Medicine and Health Sciences Commons^™

Acute Hospital-Based Services Used By Adults During The Last Year Of Life In New South Wales, Australia: A Population-Based Retrospective Cohort Study, David E. Goldsbury, Dianne L. O’Connell, Afaf Girgis, Anne Wilkinson, Jane L. Phillips, Patricia M. Davidson, Jane M. Ingham

Research outputs 2014 to 2021

Background: There is limited information about health care utilisation at the end of life for people in Australia. We describe acute hospital-based services utilisation during the last year of life for all adults (aged 18+ years) who died in a 12-month period in Australia’s most populous state, New South Wales (NSW). Methods: Linked administrative health data were analysed for all adults who died in NSW in 2007 (the most recent year for which cause of death information was available for linkage for this study). The data comprised linked death records (2007), hospital admissions and emergency department (ED) presentations (2006–2007) and …

Guidelines For Physician-Assisted Suicide, Raphael Cohen-Almagor

raphael cohen-almagor

This paper proposes a set of guidelines for physician-assisted suicide (PAS). This set of guidelines integrates pertinent guidelines that were adopted in Oregon, where physician-assisted suicide is legal, in the Netherlands and Belgium where euthanasia is legal, in Switzerland where assisted suicide is practiced, and in the Northern Territory of Australia, where physician-assisted suicide was legal for a short period of time.

Guidelines For Physician-Assisted Suicide, Raphael Cohen-Almagor

raphael cohen-almagor

This paper proposes a set of guidelines for physician-assisted suicide (PAS). This set of guidelines integrates pertinent guidelines that were adopted in Oregon, where physician-assisted suicide is legal, in the Netherlands and Belgium where euthanasia is legal, in Switzerland where assisted suicide is practiced, and in the Northern Territory of Australia, where physician-assisted suicide was legal for a short period of time.

Spiritual Well-Being, Faith, Hope, Anxiety And Loneliness In Oncology Patients: A Descriptive Correlational Study, Julia R. Mueller

Master of Science in Nursing Theses

Purpose: To test theorized relationships in the newly developed Faith-Hope-Love Model of Spiritual Wellness (FHLMSW). The research questions were: 1) do measures of faith, hope and love correlate with or predict spirituality as defined by FHLMSW in a palliative care population; and 2) do relationships exist between measures of spirituality and physical symptoms and distress among the same palliative care population.

Patients and Methods: This was a descriptive correlational study, which included 21 participants with a stage III or IV cancer diagnosis that were receiving palliative care at a community oncology practice, that took place between January 2015 to March …

An Ethical Framework For End-Of-Life Discussions, Mark E. Lones

Bioethics in Faith and Practice

The primary goal of medical care is to assist patients to address medical issues which may threaten their health in order to preserve and restore the quality of the patients’ life. However, when a patient’s prognosis for meaningful survival is poor, there is a change in focus from restorative care to palliative care. The transition from “cure to comfort” is one of the most challenging and important medical care decisions the patient and family may encounter. The purpose of this article is to help give patients, families and care-givers an ethical framework to effectively discuss treatment options, values, and preferences …

Nausea/Vomiting/Anorexia, Bree Johnston Md, Mph

Palliative Care Institute

By the end of this talk, the learner should be able to: –Identify anorexia as a common source of distress for both patients and caregivers –Discuss the importance of framing and exploring meaning when dealing with patients with anorexia –Discuss the prevalence of anorexia, nausea, and vomiting among patients with serious illness –Discuss the evidence for various pharmacologic approaches to anorexia, nausea, and vomiting –Discuss nonpharmacologic approaches to anorexia, nausea, and vomiting

Realities Of Advanced Medical Interventions, Koala (Maureen) Connelly Rn, Cathy Mcconechy

Palliative Care Institute

Strategies for sharing risks and benefits of advanced medical interventions and the implications for patients’ abilities to make informed decisions.

Understanding Death With Dignity Legislation: A Necessity For The Palliative Care Provider, Frances Derook Md

Palliative Care Institute

Evidence and experience to date of Death with Dignity in Washington and Oregon.

Spiritual Perspective, Mindfulness, And Spiritual Care Practices Of Hospice And Palliative Care Nurses, Patricia Ricci-Allegra

Seton Hall University Dissertations and Theses (ETDs)

Spiritual care is an ethical obligation of the nursing profession and an essential component of palliative care, but is often misunderstood. Lack of conceptual clarity is problematic, for each nurse will provide spiritual care based on his or her understanding of what this care should include.

Regardless of how a nurse defines spiritual care, an important element of spiritual care is what nurses bring of themselves to the patient encounter. Findings from several studies have shown a positive relationship between a nurse’s spiritual perspective and spiritual care practices. Spiritual perspective has increased as a result of participating in programs designed …

End-Of-Life Care: Crossing The Bridge From Treatment To Support, Martha C. Romney Bsn, Ms, Jd, Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Impact Of Hospice Nurse Education On After-Hours Calls And Visits, Cheryl Slack

Evidence-Based Practice Project Reports

Medicare-certified hospice home care agencies must provide a 24/7 on call system for after business hours patient concerns. An agency identified a problem with a high volume of after-hours hospice calls for symptom management. How these calls are handled impact patient and family outcomes and satisfaction. A literature review provided evidence that hospice nurse education and appropriate telephone support improves symptom management, enhances family support, provides a sense of security, reduces anxiety, and promotes comfort. Providing hospice nurse education on symptom management supported the goal of this evidence based practice (EBP) project to reduce the family/caregiver need for frequent on-call …

White Paper: Northwest Life Passages - Improving Care For Patients With Serious Illness In Whatcom County, Bree Johnston, Chris Phillips, Waha Outpatient Palliative Care

Northwest Life Passages Coalition Documents

Northwest Life Passages (NWLP) is a new collaborative service that aims to address shortcomings in care and improve services for people with serious illness and their families. The proposal is to operationally couple the outpatient palliative care services already provided by PeaceHealth and Family Care Network (FCN) with community-based support services being developed by the Whatcom Alliance for Health Advancement (WAHA). It is further being proposed that PeaceHealth and WAHA pursue a collaborative fundraising strategy that calls for WAHA to focus on the development of the community-based services and PeaceHealth Foundation to pursue support for the expansion of clinical services.

Measuring Intensity Of End Of Life Care: A Systematic Review, Xhyljeta Luta, Maud Maessen, Matthias Egger, Andreas E. Stuck, David Goodman, Kerri M. Clough-Gorr

Dartmouth Scholarship

Background: Many studies have measured the intensity of end of life care. However, no summary of the measures used in the field is currently available. Objectives: To summarise features, characteristics of use and reported validity of measures used for evaluating intensity of end of life care. Methods: This was a systematic review according to PRISMA guidelines. We performed a comprehensive literature search in Ovid Medline, Embase, The Cochrane Library of Systematic Reviews and reference lists published between 1990-2014. Two reviewers independently screened titles, abstracts, full texts and extracted data. Studies were eligible if they used a measure of end of …

Unveiling The Mysteries Of Palliative Care, Jennifer Currin-Mcculloch, Karen Terry

Journal of the Georgia Public Health Association

Unveiling the Mysteries of Palliative Care

Communicating With Patients And Their Families About Palliative And End-Of-Life Care: Comfort And Educational Needs Of Nurses, Cheryl Moir, Renee Roberts, Kim Martz, Judith Perry, Laura J. Tivis

Nursing Faculty Publications and Presentations

Introduction: Effectively discussing palliative care with patients and families requires knowledge and skill. The purpose of this study was to determine perceived needs of inpatient nurses for communicating with patients and families about palliative and end-of-life (EoL) care. Method: A non-experimental design was used. In total, 60 inpatient nurses from one hospital in Idaho completed the End of Life Professional Caregiver Survey (EPCS), which examines three domains: patient and family-centered communication, cultural and ethical values, and effective care delivery. Results: The number of years’ experience nurses had (F(9,131.57)=2.22, p=0.0246; Wilk's ^=0.709) and the unit they worked on (F(6,110)=2.49, p=0.0269; Wilk's …

The Effect Of Art Therapy On Hospice And Palliative Caregivers, Carol E. Gress

Nursing Theses and Capstone Projects

A quazi-experimental, one-group, pretest/posttest study was conducted with a group of 25 hospice workers employed by a medium sized county hospice organization in the southeastern United States that was experiencing rapid personnel turn-over. Participants in the study included a doctor, a physician’s assistant, a nurse practitioner, a massage therapist, a grief counselor, a licensed practical nurse, a certified nursing assistant, two clergy, three administrative staff, three social workers, seven volunteers, eight registered nurses and one other. The purpose was to investigate whether attending four 1-hour art therapy sessions could help reduce stress and thereby Burnout. Stamm’s (2010) Professional Quality of …

Nursing Care Of Terminal Patients In Intensive Care Units, Pervell Velethia Dunbar

Walden Dissertations and Doctoral Studies

Nursing Care for Terminal Patients in Intensive Care Units

by

Pervell Dunbar

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

August 2015

Although the goal of the ICU has always been to save lives, ICU now additionally provides end-of life (EOL) care. The objective of this project was to provide ICU nurses with a comprehensive awareness of physical, emotional, and spiritual EOL care issues of patients and their families in order to be better equipped to handle EOL care. The framework used was Jean Watson's Caring model (10 Caritas). A …

Delirium Epidemiology, Systems And Nursing Practice In Palliative Care Inpatient Settings: A Descriptive Mixed Methods Project (The Depac Project), Annmarie Hosie

Theses

Background: Delirium is a distressing and serious acute neurocognitive disorder frequently experienced by hospitalised patients yet under-recognised by nurses.

Aim: To identify the actions required to improve the capabilities of specialist inpatient palliative care nurses to recognise and assess delirium.

Design: A two-phase sequential transformative mixed methods project, involving five studies and underpinned by a knowledge translation conceptual framework – collectively termed the DePAC project.

Methods: A mixed methods design was used to examine delirium in palliative care inpatient settings from epidemiological, systems and nursing practice perspectives. Participants were nurses, physicians, allied health professionals, managers and patients of Australian palliative …

Paramedics' Perceptions And Educational Needs With Respect To Palliative Care, Ian R. Rogers, Freya M. Shearer, Jeremy R. Rogers, Gail Ross-Adjie, Leanne Monterosso, Judith C. Finn

Medical Papers and Journal Articles

Introduction: In recent years the scope of palliative care has been redefined to include patients earlier in the course of their illness, and those suffering from life-limiting conditions. Paramedics may be involved in the care of these patients, especially in situations of carer distress, sudden deterioration and imminent death, as well as in non-emergent situations such as inter-facility transfers. In these scenarios, clinical decisions regarding patient care initiated by paramedics may set the trajectory for subsequent care.

Objective: To identify and measure paramedics’ perspectives and educational needs regarding palliative care provision, as well as their understanding of the common causes …

The Impact Of The Carer Support Needs Assessment Tool (Csnat) In Community Palliative Care Using A Stepped Wedge Cluster Trial, Samar Aoun, Gunn Grande, Denise Howting, Kathleen Deas, Chris Toye, Lakkhina Troeung, Kelli Stajduhar, Gail Ewing

Medical Papers and Journal Articles

Family caregiving towards the end-of-life entails considerable emotional, social, financial and physical costs for caregivers. Evidence suggests that good support can improve caregiver psychological outcomes. The primary aim of this study was to investigate the impact of using the carer support needs assessment tool (CSNAT), as an intervention to identify and address support needs in end of life home care, on family caregiver outcomes. A stepped wedge design was used to trial the CSNAT intervention in three bases of Silver Chain Hospice Care in Western Australia, 2012-14. The intervention consisted of at least two visits from nurses (2-3 weeks apart) …

A Study To Investigate The Significance Of Knowing One's Prognosis In People Diagnosed With Life-Limiting Illnesses, Erika Currier

Graduate College Dissertations and Theses

ABSTRACT

Background: For patients with life-limiting illnesses, having adequate knowledge of prognosis can strongly impact the choice between curative and supportive treatment.

Objectives: The purpose of this research study is to explore patient understanding of prognosis and to illuminate the experience of having or not having prognostic information in people diagnosed with life-limiting illnesses. This study aims to investigate the patient's understanding of the term "prognosis", the significance of the term "prognosis" to the patient, and how prognosis may or may not affect future treatment choices. In addition, this study aims to further understand the experience of prognostic communication between …

Behavioral Adjustment In Children With Life Threatening Illness A Qualitative Study, E. Joseph Becher Jr.

Antioch University Dissertations & Theses

This study investigated factors that affect adjustment in children with life-threatening illness from the viewpoint of the parents/caregivers. The data were collected from parents/caregivers whose children have a life threatening diagnosis. Parents/caregivers were interviewed and asked to complete the Parent Request Questionnaire (PRQ) which was given to them after the in-person interview. This newly developed PRQ was utilized into prior research to predict the levels of adjustment in children. It includes age, whether the child has been informed of the diagnosis, whether the child engages in age-appropriate activities, the child's prior experience with death, the child's family's involvement in treatment, …