Social and Behavioral Sciences Commons^™

Mortality In Medicine, Maren Dougherty

Honors Projects

Practitioners in the medical field attend to health issues across one’s lifespan from birth to death and everything in between. A common conflict in today’s practice of medicine is establishing the true function of medicine. The complete reliance on medicine to ward off death proliferates the biomedicalization of natural life processes, like death. Biomedicalization is the process in which medical authority and its accompanying technology begin to control other aspects of daily life. With medicine’s ultimate goal being to cure disease and fight death, it interferes with the inevitability of human mortality. End-of-life treatment can be taken too far without …

Implementation Of Prognosticator Algorithm For Initiation Of Serious Illness Discussions And Improving The Rate Of Palliative And Hospice Referrals, Joy Isebor

Doctor of Nursing Practice (DNP) Scholarly Projects

Context: Early serious illness conversations related to end-of-life and goals of care with seriously ill patients have been associated with improving patients' outcomes and quality of care (Bernacki et al., 2015). However, initiating these serious illness discussions has been challenging in the home-based primary care setting.

Objectives: To train and support home-based primary care clinicians in integrating best practices in serious illness discussions and decision-making engagement among patients sixty-five and older with serious illnesses, optimize the alignment between patient goals and the medical care they receive, improving their quality of life and the rate of palliative care and hospice referrals. …

How Are The Vibes? Patient And Family Experiences Of Rapport During Telehealth Calls In Palliative Care, Wendy English, Jackie Robinson, Merryn Gott

Patient Experience Journal

Interactions with rapport are considered essential to palliative care and beneficial to patient outcomes. With the current interest in telehealth, more knowledge is needed about rapport during telehealth encounters in palliative care from the patient and family viewpoint. The objective of this study was to explore patient and family experiences of rapport with health professionals during telehealth interactions in the community palliative care setting. This was a qualitative Interpretive Description study, with 18 patients and 11 family member participants recruited from four hospice locations in Aotearoa, New Zealand. Semi-structured interviews were conducted, and audio recorded between November 2020 and May …

Adherence To Opioid Patient Prescriber Agreements At A Safety Net Hospital, Soraira Pacheco, Linh M T Nguyen, John M Halphen, Nikitha N Samy, Nathaniel R Wilson, Gregory Sattler, Shane E Wing, Christine Feng, Rex A D Paulino, Pulin Shah, Supriyanka Addimulam, Riddhi Patel, Curtis J Wray, Joseph A Arthur, David Hui

Faculty and Staff Publications

Patient prescriber agreements, also known as opioid contracts or opioid treatment agreements, have been recommended as a strategy for mitigating non-medical opioid use (NMOU). The purpose of our study was to characterize the proportion of patients with PPAs, the rate of non-adherence, and clinical predictors for PPA completion and non-adherence. This retrospective study covered consecutive cancer patients seen at a palliative care clinic at a safety net hospital between 1 September 2015 and 31 December 2019. We included patients 18 years or older with cancer diagnoses who received opioids. We collected patient characteristics at consultation and information regarding PPA. The …

An Exploratory Qualitative Study Of Oncology Nurses’ Experience In Providing Care For Terminally Ill Patients In Salmaniya Medical Complex In Bahrain, Layla S. Turki, Leena Khonji, Magda Bayoumi

The Qualitative Report

Oncology nurses are essential in palliative care for cancer patients, especially at end-of-life stages. Caring for terminally ill cancer patients is stressful, accompanied by negative and positive feelings, but oncology nurses have an unavoidable responsibility. However, little is known about oncology nurses' experience in the Kingdom of Bahrain caring for terminally ill cancer patients in their final weeks or days. This study aimed to explore the experience of oncology staff nurses in providing care for terminally ill patients in the Kingdom of Bahrain, and the research answered those questions: (a) What is the experience of oncology staff nurses in providing …

Using Expressive Arts Therapies To Aid The End-Of-Life Transition For Older Adults: A Literature Review, Rosemary Lape

Expressive Therapies Capstone Theses

This literature review presents the use of expressive arts therapies as they may be applied to end-of-life care for older adults. Death is inevitable and if given the chance to prepare, the expressive arts modalities provide a foundation to process the emotions associated with the ending of a life on earth. Expressive arts provide the opportunity to communicate in non-traditional ways which have the ability to locate subconscious themes. End-of-life care previously revolved around pain management. In more recent years it has evolved to caring for the whole person emotionally, socially, psychologically, and physically. Sources were found utilizing resources provided …

Barriers To The Use Of Palliative And Hospice Care Among The Latino Population, Diana Ramirez

Electronic Theses, Projects, and Dissertations

Patients suffering from irreversible and terminal illnesses may benefit from the services provided by Palliative and Hospice Care to control any symptom burden and assist in navigating complex medical decisions. Many patients may express hesitation in accepting and enrolling to this service due to misconceptions. Language barriers may add an additional layer of complexity. This study explored the challenges Palliative Care providers encounter when introducing concept of hospice to Spanish-speaking patients their families for the first time. This study implemented qualitative research methods by using semi-structured one-on-one interviews. Ten members of an In-patient Palliative Care Team at a University Hospital …

Palliative Care And Improving Quality Of Life With End Stage Renal Disease: An Integrative Review, Natoya Bender

Doctoral Dissertations and Projects

End-stage renal disease is a rising health care problem effecting greater than 10% of the US population. there are 700,000 patients in dialysis in the U.S who are characterized by multiple comorbidities and increasing, distressing symptom burden. The need for palliative care for patient with end-stage renal disease is becoming standard of care due to their complex medical needs and high symptom burden. The aim of this integrative review investigated the incorporation of palliative care will improve the quality-of-life of patients with end-stage renal disease once introduced in their care. While palliative care provides an ideal opportunity to assess the …

Understanding The Role Of Hospice Care: Reflections From A Service-Learning Project, Avery Mccutcheon

The Eleanor Mann School of Nursing Undergraduate Honors Theses

There is little known about the part end-of-life care plays in patient care. This paper examines the role of end-of-life care in the care of a dying patient and consists of findings from a service-learning project with Circle of Life hospice. To be able to effectively care for those in the end stages of life, healthcare professionals must turn away from the curative aspects of medicine, to treating symptoms and improving quality of whatever life remains for the patient. In order to normalize EOL Care and consequently make it more accessible, we must educate our healthcare practitioners regarding the benefits …

The Ant Home Care Model In Palliative And End-Of-Life Care. An Investigation On Family Caregivers’ Satisfaction With The Services Provided., Veronica Zavagli

Translational Medicine @ UniSa

The World Health Organization plan for a Decade of Healthy Ageing 2020-2030 has established some priorities in the field of palliative and end-of-life care. It states that “people require non-discriminatory access to good-quality palliative and end-of-life care” and recommends the “implementation of strategies for the provision of information, training, respite and support for informal caregivers”. The priorities described are in line with the home care services that National Tumor Assistance (ANT) Foundation has been providing in Italy. This 5-years investigation was designed to measure caregivers’ satisfaction and determine what types of support services are associated with greater satisfaction. 5.441 family …

A Systems Thinking Framework To Improve Care Of The Terminally Ill: An Australian Case Study, Elizabeth Summerfield

Patient Experience Journal

This paper argues the value of systems thinking to patients, family members and medical practitioners in end-of-life care, particularly as a mechanism for considering when palliative care should be introduced as preferred treatment. It applies a well-established set of tenets in systems thinking retrospectively to a case study of patient care in Australia. This highlights how and where different decisions might have been made, based on a holistic consideration of the patient’s best interests. The case is written from the perspective of a family caregiver. It argues that early, deliberate conversation, framed by systems thinking tenets, can support the call …

Meaning-Centered Supervision: A Structured Self-Reflection Model To Reconnect With Personal And Professional Meaning In Palliative Care Work, Rebecca Cammy, Msw, Lcsw

Department of Medical Oncology Posters

Meaning-centered supervision explores participant’s sense of meaning of past, present, and future personal and professional experiences. The series aims to reintegrate selfreflection into clinical practice through experiential exercises, homework journaling, and group discussion. Social workers develop a narrative around themes of professional attitude, living and creating work life, and connections with the social work profession. The goal is to help palliative care social workers create a sense meaning and purpose in their work as they develop their personal and professional identities. Additionally, the hope is to support supervisees through any concerns of burnout and compassion fatigue.

An Evaluation Of The Advance Directives-Live Action Simulation Training (Ad-Last) Program, Alexandra Rosa Spinelli

Theses and Dissertations

Advance Care Planning (ACP) is a process that captures a patient’s wishes in the case of future circumstances in which they are unable to express them. Studies show that less than one third of the general population has completed some type of formal Advance Directive (AD). There are barriers to completing ADs, and these barriers operate on multiple levels, including, patient, provider and institutional. To improve providers’ capacity to help patients complete ACP, and overcome these barriers, a provider-focused intervention was conducted. The current study is an analysis of archival data collected from the Advance Directives-Live Action Simulation Training (AD-LAST) …

Evaluation Of A Palliative Care Initiative On The African Continent: Responsibly Improving Access To Pain Treatment, J. Spencer Hirschi

MPA/MPP/MPFM Capstone Projects

The African continent today faces a crisis of inadequate palliative care, in spite of the growing level of suffering of its citizens who are faced with debilitating diseases and injuries. Much of this problem stems from deeply ingrained attitudes towards opioids: while the American continent grapples with the effects of opioid overprescribing, physicians trained in Africa are taught that opioids are inappropriate for virtually all scenarios, and therefore they come to fear and avoid their use or simply remain untrained on them altogether. Patients fail to advocate for themselves out of submission to the doctor’s authority, governments remain apathetic to …

Nursing Faculty And Care Of The Dying, Jessi Balagtas

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Background: There is a demand for effective and efficient palliative and end of life nursing care that will meet the needs of the aging Baby Boomer generation. Though advancement has been made, palliative and end of life care for the seriously ill adult is still lacking. That deficiency can be traced to deficiency in nursing education. Further still, nursing faculty attitudes, knowledge and self-efficacy in palliative care may present a barrier for adequate palliative care nursing curriculum.

Objective: Explore the current knowledge, attitudes and self-efficacy of nursing faculty regarding care for seriously ill adults.

Methods and Design: A quantitative, descriptive …

We Are The Medicine, Madalynn Wendland, Toni Speed

Interprofessional Education

We are all healers— to ourselves, each other and the world around us. Whether you are on the path of becoming a health professional, or have been in practice for a long time, this half-day workshop will help you to view healing from a holistic perspective that draws from the ancient traditions while respecting contemporary science.

Taking Care Of Palliative Care, Jolene Baker, Kristina Larsen, Amanda Schumacher

Master of Social Work Student Policy Advocacy Briefs

Minnesota has done well with the amount of palliative care services provided across the state. However, rural communities in Minnesota have far less access to palliative care programs than those living in urban settings. This is in part due to the lack of availability of health care professionals in rural communities, and the lower reimbursement rates provided for palliative care programs in rural settings. Although the majority of large hospitals in Minnesota offer palliative care programs, most hospitals with fifty beds or less do not. Palliative care has been shown to improve the quality of life of individuals living with …

End-Of-Life Care And Opioid Use In India: Challenges And Opportunities, Aasems Jacob, Aju Mathew

Markey Cancer Center Faculty Publications

No abstract provided.

Reducing Symptom Distress In Patients With Advanced Cancer Using An E-Alert System For Caregivers: Pooled Analysis Of Two Randomized Clinical Trials, David H. Gustafson, Lori L. Dubenske, Amy K. Atwood, Ming-Yuan Chih, Roberta A. Johnson, Fiona Mctavish, Andrew Quanbeck, Roger L. Brown, James F. Cleary, Dhavan Shah

Health and Clinical Sciences Faculty Publications

Background: Symptom distress in patients toward the end of life can change rapidly. Family caregivers have the potential to help patients manage those symptoms, as well as their own stress, if they are equipped with the proper resources. Electronic health (eHealth) systems may be able to provide those resources. Very sick patients may not be able to use such systems themselves to report their symptoms but family caregivers could.

Objective: The aim of this paper was to assess the effects on cancer patient symptom distress of an eHealth system that alerts clinicians to significant changes in the patient’s symptoms, as …

Why It’S Not Ok For Doctors To Participate In Executions, Robert F. Johnson

Peer Reviewed Articles

A plea for direct physician participation in executions was presented by Sandeep Jauhar in a New York Times Op-Ed (“Why It’s OK for Doctors to Participate in Executions”—April 21, 2017). Jauhar’s article is not a discussion of the ethics of capital punishment. He describes his own opposition “as a matter of principle, as a doctor.” However, since capital punishment is legal in 31 states, with required physician participation in several, he acquiesces to a utilitarian stance rather than the principled approach he acknowledges is expected of a physician in this circumstance.

Gadgets And Grieving: A Chronological Analysis On The Ways In Which Advancements In Medical Technologies Have Altered The Grieving Process, Grace Mcnair

Dialogue & Nexus

Since the 1940s, both end-of-life care and advancements in medical technologies have expanded exponentially. This article explores the advancements in medical technologies and how these have altered the way that Western society grieves death. With the capabilities to prolong life, the family, the patient, and the medical team, all grieve the end of life in different ways. This article provides a chronological analysis of palliative care, hospice care, and various medical advancements. These changes in medicine are then paralleled with alterations in the bereavement process. This article explores historical narratives of Western society’s transformation of grief through the lens of …

Telehealth In Palliative Care: A Systematic Review Of Patient Reported Outcomes, Barbara A. Head, Tara J. Schapmire, Yongqiang Zheng

Faculty Publications - College of Social Work

A systematic review was conducted to explore published quantitative and qualitative research describing patient-reported outcomes of palliative telehealth intervention studies. Multiple databases were searched for articles published between January 2006 and May 2016, which met study criteria. Methodological quality was assessed using Cochrane Collaboration’s tool for assessing risk of bias for quantitative articles. For studies reporting qualitative outcomes, a checklist was used to evaluate trustworthiness of the methodology. Of the 6 studies reporting quantitative outcomes, 3 studies were rated as having moderate study quality, and 3 studies were rated as having low study quality. Of the 6 studies reporting qualitative …

Palliative Chemotherapy Among People Living In Poverty With Metastasised Colon Cancer: Facilitation By Primary Care And Health Insurance, Kevin M. Gorey, Emma Bartfay, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty, Nancy L. Richter, Madhan K. Balagurusamy

Social Work Publications

Background: Many Americans with metastasised colon cancer do not receive indicated palliative chemotherapy. We examined the effects of health insurance and physician supplies on such chemotherapy in California.

Methods: We analysed registry data for 1199 people with metastasised colon cancer diagnosed between 1996 and 2000 and followed for 1 year. We obtained data on health insurance, census tract-based socioeconomic status and county-level physician supplies. Poor neighbourhoods were oversampled and the criterion was receipt of chemotherapy. Effects were described with rate ratios (RR) and tested with logistic regression models.

Results: Palliative chemotherapy was received by less than half of the participants …

The Euthanasia Debate: International Experience And Canadian Policy Proposals, Lorna M. Fratschko

Electronic Thesis and Dissertation Repository

This thesis examines the problematic prospect of the introduction of euthanasia and physician-assisted suicide into Canadian society. The thesis argues that euthanasia is too simplistic an approach to address the complexities of end of life issues. The policy proposal under active discussion is profoundly mistaken. The language of euthanasia is examined in relation to the choice of words used, drawing attention to how words, when used loosely, can distort reality in this matter. Historical experience from other jurisdictions is presented to provide a context for this discussion. A "slippery slope" argument emerges via the claim that, in practice and in …

Palliative Practices: An Interdisciplinary Approach, Kim Kuebler, Mellar Davis, Crystal Moore

Crystal Moore

The first book of its kind, this must-have resource examines the integration of palliative interventions from a disease-specific approach, providing practical guidance on caring for patients who follow a progressive, chronic disease trajectory prior to death. This uniquely practical book addresses all aspects of palliative care, going beyond theoretical information to advise practitioners on the most effective management of common symptoms and providing physical, psychological, and spiritual comfort to patients and families. The multidisciplinary focus of care is reflected by collaborative contributors and diverse authorship of an oncology/palliative care nurse practitioner, a physician, and a social worker.

A Review Of Factors Contributing To The Shortage Of Palliative Care Service For Adolescent And Young Adult Oncology Patients, Erin K. Harper

Antioch University Dissertations & Theses

Adolescent and young adult oncology (patients aged 15–39 years old) is an emerging group of patients that are recognized to have distinctive qualities concerning their cancer treatment, including intensified psychosocial needs compared to their adult and child counterparts (Bleyer, 2012). The quality of life for adolescent and young adults during and after cancer treatment is disproportionally worse than what is reported by adults and children and the incidence of cancer in this population is steadily growing (Bleyer, 2011, 2012; Pritchard, Cuvelier, Harlos, & Barr, 2011; Rosenberg & Wolfe, 2013; Siegel, Naishadham, & Jemal, 2013; Wein, Pery, & Zer, 2011). Palliative …

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.

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 …

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, …