Medicine and Health Sciences Commons^™

Earth Suit, Bowhee Gwak, Young Park

Clinical Research in Practice: The Journal of Team Hippocrates

The authors reflect on an experience learning at the feet of a spirited patient.

New Measures To Capture End Of Life Concerns In Huntington Disease: Meaning And Purpose And Concern With Death And Dying From Hdqlife (A Patient-Reported Outcomes Measurement System)., N E Carlozzi, N R Downing, M K Mccormack, S G Schilling, J S Perlmutter, E A Hahn, J S Lai, S Frank, K A Quaid, J S Paulsen, D Cella, S M Goodnight, J A Miner, M A Nance

Rowan-Virtua School of Osteopathic Medicine Departmental Research

PURPOSE: Huntington disease (HD) is an incurable terminal disease. Thus, end of life (EOL) concerns are common in these individuals. A quantitative measure of EOL concerns in HD would enable a better understanding of how these concerns impact health-related quality of life. Therefore, we developed new measures of EOL for use in HD.

METHODS: An EOL item pool of 45 items was field tested in 507 individuals with prodromal or manifest HD. Exploratory and confirmatory factor analyses (EFA and CFA, respectively) were conducted to establish unidimensional item pools. Item response theory (IRT) and differential item functioning analyses were applied to …

Dying Among Older Adults In Switzerland: Who Dies In Hospital, Who Dies In A Nursing Home?, Xhyljeta Luta, Radoslaw Panczak, Maud Maessen, Matthias Egger, David Goodman

Dartmouth Scholarship

Background: Institutional deaths (hospitals and nursing homes) are an important issue because they are often at odds with patient preference and associated with high healthcare costs. The aim of this study was to examine deaths in institutions and the role of individual, regional, and healthcare supply characteristics in explaining variation across Swiss Hospital Service Areas (HSAs).

Methods: Retrospective study of individuals ≥66 years old who died in a Swiss institution (hospital or nursing homes) in 2010. Using a two-level logistic regression analysis we examined the amount of variation across HSAs adjusting for individual, regional and healthcare supply measures. The outcome …

A Standardized Palliative Care Referral Workflow And Educational In-Service At An Outpatient Congestive Heart Failure Clinic, Rachel E. Cardosa

Doctoral Projects

Cardiovascular disease is a significant health issue in the US as it is the leading cause of death and most cited reason of hospitalizations in Medicare enrollees (Centers for Disease Control, 2014; Unroe et al., 2011). The American Colleges of Cardiology and the American Heart Association Guidelines recommend palliative care for all patients with heart failure (Yancy et al., 2013). The purpose of the scholarly project was to address the gaps in current practice by creating a standardized palliative care referral process and education for clinicians in an outpatient Advanced Congestive Heart Failure (ACHF) Clinic. A referral tracking process was …

Improving The Completion Rate Of Advance Directives In Home Health Agencies, Ndidiamaka Ezinne Mbakpuo

Walden Dissertations and Doctoral Studies

The number of individuals aged more than 65 years in the United States and their life expectancy has been increasing in the past decades. In spite of the presence of federal and accreditation policies recommending completion of advance directive documents by patients admitted to health care settings, advance directive completion rates are low in most health care organizations. The purpose of this study was to determine the level of advance directive completion among home health patients. The health belief model provided the theoretical framework that guided this study. A retrospective chart review was carried out in a home health agency …

Palliative Care Across The Lifespan, Sonya Sabrah

Senior Honors Theses and Projects

When a patient or a loved one has a chronic, life-threatening illness, it is critical to guarantee the healthcare provider or family member helping them explore their options in order to make them as comfortable and happy as possible. Palliative care programs aim to relieve the patient or loved one from suffering by managing their symptoms, and working with them to achieve their goals and enhance their quality of life. Many people may confuse hospice with palliative care but it is important to realize hospice has certain requirements that a patient has to meet whereas palliative care programs can be …

Black Caregiver Responses To And Perceptions Of Signs, Symptoms, And Treatments At The End Of Life, Samantha M. Sermarini

Honors Undergraduate Theses

Individuals in the final stages of life are often cared for by informal caregivers whose interpretation of the patient’s signs, symptoms and treatment needs and options may be incongruent with that of healthcare providers (Docherty et al., 2008). Nurses need to fully understand the scope of this disparity. The purpose of this study was to determine how Black caregivers interpreted signs, symptoms, and treatments for symptom relief during the last months of their loved one’s life. The effect on caregiver decision making was explored. This project is a secondary analysis of preexisting qualitative data. Transcripts from 5 focus groups encompassed …