods with conditions which were in previous decades an immediate death sentence. However, these welcome changes in longevity do not defy the future certainty of death.
Ramjan, J.M., Costa, C.M., Hickman, L., Kearns, M. & Phillips, J.L. 2010, 'Integrating palliative care content into a new undergraduate nursing curriculum: The University of Notre Dame, Australia - Sydney experience', Collegian, vol. 17, no. 2 Special Issue, pp. 85-91.
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The majority of society's deaths occur in a health care environment. Regardless of whether a death occurs in acute care, hospice, residential aged care or community settings, nurses are the health professionals that will spend the largest proportion of time with the patient who has a terminal condition and their families. As few nurses have specialist palliative care qualifications it is essential that nursing education prepares graduates to achieve the core capabilities required for the delivery of best evidenced based palliative care. This reality makes the integration of palliative care content into the undergraduate nursing curricula an important priority. This paper aims to describe how palliative care content has been embedded throughout the three-year University of Notre Dame Australia, Sydney (UNDA) undergraduate nursing degree. Method: The School of Nursing at the University of Notre Dame Australia, Sydney campus is committed to ensuring that students graduate with the capabilities to deliver appropriate care to people with requiring end-of-life care. The establishment of this new School of Nursing coincided with the release of the 'The Palliative Care Curricula for Undergraduates Program' (PCC4U) learning resources. These resources have been integrated into relevant units across the three-year nursing curricula. The nursing curriculum has been design to supports the integration of palliative care knowledge into clinical practice. The Palliative Care Curricula for Undergraduates Program learning resources offer engaging palliative care case studies and scenarios for academics to utilise. Adopting an iterative approach where palliative care content is spiralled across multiple units provides opportunities for undergraduate nursing students to sequentially build and consolidate their palliative care capabilities.
Phillips, J.L. & Currow, D. 2010, 'Cancer as a chronic disease', Collegian, vol. 17, no. 2, pp. 47-50.
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Background Over the past two decades the number of people living with cancer has increased. Many cancer survivors end up with long term disabilities requiring ongoing care and support. For many people, cancer survival now means living with a chronic and complex condition. Aim The purpose of this paper is to provide an overview of the long term management issues for cancer survivors and strategies to enhance their care. Discussion Cancer survivors require ongoing support in four key areas: prevention; surveillance; intervention for consequences of cancer and its treatment; and coordination between specialist and generalist providers. Conclusion Cancer survivors experience significant physical and psychological morbidity which makes minimising their burden of disability and distress an important priority. Survivors require ongoing care that is well co-ordinated, focuses on prevention, provides going surveillance whilst minimising and managing the long term effects of treatment and other co-morbidities.
Clark, K. & Phillips, J. 2010, 'End of life care - the importance of culture and ethnicity.', Australian family physician, vol. 39, no. 4, pp. 210-213.
BACKGROUND: Australia is a culturally and ethnically diverse country. Within such diversity there will be differing beliefs systems about death and dying. This may be a challenging prospect for health professionals. OBJECTIVE: This article discusses how cultural diversity may impact care and provides some strategies for the general practitioner when considering the provision of end of life care. DISCUSSION: This article does not attempt to provide GPs with a prescriptive approach to multicultural care, as this would run the risk of stereotyping individuals. Rather, it discusses the barriers to end of life care among different cultural and ethnic groups, and suggests ways in which to improve understanding of different cultural needs in end of life care.
Phillips, J.L., Davidson, P.M. & Willcock, S. 2009, 'An Insight Into the Delivery of a Palliative Approach in Residential Aged Care : The General Practitioner Perspective', Journal of Applied Gerontology, vol. 28, no. 3, pp. 395-405.
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Managing the complex care needs of older people is a global concern. General practitioners (GPs) play a pivotal role in aged care, yet little is known abouttheir capacity to provide palliative care in nursing homes. This study aimed to investigate GPs' perceptions and understanding of a palliative approach. A convenience sample of rural GPs (n = 13) participated in a series of three focus groups undertaken in August, 2005. These focus groups were all audio-taped, transcribed, and analyzed using thematic content analysis. Four key themes emerged: uncertainty about a palliative approach, a need to reorientate providers, the challenges of managing third parties, and making it work and moving forward. These preliminary findings suggest that integrating a palliative approach in aged care requires GPs to have a greater awareness of this paradigm and to be more effectively engaged in multidisciplinary care planning.
Davidson, P.M., Dracup, K., Phillips, J.L., Daly, J. & Padilla, G. 2008, 'Preparing for the worst while hoping for the best: The relevance of hope in the heart failure illness trajectory', Journal of Cardiovascular Nursing, vol. 22, no. 3, pp. 159-165.
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Background: Patients with heart failure have higher mortality rates than those with most malignant diseases. The heart failure illness trajectory is one of gradual decline characterized by unpredictable events such as acute decompensation of heart failure or a sudden cardiac death. Health professionals have an obligation to give patients and their families concise and honest information concerning their prognosis. The challenge exists to give what ostensibly may seem a bleak prognosis within a context of hope and optimism. Aim: To explore the role of hope in heart disease and the potential utility of this construct in the development of nursing interventions. Methods: The electronic databases CINAHL, MEDLINE, EmBASE, and PSYCHlit were searched from 1982 to August 2004 using the key words "hope," "hopelessness," "heart disease," and "heart failure." Articles were subsequently sorted to meet the inclusion criteria of (1) a philosophical discussion of the construct of hope and/or (2) investigation of hope in heart disease. Results: This search retrieved 768 articles, and 24 met the inclusion criteria. Key findings from the review indicate that "hope" and "hopelessness" are underdeveloped, yet important constructs and conceptually linked with depression and spirituality. Intriguing findings from descriptive, observational studies have demonstrated the positive impact of expression of hope on cardiovascular outcomes. These findings need to be validated in randomized controlled trials.
Phillips, J.L., Davidson, P.M., Jackson, D.E. & Kristjanson, L. 2008, 'Multi-Faceted Palliative Care Intervention: Aged Care Nurses' And Care Assistants' Perceptions And Experiences', Journal of Advanced Nursing, vol. 62, no. 2, pp. 216-227.
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Aim. This paper is a report of a study to describe residential aged care nurses' and care assistants' perceptions of a multi-faceted palliative care intervention to identify potential areas to be addressed during subsequent action research phases. Backgr
Phillips, J.L., Davidson, P.M., Newton, P.J. & DiGiacomo, M. 2008, 'Supporting patients and their caregivers after-hours at the end of life: the role of telephone support', Journal of Pain and Symptom Management, vol. 36, no. 1, pp. 11-21.
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Twenty-four hour access is accepted as a gold standard for palliative care service delivery, yet minimal data exist to justify the cost of this initiative to health care planners and policy makers. Further, there is scant information concerning optimal and efficient methods for delivering after-hours palliative care advice and support, particularly in regional and rural settings. This article reports on an evaluation of a local after-hours telephone support service in regional Australia. A centralized after-hours telephone support service was provided by generalist nurses at a Multipurpose Service in a rural community. A mixed-method evaluation, including semistructured interviews, was undertaken after 20 months of operation. During the period March 31, 2005 until November 15, 2006, 357 patients were registered as part of the Mid North Coast Rural Palliative Care Program. Ten percent of patients or their caregivers accessed the After-Hours Telephone Support Service, representing 55 occasions of service.
Davidson, P.M., Dracup, K., Phillips, J.L., Padilla, G. & Daly, J. 2007, 'Maintaining hope in transition: A conceptual framework to guide interventions for people with heart failure', Journal of Cardiovascular Nursing, vol. 22, no. 1, pp. 58-64.
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Theoretical frameworks provide a structure for the planning and delivery of nursing care and for research. Heart failure (HF), a condition of increasing prevalence in communities internationally, is responsible for high rates of morbidity, mortality, and great societal burden. The HF illness trajectory can be unpredictable and uncertain. Markers of transition, such as functional decline and increasing dependence, can signal the need for transition to a more palliative approach. This transition challenges clinicians to deliver information and interventions and to support patients and their families not only in relation to their physical status but also in the social, psychological, and existential dimensions. This article describes a theoretical framework, Maintaining Hope in Transition, informed by transition theory, to assist patients to cope with a diagnosis of HF and to guide development of nursing interventions. Transition theory provides a useful context to assist clinicians, patients, and their families adjust to the challenges inherent in a diagnosis of HF and negotiating the illness trajectory. Key factors acknowledged in the Maintaining Hope in Transition framework that determine its utility in models of care for HF patients are (1) acknowledging the changing of life circumstances, (2) restructuring reality, (3) dealing with vulnerability, (4) achieving normalization, and (5) resolving uncertainty. It is likely that incorporation of these factors in care planning, information, and interventions can facilitate patients' and their families' abilities to negotiate the HF illness trajectory, particularly in the advanced stages.
Phillips, J.L., Davidson, P.M., Ollerton, R., Jackson, D.E. & Kristjanson, L. 2007, 'A survey of commitment and compassion among nurses in residential aged care', International Journal of Palliative Nursing, vol. 13, no. 6, pp. 282-290.
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To assess the views and attitudes of aged care staff providing direct care towards palliative care and to identify their learning needs. Design: Survey design using purposive sampling methods. Findings: Nurses and care assistants (n=222) employed within nine residential aged care facilities in regional Australia completed the survey. The majority had received on the job training and were committed to providing end-of-life care. Differences in the level of confidence to deal with patient/family interactions and manage complex palliative care scenarios were evident between nurses and care assistants (p<0.05). Both nurses and care assistants perceived a need for further education in symptom management and communication, yet their content need differed significantly between groups. Conclusions: Nurses and care assistants in residential aged care facilities demonstrate commitment to the delivery of palliative care and express a need for increased palliative care competencies. The heterogeneity of roles and educational preparation within the aged care workforce indicate that tailored palliative care education initiatives are required to meet the learning needs of aged care nurses and care assistants, particularly in relation to end-of-life care. These data have implications for skill-mix and model of care development.
Halcomb, E., Gholizadeh, L., DiGiacomo, M., Phillips, J.L. & Davidson, P.M. 2007, 'Literature review: considerations in undertaking focus group research with culturally and linguistically diverse groups', Journal Of Clinical Nursing, vol. 16, no. 6, pp. 1000-1011.
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Aims. This integrated literature review seeks to identify the key considerations in conducting focus groups and discusses the specific considerations for focus group research with culturally and linguistically diverse groups. Background. The focus group method is a technique of group interview that generates data through the opinions expressed by participants. Focus groups have become an increasingly popular method of data collection in health care research. Although focus groups have been used extensively with Western populations, they are a particularly useful tool for engaging culturally and linguistically diverse populations. The success of focus groups in this context is dependent upon the cultural competence of the research team and the research questions.
Halcomb, E., Gholizadeh, L., DiGiacomo, M., Phillips, J.L. & Davidson, P.M. 2007, 'Considerations in undertaking focus group research with culturally and linguistically diverse groups in Bibliographies and Literature Reviews', Journal of Clinical Nursing, pp. 1000-1011.
Focus groups are a popular, widely accepted, and legitimate research method to determine attitudes, experiences, perceptions, and knowledge on a wide range of topics in many fields of endeavor. Focus groups lead to the voicing of attitudes and insights not readily attainable from other qualitative forms of data collection. The spectrum of interest in focus groups covers virtually all disciplines, and the variety of the applications for this technique is extraordinary. As part of the SAGE Benchmarks in Social Research Methods series, Graham Walden explores what a focus group is, how they are best used, the strengths and weaknesses of focus groups and the ethical issues surrounding focus groups, amongst other things. Volume 2, Part 2, 'Bibliographies and Literature Reviews' contains Halcomb et al.'s "Considerations in undertaking focus group research with culturally and linguistically diverse groups". URL: http://www.sagepub.com/books/Book235672/toc
Phillips, J.L., Davidson, P.M., Jackson, D.E., Kristjanson, L., Daly, J. & Curran, J. 2006, 'Residential aged care: The last frontier for palliative care', Journal Of Advanced Nursing, vol. 55, no. 4, pp. 416-424.
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This paper is a report of an explorative study describing the perceptions and beliefs about palliative care among nurses and care assistants working in residential aged care facilities in Australia. Background. Internationally, the number of people dying in residential aged care facilities is growing. In Australia, aged care providers are being encouraged and supported by a positive policy platform to deliver a palliative approach to care, which has generated significant interest from clinicians, academics and researchers. However, a little is known about the ability and capacity of residential aged care services to adopt and provide a palliative approach to care. Methods. Focus groups were used to investigate the collective perceptions and beliefs about palliative care in a convenience sample of nurses and care assistants working in residential aged care facilities in Australia. Thematic content analysis was used to analyse the data, which were collected during 2004. Results. Four major themes emerged: (1) being like family; (2) advocacy as a key role; (3) challenges in communicating with other healthcare providers; (4) battling and striving to succeed against the odds. Although participants described involvement and commitment to quality palliative care, they also expressed a need for additional education and support about symptom control, language and access to specialist services and resources.
Phillips, J.L., Davidson, P.M., Jackson, D.E., Kristjanson, L., Bennett, M. & Daly, J. 2006, 'Enhancing palliative care delivery in a regional community in Australia', Australian Health Review, vol. 30, no. 3, pp. 370-379.
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Although access to palliative care is a fundamental right for people in Australia and is endorsed by government policy, there is often limited access to specialist palliative care services in regional, rural and remote areas. This article appraises the evidence pertaining to palliative care service delivery to inform a sustainable model of palliative care that meets the needs of a regional population on the mid-north coast of New South Wales.
Davidson, P.M., Halcomb, E., Hickman, L., Phillips, J.L. & Graham, B. 2006, 'Beyond the rhetoric: what do we mean by a model of care?', Australian Journal of Advanced Nursing, vol. 23, no. 3, pp. 47-55.
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This paper aims to define what is meant by the term 'model of care' and document the pragmatic systems and processes necessary to develop, plan, implement and evaluate novel models of care delivery.


Rao, A., Hickman, L., Sibbritt, D. & Phillips, J.L. 2014, 'Palliative care patients may benefit from biofield (energy) therapies'.
Phillips, J.L., Shaw, T., Heneka, N., Hickman, L. & Lam, L. 2013, 'Specialist palliative care nurses pain assessment capabilities: results from a baseline survey'.
Jane regularly collaborates with members of the National Palliative Care Clinical Studies Collaborative (PaCCSC) and is the current Chair of the Trails Management Group.  She is an active member of the Improving Palliative Care through Clinical Trials (ImPaCCT) - The NSW collaborative trials group in palliative care. She has an established research relationship with palliative care clinicians at Cambridge University and Hull York Medical School, in the UK, as well as nursing scholars at Johns Hopkins University, School of Nursing, Baltimore USA.