Digital Commons Network^™

Use Of Ecomaps In Qualitative Health Research, Veena Manja, Ananya Nrusimha, Harriet Macmillan, Lisa Schwartz Dr, Susan Jack

The Qualitative Report

Qualitative health research plays a central role in exploring individuals’ experiences and perceptions of wellness, illness, and healthcare services. Visual tools are increasingly used for data elicitation. An ecomap is a visual tool that applies ecosystems theory to human communities and relationships to provide an illustration of the quality of relationships. We describe the use of ecomaps in qualitative health research. Searches across eight databases identified 407 citations. We screened them in duplicate to identify 129 publications that underwent full text review and included 73 in the final synthesis. We classified and summarized data based on iterative comparisons across sources. …

Cross-Sectional Nutrition Profile Of Palliative Home Care Clients In Ontario And Performance Of The Interrai Palliative Care Nutrition Clinical Assessment Protocol, Tara Stevens, Heather Keller, Nicole Williams, James Downar, Dawn M. Guthrie

Health Sciences Faculty Publications

Background: The nutrition profile of palliative home care clients is unknown. This study describes this group and their nutrition issues and evaluates the performance of the interRAI nutrition Clinical Assessment Protocol (CAP).

Methods: This was a cross-sectional secondary analysis using Ontario interRAI Palliative Care (interRAI PC) Assessment data. The sample represents 74,963 unique Ontario home care clients assessed between 2011 and 2018. Frequencies and standardized differences (stdiffs) of nutrition characteristics were presented for cancer (n = 62,394) and noncancer (n = 12,569) diagnostic subgroups. Rates of triggering the nutrition CAP were presented by nutrition issue to evaluate its performance.

Results: …

A Propensity-Matched, Mortality-Adjusted Study Of Palliative Care Consult To Reduce 90-Day Hospital Readmission In A Heart Failure Cohort, Janice Shirley

Health Sciences Program Student Theses, Dissertations and Capstones

Centers for Medicare and Medicaid Services (CMS) instituted the Hospital Readmission Reduction Program (HRRP) to reduce the frequency of heart failure (HF) 30-day hospital readmissions. To meet the needs of patients with end-stage HF, palliative care (PC) is promoted to provide additional support to patients and reduceunnecessary hospital readmission. While PC is a plausible and logical intervention, effectiveness in achieving reductions in readmissions has not been assessed ina HF population with adequate controls to assess confounding.

The goal of this research was to assess the effectiveness of Palliative care for HF (HFPC) consult to effect change in 90-day hospital readmissions …

Nursing Attitudes To Hospice Care In The Intensive Care Unit, Claudia Lacivita

Master of Science in Nursing Theses and Projects

Nurses deliver care to patients 24 hours per day and are experts in the care of critically ill patients in the intensive care unit (ICU). The critical care nurse is trained to assess, treat, and monitor severely ill patients to facilitate their recovery, but may often feel ill-prepared and lacking the support usually available to the hospice or palliative care nurse. It also can be difficult to refocus when the desired outcome changes from stabilizing and getting a critically ill patient better to hospice or end-of-life care (EOLC). The purpose of this project was to improve the delivery of care …

Survivor's Guide To Everyday Estate Planning, Indiana Continuing Legal Education Forum (Iclef)

Indiana Continuing Legal Education Forum 2021

Meeting proceedings of a seminar by the same name, held November 19 2021

Closing The Health Disparity Gap In U.S. Immigrant Communities In The Era Of Covid-19: A Narrative Review, Dina Refki, Rukhsana Ahmed, Jeanette Altarriba

Understanding and eliminating minority health disparities in a 21st-century pandemic: A White Paper Collection

The COVID-19 pandemic continues to have significant impacts on social determinants of health. Immigrant communities often bear a disproportionate burden of the crisis because of the immigration experience, which serves as an additional social determinant of health. Evidence suggests that these communities are hard hit by economic instability, food insecurities, isolation, lack of safe housing and safe neighborhoods, environmental dynamics that cut them off from systems of support, lack of sufficient access to educational tools that have become critical in remote and digital learning, limited access to health and healthcare resources, low health literacy, and restricted access to culturally and …

State Of New Hampshire Annual Report Of Coos County For The Year Ending December 31, 2020., Coos County Representatives

Coos County, NH Annual Reports

This is an annual report containing vital statistics for a county in the state of New Hampshire.

Early Palliative Care Implementation In Metastatic Lung Cancer Patients: A Quality Improvement Project, Megan Joan Biegler, Erin Hamar, Stephanie Spinolo

All Electronic Theses and Dissertations

This was a quality improvement project that will allow improvements to be made in healthcare services offered and the overall health status of Stage IV metastatic lung cancer patients receiving palliative care referrals. Data was collected retrospectively from electronic medical records of Stage IV metastatic lung cancer patients with palliative care referrals between January 2019 and March 2020. The palliative care referrals between January 2019 and August 2019 were given per oncologist discretion in timing compared to August 2019-March 2020 when new patients received nurse navigator driven palliative care referrals immediately upon diagnosis. Data analysis looked at correlations for each …

Assessment Of Palliative Care Needs In A Kenyan Intensive Care Unit Based On A Trigger-Based Model., Linda Atero Barasa

Master of Medicine in Internal Medicine

Background: Palliative care triggers have been used in the Intensive Care Unit (ICU) setting, usually in high-income countries, to identify patients who may benefit from palliative care consults. The utility and benefits of palliative care triggers in the ICU have not been previously studied in sub-Saharan Africa. Objectives: The primary objective of this study was to estimate the prevalence of ICU admissions who meet the criteria for one or more palliative care triggers. The secondary objectives were to determine an association between palliative care consults and length of ICU stay, mortality, and time to formal change of goals of care …

Spirituality Integrated Interventions For Caregivers Of Patients With Terminal Illness: A Systematic Review Of Quantitative Outcomes, Yongqiang Zheng, Anna Cox Cotton, Longtao He, Leslie Wuest

Faculty Publications - College of Social Work

This systematic review of published quantitative research was conducted to explore the effects of spirituality-integrated interventions for informal caregivers of terminally ill patients. Multiple databases were searched for articles published between January 2004 and November 2019. Twelve randomized controlled trials were identified. Methodological quality was assessed using the revised Cochrane Collaboration’s tool for assessing risk of bias. Studies were notably diverse in terms of spiritual background, intervention design, technology used, and outcomes measures. Spirituality-integrated interventions were found to show positive outcomes for caregivers. However, methodological flaws negatively affected the quality of most studies, warranting further and rigorous research into the …

Effectiveness Of Online Communication Skills Training For Cancer And Palliative Care Health Professionals: A Systematic Review, Melissa N. Berg, Irene Ngune, Penelope Schofield, Lisa Grech, Ilona Juraskova, Michelle Strasser, Zoe Butt, Georgia K.B Halkett

Nursing Papers and Journal Articles

Objective: To determine the reported effect of online communication skills training (CST) on health professional (HP) communication skills and patient care outcomes in cancer and palliative care.

Methods: Primary research published in English between January 2003 and April 2019 was identified in bibliographic databases including Medline, Embase and Proquest (Prospero: CRD42018088681). An integrated mixed-method approach included studies describing a CST intervention and its effect, for cancer or palliative care HPs, delivered online or blended with an online component. Included studies' outcomes were categorised then findings were stratified by an evaluation framework and synthesised in an effect direction plot. Risk of …

Evidence-Based Hospice Care Education For Healthcare Clinicians, Nonie E. Weir

Walden Dissertations and Doctoral Studies

Vulnerable populations with a terminal illness, who reside in a nursing home setting, continue to experience psychological, physical, and emotional effects that lead to end-of- life (EOL) suffering and discomfort. Globally, millions of individuals receive care from a hospice provider. By 2030, this figure will triple due to the increased lifespan of the geriatric population. The literature review has revealed that the practical problem is the lack of hospice care education received by healthcare clinicians. It is, therefore, important to prepare and educate healthcare clinicians about a peaceful death through an individualized plan-of-care (POC) from a holistic approach. The purpose …

Advance Care Planning And Palliative Care In Heart Failure: A Literature Review, Laura Dack

All Graduate Theses, Dissertations, and Other Capstone Projects

Despite advancing therapies, heart failure remains a progressive disease with high symptom burden. Advance care planning and palliative care assist in maximizing the quality of life for affected individuals. These interventions are supported by current heart failure guidelines yet application into practice is poor. The purpose of this literature review is to investigate the relationship between advance care planning and palliative care interventions on the quality of life of adults with heart failure. A search of the literature was completed between October 20^th, 2020 to November 10^th, 2020. Databases searched include Academic Search Premier, CINAHL Plus, …

Newsletters, Photos, & Articles June 2020-May 2021, Mandarin Garden Club

Mandarin Garden Club Scrapbooks

Scrapbook includes images, club news and news clippings. Newsletters housed separate. Cover material: Plastic. Size: 11.5" x 11" x 2.25".

A Proactive Approach To Bladder And Bowel Management In Adults (4th Ed.), Registered Nurses' Association Of Ontario

General Submissions: Community and Population-based Materials

This best practice guideline (BPG) focuses on bladder and bowel management in adults (aged 18 years and older). In particular, this BPG provides evidence-based recommendations for effective strategies to support adults who live with urinary incontinence, fecal incontinence and/or constipation that will improve quality of care and lead to positive health outcomes.

For more information including supplementary documents and translated versions visit: https://rnao.ca/bpg/guidelines/proactive-approach-bladder-and-bowel-management-adults

Is There A "Mulatto Escape Hatch" Out Of Racism?: A Reflection On Multiracial Exceptionalism During A Time Of #Blacklivesmatter, Tanya K. Hernandez

Faculty Scholarship

No abstract provided.

Creating An Integrated Opioid Policy For Multi-State Hospice Practices: Improving Opioid Compliance And Patient Safety, Manjeet Kaur

Yale School of Nursing Digital Theses

Abstract End of life (EOL) symptom management is the cornerstone of hospice care. Hospice patients, especially advanced cancer patients, have an increased need for pain and symptom management towards end of life. For those patients at EOL, opioids are the mainstay treatment to relieve intractable and breakthrough pain. Due to opioid regulatory changes over the past few years, there has been more confusion than clarity among the hospice & palliative care practitioners prescribing opioids for EOL pain management. Healthcare practices across the country are realigning their policies to the opioid prescription rule changes. It is imperative for hospice providers to …

Literature Review: Improving End-Of-Life Care And Creating A Good Death, Erna Smlatic

Honors Program Theses

The need for quality end-of-life care has increased drastically around the world in the last few centuries due to a surge in life expectancy. As people are living much longer, they are developing and succumbing to chronic progressive diseases which can significantly decrease quality of life. But what exactly does it mean to care for the aging population who are nearing death? Defining quality care at the end-of-life is important but also differs for individuals based on a variety of factors including age, culture, and life experiences. End-of-life care does not come as “one size fits all” and it challenges …

Factors Influencing Nurse Spiritual Care Practices At The End Of Life: A Systematic Review, Rita Mascio, Megan Best, Sandra Lynch, Jane Phillips, Kate Jones

IES Papers and Journal Articles

Objectives: The aim was to identify determinants of nurse spiritual/existential care practices toward end-of-life patients. Nurses can play a significant role in providing spiritual/existential care, but they actually provide this care less frequently than desired by patients.

Methods: A systematic search was performed for peer-reviewed articles that reported factors that influenced nurses’ spiritual/existential care practices toward adult end-of-life patients.

Results: The review identified 42 studies and included the views of 4,712 nurses across a range of hospital and community settings. The most frequently reported factors/domains that influenced nurse practice were patient-related social influence, skills, social/professional role and identity, intentions …

Integration Of Morphine And Virtual Reality: Pain Management For Adult Hospice Cancer Patients, Arlisa Hurd

Walden Dissertations and Doctoral Studies

There is currently a problem in that cancer patients engaging in hospice may experience an excessive amount of perceived pain and a decreased quality of life. The purpose of this study was to explore an intervention that could lessen the perceived pain experienced by, and increase the quality of life of, cancer patients engaging in hospice. Immersion music virtual reality (IMVR) allows a user to interact with a realistic, computer-generated environment. 3D music (IMVR) is likely suited for pain management with patients in hospice and was used for this study. The theory for the study is the gate control theory. …

Secondary Traumatic Stress Among Catholic Priests, Richard Ehusani

Walden Dissertations and Doctoral Studies

Research suggests that the clergy could be at the risk of developing secondary traumatic stress (STS) because of their secondary exposure to trauma within pastoral work; however, there has been no explicit discussion of STS related to Catholic priests who may be more at the risk of developing STS than their counterparts in other churches. The requirement of priestly celibacy often leaves Catholic priests with little to no immediate social and emotional support network of family. Because of their sacred vow to keep the confessional seal unbroken in whatever circumstance, Catholic priests also may not share confessional information, even when …

The Role Of Telehealth In Music Therapy Practice During The Covid-19 Global Pandemic Through The Lens Of The Music Therapist: A Survey, Brianne Brunick

Theses & Dissertations

This research study sought to examine the impact of the transition to telehealth music therapy services as the primary delivery mode of treatment during the COVID-19 pandemic. Board-certified music therapists were invited to participate in an online questionnaire-based survey where they were asked to provide responses to questions relating to their and their clients’ demographics, their theoretical orientation, their clinical experience prior to and during COVID- 19, and their views on the overall impact of telehealth. Analysis of the raw data from participants’ responses are summarized and integrated into the discussion section to highlight participants’ perspectives in a music therapy …

An Educational Initiative To Prevent Unnecessary Hospitalization For Hospice Patients, Alkeisha H. Mims

Dissertations

Avoidable hospitalizations of hospice patients cost Medicare $3 billion a year. When hospice nurses are able to identify early signs and symptoms of acute illness and provide appropriate interventions to prevent such admissions, 20-60% of the hospitalizations are preventable. The practice problem addressed in this quality improvement doctor of nursing project was the 30% hospital admission rate of hospice patients as evidenced by chart review, admission data, and revocation data. The first purpose of the project was to identify evidence-based nursing care paths in the literature for the top 5 medical diagnoses related to avoidable hospital admissions. The second purpose …

Exploring The Relationships Between And Among Registered Nurses' Spiritual Well-Being, Spiritual Care Perspectives, And Their Provision Of Spiritual Care In Acute Care Settings, Barbara J. Kitchener

Dissertations

Despite acknowledgment that spiritual care is an essential aspect of holistic nursing care, nurses often feel ill-prepared for, uncomfortable with, and uncertain about providing spiritual care. Studies have indicated that nurses who have a strong sense of their own spiritual well-being and/or a positive perspective [attitude, value, belief] about spiritual care are more inclined to provide spiritual care to their patients. However there is a scarcity of such studies among acute care nurses. This descriptive correlational study aimed to explore relationships between and among acute care nurses' spiritual well-being (SWB), spiritual care perspectives (SCP), and their provision of spiritual care …

Faith And/In Medicine: Religious And Conscientious Objections To Maid, Daphne Gilbert

Dalhousie Law Journal

Across Canada, health care institutions that operate under the umbrella of religious traditions refuse to offer medical assistance in dying (MAiD) on the grounds that it violates their Charter-protected rights to freedom of religion and conscience. This article analyses the Supreme Court jurisprudence on section 2(a) and concludes that it should not extend to the protection of institutional rights. While the Court has not definitively pronounced a view on this matter, its jurisprudence suggests that any institutional right to freedom of religion would not extend to decisions on publicly-funded and legal health care. MAiD is a constitutionally-protected option for individuals …

Nursing And Midwifery Links [December 2020 Issue], Secretariat At Johns Hopkins University School Of Nursing Global Network Of Who Collaborating Centers For Nursing And Midwifery

Nursing and Midwifery Links (LINKS)

As a historic year comes to a close, this edition of the Links Magazine will serve as a reflection of the incredible innovation and fortitude shown by our colleagues worldwide. For perhaps the first time in many, many years, 2020 was the year that humanity shared the experience of a common event of global proportions. Healthcare was placed front and center as the world watched from where they were sheltered in place. From varying cultures and perspectives, the nurses and midwives of the world were presented with a deadly challenge that came on quickly, and continues to plague many countries. …

A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck

Electronic Theses and Dissertations

The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.

For this study, data were collected using semi-structured, in-depth interviews with …

Aid In Dying In Montana: Ten Years After State V. Baxter, Kathryn L. Tucker

Montana Law Review

No abstract provided.

Caregiver Comfort With Tele-Hospice, Patricia L. Cameron

International Nursing Research Congress (INRC)

Tele-hospice is changing the provision of on-demand hospice and palliative care. A retrospective, descriptive study was completed examining comfort and emotional support that caregivers of community-based hospice patients derived from using electronic tablets. 667 survey responses were obtained. Data analysis included Pearson product moment correlations and Wilcoxon signed ranks tests.

A Review Of Chemotherapy And Radiotherapy Near The End Of Life In Individuals With Metastatic Non-Small Cell Lung Cancer, Benjamin C. Li, Stephanie M. Perkins, Sharon E. Phillips, Sara F. Martin, Samantha Hsieh, Eric T. Shinohara, Mark J. Stavas

Open Access Publications

No abstract provided.