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 …

Optimizing Collaboration: A Qualitative Analysis Of Bone Marrow Transplant Provider Perceptions Of Palliative Care Roles, Madeline Johnson

Theses and Dissertations

Bone marrow transplantation (BMT), also referred to as hematopoietic stem cell transplantation (HPSCT), is a medical procedure utilized to treat a range of malignant and non-malignant diseases including leukemias, lymphomas, aplastic anemia, immune deficiency disorders, solid tumor cancers, and more (Champlin, 1990; Bone Marrow Transplantation, 2021; Franjul Sanchez et al., 2020). BMT patients typically experience symptoms associated with induction or condition regiments that are especially burdensome, including but not limited to pain, mucositosis, nausea and vomiting, diarrhea, psychological, spiritual, and emotional concerns that may not be thoroughly addressed through their primary oncology and BMT teams alone (Ruiz et al., 2017). …

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. …

Public Sentiments And The Influence Of Information-Seeking Preferences On Knowledge, Attitudes, Death Conversation And Receptiveness Towards Palliative Care: Results From A Nationwide Survey In Singapore, Su Lin Yeo, Raymond Han Lip Ng, Tan Ying Peh, May O. Lwin, Poh Heng Chong, Patricia Soek Hui Neo, Jamie Xuelian Zhou, Angel Lee

Research Collection Lee Kong Chian School Of Business

Background: Low awareness about palliative care among the global public and healthcare communities has been frequently cited as a persistent barrier to palliative care acceptance. Given that knowledge shapes attitudes and encourages receptiveness, it is critical to examine factors that influence the motivation to increase knowledge. Health information-seeking from individuals and media has been identified as a key factor, as the process of accessing and interpreting information to enhance knowledge has been shown to positively impact health behaviours. Objective: Our study aimed to uncover public sentiments toward palliative care in Singapore. A conceptual framework was additionally developed to investigate the …

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 …

Perceived Outcomes And Barriers Of Advance Care Planning From Healthcare Professionals, Faith Parsons

Electronic Theses and Dissertations

Advance care planning (ACP) is the process of aligning patients’ values and preferences to their future medical care. ACP is important in promoting patient autonomy and helping patients and their families prepare for end-of-life conversations. Healthcare teams, made up of physicians, nurses, or social workers, carry the responsibility to engage patients into such conversations. The purpose of this study was to explore the perceptions and experiences of healthcare professionals regarding ACP outcomes and barriers. This cross- sectional study used survey responses of a convivence sample of 18 allied healthcare professionals and 4 physicians in a not-for-profit, faith-based hospital system in …

What Is The State Of The Literature About Robotic Animal Use Among Older Adults Receiving Hospice Or Palliative Care?, Allyson Miles

Social Work Theses

Objective: This review aims to assess the extent of the literature on robotic pet use among older adults receivinghospice or palliative care. Introduction: In 2015, in the U.S, an estimated 1,426,00 individuals received hospice; among this population, 94.6% were aged 65 or older (National Center for Health Statistics,2019). According to the literature, a social robot is defined as something that interacts with individuals socio-emotionally during the intervention (Hudson et al., 2020). Social robots, including robotic pets, are promising technological interventions that can benefit the psychosocial health of older adults and people with dementia. Although there are previous reviews on robotic …

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 …

The Caregiver's Conflict: The Toll Of Death And Dying On Nurses' Mental Health And Wellbeing, Madison Brown

Student Works

A major responsibility for nurses is caring for patients during the end-of-life process, as well as helping families and patients cope with the death and dying process. It is well known that death and dying greatly impacts families, but little holistic research has been done on how death and dying impacts nurses’ mental and emotional wellbeing. Using databases Google Scholar, Web of Science, and EBSCO, 14 articles were analyzed regarding the impact of death on nurses’ mental health. Results show that the age of a patient plays a bigger role on death impact than nursing specialty does, as younger patients’ …

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 …

A Virtue-Care Approach To Spiritually Sensitive Social Work., Ann M. Callahan

EKU Faculty and Staff Scholarship

Sensitivity to the importance of spirituality in social work practice has grown over the past thirty years (Kvarfordt, Sheridan, and Taylor, 2017; Oxhandler & Pargament, 2014). Research suggests that social workers often consider spirituality as an expression of cultural diversity, if not inherent to being human (Barker, 2007; Kvarfordt et al., 2017; Lun & Wai, 2015). Depending on how spirituality is defined or experienced, spirituality can be a source of strength or exacerbate suffering, particularly when a client is in crisis (Callahan, 2017). Social workers must be prepared to engage in spiritually sensitive social work (Cunningham & de Saussure, 2019; …

Beyond Bingo: Enhancing Quality Of Life In The Face Of Death For Hospice Patients With Dementia Through Integrated Expressive Arts Therapies, Development Of A Method, Jeanie Cooper Carson

Expressive Therapies Capstone Theses

This paper explores ways integrated expressive arts therapies (EAT) used with individuals with dementia in hospice can help facilitate living well in the face of dying. While research is limited regarding use of EAT with this population specifically, much significant research has been conducted to support the effectiveness of the employment of various creative arts modalities with individuals with dementia and also on hospice. Building on this research, the author developed and implemented an integrated EAT method with members of this population living in long-term care facilities in Greater Boston in the context of the pandemic of 2020-21. This paper …

Effects Of Psychosocial Support Interventions On Survival In Inpatient And Outpatient Healthcare Settings: A Meta-Analysis Of 106 Randomized Controlled Trials, Timothy B. Smith, Julianne Holt-Lunstad

Faculty Publications

We evaluated randomized controlled trials (RCTs) of psychosocial support interventions in inpatient and outpatient healthcare settings reporting survival data, including studies reporting disease-related or all-cause mortality. LOdds ratio (OR) and hazard ratio (HR) data were analyzed separately using random effects weighted models. Of 42,054 studies searched, 106 RCTs including 40,280 patients met inclusion criteria. Across 87 RCTs reporting data for discrete time periods, the average was OR = 1.20 (95% CI = 1.09 to 1.31, p < 0.001), indicating a 20% increased likelihood of survival among patients receiving psychosocial support compared to control groups receiving standard medical care. Among those studies, psychosocial interventions explicitly promoting health behaviors yielded improved likelihood of survival, whereas interventions without that primary focus did not. Across 22 RCTs reporting survival time, the average was HR = 1.29 (95% CI = 1.12 to 1.49, p < 0.001), indicating a 29% increased probability of survival over time among intervention recipients compared to controls. Among those studies, meta-regressions identified 3 moderating variables: control group type, patient disease severity, and risk of research bias. Studies with patients having relatively greater disease severity tended to yield smaller gains in survival time relative to control groups. In this meta-analysis, OR data indicated that psychosocial behavioral support interventions promoting patient motivation/coping to engage in health behaviors improved patient survival, but interventions focusing primarily on patients’ social or emotional outcomes did not prolong life. HR data indicated that psychosocial interventions, predominantly focused on social or emotional outcomes, improved survival but yielded similar effects to health information/classes and were less effective among patients with apparently greater disease severity.

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 …

Hall Of Fame Palliative Care Curriculum At Cedarville's School Of Nursing, Mark D. Weinstein

News Releases

Cedarville University’s school of nursing is one of five nursing schools in the state of Ohio to win the 2019-2020 Hall of Fame award for its End-of-Life Nursing Education Consortium (ELNEC) curriculum.

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 …

Spiritual Diversity, Spiritual Assessment, And Māori End-Of-Life Perspectives: Attaining Ka Ea,, Holly Nelson-Becker, Tess Moeke-Maxwell

Social Work: School of Social Work Faculty Publications and Other Works

The contemporary world is endowed with increasingly diverse spiritual and cultural perspectives, yet little is known about the spiritual concerns and spiritual resilience of Māori from Aotearoa New Zealand at the end of life. A context is provided for the value of spiritual assessment and identification of spiritual needs or concerns. Spiritual concerns and the desire to attain a state of ka ea (fulfillment, gratitude, or peace) may point to interventions, helping activities, or referrals that guide treatment. We reflect on qualitative findings from the 2017–2020 Pae Herenga study of 61 caregiving families, their helping professionals, and religious/spiritual leaders. We …

Exploring The Lived Experience Of Decision-Making Among Family Caregivers Of Black Older Adults With Advanced Chronic Illnesses, Theresa L. Lundy

Dissertations, Theses, and Capstone Projects

This phenomenological study explored the lived experience of family caregivers' making health care decisions with or for community-dwelling older Blacks with advanced chronic illnesses. Max van Manen’s interpretative phenomenological approach was used to understand the meaning of decision-making among participants. Semi-structured interviews were conducted with eleven family caregivers. Thematic analysis and interpretation of interviews revealed three essential themes: living out commitments with intention; making meaningful decisions situated in context; and reflecting on the past, anticipating the future. These essential themes culminated in an integrated interpretative statement: “Living out commitments with intentions of making or helping to make meaningful decisions that …

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.

Ethical Issues When Working With Terminally Ill People Who Desire To Hasten The Ends Of Their Lives: A Western Perspective, Alfred Allan, Maria Allan

Research outputs 2014 to 2021

Terminally ill people might want to discuss the options they have of hastening their deaths with their psychologists who should therefore know the law that regulates euthanasia in the jurisdictions where they practice. The legal, and therefore ethical, situation that influences psychologists’ position and terminally ill people’s options, however, differs notably across jurisdictions. Our aim is to provide a brief moral-legal historical context that explains how the law reform processes in different jurisdictions created these different legal contexts and options that, in turn, influence psychologists’ ethical position. We conclude by considering 8 specific ethical issues at a conceptual level that …

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) …

Racial And Ethnic Disparities In Palliative Care: A Systematic Scoping Review, Daniel Gardner, Meredith Doherty, Gleneara Bates, Aliza Koplow, Sarah C. Johnson

Publications and Research

Despite the advances and spread of palliative care programs, communities of color remain significantly underserved. Although these disparities are widely known, there is a marked lack of empirical evidence. The authors conducted a systematic scoping review that synthesized the literature since 2000 about racial and ethnic disparities in palliative and end-of-life care. We searched PubMed, Medline, SocIndex, CINAHL, Social Work Abstracts, and PsycINFO, using search terms including palliative care or end-of-life care, disparities or barriers or utilization, and race or ethnicity or African American or Hispanic. Findings lend support to extant literature that social environmental barriers and disparities distinctly affect …

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 …