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Pain Management In Nursing Home Residents With Cancer And Dementia With And Without Hospice Services, Todd Bryant Monroe

Theses and Dissertations (ETD)

Aims: We sought to identify differences in pain management between two groups; nursing home residents with malignant cancer and dementia with and without hospice services.

Methods: Decedent records from 2003-2009 were assessed for diagnosis of dementia and cause of death as cancer. Ten malignant cancer diagnoses were determined a priori from the CDC 2004 data on the top 10 malignant cancers for all races and genders. Fifty-five decedents from 10 nursing homes were included in the final sample. Four instruments were used: Minimum Data Set (MDS) a standardized assessment tool required of most U.S. nursing homes. A large …

Shared Presence: Caring For A Dying Spouse, Lana Sue Mclouth Kanacki Phd, Ms, Rn

Dissertations

There is limited research on female spouses and their end-of-life experience with their dying husbands. The purpose of this study was to explore wives' perceptions of hospital and hospice care at their husbands' end-of-life. The grounded theory method was used for this study. Data were collected over thirteen months and then transcribed and coded for meaning. Participants were 25 elderly widows (62-103 years of age) with 19 husbands' deaths in a hospice setting and 6 in the hospital. They were widowed from 6 months to 10 years after the death of their spouses. They were good informants with excellent recollections …

Prescriptions For Excellence In Health Care Winter 2009 Download Pdf Of Full Issue

Prescriptions for Excellence in Health Care Newsletter Supplement

No abstract provided.

Development And Validation Of A Palliative Care Needs Assessment Instrument-English/Arabic Versions (Pcna-Eav), For Use With Patients With Advanced Cancer, Susan Edith Volker

All ETDs from UAB

The aim of this study was to develop and translate a psychometrically valid and reliable, population-based, needs assessment instrument, the PCNA-EAV, to measure the health care and support needs of patients with advanced cancer. The cross-sectional study design combined qualitative and quantitative methods, to test instrument reliability and validity, and to examine the association between sample characteristics and health care and support needs. The 116-item, PCNA-EAV, comprised 10 domains of need: physical/functional; social; psychological/emotional; information; communication; helpful resources; financial; religious/spiritual; priority of need; and preference for care The target population was all cancer patients in the department of oncology at …

Hospice Africa Uganda: End-Of-Project Evaluation Of Palliative Care Services, Annette Bongiovanni, Mary Alexis Greenan

HIV and AIDS

Hospice Africa Uganda (HAU) is a nongovernmental organization that provides palliative care services to people living with HIV/AIDS (PHA) and cancer. Based in Kampala, HAU aims to scale-up palliative care within and beyond the nation’s borders. From 2005–08, HAU sought to achieve the following objectives: 1) Increase coverage and scope of palliative care services available to PHA and their families; 2) Train health workers and other HIV/AIDS care providers to integrate pain management, symptom control, and end-of-life care into their existing HIV/AIDS support programs; 3) Build the capacity of families, communities, and community-based organizations in palliative care provision; 4) Integrate …

The Experience Of African American Hospice Patient/Family With Board Certified Music Therapy As A Component Of Their Plan Of Care, Elizabeth Joy Gifford

Doctor of Nursing Practice (DNP) Projects

No Abstract Available

Occupational Therapy For Client Empowerment In End-Of-Life Care, Emily Johnson, Sarah Landsem

Occupational Therapy Capstones

Purpose: To enable clients in end-of-life care (EOLC ) the opportunity to continue engaging in meaningful activities throughout their remaining days to increase QoL and experience a "good death."

Methods: To complete our Scholarly Project we conducted a literature review using PubMed, CINAHL, OTsearch, and AOTA publications search engines. We also conducted an informal information session with local hospice staff and from this information we chose model/theory to guide product development.

Results: Upon completion of the literature review, we found the following problems existed in regard to utilization of Occupational Therapy in end-of-life care setting; 1) hospice care team members …

Palliative Care Patients And Their Quality Of Life As Perceived By The Patient And Their Caregiver, Debra L. Dignan

Regis University Student Publications (comprehensive collection)

This quantitative pilot study examined the quality of life of palliative care patients as perceived by the patient and their caregiver. Patients with palliative care consults at The University of Colorado and The Medical Center of Aurora were asked to participate in this study. The McGill Quality of Life Questionnaire survey tool was selected to measure the patient's quality of life due to its validity and reliability in measuring quality of life in the palliative care patient population. The McGill Quality of Life Questionnaire consists of five distinct subscales: physical well-being, physical symptoms, psychological symptoms, existential well-being, and support. Sixteen …

Efficacy Of Complementary And Alternative Medicine On Perceived Well-Being In Geriatric Long-Term Care Residents, Shannon L. Baer

Regis University Student Publications (comprehensive collection)

Non-conventional therapies have been termed and captured by the phrase Complementary and Alternative Medicine (CAM), since the establishment of The National Center for Complementary and Alternative Medicine (NCCAM), by the Federal Government in 1992. With the use of CAM on the rise in the baby boom population and the expectation that the number of nursing home residents is expected to double by 2020, it is imperative that healthcare providers gain more knowledge in effective means for treating the geriatric population holistically. The purpose of this study was to determine whether the implementation of a CAM intervention program in a sample …

Resuscitating A Healthcare Charity, R Akhileswaran, Seet Ai Mee

Social Space

When government funding policies change, voluntary welfare organisations that depend largely on subsidies to run their services can find their survival at stake. Dr R Akhileswaran and Dr Seet Ai Mee present the case study of HCA Hospice Care.

The Efficacy Of Complementary Therapies In Reducing Cancer-Related Pain, Sarah A. Hocking

Student Works

Pain is a persistent and troubling condition for patients with cancer. Because medications often provide incomplete management of cancer-related pain, adjunct treatment may be necessary to provide more complete pain management. Complementary and alternative therapies are becoming increasingly prevalent in cancer pain management. However, lack of knowledge regarding the efficacy of complementary therapies may prevent patients and nurses from implementing them. The purpose of this article is to provide a review of literature on the efficacy of various complementary and alternative therapies for managing cancer-related pain, including massage, aromatherapy, hypnosis, and music therapy. Eighteen recent research articles related to this …

Assessment Of Seminary Education On End Of Life Issues, Stefan Hakon Pomrenke

Theses and Dissertations

Background: The US health care system faces increased costs from end of life (EOL) care. The intensive approach to EOL treatment with greater use of procedures in ICUs has led to decedent spending six times greater than that of survivors in the hospital. Experts in ICU and Palliative care fields have called for greater utilization of end of life planning and education. To date, EOL education has been dominated by the technologically driven medical field and the church has been under-utilized. The US population relies on clergy support for many mental health and EOL issues. Clergy report feeling uncomfortable in …

Diagnostic Classifications And Resource Utilization Of Decedents Served By The Department Of Veterans Affairs, Sonia A. Duffy, Laurel Copeland, Faith Hopp, Robert J. Zalenski

Social Work Faculty Publications

Background: Given the volume and cost of inpatient care during the last year of life, there is a critical need to identify patterns of dying as a means of planning end-of-life care services, especially for the growing number of older persons who receive services from the Veterans Health Administration (VHA).

Methods: A retrospective computerized record review was conducted of 20,933 VHA patients who died as inpatients between October 1, 2001 and September 30, 2002. Diagnoses were aggregated into one of five classification patterns of death and analyzed in terms of health care resource utilization (mean number of inpatient days and …

Symptom Burden At End Of Life In Patients With Terminal And Life-Threatening Illness In Intensive Care Units, Peggy G. Kalowes Phd, Msn, Rn, Cns

Dissertations

The purpose of this study was to examine the symptom burden and severity of symptom distress reported by ICU patients at high-risk for death and to compare patient-rated symptoms and distress for concordance with symptoms reported by a family member. A prospective, correlational design with two data-points was used to study a convenience sample of 80 patients and 53 family members. The Condensed Memorial Symptom Assessment Scale (CMSAS) was used to gain patient/proxy report of symptoms on the first and third day after admission to the ICU. The majority of patients were symptomatic (98%), reporting an average of 10.23 symptoms. …

Evaluating Transformational Leadership Skills Of Hospice Executives, Paul D. Longenecker

Health and Sport Sciences Faculty Scholarship

Health care is a rapidly changing environment requiring a high level of leadership skills by executive level personnel. The hospice industry is experiencing the same rapid changes; however, the changes have been experienced over the brief span of 25 years. Highly skilled hospice executives are a necessity for the growth and long-term survival of hospice care. This descriptive study was conducted to evaluate the leadership skills of hospice executives. The study population consisted of hospice executives who were members of the state hospice organization in Ohio and/or licensed by the state (88 hospice providers). Three questionnaires were utilized for collecting …

Vital Signs, Spring 2006, Boonshoft School Of Medicine

Vital Signs

A twenty-eight page newsletter created by the Boonshoft School of Medicine to document the current affairs of the school. This issue includes a variety of feature articles, faculty profiles, class notes, and more.

Predictors Of Length Of Stay At Jefferson Hospice, Alexander D. Fuld, Timothy P. Cousounis, James Plumb

Population Health Matters (Formerly Health Policy Newsletter)

No abstract available.

Mid-Atlantic Ethics Committee Newsletter, Spring 2005

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Understanding Palliative Care: An Ethnographic Study Of Three Australian Palliative Care Services, Judith M. Greaves

Theses: Doctorates and Masters

Palliative care commenced in Australia in the early 1980s. Although the value of palliative care has become more widely recognised by the public and other health care professionals, there is still a lack of understanding about what palliative care is and the depth and scope of this specialty area of health care. The research that I present in this thesis is based on examination of palliative care practice in a selection of Australian services, undertaken with the aim of enhancing understanding of Palliative Care. The significance of the research arises from the notion that members of the Australian community should …

Access To Care: A Hospice Model Of Access To Care For The Homeless, Mary Ann Bridget Kinney

Theses and Graduate Projects

Access to Hospice for the terminally ill patient is a monumental problem for the disenfranchised person. According to the National Coalition for the Homeless (NCH) in Washington D.C. there is an estimate of 3.5 million people who experience homelessness in a year (2003). The homeless face many health care service gaps including the vital service of end- of- life nursing care, which allows for death with dignity. The following paper will discuss the author's experience with the homeless, the need of access to Hospice Care for the homeless, and a review of literature regarding access to Hospice for the homeless. …

Mid-Atlantic Ethics Committee Newsletter, Summer 2004

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Providing Education And Support For Rural Palliative Care Nurses In Western Australia: An Intervention Study, Ruth Mcconigley

Theses: Doctorates and Masters

Rural palliative care nurses (RPCNs) in Western Australia (WA) are a small population, who have embraced the specialist palliative care role since the first palliative care service in rural WA began in 1990. However, there are some challenges involved with being a specialist nurse in a generalist health care setting. fu particular, there is a suggestion in the literature that RPCNs may be professionally isolated, may be prone to burnout, and may therefore experience decreased job satisfaction and may consider leaving the palliative care field.

Escape From New York: Analyzing The State's Relative Interests In Proscribing The Withdrawal Of Life Support And Physician-Assisted Suicide, Colin Miller

William & Mary Bill of Rights Journal

This Note argues that states cannot consistently prohibit physician assisted suicide for terminally ill patients while they continue to allow the withdrawal of life support for even non-terminal patients. All of the state interests identified by the Supreme Court in rejecting a right to assisted suicide are implicated to a higher degree by withdrawal of life support. The primary reason for this difference is that withdrawal of life support often involves incompetent patients and surrogate decision making while assisted suicide by definition requires a competent patient choosing to hasten her death

Managing Advanced Illness: A Quality And Cost Challenge To Medicare, Medicaid, And Private Insurers, Karen Matherlee

National Health Policy Forum

This issue brief examines approaches to delivering and financing health services for persons with advanced chronic illness. It focuses on the nature and structure of the Medicare hospice benefit and its use as a model for Medicaid and other federal programs. The paper also looks at palliative-care approaches along the continuum of inpatient and post-acute services and raises cost, quality, and access issues for end-of-life care. In addition, it provides an overview of coverage through private insurance, including indemnity, point-of-service, and preferred-provider-organization products.

General Practitioners' Attitudes To Palliative Care : A Regional Perspective, Richelle Lee-Steere

Theses : Honours

The study explores regional general practitioners' attitudes to palliative care through semi- structured interviewing using a qualitative methodology. Attitudes to palliative care were examined using the general practitioners' accounts of their experiences and perceptions of caring for terminally ill patients. The participants were ten registered general practitioners located within the Greater Sunbury Division of General Practice in the South West of Western Australia. A semi-structured interview schedule containing ten open-ended questions was used to assess regional general practitioners' attitudes to palliative care. Examples of the research questions included: What are regional general practitioners' attitudes to palliative care? What supports are …

Beyond Pain Management: A Primer For Providing Quality End-Of-Life Care, Linda P. Tomko, Terri L. Maxwell

Department of Family & Community Medicine Faculty Papers

Providing excellent care for a dying patient is something all patients deserve. Hospices and palliative care centers exist in many areas to aid primary care physicians and patients through this difficult time. It is important to remember that most patients want to prepare for death, if at all possible. Everyone does this in his or her own way, but oftentimes concern about pain and symptom management interfere with this very involved and valuable process. Being prepared to treat these symptoms as well as addressing your patient's emotional needs is imperative. Referral to a hospice, if possible, will only strengthen the …

Hospice At The Crossroads: Can It Survive?, David A. Simpson

Journal of Health Care Law and Policy

No abstract provided.

Rural Palliative Care Nursing: A Modified Grounded Theory Study, Ruth Mcconigley

Theses: Doctorates and Masters

This paper presents the findings of a study of rural palliative care nurses in Western Australia. The numbers of rural centres in Western Australia offering palliative care services are increasing; however at present there is little empirical data available about the roles of the nurses involved. This study was undertaken to begin to correct this deficit. The study examines basic social processes associated with the role of rural palliative care nurses and identities issues that affect the nurses’ professional practice. A modified grounded theory approach was used to form a conceptual framework that describes rural palliative care nursing. Theoretical sampling …

Home Hospice Cancer Care: Family Members' Expectations, Perceptions And Satisfaction With Care, Kristina Medigovich

Theses : Honours

Increasingly, there is greater expectation by the public, as health consumers, that they will receive care from health professionals which meets their expectations and does not leave them dissatisfied. The stress experienced by families caring for a family member with advanced cancer may be complicated when they are dissatisfied with care received from health care professionals. To further promote family satisfaction it is important therefore for health professionals to understand the theoretical underpinning of family satisfaction with care. One theoretical explanation of family member satisfaction with advanced cancer care in the palliative care setting, Porter's Discrepancy Theory, was investigated in …

Motivating Factors Of Volunteers Serving Medicare Certified Hospice Programs, Andrew Wixcel

Dissertations and Theses @ UNI

This study was designed to identify factors which motivate volunteers to work with terminally ill patients in Medicare certified hospice programs in Iowa. The study was delimited to volunteers of the 40 Medicare certified hospice programs existing in Iowa at the time the study was executed. Results of the study were based on responses received from 205 (52%) of the 400 questionnaires distributed. Descriptive statistics were used in analyzing the data. Subjects used a Likert scale to rate the importance of 12 specific reasons to volunteer to work with a hospice program. The need to help others was rated as …