End-of-life (EoL) care is a supportive provision for patients in the final stages of life with the intent to provide the highest quality of life possible at this stage while ensuring their final needs are met with dignity (1). Advance care planning (ACP) may help patients prepare for EoL by discussing and recording their future wishes with those involved in their care and appointment of a surrogate (usually a family member) who will speak for them, should they become incapacitated. (2). For family members, stress is significantly reduced as the burden of EoL decision-making is alleviated which impacts positively on the grieving process (2-3). Key decision making is addressed during the ACP process with the patient themselves and their surrogate, such that they maintain autonomy over their EoL care, e.g. preferred treatment, details of decisions to refuse treatment, and location of EoL care. While decision-making is paramount during the ACP process, there is little research detailing the extent to which patients understand their prognosis (4-5). Advancing patient understanding on prognosis and EoL care is paramount to the development of patient decision-making skills. Results from a Delphi study using ACP specialists showed that knowledge of ACP, patient prognostic awareness, care congruent with patient wishes and nomination of a surrogate were amongst the top outcomes defining successful ACP (6). Comparatively, scant research has been conducted that prioritises patient-reported ACP outcomes. In other words how would patients define successful ACP and are there outcomes that ACP processes are lacking from the patient perspective? Therefore, this project will involve extensive Personal and Public Involvement (PPI) activities.
This project will address the following questions:
(1) What is the extent of prognosis understanding from the patient perspective prior to completion of an ACP?
(2) How can improved prognosis understanding facilitate ACP?
(3) What are the main ACP outcomes of importance to patients and their families?
(4) Does the current ACP process omit important patient reported outcomes?
(5) Can an intervention be developed to increase patients’ education of their condition and decision-making for future care, which aligns with patient prioritised ACP outcomes?
This PhD will address these questions using 4 main methods:
(1) A pre-registered systematic review of the literature to investigate patient education initiatives and impacts on the ACP process.
(2) A mixed methods investigation of patients’ knowledge on their healthcare conditions and prioritised ACP outcomes.
(3) Development and evaluation of an intervention examining the relationship between patient-centred education and EoL decision-making.
Skills required of the applicant:
Experience of qualitative and quantitative research methods, knowledge of end-of-life care including advance care planning. At minimum, a 2:1 in Psychology.
If the University receives a large number of applicants for the project, the following desirable criteria may be applied to shortlist applicants for interview.
The University offers the following awards to support PhD study and applications are invited from UK, EU and overseas for the following levels of support:
Full award (full-time PhD fees + DfE level of maintenance grant + RTSG for 3 years).
This scholarship will cover full-time PhD tuition fees and provide the recipient with £15,000 maintenance grant per annum for three years (subject to satisfactory academic performance). This scholarship also comes with £900 per annum for three years as a research training support grant (RTSG) allocation to help support the PhD researcher.
Part award (full-time PhD fees + 50% DfE level of maintenance grant + RTSG for 3 years).
This scholarship will cover full-time PhD tuition fees and provide the recipient with £7,500 maintenance grant per annum for three years (subject to satisfactory academic performance). This scholarship also comes with £900 per annum for three years as a research training support grant (RTSG) allocation to help support the PhD researcher.
Fees only award (PhD fees + RTSG for 3 years).
This scholarship will cover full-time PhD tuition fees for three years (subject to satisfactory academic performance). This scholarship also comes with £900 per annum for three years as a research training support grant (RTSG) allocation to help support the PhD researcher.
The scholarship will cover tuition fees at the Home rate and a maintenance allowance of £ 15,009 per annum for three years. EU applicants will only be eligible for the fee’s component of the studentship (no maintenance award is provided). For Non-EU nationals the candidate must be "settled" in the UK. This scholarship also comes with £900 per annum for three years as a research training support grant (RTSG) allocation to help support the PhD researcher.
Due consideration should be given to financing your studies; for further information on cost of living etc. please refer to: www.ulster.ac.uk/doctoralcollege/postgraduate-research/fees-and-funding/financing-your-studies
Completing the MRes provided me with a lot of different skills, particularly in research methods and lab skills.
Michelle Clements Clements - MRes - Life and Health SciencesWatch Video
Friday 7 February 2020
18 + 19 + 20 March 2020
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When applying for this PhD opportunity please quote reference number: