Digital Commons Network^™

“We’Re Dealing With An Inhumane Lack Of Resources”: Provider Perspectives On Palliative And End-Of-Life Care For Adults Experiencing Homelessness, M. Pilar Ingle

Electronic Theses and Dissertations

Although palliative and end-of-life (PEOL) care offer many benefits to individuals with life-limiting illness, unhoused individuals face barriers in accessing these forms of care. Despite calls over the last several decades to improve PEOL services for unhoused individuals, this population remains underprioritized in efforts to improve access to healthcare. A richer understanding of these inequities as they relate to the specific social and political contexts within a state, such as Colorado, may offer more direct guidance on opportunities to improve policy and care provision.

The purpose of this study was to explore healthcare and social service provider-identified approaches and challenges …

Survey Of Attitudes Toward Performing And Reflecting On Required Team Service-Learning (Sasl): Psychometric Data And Reliability/Validity For Healthcare Professions Students In Preclinical Courses, Lon J. Van Winkle, Shane L. Rogers, Bradley O. Thornock, Brian D. Schwartz, Alexis Horst, Jensen A. Fisher, Nicole Michels

Research outputs 2022 to 2026

Purpose: Previously we assessed healthcare professional students’ feelings about team-based learning, implicit bias, and service to the community using an in-house paper survey. In this study, we determined whether this survey is a reliable and valid measure of prospective medical students’ attitudes toward required service-learning in an Immunology course. To our knowledge, no published questionnaire has been shown to be dependable and useful for measuring such attitudes using only eight survey items. Methods: Fifty-eight prospective medical students in Colorado (CO) and 15 in Utah (UT) completed the same Immunology course using remote technology. In addition to the usual course content, …

Hearing Aid Loan Program For Hearing Loss At The End Of Life, M. Courtney Hughes, Diane Schecklong, King Chung

Faculty Articles, Papers, and Other Scholarship

This article describes a hearing aid loan program to provide free amplification devices for patients at the end of life to help them communicate more effectively at this critical time. It includes steps for establishing such a program, addressing challenges, and the role of the informal caregiver throughout the intervention. Healthcare professionals and social workers are encouraged to develop similar programs and use the information here as helpful suggestions to consider for their programs.

“The Hierarchy Is Your Constraint:” A Qualitative Investigation Of Social Workers’ Moral Distress Across A U.S. Health System, Sophia Fantus, Rebecca Cole, Lataya Hawkins

School of Social Work Faculty Publications

This paper reports findings from a qualitative study on the triggers of hospital social workers’ moral distress at a large southern U.S. health system. Moral distress occurs when ethical conflict cannot be resolved in a way that aligns with an individual’s personal and professional values and ethics. Participants indicated that moral distress derives from both individual interactions and the culture and climate of health systems. For example, participants expressed how sources of moral distress derived from client-centered decisions, such as end-of-life care and patient autonomy; interpersonal dynamics, including team or supervisory conflict; structural issues, such as insurance barriers or internal …

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

Social Work Theses - Archive

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 …

Positive Ageing And Death Or Dying: A Scoping Review, Robin Otto

Social Work Theses - Archive

This scoping review aims to examine the extent and how research that utilizes successful, active, productive, and healthy ageing framework(s) include death or dying. An examination of peer-reviewed academic articles published between 1980 and 2021 were reviewed following Joanna Briggs Institute's methodological standards for scoping reviews and conforming to Arskey and O'Malley's five-stage framework. The initial search resulted in 1,759 articles for review, and following the rigorous screening, 35 studies were included for the final review. A thematic analysis was the qualitative method employed to identify how research utilizes the concepts of death and dying in the context of four …

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’ …

Human And Social Services Direct Service Professionals' Perception Of Late-Life Cumulative Grief And Loss, Deanna Robinson

Walden Dissertations and Doctoral Studies

Globally, the adult population 65 and older is anticipated to grow, signaling the necessity of awareness of late-life issues and concerns. Although research has shown that losses and changes in late life are anticipated, there is very little empirical evidence of how HSPs direct care professionals understand, assess, or perceive the complexities of cumulative grief and loss in their 65 and older clients. Charmaz’s constructivist grounded theory (CGT) (2014) was used as the conceptual framework a qualitative methodology to explore the understanding, assessment, and perception of the complexities of late-life cumulative grief and loss of HSPs working with adults 65 …

The Use Of A Pediatric Palliative And Hospice Education Module To Enhance The Knowledge And Practice Of Emergency Room Providers, Morgan Garrett

DNP Projects

Background: Palliative and hospice care resources are underutilized in pediatric patients with chronic and life-limiting illnesses. One contributing factor is the lack of formalized education for medical providers regarding the differences and scope of palliative and hospice care models. Without adequate education about these services, providers are not able to effectively utilize otherwise available resources to provide holistic care.

Purpose: The purpose of this study was to assess the current perception of knowledge among providers pertaining to pediatric palliative and hospice care. The study investigated improvements in educational outcomes in ten categories after participation in a web-based training. A secondary …

Appreciation Day For Clinical Staff At Vna Hospice, Melody Nguyen

Capstone Projects and Master's Theses

VNA Hospice of the Central Coast is a nonprofit that was created back in 1951. The staff at VNA are visiting about 75,000 homes per year. Throughout the years the staff have been seeing patients who reached the requirement of having 6 months or less to live. Working with Hospice patients can be hard for everyone but, the staff at VNA are seeing the patients from good days and bad days. Depression is known to negatively impact the clinical staff at VNA Hospice. Staff are working long hours which leads to sleep disturbance and chronic stress. Some staff are also …

Professional Caring In Affective Services; The Ambivalence Of Emotional Nurture In Practice, Niall Hanlon

Articles

Emotional nurturance is a fundamental feature of all forms of professional caring. As well as delivering expert social, health, education, practical or personal services, good caregivers possess an other-centred disposition, are emotionally intelligent and relationally skilled, and morally caring. Despite this, the value, role, and status of emotional nurturance in professional care is ambivalent. Drawing on feminist care theory, Hochchild’s emotional labour theory, and Bourdieusian social reproduction theory, as well as diverse empirical studies, this paper identifies how emotion is marginalised and misrecognised and calls for the reappraisal of emotion in professional care work in ways that appreciate tensions, contradictions, …

Ameliorating Stress And Burnout Among Professionals Who Work With Migrants And Refugees, Mark Lusk, Samuel Terrazas

Journal of Human Services: Training, Research, and Practice

Professionals and volunteers who work with refugees and forced migrants experience burnout and secondary stress as a result of exposure to the trauma and adversities confronted by their clients. A pilot project aimed at reducing these problems through the use of group discussion, sharing, guided movement, relaxation techniques, and mindfulness was found to reduce burnout and secondary traumatic stress among participants.

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 …

The Essential Characteristics Of An Effective Hospice And Palliative Care Nurse, Alexis Doyle

The Eleanor Mann School of Nursing Undergraduate Honors Theses

No abstract provided.

Tales Of Love's Perseverance: Family Bereavement Stories As A Means To Investigating Impacts Of End-Of-Life Care On Sense-Making, Cassidy Taladay

Department of Communication Studies: Dissertations, Theses, and Student Research

The current study explored the stories of 25 participants who had lost an immediate loved one to a terminal illness one or more years ago. Through the lens of the retrospective storytelling heuristic of Communicated Narrative Sense-Making Theory (CNSM, Koenig Kellas, 2018), participants told their bereavement stories. Findings revealed seven themes of significant meanings, values, and beliefs that defined bereavement experiences which led to the development of a framework of three main types of stories told in bereavement which all centered on time: Past, Present, and Future. These stories reflected what was important to participants in their bereavement, such as …

Use Of Ecomaps In Qualitative Health Research, Veena Manja, Ananya Nrusimha, Harriet Macmillan, Lisa Schwartz Dr, Susan Jack

The Qualitative Report

Qualitative health research plays a central role in exploring individuals’ experiences and perceptions of wellness, illness, and healthcare services. Visual tools are increasingly used for data elicitation. An ecomap is a visual tool that applies ecosystems theory to human communities and relationships to provide an illustration of the quality of relationships. We describe the use of ecomaps in qualitative health research. Searches across eight databases identified 407 citations. We screened them in duplicate to identify 129 publications that underwent full text review and included 73 in the final synthesis. We classified and summarized data based on iterative comparisons across sources. …

Spirituality Integrated Interventions For Caregivers Of Patients With Terminal Illness: A Systematic Review Of Quantitative Outcomes, Yongqiang Zheng, Anna Cox Cotton, Longtao He, Leslie Wuest

Faculty Publications - College of Social Work

This systematic review of published quantitative research was conducted to explore the effects of spirituality-integrated interventions for informal caregivers of terminally ill patients. Multiple databases were searched for articles published between January 2004 and November 2019. Twelve randomized controlled trials were identified. Methodological quality was assessed using the revised Cochrane Collaboration’s tool for assessing risk of bias. Studies were notably diverse in terms of spiritual background, intervention design, technology used, and outcomes measures. Spirituality-integrated interventions were found to show positive outcomes for caregivers. However, methodological flaws negatively affected the quality of most studies, warranting further and rigorous research into the …

Literature Review: Improving End-Of-Life Care And Creating A Good Death, Erna Smlatic

Honors Program Theses

The need for quality end-of-life care has increased drastically around the world in the last few centuries due to a surge in life expectancy. As people are living much longer, they are developing and succumbing to chronic progressive diseases which can significantly decrease quality of life. But what exactly does it mean to care for the aging population who are nearing death? Defining quality care at the end-of-life is important but also differs for individuals based on a variety of factors including age, culture, and life experiences. End-of-life care does not come as “one size fits all” and it challenges …

Integration Of Morphine And Virtual Reality: Pain Management For Adult Hospice Cancer Patients, Arlisa Hurd

Walden Dissertations and Doctoral Studies

There is currently a problem in that cancer patients engaging in hospice may experience an excessive amount of perceived pain and a decreased quality of life. The purpose of this study was to explore an intervention that could lessen the perceived pain experienced by, and increase the quality of life of, cancer patients engaging in hospice. Immersion music virtual reality (IMVR) allows a user to interact with a realistic, computer-generated environment. 3D music (IMVR) is likely suited for pain management with patients in hospice and was used for this study. The theory for the study is the gate control theory. …

Secondary Traumatic Stress Among Catholic Priests, Richard Ehusani

Walden Dissertations and Doctoral Studies

Research suggests that the clergy could be at the risk of developing secondary traumatic stress (STS) because of their secondary exposure to trauma within pastoral work; however, there has been no explicit discussion of STS related to Catholic priests who may be more at the risk of developing STS than their counterparts in other churches. The requirement of priestly celibacy often leaves Catholic priests with little to no immediate social and emotional support network of family. Because of their sacred vow to keep the confessional seal unbroken in whatever circumstance, Catholic priests also may not share confessional information, even when …

A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck

Electronic Theses and Dissertations

The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.

For this study, data were collected using semi-structured, in-depth interviews with …

Metric Analysis Of Literature In The Field Of Community Health Nursing (1999 – 2018), Jagannathan Ramakrishnan Dr, Jayaraman Selvamani Dr, Kotti Thavamani Dr

Library Philosophy and Practice (e-journal)

This paper presents a metric analysis of Community Health Nursing, the records published during the year 1999 to 2018 in the MEDLINE data which are covered in the Pubmed. It is noticed that from 1999 onwards there is a gradual increase except for some years and also observed that a total of 39140 records in the field of Community Health Nursing. It was found that 51.78% was journal articles, 21.79% was Research Support, Non U.S. Gov't and 9.07% was Review. English language (95.56%)is dominated in almost all the countries irrespective of the native language of the country. This is followed …

Impact Of The Covid-19 Outbreak On Long-Term Care In The United States, Courtney H. Van Houtven, Nathan A. Boucher, Walter D. Dawson

Institute on Aging Publications

The United States (US) currently has the most confirmed cases of COVID-19 of any country. Yet, adequate testing for the virus remains a major issue. Approximately 51.6 million Americans are over the age of 65 and 56 percent of adults over 65 are living with two or more chronic conditions (23 percent have 3 or more). Given the higher risk of death and complications associated with advanced age and underlying health conditions, COVID-19 has had an immense impact upon LTC in the United States. Yet, the level and intensity of impact has been sporadic in application. This is due in …

How Relevant Is The Hippocratic Oath In Guiding Physicians' Views On Physician-Assisted Suicide, Megan Neal

Honors Program: Senior Projects (Public)

The Hippocratic Oath is an ancient vow that most doctors, especially within the last century in the United States, take upon their graduation from medical school. The importance of this oath, however, is up for debate as medical advances and cultural beliefs in the rights of the patient evolve. The Hippocratic Oath has been adapted many times over the past few centuries to reflect the beliefs of the period, but the original Oath still survives. One of the most recent movements in the medicine has been the legalization of physician-assisted suicide (PAS) in select states. Using a qualitative, thematic approach, …

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.

The Lived Experience Of Work Stress And Coping In Eldercare Hospice Nurses, Yvette Abraham

Walden Dissertations and Doctoral Studies

The number of elderly people living with terminal diagnoses has increased, along with the need for hospice nurses with specialized training to provide high-quality personal care that addresses their unique, critical needs. Research on nurses and other professionals who function in a demanding environment has demonstrated the experience of work stress, and negative physical and psychological consequences. However, little is known about the unique work stress and challenges of hospice nurses who care for the dying elderly. This study explored the meaning of hospice nurses’ experience of work stress and coping. Giorgi’s empirical phenomenological approach guided the development of the …

Evidence-Based Approach To Drug Crisis, Jiebing Wen

Theses and Dissertations--Public Policy and Administration

I am devoted to health policy research, especially tackling the opioid crisis, and evaluating marijuana laws and newly emerging issues associated with legal recreational drugs. Opioid overdose in the United States continues to jeopardize public health. Meanwhile, the majority of states have legalized medical marijuana and one third of them further liberalized recreational marijuana. Marijuana liberalization, although originally independent of the growing opioid crisis, may be a harm reduction approach to the crisis because marijuana may be a substitute for opioids in pain management at a relatively lower risk. However, marijuana liberalization may also lead to marijuana-related harms, such as …

Urban And Rural Alaskan Physicians’ Knowledge, Attitudes, And Behaviors Regarding Palliative Care, Mary Bernadette Cavalier

Walden Dissertations and Doctoral Studies

Palliative care provides multidisciplinary treatment of the physical, psychological, social, and spiritual needs of patients and families with serious illnesses. Alaska has the highest per capita rates of serious illnesses in the United States, but many Alaskans lack access to palliative care. Using Engel’s biopsychosocial model of care, Saunders’ total pain theory, and Bandura’s theory of self-efficacy, the purpose of this study was to assess the role of physicians regarding palliative care access in Alaska. This quantitative multivariable regression analysis examined the relationship between 133 Alaskan physicians’ knowledge and attitudes (independent variables) and their behaviors (dependent variable) regarding palliative care; …

Associations Among Knowledge, Attitudes, And Practices Toward Palliative Care Consultation Service In Healthcare Staffs: A Cross-Sectional Study, Li-Chun Huang, Ho-Jui Tung, Pei-Chao Lin

Health Policy & Community Health: Faculty Publications

Background

The palliative care consultation service (PCCS) of the National Health Insurance payments has been promoted in Taiwan since 2011, although few studies have been conducted on healthcare staffs’ knowledge, attitudes, and practices regarding PCCS in Taiwan; consequently, the main objective of this study was to explore any correlations regarding the above by cross-sectional design using convenience sampling.

Methods

A total of 210 healthcare staff members were enrolled from a regional hospital from June 1, 2018, to September 30, 2018. Questionnaire items on the Palliative Care Consultation Service Inventory (KAP-PCCSI) were used to measure healthcare staff’s knowledge, attitudes, and practices …

Using Dance/Movement Therapy To Educate Hospice Providers On Preventing Burnout: A Method, Victoria G. Powell

Expressive Therapies Capstone Theses

Burnout is a clinical condition that an individual may experience whenever they are in a constant state of stress. It is categorized by three groups of symptoms: emotional exhaustion, depersonalization, and negative self-evaluation of personal achievement (Rizo-Baeza et al., 2017, p. 19). This inquiry investigated the impact of burnout on hospice professionals and volunteers through researching previous literature. The research led to the development of a psychoeducational, body-based method with a Dance/Movement Therapy (DMT) foundation. This preventative method was implemented in two separate workshops for hospice professionals and volunteers at a Massachusetts-based hospital system. Results indicate a need for training …