Digital Commons Network^™

Defining Quality Of Life: The Lived Experience Of Adults With Pulmonary Hypertension And The Impact Of Activity-Induced Respiratory Distress, Bethany Jean Adams

Walden Dissertations and Doctoral Studies

Pulmonary hypertension (PH) is a progressive, life-limiting disease that significantly affects quality-of-life (QoL). Limited research has explored lived experiences of individuals with PH. Guided by Parse’s human becoming theory, this qualitative descriptive phenomenological study explored the lived experiences of individuals affected by PH and examined how activity-induced respiratory distress affected QoL. The research Question was: How do individuals with PH describe the impact of activity-induced respiratory distress on their QoL. I conducted interviews with nine participants, including eight adults diagnosed with PH and one caregiver of an individual with PH. Data were analyzed using Saldaña's comparative coding framework to identify …

Increasing Postpartum Appointment Attendance Rates, Tanya Lister

Doctor of Nursing Practice Scholarly Projects

Background: Postpartum visits provide an opportunity to detect and address potential complications, monitor healing and recovery, and offer guidance and support during the transition into motherhood. Current research shows that appointment reminders increase healthcare appointment attendance rates, whether delivered via text messages or phone calls.

Purpose: The purpose of this academic project was to plan, implement, and evaluate a process change within a single health facility to increase postpartum visit attendance rates.

Methods: This evidence-based scholarly project used telephone calls to remind patients scheduled for postpartum visits of their appointment dates and times. Appointment reminder phone calls were completed the …

Recognizing Appropriate General Inpatient Hospice Patients Time To Stop Normalizing Suffering, Oliver Charles Roth

Walden Dissertations and Doctoral Studies

Hospice patients experiencing uncontrolled pain, dyspnea, agitation, anxiety, delirium, or other severe symptoms may require General Inpatient (GIP) hospice care for intensive symptom management. However, inconsistent recognition of symptom crises can delay escalation to the appropriate level of care, contributing to unnecessary patient suffering, caregiver distress, and avoidable emergency department or hospital utilization. This Doctor of Nursing Practice executive leadership project evaluated the implementation of an educational framework designed to improve clinician recognition and timely escalation of patients who may be appropriate for GIP hospice care. Education emphasized early identification of uncontrolled symptoms, interdisciplinary communication, documentation, and escalation for clinical …

Dnp Final Report: Improving Rehospitalization Rates And Caregiver Quality Of Life In Outpatient Hospice, Carrie M. Judd

DNP Final Reports

Background: Hospital readmissions among home hospice patients disrupt continuity of care, increase healthcare costs, and may compromise end-of-life preferences.

Purpose: This quality improvement project evaluated the feasibility of implementing a telehealth communication intervention in an outpatient hospice organization. Project aims were to reduce Type I live hospice discharges by at least 2.5% and improve caregiver quality of life (QOL).

Methods: Zoom for Healthcare® video visits and three-way telephone communication supplemented standard nurse practitioner hospice visits during a three-month implementation period. Type I live discharge rates were compared with the organization's baseline quality metrics. Caregiver QOL was measured pre- and post-intervention …

Exploring Academic–Practice Partnerships In Community Settings: A Narrative Review, Laura C. Sarver

College of Nursing Faculty Papers & Presentations

Purpose: This narrative review explored the literature on academic–practice partnerships in community settings within prelicensure nursing education. Methods: A search of three databases—MEDLINE, CINAHL, and Scopus—led to the review of 12 articles exploring academic–practice partnerships in community settings within prelicensure nursing education. Results: Emergent themes encompassed components for planning, implementing, and evaluating academic–practice partnerships. Planning themes included completing community assessments, considering financial resources, and identifying guiding frameworks or models. Implementation themes included diverse nursing education and community partners and settings, academic–practice partnership initiatives, and integration of partnerships in prelicensure nursing education curricula. Lastly, evaluation themes included the exploration of a …

Identifying Palliative Care Needs In The Emergency Department, James Sullivan

All Doctor of Nursing Practice (DNP) Scholarly Projects

This quality improvement project evaluated the implementation of the Palliative Care and Rapid Emergency Screening (P‑CaRES) tool to improve early identification of unmet palliative care (PC) needs among adults with advanced, life‑limiting illnesses presenting to a community emergency department (ED). The problem addressed was the absence of a standardized PC screening process, resulting in delayed recognition, missed referral opportunities, fragmented care, and repeated ED utilization. Guided by Plan‑Do‑Study‑Act cycles and the OhioHealth Change Management Model, the project integrated P‑CaRES into ED workflows, provided staff education, and established structured referral pathways. Over 12 weeks, clinicians completed 65 screenings; 57 patients met …

Quality Domains In Home-Based Pediatric Hospice And Palliative Care: Adolescent And Young Adult Perspectives, Daniel H Grossoehme, Claire A Crawford, Jhansi Chandra Ellakula, Toluwalase Ajayi, Justin N Baker, Sarah Friebert, Lisa Humphrey, Jillann Jarrell, Rachel Thienprayoon, Pamela S Hinds

Faculty, Staff and Students Publications

Background: Current United States palliative care practice guidelines are intended to cover care across all age groups. Previous research with pediatric providers and caregivers concluded that pediatric hospice and palliative care have unique attributes. Not known is how adolescent hospice and palliative care patients understand quality palliative care. The purpose of this study was to characterize and define quality of care domains as described by adolescent and young adult patients receiving home-based hospice and palliative care.

Methods: Semi-structured interviews with 10-26 year-olds who received home-based hospice and/or palliative care visits in the prior three years at six diverse sites in …

Intersectional Inequities In End-Of-Life Care Quality: The Roles Of Race, Ethnicity, And Gender, Jessica A. Yauk

USF Tampa Graduate Theses and Dissertations

Persistent gaps remain in end-of-life care quality (EOLCQ) in the United States. Structural factors within the health care system, as well as discriminatory practices, affect the quality of care received by at-risk populations. This dissertation uses a mixed-methods research design to examine perceived EOLCQ across racial/ethnic and gender groups. Study 1 and Study 2 were guided by the intersectionality and Social Determinants of Health (SDOH) frameworks, and examined ten EOLCQ outcomes: pain, dyspnea, sadness or anxiety, having personal care needs met, having decisions made about care without enough input from decedent or family, whether the proxy or family were kept …

Staff Education To Improve End-Of- Life Pain Management Confidence Among Long-Term Care Nurses, Andrea Osuji

Walden Dissertations and Doctoral Studies

No abstract provided.

Advancing The Understanding Of Palliative Care In Singapore: Knowledge, Attitudes, Receptiveness, And The Moderating Role Of Media Information-Seeking Preferences, Su Lin Yeo, Angel Lee, Raymond Han Lip Ng, May O. Lwin, Yumin Lin

Research Collection Lee Kong Chian School Of Business

Introduction: Despite the growing demand for palliative care, this specialized medical care remains severely underutilized, with almost 50% of countries worldwide lacking access. Given that misperceptions and stigma continue to hinder progress in healthcare policy, this study aims to examine the relationships between palliative care knowledge, attitudes, and receptiveness to better understand how public health communication can enhance awareness and understanding of the topic in Singapore. Applying the adapted knowledge-attitude-practice (KAP) model, it further extends theory by examining the moderating role of media information-seeking between knowledge and receptiveness.Methods: Mixed-mode surveys involving 1,226 participants (926 online and 300 in-person respondents), representing …

Limited English Proficiency And Quality Of Hospice Care: A Retrospective-Cross Analysis, Carol Elsakr, Stephen Meyer

South Atlantic Division GME Research Days 2026

No abstract provided.

Ethical Considerations For Hospice Patients In Inpatient Settings: A Systematic Review And Thematic Analysis, Matthew D. Harry

Honors Theses and Capstones

Hospice care is intended to prioritize comfort, dignity, symptom management, and quality of life for individuals with life-limiting illness. However, when hospice-eligible patients are managed within inpatient hospital settings, significant ethical challenges frequently emerge due to the tension between comfort-focused care and the curative, intervention-driven structure of acute care medicine. This paper presents a systematic literature review and thematic analysis examining the ethical considerations surrounding hospice patients in inpatient settings, with particular attention to clinical decision-making, communication, prognostic uncertainty, moral distress among nurses, and conflicts involving patient autonomy and family wishes. A structured review of peer-reviewed literature was conducted using …

Beat By Beat: Empowering Communities With Lifesaving Cpr Skills, Allyssa Mb Hutchins

Doctor of Nursing Practice Projects

Introduction: This doctoral project was created to increase bystanders' willingness and ability to perform CPR by building their confidence in performing it effectively. A total of 13 participants participated in this project to increase knowledge and confidence in CPR interventions.

Background: Cardiac arrests remain a leading cause of death, yet research indicates that rural communities have lower rates of bystanders trained and willing to assist. Increasing CPR awareness and eliminating barriers to care for classes can improve CPR confidence and have a positive community impact.

Methods: Three 4-hour CPR classes were held in Zirconia, NC, at no …

Subanesthetic Ketamine Use For Uncontrolled Pain In Hospice Care, Tiffany Rey, Ana Sanchez

South Atlantic Division GME Research Days 2026

No abstract provided.

Utilization Of Multimodal Therapy Including Ketamine And Methadone In Cancer-Related Pain: A Case Report, Austin Mccrea, Carol Elsakr, Tyler Kilgore

South Atlantic Division GME Research Days 2026

No abstract provided.

Quick Improvement In Delirium In A Patient With Parkinson's Disease Through Rectally Administered Carbidopa/Levodopa: A Case Report, Emil Philip, Carol Elsakr, Tyler Kilgore

South Atlantic Division GME Research Days 2026

No abstract provided.

What Bereaved People Have Found Helpful Following Death Of A Loved One In A Hospital: A Survey Study, Jon Swanson Phd, Mindy Flanagan Phd, Rachel Pfafman Mph, Mba

Other Specialties

Given the individual and public health impact of bereavement, discovering what people perceive as helpful after loss can improve interventions. In contrast to national projects, this project focused on two hospitals in a Midwestern hospital system.

A survey was developed to assess the work of chaplains with next of kin following a death, to assess the awareness and helpfulness of persons and organizations in the community, and to ask what people had done, said, or given that was helpful, or what respondents wished people had done. From a list of 283 people invited to respond, 52 completed the survey.

Survey …

Quality Of Life And Mental Health: A Qualitative Exploration Of Perceived Factors That Impact Older Adults, Chasiti Herring

All-Inclusive List of Electronic Theses and Dissertations

Enhancing quality of life and well-being is a universal phenomenon across the lifespan. As the population ages, older adults are in great need of supportive services to enhance quality of life and their ability to manage their mental health. The purpose of this study is to examine the quality of life (QoL) of older adults. This study aimed to provide valuable research in the area of QoL through the exploration of perceived factors that impact the older adult population. This exploratory qualitative research study consisted of 10 older adult participants between the ages of 65 and 95. Research recruitment prioritized …

Potential Mechanisms Of Influence Between Spiritual Practices And Cognitive Health: A Systematic Review And Conceptual Model, Katherine Carroll Britt, Hayoung Oh, Augustine Cassis Obeng Boateng, Sherry Morgan, Sato Ashida, Corey Nagel, Roland J Thorpe, Harold G Koenig

Staff and Researcher Publications

Background/Objectives: This systematic review summarizes the evidence regarding potential mechanisms underlying the relationship between spiritual practices and cognitive health in adults. The review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist.

Methods: An extensive search of six electronic databases (i.e., PubMed, PsycINFO, Embase, Sociological Abstracts, ATLA, CINAHL) was conducted using keywords related to spiritual practices, religious activities, and cognitive health from 1 January 2000 to December 2025. The quality of the included studies was assessed using the Mixed Methods Appraisal tool aligned with the study design.

Results: A total of …

Family Caregivers' Perspectives On Challenges And Support Needs In Hospital-Based Palliative Care For Persons Living With Dementia, Jung Kwak, Anita Chary, Sarah Stayer, Kwaku Duah Oppong, Sumin Yoon, Snehal Patel, Elizabeth A Kvale

Faculty, Staff and Students Publications

Palliative care needs of hospitalized persons living with dementia (PLWD) and their family caregivers remain poorly understood. This mixed-methods study explored caregivers' perspectives on challenges and support needs when hospitalized PLWD received specialist palliative care consultations. Thirty-two caregivers were recruited from two hospitals; 18 completed interviews and surveys, and 14 completed surveys only. Participants were racially and ethnically diverse (19% Black or African American, 34% Latino or Hispanic). Most identified as women (65%) and adult children (56%). Commonly reported challenges included managing health issues (59%), emotional distress (56%), and decision-making (47%). Thematic analysis of interviews revealed three themes: the value …

Advancing Palliative Care Competency Through An Evidence-Based Educational Intervention For Healthcare Providers, Lauren Elizabeth Griffin

Walden Dissertations and Doctoral Studies

A major gap in acute care is the delayed initiation of palliative consultations. Although over 58 million people worldwide could benefit, only 14% receive such care. Despite evidence that early involvement improves outcomes, providers often overlook their value, leading to late referrals, typically after repeated hospitalizations or near end-of-life, when hospice may be more appropriate. This Doctor of Nursing Practice (DNP) educational intervention addressed a critical practice-focused question to enhance healthcare providers’ understanding of palliative care improve hospital-based patient outcomes. The intervention aimed to demonstrate a ≥20% knowledge gain from pretest to posttest scores related to distinguishing palliative care from …

Implementing Pain Reassessment Workflow To Improve Timely Pain Management In Hospice Patients: A Quality Improvement Project, Oluremi Omodara

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Timely pain reassessment is a vital component of hospice care, directly influencing the quality of life for patients. Despite the high prevalence of pain, which affects 55% of hospice patients due to disease progression or adverse drug reactions, only 51% of those reporting moderate to severe pain at admission receive a documented reassessment. The gap highlights an organizational issue in pain management stemming from the absence of a clearly defined period and workflow for reassessment.

Aim of the Project: The aim of the quality improvement (QI) project was to improve compliance with pain reassessment documentation within 48 hours …

Exploring Patients' Perceptions Of An Advance Care Planning Intervention In The Emergency Department: A Qualitative Study, Youkie Shiozawa, Saaya Morton, Nanako Shirai, Hannah Oelschlager, Lucy Kiernat, Anita N Chary, Anna C Revette, Adrian Haimovich, Smit Desai, Kai-Wei Chang, Shan W Liu, Maura Kennedy, Mara A Schonberg, Kei Ouchi

Faculty, Staff and Students Publications

Objectives: Emergency department (ED) visits offer opportunities for seriously ill patients to formulate future medical care goals, yet ED clinicians lack practical strategies for these conversations. ED GOAL, a behavioral intervention, engages seriously ill yet clinically stable older adults in the ED to address advance care planning (ACP) with their outpatient clinicians. In a randomized trial, goals-of-care documentation was significantly higher in the intervention group compared to controls after three (24.3% vs. 9.9%, p = 0.03) and 6 months (31.4% vs. 12.7%, p < 0.01). This study is a sub-analysis to learn about intervention arm participants' perceived benefits and obstacles of the intervention.

Methods: We conducted semi-structured interviews between October 2022 and August 2024 (N = 52) with intervention-arm patients …

Evaluation Of Palliative Care Awareness Among Hospitalized Patients And Their Relatives In Türkiye, Füsun Uzgör, Ayşe Özkaraman, Hülya Özen

Makara Journal of Health Research

Background: Today, with the advances in medical knowledge and technology, chronic diseases have increased worldwide in parallel with the prolonging life expectancy and the aging of the population. This has increased the need for palliative care in the delivery of medical services. This study aimed to evaluate the palliative care awareness and level of knowledge of inpatients receiving health services in a university hospital and their relatives in Türkiye.

Methods: This cross-sectional study was carried out with 360 patients and their relatives who volunteered to participate in the research. The study data were collected in face-to-face interviews using …

Addressing And Recognizing Secondary Traumatic Stress In Hospice And Palliative Care Clinicians, Laquisha La Chelle Jackson

Walden Dissertations and Doctoral Studies

In the emotionally demanding field of hospice and palliative care, the well-being of clinicians is critical. This Doctor of Nursing Practice (DNP) project focused on implementing a staffing education initiative to address secondary traumatic stress (STS). I designed this staffing education project to enhance clinician awareness, resilience, and coping strategies while informing organizational leadership on how improved staffing models and support systems can mitigate STS. Hospice and palliative care clinicians are uniquely vulnerable to STS due to constant exposure to trauma, death, and grieving families. The guiding question for this project was: In hospice and palliative care clinicians, how does …

2025-2026 Pediatric Subspecialty Trainees, Children's Mercy Kansas City

Residents and Fellows Portraits

Photo composites of the graduate pediatric trainees in advanced non-invasive imaging,, allergy/immunology, Pediatric EM/child abuse, child abuse pediatrics, child neurology, clinical neuro-psychology, clinical child psychology, clinical child psychology internship, congenital cardiac surgery, developmental-behavioral, epilepsy, hospice & palliative care, laboratory genetics & genomics, pediatric anesthesiology, pediatric bioethics, neonatal-perinatal medicine, pediatric adolescent gynecology, pediatric cardiology, pediatric clinical pharmacology, pediatric critical care medicine, pediatric dentistry, pediatric emergency medicine, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric hospital medicine, pediatric infectious diseases, pediatric nephrology, pediatric optometry, pediatric orthopedic surgery, pediatric otolaryngology, pediatric pathology, pediatric pulmonology, pediatric rehabilitation, pediatric sports medicine, pediatric surgery, sleep medicine, pharmacy, …

Navigating Early Career As An Oncologist: Thriving In Diverse Paths., Gita Suneja, Marjorie C Green, Janaki Parameswaran, Joseph Mccollom Do

PCI Publications and Projects

Early-career oncologists navigate a complex landscape of professional development, clinical responsibilities, and research endeavors. This manuscript explores key challenges and strategies for success in the early years of an oncology career, focusing on the first job after fellowship, career transitions, and practical tips for intentionality. Effective mentorship is pivotal, providing guidance in clinical decision making, research pursuits, and professional networking. Career development strategies include securing funding, building collaborative networks, and identifying opportunities for leadership. Additionally, balancing clinical duties with research and personal well-being requires time management and institutional support. This article emphasizes the importance of fostering inclusive mentorship, advocating for …

Navigating Challenges In Palliative Care: A Survey On Asco Guideline Adherence Among Health Care Providers In Low- And Middle-Income Countries., Cristiane Decat Bergerot, Enrique Soto-Perez-De-Celis, Chadane Thompson, Rushil Patel, Jafar Al-Mondhiry, Tingting Zhang, Nathasha Dhawan, Darcy Burbage, Joseph Mccollom Do, Mazie Tsang, Ramy Sedhom, William E Rosa

PCI Publications and Projects

PURPOSE: Integrating palliative care into oncology is essential, yet disparities in access and quality persist, particularly in low- and middle-income countries (LMICs). The ASCO guidelines advocate for early, routine, interdisciplinary palliative care for patients with advanced cancer. Barriers to implementing these recommendations include resource limitations, inadequate training, and cultural perceptions. Recognizing these challenges is essential for improving equitable access to palliative care worldwide.

METHODS: This prospective survey assessed adherence to ASCO recommendations for palliative care integration among LMIC health care providers (HCPs). Participants were recruited via e-mail, social media, and a list of members involved in the ASCO Palliative Care …

End-Of-Life Volunteerism: An Analysis Of No One Dies Alone (Noda) Program Volunteers, Kristin Sarsfield, Kevin Hickey

Posters

The inception of hospice in the United Kingdom during the mid 20th century marked a focal point in medical care for dying individuals. Hospice founder Cicely Saunders wanted to maintain a balance of “the sophisticated science of our treatments with the art of our caring, bringing competence alongside compassion”.1 Since then, hospice has grown into a household term for end of-life medical care.

Organized care for terminally ill and dying individuals was further developed in 2001 by Sandra Clarke, CCRN. Clarke founded the No One Dies Alone (NODA) Program after being unable to fulfill a dying patient’s wish of end-of-life …

Assessing The Use Of Motivational Interviewing And Appreciative Inquiry For Hypertension Control In Vulnerable Populations, Anjali Mahapatra, Orlando J. Penaloza Md, Facp, Shanestka Menendez, Jorge Martinez

USF-LVHN SELECT

No abstract provided.