Digital Commons Network^™

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 …

Death And Dying Across The Lifespan, Paige Sala

Entry Level Occupational Therapy Doctoral Capstone Projects Class of 2025

Death and Dying Across The Lifespan centers on the creation of three interdisciplinary educational courses focused on end-of-life care for three distinct age groups: geriatrics, adults, and pediatrics. The courses aim to improve undergraduate students’ competence in addressing death and dying with patients, caregivers, and other healthcare professionals within the team. The courses were developed in response to growing evidence that supports the need for education on death, dying, and caring for individuals at the end of life. Many students are not adequately exposed to these topics in current curricula, despite the importance of interdisciplinary collaboration in this area of …

The Perspectives Of Provisionally Registered Psychologists On Voluntary Assisted Dying In Australia: An In-Depth Qualitative Investigation, Ker-Ni Vivienne Heng, Eyal Gringart

Research outputs 2022 to 2026

In Australia, voluntary assisted dying (VAD) is now widely legalised, and VAD uptake is on the rise. Thus, the demand for psychological support in the context of VAD is expected to grow. Despite their relevant expertise, psychologists remain underrepresented in end-of-life (EOL) literature and practice. The current in-depth qualitative study examined the perspectives of 20 provisionally registered psychologists in Australia on VAD, using reflexive thematic analysis grounded in social constructionism. Four main themes (‘Values’, ‘Fit-for-Role’, ‘Exposure’, and ‘Contributions’) and 14 sub-themes were generated from the data. Participants supported availing VAD for terminally ill patients and expressed the potential for its …

Public Sentiments And The Influence Of Information-Seeking Preferences On Knowledge, Attitudes, Death Conversation And Receptiveness Towards Palliative Care: Results From A Nationwide Survey In Singapore, Su Lin Yeo, Raymond Han Lip Ng, Tan Ying Peh, May O. Lwin, Poh Heng Chong, Patricia Soek Hui Neo, Jamie Xuelian Zhou, Angel Lee

Research Collection Lee Kong Chian School Of Business

Background: Low awareness about palliative care among the global public and healthcare communities has been frequently cited as a persistent barrier to palliative care acceptance. Given that knowledge shapes attitudes and encourages receptiveness, it is critical to examine factors that influence the motivation to increase knowledge. Health information-seeking from individuals and media has been identified as a key factor, as the process of accessing and interpreting information to enhance knowledge has been shown to positively impact health behaviours. Objective: Our study aimed to uncover public sentiments toward palliative care in Singapore. A conceptual framework was additionally developed to investigate the …

Family Caregiver Reports Of Their Own And Patient Symptoms In Cancer Home Hospice Approaching End-Of-Life, Maija Reblin, Eli Iacob, Djin L Tay, Hui Li, Megan C Thomas Hebdon, Anna Beck, Gary Donaldson, Kristin G Cloyes, Lee Ellington

Faculty, Staff and Student Publications

Context: Family caregivers assume the primary responsibility of assessing and managing hospice cancer patient symptoms while simultaneously managing their own wellbeing and symptoms. Objectives: Describe caregivers' assessment of hospice cancer patient and their own symptoms during the last 60 days of patient life, and assess the relationship between patient and caregiver symptoms over time.

Methods: Caregiver symptom report of self and cancer home hospice patient symptom data were collected via telephone in the final 60 days of patient life. Descriptive data on symptom severity and prevalence were summarized. Exploratory Factor Analysis was used to group individual symptoms. …

“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 …

Improving Palliative Care Education In The Acute Hospital Setting, Maria Klug

Doctor of Nursing Practice Scholarly Project

As the geriatric population grows rapidly, the importance of utilizing and understanding palliative services continues to rise. Although palliative and hospice care are included in different healthcare courses, misconceptions and lack of knowledge continue to serve as barriers to the utilization of palliative care. The purpose was to assess knowledge, improve palliative care education, and increase understanding of the perspectives of the interdisciplinary team involved in acute patient care. The setting was the telemetry unit in a 300-bed acute care Kansas hospital. A mixed design was utilized with a goal of quality improvement in the use of palliative care. The …

The Interrai Chess Scale Is Comparable To The Palliative Performance Scale In Predicting 90-Day Mortality In A Palliative Home Care Population, Nicole Williams, Kirsten Hermans, Joachim Cohen, Anja Declercq, Ahmed Jakda, James Downar, Dawn M. Guthrie, John P. Hirdes

Health Sciences Faculty Publications

Background: Prognostic accuracy is important throughout all stages of the illness trajectory as it has implications for the timing of important conversations and decisions around care. Physicians often tend to over-estimate prognosis and may under-recognize palliative care (PC) needs. It is therefore essential that all relevant stakeholders have as much information available to them as possible when estimating prognosis.

Aims: The current study examined whether the interRAI Changes in Health, End-Stage Disease, Signs and Symptoms (CHESS) Scale is a good predictor of mortality in a known PC population and to see how it compares to the Palliative Performance Scale (PPS) …

Impact Of Provider Cultural Competency On Latino/Hispanic Patients During End-Of-Life And Hospice Care, Nicholle Nacionales

Theses and Graduate Projects

Background: Cultural competency in healthcare means delivering high quality care to patients with diverse beliefs, attitudes, values, and behaviors. Latinos/Hispanics are one of the fastest growing ethnic group and with an aging population, there is an increased need for providers to deliver culturally sensitive end-of-life and hospice care. Latino/Hispanic patients face many disparities that affect their quality of care which cultural competency aims to address. Purpose: The purpose of this literature review is to identify factors that affect Latino/Hispanic patient’s end-of-life and hospice care and how cultural competency of providers can influence management of their pain and quality of …

An Educational Program For Hospice Nurses About End-Of-Life Protocols, Rhonda Coleman

Walden Dissertations and Doctoral Studies

Abstract Palliative care is specialized care for people living with a serious illness. This type of care is centered on providing relief from the symptoms and stress of the illness with a primary goal to improve the quality of life for both the patient and the family. A gap in nursing practice was identified in a hospice facility in the South Central United States.; the nurses did not use palliative care or end-of-life (EoL) protocols. This project focused, therefore, on the development of a nursing staff education program for hospice nurses to increase knowledge about the use of EoL protocols. …

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 …

Reducing The Rate Of Falls In Hospice Patients: A Fall Prevention Pilot Program, Allison Floyd

Doctor of Nursing Practice Final Manuscripts

Background and Evidence Problem: As the population ages, there is an increase in the incidents of falls. Falls are the predominant cause of both nonfatal and fatal injuries among adults aged 65 years and older (Bergen et al., 2016). Extensive research has been conducted in fall prevention in hospitals, skilled nursing, and rehabilitation units. End-of-life care in a hospice setting presents a greater challenge in risk identification and prevention of falls. A local hospice had 457 falls between July 2018 to mid-March 2019 with a lack of consistent, detailed, fall education and documentation.

Evidence-Based Practice Intervention: Utilizing the American Geriatrics …

Final Opportunities For Healthcare Chaplains To Share The Gospel To Those Facing End Of Life, Michal Lynn Lee

Masters Theses

Spiritual care is a necessity for end-of-life care. Those with terminal illnesses and facing death are concerned about things of spiritual or existential nature. The National Consensus Project for Quality Palliative Care study indicated that most patients want to have their spiritual concerns addressed, and yet, spiritual concerns are not adequately addressed with the medical team and the current system of care. This paper builds on the role of the chaplain within a healthcare context for those facing end-of-life scenarios and reinforces the impact of the chaplain to fulfill his primary role of addressing eternal issues. Healthcare chaplains enter the …

Interventions For Promoting Earlier Enrollment Into Hospice And Palliative Care Among Patients With A Terminal Illness, Jody K. Kampa

All Electronic Theses and Dissertations

Background: Although research supports palliative care (PC) to improve symptoms and quality of life for patients with terminal illnesses, these services are underutilized. While 80% of people prefer to die at home, the majority still die in an acute care facility, sometimes receiving aggressive interventions that may increase suffering up until the very end of life. Earlier referral to PC or hospice care can improve symptom management and facilitate end-of-life (EOL) wishes. Purpose: The purpose of this critical review of literature was to identify barriers as well as evidenced-based interventions to promote earlier enrollment into hospice and PC among patients …

Implementing Aromatherapy For Falls Reduction In The Inpatient Hospice Population, Kimberly Kay Pistek

Walden Dissertations and Doctoral Studies

Falls among the elderly is a health concern affecting multiple patients annually. Hospice patients and those with multiple comorbidities are at the greatest risk of falling and sustaining injuries from falls. Aromatherapy has been used for reducing multiple symptoms as well as for decreasing falls. The practice-focused question explored whether an education program on using aromatherapy for fall prevention would increase knowledge of this intervention for an interdisciplinary group of hospice staff. The design was developed using Knowles's theory of andragogy and Bloom's taxonomy. Thirteen staff members from the same facility participated in the education program. The program was targeted …

Health-Services Utilisation Amongst Older Persons During The Last Year Of Life: A Population-Based Study, Danielle Ní Chróinín, David E. Goldsbury, Alexander Beveridge, Patricia M. Davidson, Afaf Girgis, Nicholas Ingham, Jane L. Phillips, Anne M. Wilkinson, Jane M. Ingham, Dianne L. O'Connell

Research outputs 2014 to 2021

BACKGROUND: Accurate population-based data regarding hospital-based care utilisation by older persons during their last year of life are important in health services planning. We investigated patterns of acute hospital-based service use at the end of life, amongst older decedents in New South Wales (NSW), Australia.

METHODS: Data from all persons aged ≥70 years who died in the state of NSW Australia in 2007 were included. Several measures of hospital-based service utilisation during the last year of life were assessed from retrospectively linked data comprising data for all registered deaths, cause of death, hospital care during the last year of life …

Inclusion Of Social Workers In End-Of-Life Discussions In Intensive Care Units, Olivett D. Underwood-Mobley

Walden Dissertations and Doctoral Studies

Clinical social workers have roles in providing end-of-life care in the United States. Although clinical social workers are present in the intensive care unit (ICU) setting and have expertise to address end-of-life care dynamics, social workers are not consistently included in end-of-life discussions in the ICU setting. The purpose of this action research study was to explore the barriers that prevent clinical social workers from being included in end-of-life discussions in the ICU and how clinical social workers perceive their roles in end-of-life discussions in the adult ICU setting. Open-ended questions were used to gather data by facilitating 4 focus …

End Of Life Care Practices For Patients Who Die In Intensive Care Units (Icu), Jila Ghabeljoo

Doctoral Projects

Today, one in five hospital deaths happens in the intensive care unit with the expectation of twice as many by 2030. Increasing, mortality has triggered a growing attention to end-of-life (EOL) care in the ICU. However, the lack of coveted EOL and palliative care skills creates a challenge for ICU nurses. The aim of this study was to assess the current practices of EOL care in the ICU. In this quantitative research, a retrospective chart review method was employed to analyze the collected data from a population 60 EOL patients who died in the ICU of a Southern California hospital. …

The Rhetoric Of Hospitality: Conditions Of Death In America, Margaret Anne Callahan

LSU Doctoral Dissertations

The Right of Hospitality: Conditions of Death in America calls Western biomedicine’s approach to death into question. Death unifies all human experiences and is always possible, despite the human tendency to deny its existence and, instead, orient the self towards a futurity that is always out of reach. This project investigates the structures influencing how death in America occurs, and traces the roots of Western culture’s rejection of death to the execution by hemlock of Socrates’ immortalized in the Phaedo. Western biomedicine’s institutionalization of medicine requires that both patients and doctors enter into imbalanced hospitable relationships, and these pressures, along …

Nurses' Knowledge Of Advance Directives And Perceived Confidence In End-Of-Life Care: A Cross-Sectional Study In Five Countries, A. Coffey, G. Mccarthy, E. Weathers, M. I. Friedman, K. Gallo, M. Ehrenfeld, S. Chan, W. H.C. Li, P. Poletti, M. Itzhaki, +4 Additional Authors

Journal Articles

No abstract provided.

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 …

Ethical Decision Making Of Counseling Mental Health Practitioners Working With Clients Right-To-Die Issues, Amanda E. Johns

LSU New Orleans Theses and Dissertations

The purpose this study was to explore the relationship between counseling mental health practitioners’ attitudes toward euthanasia and their ethical decision making levels when confronted with clients facing end-of-life concerns. A review of literature indicated a series of complex ethical, moral, and societal issues surrounding clients’ right-to-die issues. Because of the lack of research in the counseling field and the growing prevalence of right-to-die issues with clients who have a diagnosis of a terminal illness, more research in the counseling field is needed (Hadjistavropoulos, 1996; Winograd, 2012). Participants for the present study were recruited from six state divisions of the …

Impact Of Hospice Nurse Education On After-Hours Calls And Visits, Cheryl Slack

Evidence-Based Practice Project Reports

Medicare-certified hospice home care agencies must provide a 24/7 on call system for after business hours patient concerns. An agency identified a problem with a high volume of after-hours hospice calls for symptom management. How these calls are handled impact patient and family outcomes and satisfaction. A literature review provided evidence that hospice nurse education and appropriate telephone support improves symptom management, enhances family support, provides a sense of security, reduces anxiety, and promotes comfort. Providing hospice nurse education on symptom management supported the goal of this evidence based practice (EBP) project to reduce the family/caregiver need for frequent on-call …

Nursing Care At The End Of Life: What Every Clinician Should Know, Susan E. Lowey

Milne Open Textbooks

Nursing Care at the End of Life: What Every Clinician Should Know should be an essential component of basic educational preparation for the professional registered nurse student. Recent studies show that only one in four nurses feel confident in caring for dying patients and their families and less than 2% of overall content in nursing textbooks is related to end-of-life care, despite the tremendous growth in palliative and end-of-life care programs across the country. The purpose of this textbook is to provide an indepth look at death and dying in this country, including the vital role of the nurse in …

“Comfort, Comfort My People”: A Qualitative Study Examining Dying Persons’ And Their Caregivers’ Experience Of Spiritual Care As An Aid To Having A Good Death In Grey And Bruce Counties, Ontario, Dwight Biggs

Theses and Dissertations (Comprehensive)

Dying persons and their caregivers encounter several needs as part of the dying journey. Spiritual care, when offered effectively, can help address many of those needs. When people’s needs are fulfilled, their suffering is lessened and there is an increased possibility of them experiencing a good death. However, when spiritual care is not offered effectively, dying persons and their caregivers often continue to face unalleviated suffering which limits their ability to experience a good death. This research project explores how dying persons and their caregivers experience spiritual care in their homes as an aid to dying well and having a …

Measuring The Cultural Competence Of Hospice Social Workers Using The Multicultural Counseling Self-Efficacy Scale-Racial Diversity Form, Revised Version For Use In Hospice Settings, Jessica Moore Begans

Theses, Dissertations, and Projects

Although about 40% of American deaths occur in hospice care, and although social workers are members of nearly all hospice teams, there is scant research on the cross-cultural practices and competence of hospice social workers. Before this study, no self-report cultural competence scale was available to measure the perceived cultural competence skills of hospice social workers. To address this issue, a validated cross-cultural competence scale, the Multicultural Counseling Self-Efficacy Scale – Racial Diversity (Sheu, 2005) was modified to reflect the functions of hospice social workers. The revised scale (Begans, 2011) was completed by 33 hospice social workers in a New …

Understanding Nurses’ Experiences Of Providing End-Of-Life Care In The United States Hospital Setting, Susan Johnson

Theses and Dissertations

Nurses perform a vital role in the care of dying patients and their families. Hence, experiences of nurses are a meaningful source from which to advance holistic end-of-life care. In this study, a hermeneutic phenomenological perspective was used to explore the phenomenon of end-of-life nursing care. Details derived from a scientific exploration into the experiences of 13 registered nurses who provided care for patients and families at end-of-life in the inpatient hospital setting offer understandings regarding this important phenomenon. The hermeneutic phenomenological methods of Max van Manen guided data collection and analysis. Three main themes described the participants’ experience of …