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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 …

Fatigue-Related Symptom Clusters And Their Relationship With Depression, And Functional Status In Older Adults Hospice Patients With Cancer., Suzan Fouad Abduljawad

USF Tampa Graduate Theses and Dissertations

The hospice care population with cancer are often older adults who report many cancer-related symptoms experienced often in clusters. Most prevalent of these symptoms is fatigue and often it co-occurs with depressive symptoms and poor physical functioning. This dissertation examined fatigue, symptom clusters, depression, physical activity, and functional status in older adults with cancer. The aims of the literature review were to understand the relationship among physical functioning, cancer fatigue, fatigue-related symptom clusters, and their relationship with functional status In older adults. The literature related to these associations is insufficient and inconclusive. The methods section aimed to investigate the reliability …

Exergame Grading Scheme: Concept Development And Preliminary Psychometric Evaluations In Cancer Survivors, Hsiao-Lan Wang, Chiung-Ju Liu, Marcus Kilpatrick, Heather Jim, Susan Mcmillan, Nisha Vijayakumar, Sally Mcdonald, Tapan Padhya, Jeffery Russell, Karen Vondruska, Constance Visovsky

Nursing Faculty Publications

The challenge of using exergames to promote physical activity among cancer survivors lies in the selection of the exergames that match their fitness level. There is a need for a standardized grading scheme by which to judge an exergame’s capacity to address specific physical fitness attributes with different levels of physical engagement. The study aimed to develop an Exergame Grading Scheme and preliminarily evaluate its psychometric properties. Fourteen (14) items were created from the human movement and exergame literature. The content validity index (CVI) was rated by content experts with two consecutive rounds ( and independently). The interrater reliability (IRR) …

Family Communication Concerning End-Of-Life Care Preferences, Lindsay Jo Peterson

USF Tampa Graduate Theses and Dissertations

Communication concerning the care one wishes to receive at the end of life (EOL) is central to ensuring that wishes are honored. Many studies have examined doctor-patient or doctor-family EOL communication. However, relatively few studies have focused on the occurrence of EOL care discussions among family members. This is an important topic, as research suggests that advance directives (ADs) are ineffective if patients have not involved surrogate decision-makers, most of whom are family members. This study examined EOL care discussions among family members. It used quantitative and qualitative data from a diverse sample of older adults from West Central Florida …

Spiritual Frameworks In Pediatric Palliative Care: Understanding Parental Decision-Making, Lindy Grief Davidson

USF Tampa Graduate Theses and Dissertations

Parents of seriously ill children are charged with making complicated medical decisions, and many of those decisions are made during their children’s hospitalizations. As medical staff seek to support parents, it is important for them to understand what resources parents are drawing upon for decision-making. This project explored parental decision-making by examining the following research questions: RQ1: What resources do parents draw upon to make medical decisions for their seriously ill children? RQ2: How do parents enact their spiritual or religious frameworks in clinical settings when faced with medical decisions for their seriously ill children? Methods of research included ethnographic …

The Mediating Effect Of Distress Caused By Constipation On Predictors Of Quality Of Life Of Hospice Patients With Cancer., Abdel Alkhalouf

USF Tampa Graduate Theses and Dissertations

Abstract

The Mediating Effect of Distress Caused by Constipation on Predictors of Quality of Life of Hospice Patients with Cancer.

Key positive outcomes for hospice patients include the prevention and alleviation of physical and psychological distress, maintenance of physical and mental functioning and all aspects of quality of life. This research used secondary analysis of previously gathered data to answer new research questions with alternative strategies to examine relationships not previously analyzed. The researchers collected data from 717 cancer patients who had been admitted to one of two private hospices. The aim of their experimental intervention was to define the …

Factors Affecting The Utilization And Quality Of Long-Term Care, April Temple

USF Tampa Graduate Theses and Dissertations

The aging of the nation in the coming decades will contribute to an increased demand for long-term care. Given this trend, it is becoming increasingly important to understand utilization of services along the continuum of care and to determine factors that influence the provision of quality care. These insights are needed to reduce national expenditures on long-term care and to maximize independence and well-being among older adults.

The purpose of the present dissertation was to explore factors that influence the utilization and quality of long-term care by conducting three separate studies. The first study examined risk of nursing home (NH) …

Communicating Spirituality, Dying And A “Good Death” At The End-Of-Life: The Role Of Hospice Interdisciplinary Team Members, Jillian A. Tullis Owen

USF Tampa Graduate Theses and Dissertations

Hospices use interdisciplinary teams to aid patients and families as they cope with the imminence of death while helping them achieve a death free of physical and spiritual pain, also known as a good death. This study investigated the communication between hospice team members and their patients regarding spirituality, dying, death and a good death. Through 300 hours of participant observation and interviews with hospice staff at one large not-for-profit hospice in the Southeastern United States this project shows that team members understand patient's spirituality through a religious frame potentially compromising spiritual care. Talk between patients and their care …

Predictors Of Cancer Caregiver Depression Symptomatology, Henry R. Rivera

USF Tampa Graduate Theses and Dissertations

While the duration of the cancer illness may be shorter than that of other serious diseases, such as Alzheimer's disease, cancer caregivers provide many more hours of care during a week. Research directed at the intensive experience of caregiving of hospice cancer patients is needed as there is limited research of predictors of hospice cancer caregiver depression symptomatology. The purpose of the study was to examine predictors of depression symptomatology in caregivers of hospice cancer patients. A secondary analysis was conducted using baseline assessment data of patients and caregivers from a larger study of patient/caregiver dyads from two large hospices …

Service Utilization Among Bereaved Spouses And Family Caregivers, Elizabeth J. Bergman

USF Tampa Graduate Theses and Dissertations

For family caregivers, response to the death of the care recipient is marked by a high degree of variability. In recognition of this variability, a range of services and interventions is available to assist individuals in the adjustment to bereavement. The present dissertation, consisting of three related studies, was conducted to examine the utilization of bereavement services by family caregivers.

The first study examined the role of psychological distress in the utilization of bereavement services by spousal caregivers in the Changing Lives of Older Couples (CLOC) study. The second study examined bereavement service utilization among dementia caregiver participants in the …

The Relationship Between Nurses' Anxiety And Attitude Related To Pediatric Hospice, Teresa Lyn Hoover

USF Tampa Graduate Theses and Dissertations

To lose a child is a profoundly emotional experience. Even if it is not your own, the experience involves deeply held beliefs about death, the quality of death, ethics, and perhaps personal experience. Left unexplored, these beliefs and the anxiety they may produce, can become barriers to providing quality end-of-life care for children with life limiting conditions and their families. The purpose of this study was to explore the relationship between hospice nurses' attitudes toward providing pediatric hospice care and the level of anxiety they may experience related to pediatric hospice care. A self administered questionnaire was completed by 30 …

The Relationship Between Caregiving And Bereavement: A Series Of Three Studies, Allison Burton

USF Tampa Graduate Theses and Dissertations

Spousal bereavement has been consistently demonstrated in the literature to be one of the most highly stressful experiences in an individual’s lifetime. In addition many deaths in the United States are preceded by a period of caregiving, which is also believed to be highly stressful and have a profound impact on bereavement. However the literature has been inconsistent as to the exact nature of the relationship between caregiving and bereavement and there has been some debate as to whether or not positive and negative affect variables are mutually exclusive.

This dissertation sought to further address the issue of the relationship …