Digital Commons Network^™

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 …

Quality Of Life And Mental Health: A Qualitative Exploration Of Perceived Factors That Impact Older Adults, Chasiti Herring

All-Inclusive List of Electronic Theses and Dissertations

Enhancing quality of life and well-being is a universal phenomenon across the lifespan. As the population ages, older adults are in great need of supportive services to enhance quality of life and their ability to manage their mental health. The purpose of this study is to examine the quality of life (QoL) of older adults. This study aimed to provide valuable research in the area of QoL through the exploration of perceived factors that impact the older adult population. This exploratory qualitative research study consisted of 10 older adult participants between the ages of 65 and 95. Research recruitment prioritized …

Barriers To Hospice Access For The Latino Community, Guadalupe Rivera

Capstone Projects and Master's Theses

The Latino community in Monterey County faces significant obstacles to accessing hospice care, including language barriers and cultural misunderstandings. Many community members are unfamiliar with available hospice services or hold common misconceptions, such as equating hospice only with dying or abandonment. This capstone project, in partnership with the Central Coast Visiting Nurse Association (VNA), investigated these barriers through interviews conducted at a local senior event. An important outcome of the project was the creation of a bilingual (Spanish and English) resource guide for new Social workers which helps social workers efficiently connect Latino families to appropriate services in their preferred …

Potential Mechanisms Of Influence Between Spiritual Practices And Cognitive Health: A Systematic Review And Conceptual Model, Katherine Carroll Britt, Hayoung Oh, Augustine Cassis Obeng Boateng, Sherry Morgan, Sato Ashida, Corey Nagel, Roland J Thorpe, Harold G Koenig

Staff and Researcher Publications

Background/Objectives: This systematic review summarizes the evidence regarding potential mechanisms underlying the relationship between spiritual practices and cognitive health in adults. The review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist.

Methods: An extensive search of six electronic databases (i.e., PubMed, PsycINFO, Embase, Sociological Abstracts, ATLA, CINAHL) was conducted using keywords related to spiritual practices, religious activities, and cognitive health from 1 January 2000 to December 2025. The quality of the included studies was assessed using the Mixed Methods Appraisal tool aligned with the study design.

Results: A total of …

Family Caregivers' Perspectives On Challenges And Support Needs In Hospital-Based Palliative Care For Persons Living With Dementia, Jung Kwak, Anita Chary, Sarah Stayer, Kwaku Duah Oppong, Sumin Yoon, Snehal Patel, Elizabeth A Kvale

Faculty, Staff and Students Publications

Palliative care needs of hospitalized persons living with dementia (PLWD) and their family caregivers remain poorly understood. This mixed-methods study explored caregivers' perspectives on challenges and support needs when hospitalized PLWD received specialist palliative care consultations. Thirty-two caregivers were recruited from two hospitals; 18 completed interviews and surveys, and 14 completed surveys only. Participants were racially and ethnically diverse (19% Black or African American, 34% Latino or Hispanic). Most identified as women (65%) and adult children (56%). Commonly reported challenges included managing health issues (59%), emotional distress (56%), and decision-making (47%). Thematic analysis of interviews revealed three themes: the value …

Advancing Palliative Care Competency Through An Evidence-Based Educational Intervention For Healthcare Providers, Lauren Elizabeth Griffin

Walden Dissertations and Doctoral Studies

A major gap in acute care is the delayed initiation of palliative consultations. Although over 58 million people worldwide could benefit, only 14% receive such care. Despite evidence that early involvement improves outcomes, providers often overlook their value, leading to late referrals, typically after repeated hospitalizations or near end-of-life, when hospice may be more appropriate. This Doctor of Nursing Practice (DNP) educational intervention addressed a critical practice-focused question to enhance healthcare providers’ understanding of palliative care improve hospital-based patient outcomes. The intervention aimed to demonstrate a ≥20% knowledge gain from pretest to posttest scores related to distinguishing palliative care from …

Palliative Care Nurse, Shaunte Jean Poix

One Map, Limitless Destinations 2.0

No abstract provided.

Implementing Pain Reassessment Workflow To Improve Timely Pain Management In Hospice Patients: A Quality Improvement Project, Oluremi Omodara

All Doctor of Nursing Practice (DNP) Scholarly Projects

Problem: Timely pain reassessment is a vital component of hospice care, directly influencing the quality of life for patients. Despite the high prevalence of pain, which affects 55% of hospice patients due to disease progression or adverse drug reactions, only 51% of those reporting moderate to severe pain at admission receive a documented reassessment. The gap highlights an organizational issue in pain management stemming from the absence of a clearly defined period and workflow for reassessment.

Aim of the Project: The aim of the quality improvement (QI) project was to improve compliance with pain reassessment documentation within 48 hours …

College Of Nursing Apr 2024 Self-Study Report, Unm Academic Program Review

UNM Academic Program Review

College of Nursing complete an annual academic program review and included in the self-study report for AY2024

Exploring Patients' Perceptions Of An Advance Care Planning Intervention In The Emergency Department: A Qualitative Study, Youkie Shiozawa, Saaya Morton, Nanako Shirai, Hannah Oelschlager, Lucy Kiernat, Anita N Chary, Anna C Revette, Adrian Haimovich, Smit Desai, Kai-Wei Chang, Shan W Liu, Maura Kennedy, Mara A Schonberg, Kei Ouchi

Faculty, Staff and Students Publications

Objectives: Emergency department (ED) visits offer opportunities for seriously ill patients to formulate future medical care goals, yet ED clinicians lack practical strategies for these conversations. ED GOAL, a behavioral intervention, engages seriously ill yet clinically stable older adults in the ED to address advance care planning (ACP) with their outpatient clinicians. In a randomized trial, goals-of-care documentation was significantly higher in the intervention group compared to controls after three (24.3% vs. 9.9%, p = 0.03) and 6 months (31.4% vs. 12.7%, p < 0.01). This study is a sub-analysis to learn about intervention arm participants' perceived benefits and obstacles of the intervention.

Methods: We conducted semi-structured interviews between October 2022 and August 2024 (N = 52) with intervention-arm patients …

Evaluation Of Palliative Care Awareness Among Hospitalized Patients And Their Relatives In Türkiye, Füsun Uzgör, Ayşe Özkaraman, Hülya Özen

Makara Journal of Health Research

Background: Today, with the advances in medical knowledge and technology, chronic diseases have increased worldwide in parallel with the prolonging life expectancy and the aging of the population. This has increased the need for palliative care in the delivery of medical services. This study aimed to evaluate the palliative care awareness and level of knowledge of inpatients receiving health services in a university hospital and their relatives in Türkiye.

Methods: This cross-sectional study was carried out with 360 patients and their relatives who volunteered to participate in the research. The study data were collected in face-to-face interviews using …

A Study Of Rural Health Care For Chronic Care Management Using Machine Learning To Determine Costs, Joanna Maria Keeling

Doctoral Dissertations

Management of diabetes or heart disease may be uniquely challenging for older individuals with multiple chronic conditions[1]. Chronic Care Management would target patients living with comorbidities in Louisiana, who are not receiving sufficient healthcare services and help them receive the care they deserve[2]. This study is aimed at comparing the results of rural Louisiana Medicaid recipients with comorbidities to the National Averages. We will also use Machine Learning to predict Churn and Medical Costs. To help us identify these patients with comorbidities, we decided to use NCQA Quality Measures. We identified several measures from NCQA that we wanted to use, …

Addressing And Recognizing Secondary Traumatic Stress In Hospice And Palliative Care Clinicians, Laquisha La Chelle Jackson

Walden Dissertations and Doctoral Studies

In the emotionally demanding field of hospice and palliative care, the well-being of clinicians is critical. This Doctor of Nursing Practice (DNP) project focused on implementing a staffing education initiative to address secondary traumatic stress (STS). I designed this staffing education project to enhance clinician awareness, resilience, and coping strategies while informing organizational leadership on how improved staffing models and support systems can mitigate STS. Hospice and palliative care clinicians are uniquely vulnerable to STS due to constant exposure to trauma, death, and grieving families. The guiding question for this project was: In hospice and palliative care clinicians, how does …

Culturally Inclusive End-Of-Life Simulation For Undergraduate Nursing Students, Jodi Olson

DNP Projects

Background
End-of-life (EOL) care is a challenging yet essential aspect of nursing practice. Nursing students often report low confidence and competence in managing culturally and spiritually diverse EOL scenarios. Simulation-based learning has proven to be effective in enhancing students' preparedness for complex clinical situations.

Purpose
This project aimed to evaluate the impact of a high-fidelity, culturally, and spiritually diverse EOL simulation on undergraduate nursing students’ perceived competence in delivering culturally sensitive EOL care.

Methods
A quantitative pre/post design was used with a convenience sample of 50 junior-year nursing students enrolled in a chronic care management course. Students participated in a …

2025-2026 Pediatric Subspecialty Trainees, Children's Mercy Kansas City

Residents and Fellows Portraits

Photo composites of the graduate pediatric trainees in advanced non-invasive imaging,, allergy/immunology, Pediatric EM/child abuse, child abuse pediatrics, child neurology, clinical neuro-psychology, clinical child psychology, clinical child psychology internship, congenital cardiac surgery, developmental-behavioral, epilepsy, hospice & palliative care, laboratory genetics & genomics, pediatric anesthesiology, pediatric bioethics, neonatal-perinatal medicine, pediatric adolescent gynecology, pediatric cardiology, pediatric clinical pharmacology, pediatric critical care medicine, pediatric dentistry, pediatric emergency medicine, pediatric endocrinology, pediatric gastroenterology, pediatric hematology/oncology, pediatric hospital medicine, pediatric infectious diseases, pediatric nephrology, pediatric optometry, pediatric orthopedic surgery, pediatric otolaryngology, pediatric pathology, pediatric pulmonology, pediatric rehabilitation, pediatric sports medicine, pediatric surgery, sleep medicine, pharmacy, …

Navigating Early Career As An Oncologist: Thriving In Diverse Paths., Gita Suneja, Marjorie C Green, Janaki Parameswaran, Joseph Mccollom Do

PCI Publications and Projects

Early-career oncologists navigate a complex landscape of professional development, clinical responsibilities, and research endeavors. This manuscript explores key challenges and strategies for success in the early years of an oncology career, focusing on the first job after fellowship, career transitions, and practical tips for intentionality. Effective mentorship is pivotal, providing guidance in clinical decision making, research pursuits, and professional networking. Career development strategies include securing funding, building collaborative networks, and identifying opportunities for leadership. Additionally, balancing clinical duties with research and personal well-being requires time management and institutional support. This article emphasizes the importance of fostering inclusive mentorship, advocating for …

Mindfulness As A Buffer Against Death Anxiety: Implications For End-Of-Life Care, Chad Alexander

University Honors Theses

Death anxiety, defined as the distress associated with the awareness of mortality, has profound psychological and cultural impacts. Western societies often respond to death salience through avoidance and medicalization, reinforcing defensive strategies described by Terror Management Theory. This project aimed to investigate whether mindfulness can serve as a buffer against death anxiety. A structured literature review was conducted using PsycINFO, PubMed, the Portland State University Library, and Google Scholar between January 2025 and April 2025. One study found that mindfulness moderated the effects of death anxiety on health-related quality of life in people living with HIV. Two experiments linked mindfulness …

Exploring Fiber Art Materials In Art Therapy Treatment With Bereaved Families, Elise Leinaweaver

Expressive Therapies Theses

The purpose of this thesis was to explore why families are particularly impacted by negative effects of grief, why it is imperative that the arts be utilized in treatment for bereavement, and why fiber arts are a great vessel for art therapy grief work. The literature was collected and organized through visual coding and reflective tactile methods before being presented in the following review. The first section of the literature review includes definitions of grief, death-related grief, and familial grief and how these experiences cause long lasting impacts and mental health issues. The second and third sections cover the definitions …

Hope After Grief And Loss: A Needs Assessment Of Peer-Led, Non-Denominational Bereavement Support Services At Laurel’S Grief Center, Julia A. Lange

Public Administration Master’s Projects

This needs assessment examines the grief support services provided by Laurel’s Grief Center (LGC), a nonprofit organization in Buffalo, New York, and identifies opportunities to expand tailored services for grieving adults in Western New York. Using a convergent mixed-methods design, this study collected data through semi-structured interviews with LGC board members and surveys with clients and peer volunteers. Key findings highlight the importance of peer-led, non-denominational grief support and creative approaches, such as art therapy, while identifying barriers, such as stigma, limited awareness, and fragmented regional services.

Based on these findings, this study recommends expanding healing arts programs, enhancing outreach …

Improving Hospice Care Awareness In The Hispanic/Latino Community Of Monterey County, Dulce M. Cortez Cruz

Capstone Projects and Master's Theses

Montage Health is a nonprofit healthcare provider in Monterey County, offering many services, including the Hospice of the Central Coast. This hospice agency supports older adults and their families with end-of-life care. Although Monterey County has a large Hispanic/Latino population, only a small number use hospice services—mainly due to language barriers, lack of awareness, and insurance concerns. This project focuses on helping the Hispanic community learn more about hospice care through surveys and Spanish-language presentations in the future. The goal is to clarify misunderstandings and help more families feel comfortable using hospice when needed. By sharing information and building trust, …

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 …

End-Of-Life Volunteerism: An Analysis Of No One Dies Alone (Noda) Program Volunteers, Kristin Sarsfield, Kevin Hickey

Posters

The inception of hospice in the United Kingdom during the mid 20th century marked a focal point in medical care for dying individuals. Hospice founder Cicely Saunders wanted to maintain a balance of “the sophisticated science of our treatments with the art of our caring, bringing competence alongside compassion”.1 Since then, hospice has grown into a household term for end of-life medical care.

Organized care for terminally ill and dying individuals was further developed in 2001 by Sandra Clarke, CCRN. Clarke founded the No One Dies Alone (NODA) Program after being unable to fulfill a dying patient’s wish of end-of-life …

Empowering Kansas City Veterans Administration Chaplains: A Spiritual Leadership Toolkit For Nursing Staff Support, Leonard Gicheru

Doctoral Dissertations and Projects

This doctoral research project addresses the critical issue of burnout among nursing staff at the Kansas City Veterans Administration (KCVA). Burnout is often worsened by a lack of spiritual support, thereby negatively impacting both the well-being of nurses and the quality of patient care. This project study aims to mitigate these challenges by implementing a spiritual leadership resource toolkit, tailored to equip KCVA chaplains with creative strategies to provide spiritual care for nurses.

Based on Spiritual Leadership Theory and guided by biblical principles, this project explores how structured spiritual direction can improve the resilience and emotional well-being of nursing staff. …

The Implementation Of The Edmonton Symptom Assessment System To Standardize Symptom Assessment, Rachel C. Mea Msn, Rn, Ocn

Doctor of Nursing Practice Projects

Background

Evaluating symptoms in patients with advanced cancer is critical to mitigating symptom burden and improving quality of life. Cancer patients experience an array of physical, emotional, and psychological symptoms, which can significantly impact compliance with treatment, daily functioning, and well-being. Early and thorough assessment enables healthcare providers to identify and address these issues, ensuring symptom management strategies are tailored to the patient's needs.

Objective

This project aimed to implement the Edmonton System Assessment System (ESAS) in an inpatient oncology service and evaluate the acceptability (AIM), appropriateness (IAM), and feasibility (FIM) of the assessment by nurses and palliative care providers. …

“How To Have Courageous, Culturally And Soulfully Competent Conversations At End-Of-Life”, Jana Dluehosh

Doctor of Leadership

Signature Healthcare at Home (Hospice, Palliative, and Home Health) workers are often not prepared to facilitate courageous and culturally competent “Goals of Care” conversations with their patients as they approach the End-of-Life. Working in Hospice has given me a direct line of research as I worked on ways to help healthcare workers gain confidence in talking with patients about death and dying in what we call a Goals of Care conversation.

One of the challenges I found in my research was finding healthcare workers who could give the time to participate in stakeholder workshops. Much healthcare operates at high demand, …

Assessing The Use Of Motivational Interviewing And Appreciative Inquiry For Hypertension Control In Vulnerable Populations, Anjali Mahapatra, Orlando J. Penaloza Md, Facp, Shanestka Menendez, Jorge Martinez

USF-LVHN SELECT

No abstract provided.

Implementation Of Electronic Triggers To Identify Diagnostic Errors In Emergency Departments, Viralkumar Vaghani, Ashish Gupta, Usman Mir, Li Wei, Daniel R Murphy, Umair Mushtaq, Dean F Sittig, Andrew J Zimolzak, Hardeep Singh

Faculty, Staff and Students Publications

Importance: Missed diagnosis can lead to preventable patient harm.

Objective: To develop and implement a portfolio of electronic triggers (e-triggers) and examine their performance for identifying missed opportunities in diagnosis (MODs) in emergency departments (EDs).

Design, setting, and participants: In this retrospective medical record review study of ED visits at 1321 Veterans Affairs health care sites, rules-based e-triggers were developed and implemented using a national electronic health record repository. These e-triggers targeted 6 high-risk presentations for MODs in treat-and-release ED visits. A high-risk stroke e-trigger was applied to treat-and-release ED visits from January 1, 2016, to December 31, 2020. A …

Exploring Medical Assistance In Dying: A Review Article, David Pfrimmer

Consensus

No abstract provided.

Enhancing End Of Life Care Through Recognition & Flagging Of Imminence To Increase Visits, Ali Ahmed, Guru Chinnaraj, Ana Goncalves, Ahad Ahmed, Ezekiel Ijaopo, Joseph Shega, Diana Tren

North Florida Division GME Research Day 2025

No abstract provided.

Protecting Older Adults Who Are Incarcerated: Does The 8th Amendment Work?, Jalayne J. Arias

Health Matrix: The Journal of Law-Medicine

Older adults in prison and within other carceral systems (i.e. jails, parole) are uniquely at risk for elder mistreatment. Emerging research has begun to consider the experiences of older adults within carceral settings, including aging in prison, chronic conditions and medical care, compassionate release, and end-of-life care. This research exposes evidence that prisons and other carceral settings lack resources and services for older adults. Given increased vulnerability and a lack of protective resources, older adults experiencing incarceration may experience disproportional rates and consequences of elder mistreatment. A public health approach to develop tools and resources that would prevent, detect, and …