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Impact Of Debriefing Methods On Psychological Outcomes In End-Of-Life Simulation, Jennifer A. Wentzel, Julie Steele, Desireé Hensel

International Nursing Research Congress (INRC)

Introduction: Nursing students do not feel adequately prepared to care for patients at the end of life (EOL) (Yoong et al., 2023). Current EOL education focuses on students’ learning outcomes instead of their psychological needs (Harder & Harwood, 2019). This is the first study to compare the impact of debriefing methods on psychological outcomes in EOL nursing education.

Purpose: Guided by the Transactional Model of Stress and Coping and Kolcaba’s Comfort Theory, this study examined the impact of the Trauma-informed, Psychologically Safe (TiPS) debriefing method on coping with death, attitudes toward care of the dying, and debriefing experience in undergraduate …

Factors Influencing Pediatric Palliative Care Utilization: A 12-Year Retrospective Study In Taiwan, Tzu-Ying Yang, Wei-Wen Wu, Frank Leigh Lu, Shao-Yi Cheng, Tsung-Hsien Yu, Kristin Berg

International Nursing Research Congress (INRC)

Background and objective: Pediatric palliative care (PPC) improves the quality of life for children with life-limiting conditions and their families by addressing physical, psychological, and spiritual needs. Despite increasing recognition of its benefits, PPC remains underutilized, particularly in Asian contexts where early integration and service accessibility are still limited. This study aimed to examine trends and factors influencing PPC utilization among deceased children in a tertiary children’s hospital in Taiwan from 2012 to 2023, to provide evidence on predictors for more equitable access to PPC.

Methods: A retrospective study was conducted using medical records of children aged 1–18 years who …

Assessing Nursing Students’ Palliative Care Competence To Inform Course And Curriculum Design, Wen-Wen Li, Jung Eun Kim, Derrick Huang

International Nursing Research Congress (INRC)

Purpose: This project evaluated undergraduate nursing students’ competency and knowledge in palliative care (PC) before a semester-long course. Findings informed curriculum design to strengthen students’ understanding and application of PC concepts in clinical practice.

Background/Significance: Palliative care is vital in nursing education, yet integration into undergraduate curricula remains inconsistent (Lippe & Becker, 2021). Developing PC competence enhances patients’ and families’ quality of life (Alhaddar et al., 2025). Assessing students’ baseline knowledge helps identify learning gaps and align curricula with the American Association of Colleges of Nursing [AACN] CARES Competencies (AACN, 2021) in PC education.

Methods: A cross-sectional study was conducted …

Virtual Reality Simulation For End-Of-Life Communication: Case Development And Pilot Implementation, Kathryn M. Ledwin, Kylene Abraham, Karen Parker

International Nursing Research Congress (INRC)

Background: Registered nurses have reported feeling unprepared and lacking proper skills for critical end-of-life discussions with patients and their families (Kerr et al., 2020). Virtual reality (VR) simulation presents a novel approach to providing immersive opportunities to support learning and skill development (Liu et al, 2023; Sinurat et al.,2025). VR has been successfully integrated into nursing education to support clinical skill development (Foronda et al. 20220; Liu et al, 2023), however less research has focused on specific applications for complex medical discussions.

Purpose: This project aimed to develop and examine the feasibility of using VR simulation as an educational intervention …

“I Started Healing Myself”: Black Mothers’ Grief Journeys After Stillbirth, Carrie J. Henry, Sara Kaylor, Mallory Scogin

International Nursing Research Congress (INRC)

Introduction: Stillbirth (fetal death after 20 weeks gestation) occurs twice as often for Black mothers compared to White in the United States (Gregory et al., 2024), yet limited research has explored how Black mothers cope with stillbirth-related grief and distress (Boyden et al., 2014; Henry et al., 2023). Evidence suggests coping behaviors after perinatal loss differ across cultural and racial groups (Henry et al., 2024; Moore et al., 2022), yet most studies reflect mostly White samples. Understanding how Black mothers navigate the grieving process is essential to inform culturally responsive care and bereavement support (Fenstermacher & Hupcey, 2019; Henry et …

Ecological Momentary Assessment Of Caregiver Distress In Home Hospice Caregivers: A Study Protocol, Tuzhen Xu, Ya-Ching Huang

International Nursing Research Congress (INRC)

Background: Caregivers of hospice patients, often family or close friends, provide continuous support for individuals with a life expectancy of six months or less. In 2022, 1.72 million Medicare beneficiaries received hospice care, most at home, with an average stay of 98 days. Caregivers manage medications, symptoms, personal care, emotional support, and provider coordination, placing them at high risk for fatigue, anxiety, depression, sleep disturbance, and burnout. Traditional surveys or single-point interviews often fail to capture the dynamic nature of distress, especially during nighttime care or crises.

Purpose: To characterize real-time patterns of physical and psychological distress among home hospice …

Psychometric Evaluation Of The Chinese Version Of The Death Literacy Index Among Nursing Students, Shu-Fen Wu, Li-Er Hung, Hsiu-Chen Liao, Shih-Ting Lo, Chia-Yu Chen

International Nursing Research Congress (INRC)

Background: Death literacy encompasses the knowledge and skills enabling individuals and communities to access, understand, and act on end-of-life care options. For nurses, it influences communication, decision-making, and palliative care quality. However, few studies have examined death literacy among healthcare providers, and no validated Chinese instruments exist for its assessment.

Purpose: To translate the Death Literacy Index (DLI) into Chinese and examine its reliability and validity among nursing students in Taiwan.

Methods: A cross-sectional correlational study was conducted. The DLI underwent translation and back-translation to ensure conceptual and linguistic equivalence, followed by expert review for content validity. Convenience sampling was …

Parent Perspectives On The Potential For And Process Of Infant Organ Donation, Julia St Louis, Amy L. Wright, Sonny Dhanani, Charles Keown-Stoneman, Jennifer Woolfsmith, Danielle Joseph, Kimberley Widger

International Nursing Research Congress (INRC)

Introduction: Despite the potential to shorten waitlists for life-saving transplants, infant organ donation is rare globally (1). Infant donors (less than one year of age) can reduce waitlist mortality for both infants and children who require size-matched organs like hearts and lungs, and adults who can receive kidney transplants from infant donors (2). Infants can donate their organs after death by circulatory criteria (DDCC) (i.e., the heart stops beating)(1) if the death follows the withdrawal of life-sustaining measures (WLSM) (i.e., mechanical ventilation and hemodynamic supports like vasopressors). However, donation rates are very low(2). Providers have reported rarely offering donation due …

A Heart-Stopping Decision: An Ethical Dilemma Involving Pacemaker Deactivation At End Of Life, Hailee Grannan Md, Nora Badi Md, Kavita Sharma Md

Scientific Day

Introduction/Background:

Pacemaker deactivation at the end of life presents complex ethical and logistical challenges. While Heart Rhythm Society affirms a patient’s right to withdraw life-sustaining treatments, clinicians often experience moral distress when patients are pacemaker-dependent. Unlike defibrillators, pacemakers are perceived as integral to the body rather than external interventions, leading to concerns regarding hastening of death with pacemaker deactivation. In this case, we highlight how device manufacturer procedural requirements can also create obstacles to deactivation, resulting in unintended prolonged suffering and increased distress for the patient and family.

Description:

A 74-year-old male with metastatic renal cell carcinoma developed third-degree heart …

Balancing Safety And Quality With End-Of-Life Realities: A Single Inpatient Hospice Facility Review, Hailee Grannan Md, Sarah Riutta Phd, Kavita Sharma Md

Scientific Day

Background/Significance:

Patient safety in hospice care requires balancing traditional safety metrics with individualized, comfort-focused goals at the end of life. Inpatient hospice units manage complex symptoms, high-risk medications, and dynamic family preferences, yet limited literature characterizing safety events in this setting. Despite routine event reporting, no comprehensive evaluation of safety incidents has been conducted at Zilber Family Hospice (ZFH).

Purpose:

The purpose of this project was to characterize and analyze patient safety incidents at ZFH to identify patterns, clarify event categorization, and inform hospice-specific safety practices and staff education that support comfort and harm reduction.

Methods:

Safety incidents at ZFH …

Pediatric Home-Based Hospice And Palliative Care: A Scoping Review, Ellen Davis, Daniel H Grossoehme, Toluwalase Ajayi, Justin N Baker, Pamela S Hinds, Lisa Humphrey, Jill Ann Jarrell, Rachel Thienprayoon, Sarah Friebert

Faculty, Staff and Students Publications

Pediatric palliative and/or hospice care is provided across a broad spectrum of settings, ranging from inpatient to outpatient to a child's home. Pediatric home-based hospice and/or palliative care teams offer a specialized, interdisciplinary approach to care, allowing children to stay in the home while offering comprehensive support. This scoping review seeks to summarize what is known about pediatric home-based hospice and/or palliative care and to identify gaps in the current research. Following Arskey and O'Malley's scoping review framework, we searched four databases for studies focused on pediatric home-based hospice and/or palliative care programs. Studies were included if they were published …

“Do Everything” Versus Realistic Surgical Interventions: Navigating The Road To Shared Decision-Making In Trauma Surgery, Victoria E Wagner, Ashna S Karpe, Martin L Blakely, Lillian S Kao, Thaddeus J Puzio

Faculty, Staff and Student Publications

"DO EVERYTHING!!" How many times have you heard that phrase from a distressed family member? We routinely receive this desperate plea, and our knee-jerk reaction is to press on, push harder, be more aggressive. We, as acute care surgeons, have spent our lives learning a craft geared towards "doing everything" to heal patients so this response comes naturally. However, how do we respond to "do everything" when the probability of a meaningful recovery is extremely low or non-existent? These situations create moral tension for surgeons who must reconcile the desire to preserve life with the obligation to avoid harm, respect …

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

Tree Of Life, Sandra Rogers, Brooke Judd, Mollie Slugantz

Biennial Convention (CONV)

Introduction / Background: Most people understand the term death. However, in the world of organ donation, death can have different meanings. Donation after brain death (DBD) is when there is irreversible cessation of all brain activity due to lack of blood and/or oxygenation. The other form is donation after circulatory death (DCD) in which the patient has not deteriorated to brain death but there still may be an opportunity for families to opt for organ donation. Research has shown that healthcare providers working in intensive care units (ICUs) are not always at ease with DBD and even more uncomfortable with …

Assessment Of Cognitive Decline During Cancer Treatment: A Mixed-Methods Study, Katy Fisher-Cunningham, Trista Michelle Anderson

Biennial Convention (CONV)

Background: Cancer-Related Cognitive Impairment (CRCI), often termed "chemo brain," impacts 50-70% of chemotherapy patients and 12-75% of cancer survivors, with symptoms such as memory difficulties, attention issues, and executive dysfunction potentially lasting up to 20 years. Most research has centered on breast cancer, leaving gaps for other cancer types. Non-treatment factors can also induce CRCI, including the cancer itself. The mechanisms of CRCI share similarities with Alzheimer's disease. Currently, there is no standardized assessment tool for CRCI, emphasizing the need for tailored evaluation methods.

Objective/Specific Aims: This study aims to assess CRCI in patients with current cancer diagnoses and explore …

An Interprofessional Approach To Advanced Birth Planning For Special Babies And Parents, Rebel L. Heasley, Maripi M. Dizon

Biennial Convention (CONV)

Introduction: This community hospital in Southeast Texas strives to provide unparalleled care to even the most unique patients. According to the Centers for Disease Control and Prevention (CDC, 2023), Trisomy 13 affects one in every 6,967 births, and Trisomy 18 affects one in every 3,336 births. A more staggering statistic is that one in 33 births is impacted by some form of birth defect in the United States each year (CDC, 2023). There were minor differences in the historical pattern of caring for patients and babies with special circumstances. After delivery, mothers faced with birth defects and fetal demise were …

Culturally Diverse End-Of-Life Simulation And Perceptions In Undergraduate Nursing Students, Jodi Kay Olson, Mary Pesch, Julie Keller-Dornbusch

Biennial Convention (CONV)

End-of-life (EOL) patient care is a challenging reality that nearly all nurses will face during their careers. Preparing nursing students for these situations can alleviate anxieties related to patient death (Venkatasalu et al., 2015). Simulation-based learning is an effective approach for teaching complex scenarios like EOL care (Cannity et al., 2021), with numerous studies highlighting improved confidence and competence in students who participate in EOL simulations (Gillan et al., 2014; Tamaki et al., 2019; Venkatasalu et al., 2015; Lewis et al., 2016; Jablonski et al., 2020). However, the lack of cross-cultural variations in death and dying highlights the need for …

Emergency Department-Initiated Palliative Care Screening Among Older Adults: A Systematic Review And Meta-Analysis Protocol, Dimitri E Lin, Satheesh Gunaga, Fabrice I Mowbray, Eric D Isaacs, Daniel Markwalter, Naomi George, Alison E Hay, Rita Manfredi, Erica Westlake, Murtaza Akhter, Jason K Bowman, Naomi Rebollo-Lee, Brian Gacioch, Alexander D Ginsburg, Justin Kenneth Brooten, Sarah Pajka, Katie Selman, Paul Bain, Joshua J Davis, Shan Liu, Kei Ouchi

Faculty, Staff and Students Publications

Introduction: The rapidly growing population of older adults (individuals aged 65 years and older) presents a new set of challenges for healthcare providers in the emergency department (ED), given the prevalence of severe and life-threatening conditions among this group, such as chronic cancer, Alzheimer's disease/dementia and congestive heart failure. ED encounters often represent a critical point in an older patient's trajectory of care and can thus be an important opportunity for various interventions such as palliative care consultation. Therefore, identifying those who will benefit most from palliative care is of high importance, especially in determining the course of future treatment. …

A Heart-Breaking Decision: An Ethical Dilemma Involving Pacemaker Deactivation At End Of Life, Haley Grannan, Kimberly Battle-Miller, Kavita Sharma

Aurora GME

Background Requests for pacemaker deactivation at end of life raise unique ethical challenges. Physicians often experience moral distress when patient autonomy conflicts with perceived duties of beneficence and non-maleficence. Case A 74-year-old man with metastatic renal cell carcinoma receiving checkpoint inhibitor therapy presented with third-degree heart block. He underwent extensive evaluations, including cardiac catheterization, transvenous pacing, and steroids. After two cardiac arrests, a permanent pacemaker was implanted. Despite treatment for several weeks, he experienced progressive functional and nutritional decline. He requested pacemaker deactivation with goal of comfort focused care. The hospital ethics committee affirmed his decisional capacity and noted that …

A Puzzling Case Of Visual Disturbances Leads To A Fatal Neurodegenerative Diagnosis, Courtney J. Austin, Aaron Carrillo, Jennifer Rojas Huen, Victoria Parada

Research Colloquium

Background: Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative disease in which early diagnosis is complicated by the presence of early non-specific and atypical presentations. Sporadic CJD (sCJD), the most common type of CJD, is caused by the spread of a disease-forming prion known as PrPSc. PrPSc multiplies and binds to the normal form of prion, or PrP, converting it to an abnormal, structurally altered disease form that spreads throughout the brain. sCJD can initially present with six different phenotypes: cognitive, affective, classic, visual (Heidenhain variant), atactic (Oppenheimer-Brownell variant), and indeterminate. The classic presentation of CJD includes rapidly progressive dementia with …

Palliative Care Beyond Cancer: The Use Of The P-Cares Tool, Breslin E. Meyer

Dissertations

Emergency Departments (EDs) often lack the necessary resources and protocols to provide comprehensive palliative care, resulting in inadequate pain and symptom management (Stoltenberg et al., 2022). This study investigates the potential transformative impact of a palliative care consultation on patients with advanced disease who screen positive using the validated P-CaRES tool. The PICOT questions: Will patients with end-stage COPD, CHF, and or other chronic conditions benefit from P-CaRES screening in the emergency department over nine weeks and receive more palliative care consultations from their primary care providers?

This project was conducted over 9 weeks, utilizing convenience sampling to select 20 …

Increasing Depression Risk Screening In Hospice And Palliative Care Patients, Elizabeth Kanini Michaels

Walden Dissertations and Doctoral Studies

This doctoral project was conducted as a staff education project. The practice problem involved inconsistent depression risk screening in hospice and palliative care patients. It was crucial to address this, as depression can be pervasive in this population. The practice-focused question was, For registered nurses who work in a palliative or hospice care unit, does education on depression risk screening increase depression screening rates as compared 12 weeks before to 12 after the education? The project aimed to improve depression risk screening rates through staff education. The Johns Hopkins nursing evidence-based practice model was used to assess 13 supporting articles …

Pacemaker Deactivation: Perspectives Among Clinicians And Providers, Jaafar Zalzaleh Do, Kavita Sharma Md, Sarah Riutta Phd, Dawn Wankowski Ms, Nora Badi Md

Scientific Day

No abstract provided.

Navigating Challenges In Palliative Care: A Survey On Asco Guideline Adherence Among Health Care Providers In Low- And Middle-Income Countries., Cristiane Decat Bergerot, Enrique Soto-Perez-De-Celis, Chadane Thompson, Rushil Patel, Jafar Al-Mondhiry, Tingting Zhang, Nathasha Dhawan, Darcy Burbage, Joseph Mccollom Do, Mazie Tsang, Ramy Sedhom, William E Rosa

PCI Publications and Projects

PURPOSE: Integrating palliative care into oncology is essential, yet disparities in access and quality persist, particularly in low- and middle-income countries (LMICs). The ASCO guidelines advocate for early, routine, interdisciplinary palliative care for patients with advanced cancer. Barriers to implementing these recommendations include resource limitations, inadequate training, and cultural perceptions. Recognizing these challenges is essential for improving equitable access to palliative care worldwide.

METHODS: This prospective survey assessed adherence to ASCO recommendations for palliative care integration among LMIC health care providers (HCPs). Participants were recruited via e-mail, social media, and a list of members involved in the ASCO Palliative Care …

Symptom Documentation In Unstructured Palliative Care Notes Of Children And Adolescents With Cancer., Katherine Bernier Carney, Jacob Wilkes, Tumilara Aderibigbe, Kristin Stegenga, Holly Spraker-Perlman, Lauri A. Linder

Manuscripts, Articles, Book Chapters and Other Papers

CONTEXT: Children and adolescents with cancer experiencing complex symptoms can benefit from subspeciality palliative care. However, standardized methods of symptom documentation by pediatric palliative care teams are lacking. Understanding current approaches to symptom documentation will inform next steps to optimize symptom support.

OBJECTIVE: To explore the documentation of symptom prevalence and characteristics in unstructured clinical notes by pediatric palliative care clinicians caring for children and adolescents with cancer.

METHODS: We reviewed unstructured clinical notes documented by the pediatric palliative care team for 115 children and adolescents with cancer. Symptom-related data were abstracted and evaluated using content analysis based on the …

Pathways To Peace: A Timely Shift To Hospice For Dignified End-Of-Life Care, Josefina Hernandez Garcia

Cohort XIII

Background: Timely transitions to hospice care remain a significant challenge in many healthcare settings, often resulting in patients transitioning too late to fully benefit from the services. Palliative interventions can improve care for patients nearing end of life, many patients do not receive timely palliative care (Perri et al., 2020). Delays in hospice referrals are frequently due to a lack of standardized processes for identifying patients nearing end-of life.

Objective: This is a Quality improvement project that aims to improve the timeliness and accuracy of transitioning new palliative care patients and existing Bridges High risk patients to hospice services by …

Finding Grace With Advanced Cirrhosis: Improving Palliative Care Consult Utilization Final Results, Saud Khan, Samuel Kwiatkowski, Anjali Lukose, Amanda T. Rivera Miranda, Priscilla Phan, Ashwini Komarla, Sabiha Kazi, Diana Treu, Amar Mandalia

North Florida Division GME Research Day 2025

No abstract provided.

Kentucky Comfort Care: Understanding And Awareness Of Palliative And Hospice Care In Kentucky Adults, Riley E. Hicks

Honors Theses

Kentucky has an overwhelming need for both palliative and hospice care services because of the high percentage of individuals who struggle with chronic or life-threatening conditions. Studies have shown that access to palliative and hospice care may be inhibited by the knowledge patients have of these services. The purpose of this study was to examine the awareness and understanding Kentuckians have of palliative and hospice care and to determine the factors influencing them. A 22-question survey was administered to collect information about Kentuckians understanding of available palliative and hospice care services and common vocabulary used by providers in these settings. …

Artificial Intelligence-Powered Robotic Technology For Transforming Palliative Care, Adebo Thomas, Asiku Denis, Wamusi Robert, Simon Peter Kabiito, Zaward Morish, Aziku Samuel, Malik Sallam, Ioannis Adamopoulos

Mesopotamian Journal of Artificial Intelligence in Healthcare

Palliative care seeks to improve the quality of life of patients with life-threatening illnesses by addressing their physical, emotional, and psychological needs. However, global challenges such as workforce shortages, limited access to specialized care, and inconsistent care quality demand innovative solutions. Advances in artificial intelligence (AI)-powered robotics offer transformative potential to overcome these barriers and strengthen palliative care delivery. This study explores how AI-driven robotic technologies support palliative care through applications in symptom monitoring, clinical decision-making, emotional companionship, and personalized care planning. It reviews cutting-edge robotic systems, including assistive, companion, diagnostic, nursing, procedural, service, and rehabilitation robots. Enabled by machine …

Extension For Community Healthcare Outcomes-Palliative Care In Africa And Quality Of Life, Symptoms, Patient Experience, And Caregiver Distress Among Patients With Cancer, Sriram Yennurajalingam, Olaitan Soyannwo, John Weru, Edwina Beryl, Henriette Burger, Esther Nafulah, Oladayo Aikomo, Adeniyi Adenipekun, Irene Botchway, Mary Ocansey

Haematology and Oncology, East Africa

Purpose: In this study, we aimed to evaluate the association between the Extension for Community Healthcare Outcomes-Palliative Care (ECHO-PC; ECHO Model–Based comprehensive educational and telementoring intervention) for health care professionals (HCPs) and change in patient-reported quality-of-life (QOL; Functional Assessment of Cancer Therapy-General [FACT-G]) among patients with advanced cancer. We also examined the association between ECHO-PC and changes in symptom distress (Edmonton Symptom Assessment Scale [ESAS]), patient experience and satisfaction, and caregiver distress scores.

Methods: ECHO-PC Clinic sessions were conducted twice a month for 1 year by an interdisciplinary team of PC clinicians at the MD Anderson Cancer Center, with participation …