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Efficacy Of Concreteness Training With Persons Qualifying For Palliative Care: Piloting An Ios Application, Diana Zarb

Doctor of Psychology (PsyD)

Palliative care services (PCS) seek to increase quality of life and manage symptoms of persons with chronic illnesses. Depression and anxiety are common concerns for persons receiving PCS. One intervention that has demonstrated some effectiveness and requires further research is a brief concreteness training (CT) intervention based on cognitive-behavioral techniques. This study piloted the implementation of a brief CT intervention via an iOS application for persons qualifying for PCS. Forty-one people completed all of the pretest measures, and 9 participants completed the entire study. Variables measured were anxiety, depression, spiritual well-being, health-related quality of life (HRQOL), and patient activation. Participants …

Hospice Performance: Environmental And Organizational Correlates, Mengying He

All ETDs from UAB

The purpose of this dissertation is to explore hospice performance using a three paper format. Based on Structure-Conduct-Performance (SCP) and Structure-Process-Outcome (SPO) models, paper 1 conducts a systematic literature review to identify gaps in hospice performance research. Paper 2 explores the relationship between hospice market structure and inpatient services provision (Structure-Conduct). Market munificence is related to hospice inpatient services offering. Organizational factors such as hospice chain-affiliation, age, and ownership also play roles in predicting hospices’ probability in providing inpatient services. Paper 3 examines the impact of hospice inpatient service provision on service utilization and financial performance (Structure-Process-Outcome). Hospices that not …

Examining Nurse Practitioners' Perceptions And Beliefs Regarding Hospice Referrals For African Americans, Karen Jackson Mcclary

Walden Dissertations and Doctoral Studies

Terminally ill patients often have difficult choices at the end-of-life, and electing to receive hospice services is one of them. Hospice has been linked to improved quality of life and death and is accessible to terminally ill patients. Despite the accessibility, African American patients often make the decision to forgo hospice services. The purpose of this descriptive study was to explore perceptions and beliefs of nurse practitioners (NPs) regarding the lack of utilization of hospice for African American patients and the feasibility of NPs for initial referral for terminally ill African American patients. The research questions addressed whether an NP's …

An Educational Initiative To Prevent Unnecessary Hospitalization For Hospice Patients, Alkeisha Hill Mims

Walden Dissertations and Doctoral Studies

Avoidable hospitalizations of hospice patients cost Medicare $3 billion a year. When hospice nurses are able to identify early signs and symptoms of acute illness and provide appropriate interventions to prevent such admissions, 20-60% of the hospitalizations are preventable. The practice problem addressed in this quality improvement doctor of nursing project was the 30% hospital admission rate of hospice patients as evidenced by chart review, admission data, and revocation data. The first purpose of the project was to identify evidence-based nursing care paths in the literature for the top 5 medical diagnoses related to avoidable hospital admissions. The second purpose …

Music Therapy Interventions For End-Of-Life Care: An Integrative Literature Review, Ranjani Sukumaran

Theses and Dissertations--Music

Music therapy plays an integral role in end-of-life care, positively impacting emotional, social, physical, cognitive and spiritual health. The purpose of this integrative review was to collect and compile studies (N= 55) between 2000 and 2016 on the topic of music therapy interventions in end-of-life care, in order to provide both music therapy students and therapists access to the most recent and commonly used music therapy interventions and goals. Results of the integrative literature review indicate that the most common intervention for all age groups in end-of-life care is songwriting and composition, with the most common therapeutic goal …

I'M Still Standing, But I'M Not Standing Still, Janice E. Hawkins

Ellmer School of Nursing Faculty Publications

(First paragraph) When I made the decision to return to school for a PhD, I anticipated hard work, challenges, and a demanding schedule. Two years into my part-time program, I proudly informed readers of Reflections on Nursing Leadership that I was still standing and happy with my decision (Hawkins, 2014). Two years later, I'm not quite done.

Motivation For Volunteering With Older Adults In A Rural Community, Tonia Maria Truesdell

Walden Dissertations and Doctoral Studies

The Baby Boomer generation in the United States is growing older, and the number of adults age 65 years or older is expected to double by 2050. The increase in older adults combined with the reduction in services to older adults has created a gap in available social services and volunteers are needed to fill those gaps. This quantitative, nonexperimental study was designed to identify the motivations of volunteers who served the socialization needs of isolated older adults in a rural U.S. community. The functional approach theory was utilized to explain how volunteers engage in the same volunteer activity for …

Hospice Social Work And The Patient Protection And Affordable Care Act, Christine A. Couture

Theses, Dissertations, and Projects

This study was undertaken to explore how hospice social workers based at United States hospice agencies perceive changes in their work responsibilities in relation to the Patient Protection and Affordable Care Act (PPACA). Secondly, this study sought to explore hospice social worker support of the Patient Protection and Affordable Care Act healthcare policy reform.

A nonprobability sample of availability was used to find research participants. The researcher recruited participants through online social and professional networking groups and forums and by snowball sampling methods. Self-selected participants electronically confirmed their eligibility for participation in the study, prior to completing the 20-question online …

Dying Discourse: Contextualizing Advance Care Planning, Janet L. Dolgin

Hofstra Law Faculty Scholarship

No abstract provided.

Comparing The Quality Of End Of Life Cancer Care In The Medicare Population Prior To And After The Enactment Of The Medicare Prescription Drug, Improvement And Modernization Act Of 2003, Rene Jooste

All ETDs from UAB

Reimbursement for chemotherapy could account for two thirds of the income for oncologists in private practice. The Medicare prescription drug improvement and modernization act of 2003 (MMA) brought about a dramatic change in the way physicians were reimbursed for delivering chemotherapy in an attempt to slow the skyrocketing costs of drugs and Medicare costs for covering these drugs . The MMA reduced Medicare reimbursements for covered outpatient prescription drugs from 95% to 85% of the average wholesale price. In 2005, a new payment system was instituted that reimbursed fee-for-service providers for drugs at the national average sales price plus 6%. …

Moral Distress And The Health Care Organization, Andy Kondrat

Dissertations

A health care professional may experience moral distress when she believes she knows the ethical course of action in a given situation, but is unable to enact that plan, or must do otherwise. This dissertation argues that health care organizations have an ethical obligation to address moral distress in their health care professionals, and that common responses to moral distress are ethically insufficient due to their reliance on hierarchical solutions when hierarchies are, in fact, often a cause of moral distress. Thus, health care organizations, as moral agents, have a responsibility to find a non-hierarchical response to moral distress.

In …

Provision Of Hospital-Based Palliative Care And The Impact On Organizational And Patient Outcomes, Marisa L. Roczen

Theses and Dissertations

Hospital-based palliative care services aim to streamline medical care for patients with chronic and potentially life-limiting illnesses by focusing on individual patient needs, efficient use of hospital resources, and providing guidance for patients, patients’ families and clinical providers toward making optimal decisions concerning a patient’s care. This study examined the nature of palliative care provision in U.S. hospitals and its impact on selected organizational and patient outcomes, including hospital costs, length of stay, in-hospital mortality, and transfer to hospice. Hospital costs and length of stay are viewed as important economic indicators. Specifically, lower hospital costs may increase a hospital’s profit …

Development Of A Program Proposal For A Nitrous Oxide Program In Pediatrics, Sarah Oleson

Walden Dissertations and Doctoral Studies

When pediatric patients are admitted to the inpatient or outpatient hospital setting they potentially have to endure procedures that cause pain, fear, and anxiety which can have a lifelong impact on the child's response to future healthcare needs. The purpose of this project was to create a comprehensive program proposal for a nitrous oxide sedation program to minimize those perceptions towards medical procedures. The project utilized a systematic review of literature and secondary data to address the most important indicators for developing a comprehensive program proposal to present to the pediatric leadership team. Multiple studies have shown nitrous oxide having …