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Implementing Palliative Care Pre-Cardiothoracic Transplant, Sarah E. Bakker

Honors Projects

Palliative care is defined as a specialty of medicine that improves the quality of life of patients and family members facing a life-threatening illness, by providing early detection and prevention of pain, psychological, and other physical struggles. Patients diagnosed with diseases such as congestive heart failure or lung disease will face an ongoing list of problems that impacts their quality of life, yet most do not receive the proper tools to manage their disease until the last stages of their life. Implementing palliative care at the initial diagnosis of a chronic cardiothoracic disease improves precision of patient-centered goals, symptom management, …

We Are The Medicine, Madalynn Wendland, Toni Speed

Interprofessional Education

We are all healers— to ourselves, each other and the world around us. Whether you are on the path of becoming a health professional, or have been in practice for a long time, this half-day workshop will help you to view healing from a holistic perspective that draws from the ancient traditions while respecting contemporary science.

Post Discharge Follow-Up Telephone Calls For Patients Who Received Hospital Based Palliative Care Services To Improve Quality Of Care And Outcomes: A Pilot Study, Katherine Adams

DNP Scholarly Projects

Background

There is a rising number of patients with chronic health conditions concurrent with an increasing number of hospital readmissions within 30 days and emergency department visits. Predominantly based in acute care facilities, palliative care services have been effective in improving the quality of life in patients with chronic health conditions. However, the largest population that could benefit from palliative care services is community based in the home setting.

Purpose

The purpose of this project was the implement and evaluate follow-up telephone calls made in addition to visiting nursing (VNA) services to detect in early decline in patients who have …

Physician-Assisted Suicide And Euthanasia: Emerging Issues From A Global Perspective, Charles L. Sprung, Margaret Somerville, Lukas Radbruch, Nathalie Steiner Collet, Gunnar Duttge, Jefferson P. Piva, Massimo Antonelli, Daniel P. Sulmasy, Willem Lemmens, E Wesley Ely

Medical Papers and Journal Articles

Medical professional societies have traditionally opposed physician-assisted suicide and euthanasia (PAS-E), but this opposition may be shifting. We present 5 reasons why physicians shouldn’t be involved in PAS-E. 1. Slippery slopes: There is evidence that safeguards in the Netherlands and Belgium are ineffective and violated, including administering lethal drugs without patient consent, absence of terminal illness, untreated psychiatric diagnoses, and nonreporting; 2. Lack of self-determination: Psychological and social motives characterize requests for PAS-E more than physical symptoms or rational choices; many requests disappear with improved symptom control and psychological support; 3. Inadequate palliative care: Better palliative care makes most patients …

Gadgets And Grieving: A Chronological Analysis On The Ways In Which Advancements In Medical Technologies Have Altered The Grieving Process, Grace Mcnair

Dialogue & Nexus

Since the 1940s, both end-of-life care and advancements in medical technologies have expanded exponentially. This article explores the advancements in medical technologies and how these have altered the way that Western society grieves death. With the capabilities to prolong life, the family, the patient, and the medical team, all grieve the end of life in different ways. This article provides a chronological analysis of palliative care, hospice care, and various medical advancements. These changes in medicine are then paralleled with alterations in the bereavement process. This article explores historical narratives of Western society’s transformation of grief through the lens of …

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. …

Hospice And Palliative Care: Imperative To The Education Of Nursing, Crystal Lynn Jordan

Nursing Theses and Capstone Projects

Many advanced practice nursing programs do not have hospice and palliative care content included in their curricula. Reviewing the literature regarding the nature of hospice and palliative care content in advanced practice nursing curricula revealed few published studies. Rather than a small snapshot of what end-of-life care entails, it is vital to integrate end-of-life care into every aspect taught in advance practice nursing school. The purpose of this thesis was ascertain the nature of hospice and palliative care content contained in advanced practice nursing curricula. A survey was sent to advance practice nursing program directors asking for information related to …

Improving The Reach And Effectiveness Of Palliative Care In Low-Resource Countries, Maryellen Potts

MUSC Theses and Dissertations

Purpose: The purpose of this compendium is to identify strategies to extend the reach and effectiveness of palliative care in low resource countries by 1) examining palliative care interventions, outcomes, and outcome measures, 2) evaluating a home-based palliative care program in rural India, and 3) exploring the concept of acceptability of rural medical practitioners in rural India. Problem: Limited access to effective palliative care services remains an urgent global concern for the over 19 million people requiring palliative care, the majority of whom live in low resource countries. An accompanying lack of research into palliative care interventions in resource-poor areas …

“Life Within The Person Comes To The Fore”: Pastoral Workers’ Practice Wisdom On Using Arts In Palliative Care, Clare O'Callaghan, Libby Byrne, Eleni Cokalis, David Glenister, Margaret Santilli, Rose Clark, Therese Mccarthy, Natasha Michael

Medical Papers and Journal Articles

Background: Pastoral care (also chaplaincy, spiritual care) assists people to find meaning, personal resources, and connection with self, others, and/or a higher power. Although essential in palliative care, there remains limited examination of what pastoral workers do. This study examined how pastoral workers use and consider the usefulness of art-based modalities.

Methods: Qualitative research was used to examine the practice wisdom (tacit practice knowledge) of pastoral workers experienced in using visual arts and music in palliative care. Two focus groups were conducted. Thematic analysis was informed by grounded theory.

Results: Six pastoral workers shared information. Three themes emerged. First, pastoral …

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 …

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

Theses, Dissertations, and Projects

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

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

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 …

The Effect Of Art Therapy On Hospice And Palliative Caregivers, Carol E. Gress

Nursing Theses and Capstone Projects

A quazi-experimental, one-group, pretest/posttest study was conducted with a group of 25 hospice workers employed by a medium sized county hospice organization in the southeastern United States that was experiencing rapid personnel turn-over. Participants in the study included a doctor, a physician’s assistant, a nurse practitioner, a massage therapist, a grief counselor, a licensed practical nurse, a certified nursing assistant, two clergy, three administrative staff, three social workers, seven volunteers, eight registered nurses and one other. The purpose was to investigate whether attending four 1-hour art therapy sessions could help reduce stress and thereby Burnout. Stamm’s (2010) Professional Quality of …

The Impact Of The Carer Support Needs Assessment Tool (Csnat) In Community Palliative Care Using A Stepped Wedge Cluster Trial, Samar Aoun, Gunn Grande, Denise Howting, Kathleen Deas, Chris Toye, Lakkhina Troeung, Kelli Stajduhar, Gail Ewing

Medical Papers and Journal Articles

Family caregiving towards the end-of-life entails considerable emotional, social, financial and physical costs for caregivers. Evidence suggests that good support can improve caregiver psychological outcomes. The primary aim of this study was to investigate the impact of using the carer support needs assessment tool (CSNAT), as an intervention to identify and address support needs in end of life home care, on family caregiver outcomes. A stepped wedge design was used to trial the CSNAT intervention in three bases of Silver Chain Hospice Care in Western Australia, 2012-14. The intervention consisted of at least two visits from nurses (2-3 weeks apart) …

Behavioral Adjustment In Children With Life Threatening Illness A Qualitative Study, E. Joseph Becher Jr.

Antioch University Dissertations & Theses

This study investigated factors that affect adjustment in children with life-threatening illness from the viewpoint of the parents/caregivers. The data were collected from parents/caregivers whose children have a life threatening diagnosis. Parents/caregivers were interviewed and asked to complete the Parent Request Questionnaire (PRQ) which was given to them after the in-person interview. This newly developed PRQ was utilized into prior research to predict the levels of adjustment in children. It includes age, whether the child has been informed of the diagnosis, whether the child engages in age-appropriate activities, the child's prior experience with death, the child's family's involvement in treatment, …

Into The Abyss: A Review Of The Literature Related To The Spiritual Care Of Family Caregivers In Community Hospice And Palliative Care, Donna Mann

Consensus

No abstract provided.

Palliative Care And Hospice Community Education, Mary Castang

Regis University Student Publications (comprehensive collection)

Executive Summary Palliative Care and Hospice Community Education Problem In the researcher's home hospice practice, a need for community education regarding Palliative Care and Hospice is recognized. Patients and family members need information about End of Life (EOL) care options prior to the urgency of a crisis. According to Szirony, Oopko, Masiulaniec and Binder (2011) many patients and family members learn of hospice and palliative care services only after admission into a program. The decision to sign in to a program reflects their perception of there being no other choice rather than understanding the options and benefits (Szirony, et al, …

Utilizing Watson's Theory Of Caring To Develop A Palliative Care Proposal For Olmsted Medical Center, Tammie Johnson

Theses and Graduate Projects

Palliative care is aimed at alleviating the suffering of patients with serious or chronic illnesses. Literature examined to determine the needs of seriously or chronically ill patients and their farnilies found patients to have physical, psychosocial, and spiritual needs while coping with their illness. In addition, patients' family needed support in physical care of their loved ones, as well as information and psychosocial needs for themselves. The purpose of this project is to develop a proposal for an inpatient palliative care program for Olmsted Medical Center's (OMC's) consideration, Watson's Theory of Caring was utilized in the development of a palliative …

Impact Of Work Environment On Nurses' Job Satisfaction And Well-Being: Improving End-Of-Life Care And Services, Lise Fillion, Manon Truchon, Michel L'Heureux, Céline Gélinas, Marie Bellemare, Lyse Langlois, Jean-François Desbiens, Clémence Dallaire, Réjeanne Dupuis, Geneviève Roch, Marie Anik Robitaille

Rapports de recherche scientifique

Cliquez ici pour la version française de ce rapport

Avec le vieillissement de la population, la demande de soins palliatifs (SP) de fin de vie est croissante et les services de santé s’organisent. Au Québec, les SP de fin de vie sont surtout intégrés aux soins curatifs et on retrouve peu d’unités de SP spécialisées. Ces soins s'incorporent alors aux soins à domicile ou à ceux dispensés dans les unités de soins spécialisés en centre hospitalier, comme l’oncologie et les soins critiques. Les infirmières y jouent un rôle majeur. Selon ce choix organisationnel, les infirmières vivent un contexte de travail …

The Role Of Race In End-Of-Life Care, Barbara A. Noah

Journal of Health Care Law and Policy

No abstract provided.

An Examination Of The Influence Of Socioeconomic Status And Race On End-Of-Life Treatment Level Following A Palliative Intervention, Kathleen Benton

College of Graduate Studies: Theses & Dissertations

The purpose of this study was to examine differences in treatment level at the end of life according to race and socioeconomic status and the extent a palliative intervention may change the course and cost of care. The study population included patients from the Medical Center of Central Georgia (N=2,920). The data were examined as a secondary analysis retrospectively. Data from the medical record and a unique clinical database were coded into descriptive, predictor, and outcome variables to define the population, and the patient's treatment status before and after the intervention. McNemar's test of symmetry, Chi Square, and Logistic Regression …

Palliative Care For People Living With Hiv/Aids In Uganda: An Investigation Of Patients & Caregiver’S Outcome And Professional Perspectives, Wesley Too

School of Nursing & Midwifery, East Africa

Background: Although antiretroviral treatment is expanding in sub-Saharan Africa, the World Health Organization advocates for integration of palliative care with HAART because pain, other distressing symptoms and complex psychosocial challenges persist throughout the HIV trajectory. Palliative care improves the outcome for patients with HIV and may complement antiretroviral treatment by increasing adherence through better management of side effects from the treatment, providing patient and family-centred holistic care, and giving end-of-life care when necessary. However, integrating what have become two disciplines is challenging. Aim: To study the implications for palliative care provision in the context of changing policy to universal access …

Physician's Experiences With Death And Dying: A Phenomenological Study, Deborah Jo Corker

Dissertations

This qualitative phenomenological study attempts to gain the physician's essences, meanings and understanding surrounding death and dying. Starting with themes revealed in literature, in-depth interviews were used to ask selected physicians providing care: How does death affect them? Are physicians receiving adequate training in end-of-life care? Does the medical culture still see death as failure? How do they find meaning in end-of-life care? Using three different groups of physicians: early in career, mid-career, and retired, this research attempted to examine the phenomena of death and dying over apparent time and developmental experiences of physicians. Results: Physicians have not been adequately …

Development And Validation Of A Palliative Care Needs Assessment Instrument-English/Arabic Versions (Pcna-Eav), For Use With Patients With Advanced Cancer, Susan Edith Volker

All ETDs from UAB

The aim of this study was to develop and translate a psychometrically valid and reliable, population-based, needs assessment instrument, the PCNA-EAV, to measure the health care and support needs of patients with advanced cancer. The cross-sectional study design combined qualitative and quantitative methods, to test instrument reliability and validity, and to examine the association between sample characteristics and health care and support needs. The 116-item, PCNA-EAV, comprised 10 domains of need: physical/functional; social; psychological/emotional; information; communication; helpful resources; financial; religious/spiritual; priority of need; and preference for care The target population was all cancer patients in the department of oncology at …

Evaluation Of The Pathways Palliative Care Program At The Denver Hospice, Adam Berquist

Regis University Student Publications (comprehensive collection)

As the patterns of morbidity and mortality in the United States shift toward chronic illness requiring the need for quality continuous care over extended periods of time, more research has been devoted to end-of-life care. The purpose of this study was to evaluate the Pathways palliative care program at the Denver Hospice as seen through the eyes of patient caregivers. Nine caregivers were interviewed in order to determine their perceptions of the Pathways program and a thematic analysis of their responses was performed. Results of the thematic analysis, as confirmed by a second reviewer, yielded very positive feelings towards the …

Beyond Pain Management: A Primer For Providing Quality End-Of-Life Care, Linda P. Tomko, Terri L. Maxwell

Department of Family & Community Medicine Faculty Papers

Providing excellent care for a dying patient is something all patients deserve. Hospices and palliative care centers exist in many areas to aid primary care physicians and patients through this difficult time. It is important to remember that most patients want to prepare for death, if at all possible. Everyone does this in his or her own way, but oftentimes concern about pain and symptom management interfere with this very involved and valuable process. Being prepared to treat these symptoms as well as addressing your patient's emotional needs is imperative. Referral to a hospice, if possible, will only strengthen the …

Hospice At The Crossroads: Can It Survive?, David A. Simpson

Journal of Health Care Law and Policy

No abstract provided.