2022 Seed Funding Awardees

In 2022, we awarded four one-year-long grants of $20,000. Here are the abstracts from our winners.

Palliative care Awareness and Referral patterns of Adolescents and young adults with Life Limiting illness at End of Life (PARALLEL study)

Dr. Mohamed Abdelaal

The Ottawa Hospital

Adolescents and Young Adults (AYA), aged 15-39 years old in North America, represent approximately 7600 patients of the annual Canadian cancer population. Similarly, AYA patients with HIV, another life-threatening disease, have 30 times higher mortality rates than the general population of the same age. AYA patients face different psychosocial, medical and supportive care challenges during their illness trajectory. Palliative care is a medical specialty that aims to improve the quality of life of patients with life limiting illnesses and their families, by providing physical and psychosocial support. Despite its proven benefits, establishing AYA-specific palliative care services is limited. Moreover, there is resistance to early palliative care referrals.

This study will describe the referral patterns of AYA patients to palliative care, and define the factors associated with the incidence and timing of these referrals. Studying the referral patterns will help define the optimal time for palliative care referral, which will improve the treatment outcomes at end of life. Also, understanding who the referral teams are and classifying them as to their referral frequency will help allocate more focus to promote adequately timed palliative care referrals from the low and intermediate referring services.

Exploring the Facilitators to and Barriers in Providing Outpatient Palliative Care to Refugees: A Mixed Methods Case Study

Dr. Priya Gupta

Division of Palliative Care
Department of Family Medicine
McMaster University

Despite palliative care being key to the right to health, the World Health Organization estimates that only 14% of the 40 million people requiring palliative care each year receive it, thus highlighting a significant gap in equitable access. Often, due to lack or delay in obtaining provincial health coverage when arriving to Canada, refugees face significant challenges in accessing community palliative care services and therefore – compared to Canadian residents – are more likely to have aggressive medical interventions at the end of life.

The goal of this project is to identify and to explore the challenges refugees face when trying to access palliative care in the greater Hamilton area of Ontario. Through this, we hope to get a better understanding to what degree are refugees with palliative care needs able to access the palliative care services they require. We also hope to see if their health insurance status has an impact on access as well. This project will explore these questions by interviewing healthcare professionals in community health care centers who provide palliative care and refugee patients who have palliative care needs. We also hope to look at administrative data that will supplement the interviews to provide a more thorough understanding of our questions. This project ultimately hopes to add to understanding of the refugee experience in palliative care and begin the process of closing the inequitable gaps that exists for refugees accessing palliative care.

Speaking Compassionately with Seriously Ill Chinese Immigrants and Their Caregivers (仁医仁语)

Dr. Zhimeng Jia

Temmy Latner Centre for Palliative Care

The limited evidence describing the quality of Chinese patients’ care during serious illness reveals significant inequities. Although healthcare disparities are evident for all racial and ethnic minorities, most efforts to understand and alleviate these disparities have focused on indigenous, Black and Hispanic communities. As a result, there remains a paucity of literature aimed at understanding and alleviating health inequities among Chinese and Asian adults with serious illness in North America. Palliative care may be uniquely positioned to address these health disparities, because it aims to provide “active holistic care of individuals across all ages with serious health-related suffering due to severe illness and especially of those near the end-of-life.” While growing research points to the benefit of palliative care during serious illness, including improved quality of life, care satisfaction, and care outcomes, the role among marginalized, minoritized, and racialized communities are unknown.

The overall purpose of this research plan is to better understand the perceived role and lived experiences of palliative care among Chinese patients through a combination of recorded naturally-occurring conversations and in-depth interviews. The generated data will be used to develop a culturally-tailored communication intervention to improve seriously ill Chinese patients’ and their caregivers’ engagement and satisfaction with palliative care.

Embedded Palliative Outpatient Care for Heart disease (EPOCH): Innovative Research in Palliative and End-of-Life Care in an Ambulatory Heart Failure Population

Dr. Caroline McGuinty

University of Ottawa Heart Institute

Heart failure (HF) is a chronic, progressive and highly symptomatic disease. Palliative Care is an interdisciplinary service that improves the quality of life of patients with life-threatening illness and is well suited to support patients with HF. While there has been research on palliative care in the inpatient and home settings for patients with HF, studies on palliative care in the outpatient setting remain sparse. In 2020, the University of Ottawa Heart Institute’s Cardiac Palliative and Supportive Care clinic was created
to identify unmet palliative needs and initiate outpatient palliative care for individuals with advanced cardiac disease. This pilot seeks to understand what care is provided in the clinic, how patients and caregivers perceive the clinic, and how quantitative and qualitative data can be triangulated to provide a richer understanding of the needs of these patients and how current care can address these needs. Our pilot project will use a convergent parallel mixed methods study design.

For the quantitative component, we will conduct a retrospective chart review describing the demographics of patients, processes of care, and outcomes of the program from its inception. The qualitative component encompasses semi-structured interviews allowing us to delve deeply into patients’ and caregivers’ experiences. We will leverage thematic analysis to code and interpret the transcripts. Finally, in the mixed methods component of this work, we will triangulate the findings from the previous two aims. Future research will focus on patient reported outcomes and healthcare utilization using linkages to ICES data to inform the ongoing design and delivery of palliative care for patients. Findings from this study can be scaled to other non-malignant diseases.

2022 Seed Funding Awardees

Palliative care Awareness and Referral patterns of Adolescents and young adults with Life Limiting illness at End of Life (PARALLEL study)

Dr. Mohamed Abdelaal

The Ottawa Hospital

Exploring the Facilitators to and Barriers in Providing Outpatient Palliative Care to Refugees: A Mixed Methods Case Study

Dr. Priya Gupta

Division of Palliative Care
Department of Family Medicine
McMaster University

Speaking Compassionately with Seriously Ill Chinese Immigrants and Their Caregivers (仁医仁语)

Dr. Zhimeng Jia

Temmy Latner Centre for Palliative Care

Embedded Palliative Outpatient Care for Heart disease (EPOCH): Innovative Research in Palliative and End-of-Life Care in an Ambulatory Heart Failure Population

Dr. Caroline McGuinty

University of Ottawa Heart Institute

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