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Exploring The Impact Of Cultural Beliefs On Death Anxiety: A Qualitative Study To Inform Healthcare Education And Practices, Sharon Sonnilal

Doctoral Dissertations and Projects

A hermeneutic phenomenological approach framed this qualitative study, examining how cultural beliefs, spiritual traditions, and relational contexts shape death anxiety and meaning-making among adults from diverse backgrounds. Terror Management Theory and Culturally Sensitive Grief Treatment guided the conceptualization of death anxiety as a culturally mediated and relational phenomenon rather than an isolated psychological response. A purposive sample of 13 adults aged 18 and older represented diverse cultural, racial, gender, and spiritual identities. Recruitment occurred via Instagram, and participants completed an open-ended demographic and narrative survey. Participants who provided rich survey narratives received invitations to complete semi-structured Zoom interviews to deepen …

Provider Admission Visit To Implement Medication Deprescribing In Hospice, Shaunda A. Bueno

SACAD: Scholarly Activities

A large portion of healthcare spending is focused on patients with multiple chronic illnesses, and most of these patients are on numerous medications, commonly referred to as polypharmacy or hyper-polypharmacy. Furthermore, hospice-eligible patients have at least one disease process that is considered life-limiting with a life expectancy of less than six months, and often have multiple medical conditions with complicated treatment regimens known as multimorbidity. The high incidence of multiple comorbidities for hospice patients, combined with advanced age and the incidence of polypharmacy and hyperpolypharmacy, has also caused an increased treatment burden for patients and caregivers. To address this issue, …

Navigating End-Of-Life Decisions: Cultural Considerations For Latine Patients, Michelle Carbajal Hernandez

Honors Capstones

Healthcare professionals face many challenges when communicating terminal illness prognoses for individuals. This responsibility to address a terminal prognosis is further complicated when communicating with Latine patients who may face multiple barriers within the healthcare system and whose cultural preferences influence end-of-life care planning (Carrion, 2010). For example, Latines are less likely to enroll in end-of-life (EOL) care services (e.g., hospice) (Barragan-Carrillo et al., 2022). As well as engage in end-of-life care planning than White Non-Latines (Shen et al., 2016). To understand this hesitancy towards EOL care options, this literature review aims to explore how terminally ill Latine and …

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 …

Implementing An Evidence-Based Wound Care Protocol For Inpatient End-Of-Life Residents That Aligns With Hospice Comfort Care Goals, Oge C. Okeke, Oge C. Okeke

Doctor of Nursing Practice Final Project Abstract

Abstract uploaded

Exploring Detached Concern, A Dual-Process Emotional-Regulation Strategy, Among Intensive Care Nurses Providing End-Of-Life Care In The United States, Melissa Milton Miasek

Dissertations

Intensive care unit (ICU) nurses repeatedly provide end-of-life care (EoLC) and experience significant emotional distress, burnout, and moral distress that can lead to leaving the profession. Detached concern (DC), a dual-process emotional-regulation strategy which balances empathetic concern with emotional detachment, may support ICU nurses' emotional well-being; however, DC among nurses remains vastly understudied. This qualitative descriptive study gained deeper understanding of DC among ICU nurses providing EoLC in the United States. The study was guided by a conceptual model adapting Lampert and Glaser's dynamic DC process within Elfenbein's emotional regulation framework. The overarching research question explored ICU nurses' perspectives on …

Implementing An Evidence-Based Wound Care Protocol For Inpatient End-Of-Life Residents That Aligns With Hospice Comfort Care Goals, Oge C. Okeke

Doctor of Nursing Practice Final Project Abstract

Implementing an evidence-based wound care protocol for inpatient end-of-life residents that aligns with hospice comfort care goals.

Purpose

This quality improvement (QI) project aimed to adopt a patient-centered, comfort-focused approach to wound care at the DNP project site and improve patient outcomes by increasing nursing staff's knowledge of evidence-based wound treatment strategies by 20%.

Background

Curative treatments involving aggressive methods do not align with hospice principles. Residents at the project site experience increased suffering at the end of life because of limited nursing knowledge of evidence-based, atraumatic wound care practices for end-of-life patients.

Results

Pre-intervention nursing knowledge survey scores ranged …

Video Conversation Aids To Assist In Goals-Of-Care Discussions With Older Adults In A Medical Setting: A Systematic Review, Ashna S Karpe, Mokunfayo O Fajemisin, Stephanie Martinez Ugarte, Lara Ouellette, Martin L Blakely, Gina H Khraish, Shreyans V Sanghvi, Min J Kwak, Jessica L Lee, Lillian S Kao, Thaddeus J Puzio

Library Staff Publications

Background

Methods

Determining Timeframes To Death For Imminently Dying Patients: A Retrospective Cohort Study, Tricia O’Connor, Wai Man Liu, Juliane Samara, Joanne Lewis, Karen Strickland, Catherine Paterson

Research outputs 2022 to 2026

Background: Clinicians are frequently asked ‘how long’ questions at end-of-life by patients and those important to them, yet predicting timeframes to death remains uncertain, even in the last weeks and days of life. Patients and families wish to know so they can ask questions, plan, make decisions, have time to visit and say their goodbyes, and have holistic care needs met. Consequently, this necessitates a more accurate assessment of empirical data to better inform prognostication and reduce uncertainty around time until death. The aims of this study were to determine the timeframes for palliative care patients (a) between becoming comatose …

Decreasing Burdensome Transitions In Hospice Care By Increasing Nursing Visits, Kristin S. Rivers

Doctor of Nursing Practice Projects

Background: Burdensome transitions occur when hospice patients discontinue hospice services to seek hospital treatment, often disrupting end-of-life goals and creating distress for patients and caregivers. These transitions continue to rise throughout the country, highlighting the need for strategies to support patients in remaining at home throughout the dying process.

Purpose: This quality improvement project aimed to decrease hospital transitions by increasing nursing visits for hospice patients at high-risk for burdensome transitions.

Project Design: This quality improvement project used a Plan-Do-Study-Act methodology to form and implement an intervention to reduce burdensome transitions. Patients were already identified as low or high-risk …

Implementation Of A Standardized Pain Assessment Tool To Drive Opioid Management In End-Of-Life Patients In A Medical Intensive Care Unit, Sonia Carrizales

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement project implemented a standardized pain assessment tool, the Multidimensional Observational Pain Assessment Tool (MOPAT), to drive opioid administration for end-of-life (EOL) patients. This project intended to increase opioid administration to EOL patients through increased confidence levels noted in bedside staff with the use of a standardized pain assessment tool.

Background

The project was implemented in a thirty-two-bed adult medical intensive care unit in Round Rock, Texas. The patients focused on in this project were those transitioned to EOL care.

Methodology

A pre-and post-survey was sent to bedside staff to gauge confidence levels. The MOPAT was then …

Educating Occupational Therapy Students On The Role, Scope, And Delivery Of Occupational Therapy Services In End-Of-Life Care, Zaria Favorite, Angela Labrie Blackwell, Shannon Kauppila

Spring 2025 OTD Capstone Symposium

Patients at the end-of-life (EoL) experience a decline in body functions and performance skills along with challenges in maintaining occupational roles, routines, habits, and performance patterns (American Occupational Therapy Association [AOTA], 2020). Despite their decline, patient want to continue to participate in their chosen occupations, which are unfulfilled due to the role, scope, and delivery of OT services in EoL care being misunderstood by OT students and practitioners, healthcare professionals, patients, families, and caregivers (Hammill et al., 2019; Knecht-Sabres et al., 2019; Mueller et al., 2021). There is a need for increased education and training so OT students can better …

An Equitable End: Meeting The Needs Of Queer Families Within Deathcare, Nyssa Peck

University Honors Theses

This thesis seeks to explore end-of-life care experiences of queer families, focusing on interactions with palliative and hospice caregivers. Currently, end-of-life (EOL) practitioners in institutional and medical care settings are often poorly equipped to interact with queer families due to inadequate cultural training models, personal biases, and ignorance regarding the queer identities of their clients. This manifests in substantial inequities within deathcare systems regarding the accommodation of the unique needs of queer familial structures. Drawing upon multidisciplinary scholarship, I sought to examine these needs, which diverge from that of heterosexual families due to queer families’ absence of legal protections and …

What Are Family Caregivers’ Experiences Of Coordinating End-Of-Life Care At Home: A Narrative Review, Harriet Nicholls, Matthew Carey, Kevin Hambridge

School of Nursing and Midwifery

Objectives People with life-limiting diseases, who are no longer receiving active or curable treatment, often state their preferred place of care and death as the home. This requires coordinating a multidisciplinary approach, using available health and social care services to synchronize care. Family caregivers are key to enabling home-based end-of-life support; however, the 2 elements that facilitate success - coordination and family caregiver - are not necessarily associated as being intertwined or one and the same. This narrative review explores family caregiver experiences of coordinating end-of-life care in the home setting. Methods Studies were identified systematically following the Preferred Reporting …

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 …

Improving End-Of-Life Care: A Nursing Education Initiative, Spring C. Kingsley

DNP Projects

Background: This study addresses the gap in education and training for medical intensive care unit (MICU) nurses regarding the care of hospice patients. The traditional medical model of healthcare prioritizes illness treatment, often leading to inadequate end-of-life support and increased hospitalization during patients' final days. The rise of in-hospital hospice programs, or scatter-bed hospice models, highlights the need for nurses to enhance their skills in providing end-of-life compassionate care. The MICU at the University of Kentucky’s Chandler Hospital serves as a focal point for this initiative, given its role in caring for critically ill patients who require hospice attention.

Purpose: …

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 …

Planning In Advance (Pia): Teaching London Seventh-Day-Adventist Church Leaders In Providing Spiritual Care For Dying And Mourning Parishioners, Walace Saint Louis

Doctoral Dissertations and Projects

The London Seventh-Day Adventist Church (LSDAC), Maybee, Michigan, grapples with the lack of trained leaders in EoL to provide pastoral care for dying and mourning African American parishioners. The purpose of this DMIN action research project is to educate LSDAC leaders in providing spiritual care for their congregants as lay chaplains. The city of Maybee contains 612 people, with 95 % Caucasians and 5% other racial groups. The LSDAC membership is 99% African Americans and 1% Caucasians. It has around 30 members.

The philosophical concept of this research lies in the presuppositions that African Americans prefer spiritual EoL care from …

I Would Do Anything For You: Exploring The Experiences Of Guardians Providing Hospice Care For Their Dying Companion Animals, Amanda Riches, Charlotte Brigden

People and Animals: The International Journal of Research and Practice

Veterinary hospice is a philosophy of care that seeks to maintain comfort and quality of life for terminally ill or geriatric animals. The practice is in its infancy in the United Kingdom (UK) and the needs and wants of caregivers are therefore not clearly understood. This study explored the unique perspectives and experiences of guardians undertaking hospice care for their dying canine and feline companions, filling an immediate knowledge gap in this field of study. Semi-structured telephone interviews were conducted with 15 hospice caregivers, consisting of 11 females and 4 males, sharing personal experiences with 17 dogs and 4 cats. …

The Implementation Of Comfort Medication Kits In Hospice Patients’ Homes To Reduce Hospice Revocations, Brandi J. Parker

Doctor of Nursing Practice Projects

Background: When hospice patients experience a symptomatic crisis at the end of life, unmanaged symptoms can lead to unwanted hospitalizations and the revocation of their hospice benefits. Strategies to reduce the incidents of hospice revocation are needed to improve patient care and quality of life.

Purpose: The quality improvement project aimed to reduce hospice revocation rates by implementing comfort medication kits in eligible hospice patients’ homes.

Methods: The project’s intervention included identifying patients at high risk for revocation, patients with a cancer diagnosis, and patients with a prognosis of two weeks or less. Comfort medication kits were placed in the …

End-Of-Life Patient Communication: Exploring Comfort, Communication And Education Of Healthcare Professionals For End-Of-Life Care, Madison Gremillion

Undergraduate Honors Theses

Historically, the medical field has viewed death and dying as incurable ‘medical failures,’ and as a result, many healthcare professionals have difficulties when facing a patient who is dying or at the end of their life. These individuals will use avoidant behavior to avoid end-of-life (EOL) patients or can have difficulty providing essential aspects of care including communication, that contribute to building a strong relationship between the healthcare provider and patient. For the healthcare professional (HCP), this can stem from anxiety related to thoughts of death and a lack of educational support or experience. The study of death is where …

Occupational Impact Of Caregivers In Pediatric Palliative Care, Lezlye Ramos, Karen Park, Jazminne O. Arteaga

Spring 2024 Virtual OTD Capstone Symposium

The purpose of this study is to understand the occupational impact for caregivers who had a child with a life-limiting or life-threatening condition who had received pediatric palliative care. A lack of understanding of occupational therapy’s role in end-of-life care ultimately underutilizes and under-prepares occupational therapists to work in this practice area. Becoming a medical family caregiver, neglecting personal needs and desires becomes a norm having a in-direct effect on physical and psychological health and well-being. Findings from this study suggest that it is reasonable to infer that occupational participation among caregivers is influenced by finding time for self and …

The Effect Of The Gocomm Educational Intervention On Physician Distress Surrounding Goc Conversations Using The Physician Distress Inventory (Pdi), Thomas Anthony Bozzo

Theses and Dissertations

End-of-life (EOL) care refers to the medical, emotional, and practical support provided to individuals who are nearing the end of their lives. Goals of care (GOC) discussions involve physician exploration of patient beliefs and values, though they do not need to be primarily focused on end-of-life health-care decisions. Engaging in EOL/GOC conversations has been linked to increased quality of life, decreased healthcare costs, and more frequently receiving care in line with patient preferences. Barriers to these discussions occurring exist at both the clinician-level (e.g., inadequate communications training) and the patient-level (e.g., heightened death anxiety). This study aimed to determine if …

Improving Spiritual Care Competency Among Intensive Care Unit Nurses: Promoting Holistic Patient Care Towards End-Of-Life, Joanne Nguyen, Dana Bagis

Nursing | Senior Theses

Intensive care unit (ICU) nurses play a crucial role in providing physiological stabilizing care in a dynamic and fast-paced environment, often marked by constant changes and variability in complex patients. Despite their specialization, the aspect of spiritual care tends to be overlooked, particularly in the context of end-of-life care. This is significant because previous studies have shown that a lack of spiritual care leads to poorer health outcomes, decreased coping, increased depression, and diminished quality of life for patients. This research proposal aims to investigate the spiritual care competency among ICU nurses who partake in spiritual care-based training, with the …

The Cost Of Providing Care By Family And Friends (Informal Care) In The Last Year Of Life: A Population Observational Study, Miriam J. Johnson, David C. Currow, Jade Chynoweth, Helen Weatherly, Gamze Keser, Ann Hutchinson, Annie Jones, Laurie Dunn, Victoria Allgar

Peninsula Medical School

Introduction: Little is known about replacement costs of care provided by informal carers during the last year of life for people dying of cancer and non-cancer diseases. Aim: To estimate informal caregiving costs and explore the relationship with carer and decedent characteristics. Design: National observational study of bereaved carers. Questions included informal end-of-life caregiving into the 2017 Health Survey for England including estimated recalled frequency, duration and intensity of care provision. We estimated replacement costs for a decedent’s last year of life valuing time at the price of a substitutable activity. Spearman rank correlations and multivariable linear regression were used …

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 Caregivers’ Preparedness With Death And Dying: An Ethnographic Study, Erna Rochmawati, Rick Wiechula

Jurnal Keperawatan Indonesia

Death and dying is a complex process and influenced by belief and culture. Understanding the cultural practice is therefore important to enable providing quality end-of-life care. This paper focus in reporting how family caregivers prepare and deal with death and dying within palliative care context. This study was a contemporary ethnographic study that deriving data from observations and informal interviews. Field observation and informal interviews were conducted over three months with 21 patients’ relatives. Data was analyzed using ethnographic data analysis framework. Dealing with death and dying relates to how this was experienced and managed by the patient’s relatives. Three …

Review Of Octreotide Use For End-Of-Life Symptom Management By Indication In An Inpatient Hospice Setting, Lisa Peterson, Kavita Sharma, Sarah Riutta

Scientific Day

No abstract provided.

Improving Advance Directive Documentation In A Primary Care Clinic In The Midwest, Teresa Hagedorn

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Teresa Gayle Hagedorn

Advance care planning (ACP) is a continuous communication process linking patients, family members, caregivers, and healthcare providers. Personal values, life goals, and preferences regarding future medical care are significant to every person as we will inevitably reach the end of life. Advance directives (ADs) promote patient autonomy and provide legal documentation of a patient’s wishes for future care. According to the National Institute of Health (2018), only 1 in 3 adults in the United States have a documented AD in their electronic medical records (EMR). This quality improvement project aimed …

Talking About Death: Exploration Of The Impact Of Death Communication Norms On End-Of-Life Caregivers, Maureen H. Mckenzie

Masters Theses

This study seeks to understand the experience of end-of-life caregivers and how their subscribed communication norms regarding death impacted their caregiving experience and preparedness to make decisions on their person’s behalf. Eight participants were recruited from a Midwestern support group facility with a population of nearly 8,000 members that include cancer and grief support members. Criteria required adult participants that were less than 10 years out from their caregiving experience. Phenomenological research methods were used capturing eight opened ended interviews about participants death communication history, caregiving experience, and reflection on current death communication norms. Thematic analysis was utilized to assess …