Centre for Palliative Care awards inaugural PhD studentship
A new Graduate Research Studentship focused on enhancing palliative care has been awarded to PhD Candidate Alysia Coventry.
The inaugural study grant was offered to Alysia by The Centre for Palliative Care and University of Melbourne’s Department of Nursing to pursue PhD research on improving bereavement support for families of patients in the Intensive Care Unit (ICU).
Having worked as an ICU nurse for more than 20 years, she has seen first-hand the difficulties families face when a loved one dies in this setting.
Bereavement within the intensive care unit is often sudden and unexpected and as a result, families are at increased risk of experiencing adverse psychological reactions to grief, Alysia explains.
“In ICU, the model of care is traditionally curative, but a family-centred model of care is recommended to guide the care of patients and their families before and after death in the ICU, as this can be quite traumatic.”
Alysia was among numerous PhD candidates vying for the prestigious three-year studentship that aims to broaden the scope of higher learning and research opportunities across palliative care in Australia.
Subsequent to receiving the studentship she was offered a prestigious and highly competitive national scholarship based on her outstanding prior academic work and quality of her PhD proposal.
After completing a Masters of Philosophy thesis in 2017 about families’ perceptions of end-of-life care in the ICU, Alysia discovered areas that needed considerable attention.
“I found bereavement care was one of the biggest gaps reported by families,” she adds.
Investigating how best to support families during this challenging time, as well as identifying the barriers currently faced and collating strategies to improve delivery of care will form part of Alysia’s PhD work.
The aim is to develop an evidence-based model of bereavement care that is more family-centred and can be applied consistently across ICUs in Australia.
The COVID-19 pandemic brings to forefront how grieving in isolation heightens the levels of distress experienced by family carers during the bereavement period.
“A big part of the grieving process and end-of-life care involves family being able to see the care their loved one is receiving – to see the nurse touching the patient and talking to the patient – and with COVID restrictions, that was suddenly cut out of the equation because visitation was cut out,” Alysia says.
Peter Hudson, Director of The Centre for Palliative Care – part of St Vincent’s Hospital Melbourne (SVHM) and a collaborative centre of the University of Melbourne – believes many families potentially suffer unnecessarily because the bereavement support throughout Australia is currently unsystematic.
He describes Alysia’s PhD topic as “a unique area of inquiry that will provide an important way forward in creating a novel model of care that improves end-of-life support within the ICU setting”.
He also conveys the benefits for the future of nursing scholarship in palliative care: “Nurses are typically the healthcare workers who spend the most time with patients and families, but there have been few opportunities to support nurses to build the evidence base of palliative care.”
From the ground up
Alysia hopes her PhD work will eventually be used to assist clinicians and healthcare groups provide targeted support for bereaved families of ICU patients.
Her research will incorporate surveys and interviews with those directly involved –doctors, nurses, social workers, as well as family members who recently lost a loved one in ICU – to gain essential knowledge to identify key areas of need including barriers, facilitators and opportunities for change to co-design interventions and recommendations.
She will also work closely with these key stakeholders across a number of ICUs around Australia.
“I believe if you involve the people that are going to have to deliver the care, and have to believe in the care, the end result is more likely to be accepted,” Alysia says.
Her PhD will be supervised by Prof Peter Hudson, Prof Marie Gerdtz, head of the Department of Nursing, Melbourne School of Health Sciences at the University of Melbourne, and Prof Elizabeth McInnes, Professor of Nursing at SVHM and Deputy Director of the Nursing Research Institute - St Vincent's Hospital Melbourne, St Vincent’s Health Network Sydney and Australian Catholic University.
“Alysia brings both academic and clinical expertise in the care of family members’ experiences and perceptions of end-of-life care in the ICU environment,” Prof Gerdtz says.
“Her recently published systematic review on the topic in the prestigious Journal of Advanced Nursing, along with her extensive background working as an ICU nurse, places her in the ideal position to undertake nurse-led health services research with real-world impacts for individuals, bereaved families and organisations.”
Alysia describes this as the first step in a program of research she hopes will lead to post-doctoral studies to test the feasibility of the model of care and, subsequently, piloting and evaluating its efficacy and effectiveness.
“My ultimate goal is to contribute to changes in practice that result in better outcomes for families in terms of their bereavement care,” she says.