Background: Increasing attention to palliative care for the general population has led to the development of various evidence-based or consensus-based tools and interventions. However, specific tools and interventions are needed for people with severe mental illness (SMI) who have a life-threatening illness. The aim of this systematic review is to summarize the scientific evidence on tools and interventions in palliative care for this group. Methods: Systematic searches were done in the PubMed, Cochrane Library, CINAHL, PsycINFO and Embase databases, supplemented by reference tracking, searches on the internet with free text terms, and consultations with experts to identify relevant literature. Empirical studies with qualitative, quantitative or mixed-methods designs concerning tools and interventions for use in palliative care for people with SMI were included. Methodological quality was assessed using a critical appraisal instrument for heterogeneous study designs. Stepwise study selection and the assessment of methodological quality were done independently by two review authors. Results: Four studies were included, reporting on a total of two tools and one multi-component intervention. One study concerned a tool to identify the palliative phase in patients with SMI. This tool appeared to be usable only in people with SMI with a cancer diagnosis. Furthermore, two related studies focused on a tool to involve people with SMI in discussions about medical decisions at the end of life. This tool was assessed as feasible and usable in the target group. One other study concerned the Dutch national Care Standard for palliative care, including a multicomponent intervention. The Palliative Care Standard also appeared to be feasible and usable in a mental healthcare setting, but required further tailoring to suit this specific setting. None of the included studies investigated the effects of the tools and interventions on quality of life or quality of care. Conclusions: Studies of palliative care tools and interventions for people with SMI are scarce. The existent tools and intervention need further development and should be tailored to the care needs and settings of these people. Further research is needed on the feasibility, usability and effects of tools and interventions for palliative care for people with SMI.
Background: Increasing attention to palliative care for the general population has led to the development of various evidence-based or consensus-based tools and interventions. However, specific tools and interventions are needed for people with severe mental illness (SMI) who have a life-threatening illness. The aim of this systematic review is to summarize the scientific evidence on tools and interventions in palliative care for this group. Methods: Systematic searches were done in the PubMed, Cochrane Library, CINAHL, PsycINFO and Embase databases, supplemented by reference tracking, searches on the internet with free text terms, and consultations with experts to identify relevant literature. Empirical studies with qualitative, quantitative or mixed-methods designs concerning tools and interventions for use in palliative care for people with SMI were included. Methodological quality was assessed using a critical appraisal instrument for heterogeneous study designs. Stepwise study selection and the assessment of methodological quality were done independently by two review authors. Results: Four studies were included, reporting on a total of two tools and one multi-component intervention. One study concerned a tool to identify the palliative phase in patients with SMI. This tool appeared to be usable only in people with SMI with a cancer diagnosis. Furthermore, two related studies focused on a tool to involve people with SMI in discussions about medical decisions at the end of life. This tool was assessed as feasible and usable in the target group. One other study concerned the Dutch national Care Standard for palliative care, including a multicomponent intervention. The Palliative Care Standard also appeared to be feasible and usable in a mental healthcare setting, but required further tailoring to suit this specific setting. None of the included studies investigated the effects of the tools and interventions on quality of life or quality of care. Conclusions: Studies of palliative care tools and interventions for people with SMI are scarce. The existent tools and intervention need further development and should be tailored to the care needs and settings of these people. Further research is needed on the feasibility, usability and effects of tools and interventions for palliative care for people with SMI.
Cities are becoming increasingly vulnerable to climate change, and there is an urgent need to make them more resilient. The Climatescan adaptation tool www.climatescan.nl is applied as an interactive tool for knowledge exchange and raising awareness on Nature-Bases Solutions (NBS) targeting young professionals in ClimateCafes. Climatescan is a citizen science tool created through ‘learning by doing’, which is interactive, open source, and provide more detailed information on Best Management Practices (BMPs) as: exact location, website links, free photo and film material. BMPs related to Innovations for Climatic Events (INXCES) as stormwater infiltration by swales, raingardens, water squares, green roofs subsurface infiltration are mapped and published on social media. Climatescan is in continuous development as more data is uploaded by over 250 people around the world, and improvements are made to respond to feedback from users. In an early stage of the international knowledge exchange tool Climatescan, the tool was evaluated by semi-structured interviews in theClimatescan community with the following result: stakeholders demand tools that are interactive, open source, and provide more detailed information (location, free photo and film material). In 2016 Climatescan (first stage of INXCES) was turned into an APP and within two years the tool had over10,000 users and more than 3,000 international projects. More than 60% of the users are younger than 34 and 51% of users are female, resulting in engagement with an important target group: young professionals. The tool is applied in Climatecafe.nl around the world (The Netherlands, Sweden, Philippines, Indonesia, South Africa) where in a short period of time stakeholders in triple helix context (academia, public and private sector) work on climate related challenges and exchange their knowledge in a café setting. Climatescan has also been used in other water challenges with young professionals such as the Hanseatic Water City Challenge and Wetskills. During the INXCES project over 1000 BMPs related to Innovations for Climatic Events (INXCES) are mapped inall partner countries (figure 1). The points of interest vary from just a location with a short description to a full uploaded project with location, description and summary, photos and videos, presentations, links to websites with more information and scientific papers and books (as Bryggen in Norway: https://www.climatescan.nl/projects/16/detail ).
