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A Systematic Review - The Effect Of Hospice And Palliative Care, Justin M. Brown, David J. Havener, Jeffrey T. Byrne

Williams Honors College, Honors Research Projects

Many older adults nearing death experience unnecessarily invasive and costly healthcare treatments, often causing more harm than good. Hospice and palliative care interventions offer a possible solution to this problem by prioritizing high-quality and cost-effective care with a strong focus on comfort and satisfaction. The authors of this paper seek to answer the following question: Do hospice and palliative care interventions directed toward older adults at the end of life improve quality of life, cost of care, and satisfaction? This paper thoroughly reviews and critically appraises existing research related to the effect of hospice and palliative care directed toward older …

More Than Medication: Perinatal Palliative Care., Brian S. Carter

Manuscripts, Articles, Book Chapters and Other Papers

No abstract provided.

Development And Validation Of The Palliative Care Knowledge Scale (Packs), Elissa Kozlov

Arts & Sciences Graduate Student Theses and Dissertations

Palliative care is a team-based, specialty service that improves the quality of life for individuals with serious illness and their families. However, current research suggests that this life-improving service is drastically underutilized. Patient knowledge of a healthcare service is theorized to drive utilization. If people do not know what palliative care is, they cannot be expected to seek out or accept a referral for the service. Currently, there are no psychometrically evaluated scales to assess knowledge of palliative care. The purpose of this study is to develop a reliable and valid scale that broadly measures knowledge about palliative care. An …

Pain Management And Palliative Care: A Program Of Research, Huda Abu-Saad Huijer

International Nursing Research Congress (INRC)

In this session a number of studies conducted in the field of pain management and palliative care in different countries and most recently in Lebanon will be presented. The session will depict the importance of a research trajectory and a clear program of research for knowledge development in the field and on impacting policy and health care practice. The trajectory of research started in the 1980s with a clear focus on pain assessment and pain management in children of all age groups first in the USA and at a later stage in the Netherlands and more recently in Lebanon. Palliative …

Palliative And Supportive Care In Turkey: Literature Review And Current Status Of Research, Imatullah Akyar

International Nursing Research Congress (INRC)

Session presented on Sunday, July 24, 2016:

Purpose: The aim of this study was to examine the current literature on palliative and supportive care in Turkey, discuss current status and future research areas.

Methods: This study was conducted as a literature review. Literature review focused on palliative and supportive care studies done in Turkey. PubMed and Turkish National databases through Turkish Academic Network and Information Center were searched in 12-16 October 2015 with keywords 'Turkey/Turkish', 'palliative care', 'supportive care'. All hits including palliative and supportive care papers from Turkey written either in English or Turkish were included whereas letters to …

Describing The End Of Life Knowledge, Beliefs, And Preferences Of Alaska Native And American Indian Peoples, Colleen Marie Kelley

Theses and Dissertations

This dissertation is comprised of three manuscripts that will be submitted for publication, describing the end of life knowledge, beliefs, and preferences of Alaska Native and American Indian Peoples. The first manuscript is a literature review that examines what is known about the understanding about the end of life knowledge, beliefs, and preferences of Alaska Native and American Indian Peoples. The second manuscript offers results of an exploratory descriptive study designed to describe the end of life knowledge of hospice care services, beliefs about dying, and preferences for end of life care of Alaska Native and American Indian Peoples. Finally, …

The Development Of A New Model For Assessing African-American Spirituality In Palliative Care, John C. Welch

Electronic Theses and Dissertations

Research has shown that African-Americans are least likely to receive adequate palliative interventions leading to concerns about the quality of health care in general and palliative care in particular for this population. Acknowledging patient preferences are essential in administering quality health care especially when a patient's condition is terminal. But when African-Americans are least likely to complete living wills or durable power of attorneys for health care and more likely to continue to request life sustaining treatments when near death, conflicts between patients and medical professionals can result.

Recognizing patient spirituality and addressing their spiritual needs can help the patient, …

Investigating The Mutual Effects Of Depression And Spiritual Well-Being On Quality Of Life In Hospice Patients With Cancer And Family Caregivers Using The Actor-Partner Interdependence Model, Li-Ting Huang

USF Tampa Graduate Theses and Dissertations

The World Health Organization and the leading hospice organizations have emphasized the inclusion of family caregivers of hospice patients with cancer into end-of-life care, as these two dyad members may spiritually and emotionally influence each other. Given that depression and spiritual needs, which are prominent in these pairs, may impair quality of life (QOL) of hospice dyads, examining mutuality within dyads is imperative to develop a more accurate model that includes family caregivers. Therefore, the purpose of the study was to elucidate the importance of mutual effects within hospice dyads by examining the contribution of depression and unmet spiritual needs …

Cultural Relevancy Of Palliative And End-Of-Life Care: Conversations With Indigenous Elders, Mary J. Isaacson

Biennial Convention (CONV)

Session presented on Monday, November 9, 2015:

Purpose: Access to palliative and end-of-life (EOL) care is severely limited for South Dakota (SD) Native American/American Indians [NA/AI] (Isaacson et al., 2014), which is of significant concern given their high morbidity and mortality rates (SD Vital Statistics Report, 2012). Palliative care professionals and NA/AI healthcare providers identify funding, infrastructure, and misperceptions specific to the NA/AI population and palliative/EOL care as barriers to access (Isaacson et al., 2014). Addressing these barriers and feasibility concerns must occur by bringing together key individuals and include persons receptive to the voices and concerns of NA/AIs residing …

Exploring The Factors That Influence The Interprofessional Delivery Of Palliative Care In Long-Term Care Facilities, Kathryn A. Pfaff, Jean Echlin, Lisa A. Hamilton

Biennial Convention (CONV)

Session presented on Tuesday, November 10, 2015:

The implementation of palliative care is considered the'gold standard' for care at end-of-life (Department of Health End of Life Care Strategy, 2008). Palliative care is an interprofessional approach that improves the quality of life for individuals with life-threatening illness, by early identification and management of pain and other physical symptoms. It integrates the psychological and spiritual aspects of patient care, offering a support system to help individuals live as actively as possible until death, and addresses the coping needs of individuals and families through illness and bereavement (World Health Organization, 2011). Nevertheless, there …

The Lived Experience Of Caregivers Providing Home Care For Terminal Cancer Patients: A Phenomenological Study, Fatima Saleh Mohamed

International Nursing Research Congress (INRC)

Session presented on Sunday, July 26, 2015:

Purpose: The aim of the study was to explore the lived experience of caregivers providing home care for terminal cancer patients with the objectives of documenting their experiences of caring for relatives who are terminally ill with cancer and the needs of home caregiving in Bahrain.

Methods: The study adopted qualitative, Heideggerian, hermeneutic phenomenological design, with a purposive sample of eight family caregivers. Data was collected through one to one, in depth semi-structured interviews and analyzed using Interpretative Phenomenological Analysis.

Results: Three main themes emerged; Burdens of Care; Comforts; and Coping. The findings …

And The Evidence Shows Using Specialty Certification From The Joint Commission Improves Quality, Leisha Buller, Lindsey Canon, Ashley Hodo

International Nursing Research Congress (INRC)

Session presented on Saturday, July 25, 2015:

The Palliative Care Service (PCS) line at our 731 licensed-bed metropolitan-based facility recently received our first recertification for Advanced Palliative Care (APC) from The Joint Commission (TJC). Initial designation of this specialty certification facilitated the growth of our well-established adult PC program and our newly developed neonatal program (weeCARE). Seemingly counterintuitive, these two diverse populations served by our service by separate interdisciplinary teams (IDT) have become a unified service over the previous 2 years. Quality improvement opportunities were identified and structural homogeneity was achieved through a more stringent implementation of evidence-based guidelines within …

Tough Decisions For Premature Triplets., Ashley Hurst, Scott And Emily (Parents), Brooke D. Vergales, Alix Paget-Brown, Mark Mercurio, John Lantos

Manuscripts, Articles, Book Chapters and Other Papers

When infants are born at the borderline of viability, doctors and parents have to make tough decisions about whether to institute intensive care or provide only palliative care. Often, these decisions are made in moments of profound emotional turmoil, and parents receive different information from different health professionals. Communication can become garbled. It may be difficult to tell when and whether the patient's clinical condition has changed enough so that certain choices that had once been permissible become impermissible. In this "Ethics Rounds," we present a case of triplets born at the borderline of viability. We sought comments from the …

Making A Difference: Evidence Based Palliative Care Education For Neonatal Nurses, Sherry Elaine Pye

Walden Dissertations and Doctoral Studies

The death of a neonate is a life-changing and tragic experience for the individuals involved in the final moments of the infant's life. As the frontline provider in this clinical scenario, the bedside nurse supports the patient and family through their individual journey of loss. If the nurse does not possess the palliative care educational background and communication skills to support this unique care delivery process, the journey of death can evolve into a particularly negative experience for the parents and the nurse. This specific delivery of care concern was identified and gleaned from a parental bereavement exit interview after …

Intricate Conversations: Caring For Clients With Severe Mental Illness, John D. Chovan

Nursing Faculty Scholarship

This presentation describes the characteristics of persons living with severe mental illness who intersect with hospice, and palliative care, and their communication challenges.

Palliative Care: Evaluating And Designing Process Improvements For An Inpatient Consultative Program, Shawn M. Crouch

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

The purpose of this capstone project paper and study was to evaluate an inpatient palliative care consultation service and then make recommendations for improving the program. This paper includes a literature review related to palliative care models and best practices in structuring a successful inpatient palliative care service. The project included an analysis of how the program at one university based hospital measured success of the program and SWOT analysis based on interviews with members of the program’s team and leadership. Data sources used for the analysis included palliative care consultation utilization data from the identified hospital; other metrics used …

Isncc Palliative Care Position Statement, International Society Of Nurses In Cancer Care

General Submissions: Organizations - Position Statements, White and Resource Papers

The International Society of Nurses in Cancer Care (ISNCC) published a position statement on palliative care in October 2015. The purpose of this position statement is to (1) integrate a palliative approach into the comprehensive care of cancer patients, in accordance with need, (2) acknowledge and recognize the unique and critical role of the cancer nurse in assessing and addressing cancer patients' and their caregivers' palliative care needs, and (3) support cancer nurses to adopt an evidence-based, palliative approach to support cancer patients and their caregivers across the entire trajectory of illness.

Removal Of Mechanical Ventilator On A Patient Of Als, Ying-Chin Lu, Kuan-Ting Chen

International Nursing Research Congress (INRC)

Session presented on Friday, July 25, 2014:

Purpose: In this case, the patient with ALS in the final stages had a respiratory problem in our hospital. A tracheal intubation is performed for applying ventilation in the intensive care unit to avoid his respiratory failure. Knowing that although mechanical ventilators can prolong survival, it does not provide life quality and dignity, the patient decided to not have a tracheostomy. He requested for removing ventilation and moved into palliative care unit for ventilation removal the next day. The removal of ventilation and the palliative hospice care during the final stages of ALS …

Palliative Care's Sacramental And Liturgical Foundations: Healthcare Formed By Faith, Hope, And Love, Darren M. Henson

Dissertations (1934 -)

Medical history identifies Dame Cicely Saunders as the founder of modern hospice and palliative care for the unique care she gave to the incurably and terminally ill. Less known is how her Christian faith, combined with her knowledge of medicine, influenced her vision. This work retrieves the Christian roots of palliative care and asserts that the practice of faith preserves the practice of medicine from succumbing to medicalized dying--a phenomenon that excessively relies on technology with the implied hope that it will ultimately conquer illnesses and even death. Efficiency and effectiveness ground modern medicine's epistemology. These concepts follow the philosophical …

Design Of A Problem-Based Learning Pain And Palliative Care Elective Course, Katherine Juba, Bernard P. Ricca

Pharmacy Faculty/Staff Publications

Objective

To implement and evaluate a problem-based learning (PBL) pain and palliative care elective course to develop studentsʼ pain and symptom management pharmacotherapy knowledge, clinical reasoning process, and self-directed learning skills.

Methods

Each week students received a patient case to independently develop an assessment and plan for each pain and symptom management problem. During class the students discussed their findings within small groups in preparation for a large-group discussion with the instructor. Studentsʼ course grades were based on weekly pre-class case preparation, individual case studies, and self-reflection questions. To assess knowledge gained over the semester a free-response pre- and post-course …

Understanding The Impact Of Values On Organizational Culture, Paul D. Longenecker

Health and Sport Sciences Faculty Scholarship

No abstract provided.

Validation Of An Instrument To Measure United States Healthcare Providers Attitudes And Beliefs Regarding Early Palliative Care, Randall Hall Alban

Theses

Palliative care implemented early, at the time of a diagnosis of a life-limiting disease, has been shown to have multiple benefits for patients with life-limiting chronic illnesses as well as potentially positive financial benefits for payers. The reasons that early palliative care (EPC) has not been more widely implemented include financial resource limitations and personnel limitations. Data is absent regarding the attitudes and beliefs of United States healthcare providers regarding EPC. The initial literature review revealed that only two surveys of attitudes and beliefs of providers had been done with respect to providing palliative care, but these were done in …

The Making Of A Myth: Unreliable Data On Access To Palliative Care In Canada, Jocelyn Downie, Georgia Lloyd-Smith

Articles, Book Chapters, & Popular Press

Assisted death is now the subject of conversation in the media, in public meetings, and around kitchen tables across the country. A frequent part of many conversations about assisted death law reform is access to quality palliative care in Canada. Throughout the literature and other forms of media, the claim is made that only 16-30% of Canadians have access to palliative care (or, its derivative, 70% are without access). The “16-30%” claim has been widely accepted as a fact. But is it, in fact, true? We are driven to the conclusion that the oft-repeated claim that only 16-30% of Canadians …

Implementing Palliative Care Across The Life Span, Leisha Buller

Biennial Convention (CONV)

Session presented on: Saturday, November 16, 2013:

The palliative care service line at our 735 licensed bed facility recently received palliative care (PC) certification through TJC. Moving forward, our newly unified service line quickly learned that 2 diverse PC teams, adult PC and perinatal PC, must form an unlikely partnership. Our overarching goal for seeking certification is to provide patients in need with the augmented care PC services offers. We examined the percentage of deaths in the adult ICUs with and without PC services; examined the percentage of family conferences that established goals, were multidisciplinary, and had both elements; determined …

Learner-Based Teaching In Hospice And Palliative Care, Paul D. Longenecker

Health and Sport Sciences Faculty Scholarship

No abstract provided.

Education And Referral Criteria: Impact On Oncology Referrals To Palliative Care., Barbara Reville, Joanne Reifsnyder, Deborah B Mcguire, Karen Kaiser, Abbie Santana

Department of Family & Community Medicine Faculty Papers

OBJECTIVE: To describe a quality improvement project involving education and referral criteria to influence oncology provider referrals to a palliative care service.

METHODS: A single group post-test only quasi-experimental design was used to evaluate palliative care service (PCS) referrals following an intervention consisting of a didactic presentation, education outreach visits (EOV) to key providers, and referral criteria. Data on patient demographics, cancer types, consult volume, reasons for referral, pre-consult length of stay, overall hospital stay, and discharge disposition were collected pre-intervention, then post-intervention for 7.5 months and compared.

SETTING AND SAMPLE: Attending oncologists, nurse practitioner, and house staff from the …

Virginia Post: Improving Patient- Physician Communication About End Of Life Care, Chris Pile, Laura Pole

Case Studies from Age in Action

Educational Objectives

1. Examine the complexities of medical decision-making at the end of life and the inadequacy of advance directives alone to affect care at the end of life.

2. Demonstrate how effective communication can facilitate medical decision-making and improve congruency between care received and patient goals, priorities, and values.

3. Discuss the National POLST Paradigm and the current status of POST in Virginia.

Few U.S. Public Health Schools Offer Courses On Palliative And End-Of-Life Care Policy, Dale Lupu, Caroline Deneszczuk, Tara Leystra, Rebecca Mckinnon, Victoria Seng

Physical Therapy and Health Care Sciences Faculty Publications

Background: Palliative care has been identified by the World Health Organization (WHO) as a critical policy element for the relief of suffering, yet palliative care policy receives minimal attention in mainstream U.S. public health journals, conferences, or textbooks. In the ’90s, documentation of the lack of attention to end-of-life and palliative care in medical and nursing curricula led to concerted efforts to improve medical and nursing education in palliative care. No such educational effort has yet been directed toward public health professionals.

Objective: This study's objective was to quantify current course offerings covering palliative and end-of-life care from a public …

Palliative Care Consultation Trajectories, Elissa Kozlov

All Theses and Dissertations (ETDs)

In 2008, the Veterans Association: VA) mandated that all VA hospitals have a palliative care consult team: PCCT) to provide services to veterans with life-limiting illness. PCCTs within the VA are new, so little is known about their efficacy and utilization. The purpose of this study is to examine the timing of PCCT consultations and responses; document and categorize types and rates recommendations; determine rates at which recommendations are implemented; and identify factors related to if recommendations are made and implemented. This electronic medical records review study examined 200 initial palliative care consultations conducted in one VA hospital between January …

An Educational Intervention For Hospice And Palliative Care Nurses, Troy E. Fletcher

Regis University Student Publications (comprehensive collection)

The provision of high quality nursing care to the dying has become a significant concern in the United States (Kruse, Melhado, Convertine & Stecher, 2008). The goal of palliative care is to provide care that allows for optimal quality of life for patients and their families (Betcher, 20 10; Mcllfatrick, Mawhinney, & Gilmour, 2010). The recognition of valuable and underutilized zed end-of-life nursing skills may provide guidance for the development of interventions to improve nurses' roles in caring for dying patients and their family members (Reinke et al., 2010). The American Association of the Colleges of Nursing (AACN. 2002) has …