Palliative Care Commons^™

Patient-Reported Outcomes Screening For Improved Patient Wellness: A Cancer Center Initiative, Alison Morris

Doctor of Nursing Practice (DNP) Projects

Background: People experiencing serious illness have significant unmet physical, emotional, social and spiritual needs. The Quality Oncology Practice Initiative (QOPI) requires patients to be screened for emotional wellbeing and pain by their second oncology visit. This project details one cancer center’s quality improvement initiative to (a) implement electronic screening of every cancer patient by their second oncology visit, (b) design processes for ongoing assessment and intervention of need(s), and (c) develop measurable and sustainable evaluation metrics to ensure that palliative care needs are met. Methods: In June 2015, we launched electronic collection of patient-reported outcomes (PROs) using the Patient Reported …

Acute Hospital-Based Services Used By Adults During The Last Year Of Life In New South Wales, Australia: A Population-Based Retrospective Cohort Study, David E. Goldsbury, Dianne L. O’Connell, Afaf Girgis, Anne Wilkinson, Jane L. Phillips, Patricia M. Davidson, Jane M. Ingham

Research outputs 2014 to 2021

Background: There is limited information about health care utilisation at the end of life for people in Australia. We describe acute hospital-based services utilisation during the last year of life for all adults (aged 18+ years) who died in a 12-month period in Australia’s most populous state, New South Wales (NSW). Methods: Linked administrative health data were analysed for all adults who died in NSW in 2007 (the most recent year for which cause of death information was available for linkage for this study). The data comprised linked death records (2007), hospital admissions and emergency department (ED) presentations (2006–2007) and …

An Assessment Of Current Palliative Care Beliefs And Knowledge: The Primary Palliative Care Providers' Perspective, Yvonne Patten, Maria M. Ojeda, Carolyn Lindgren

All Publications

No abstract provided.

Las Percepciones De Los Profesionales De La Salud Sobre Los Cuidados Paliativos En Diferentes Sectores De Salud En La Ciudad De Buenos Aires / Perceptions Of Health Professionals About Palliative Care In Different Health Sectors In The City Of Buenos Aires, Kate Paulsen

Independent Study Project (ISP) Collection

Información contextual: Los cuidados paliativos son un campo de medicina para pacientes con enfermedades avanzadas o terminales. El propósito de la medicina paliativa es mejorar la calidad de vida de los pacientes y su familia y cuidar los síntomas físicos, psicológicos, sociales y espirituales. Los equipos interdisciplinarios compuestos de médicos, enfermeros, trabajadores sociales, psicólogos y otros tienen un papel esencial en el cuidado del paciente en una manera completa. Los cuidados paliativos son importantes porque todos tienen el derecho a ser acompañados en el final de la vida. En Argentina, los cuidados paliativos se han desarrollado considerablemente y existen en …

An Assessment Of Current Palliative Care Beliefs And Knowledge: The Primary Palliative Care Providers' Perspective, Yvonne Patten, Maria M. Ojeda, Carolyn Lindgren

All Publications

No abstract provided.

An Assessment Of Current Palliative Care Beliefs And Knowledge: The Primary Palliative Care Providers' Perspective, Yvonne Patten, Maria M. Ojeda, Carolyn Lindgren

All Publications

No abstract provided.

Hospice Care In Malaysia: Knowledge, Attitude And Time Of Discussion, Shanthi Ellen Solomon

Loma Linda University Electronic Theses, Dissertations & Projects

Despite available and adequate hospice care resources, fewer terminally ill patients in Malaysia use hospice care services than one might reasonably expect. It is reported that only around 10% of patients who die of terminal illness in Malaysia, die in hospice care (Devaraj, 2003). The projected number of individuals that should receive palliative care in Malaysia is 17 to 27% (Connor & Sepulveda Bermedo, 2014). In order to study why hospice care is not accessed as expected, nurses and doctors in Penang and Sabah completed a survey measuring knowledge of current hospice practices, attitude toward caring for the dying, personal …

Promoting Completion Of Advance Directives In A Hispanic Religious Congregation: An Evidence-Based Practice Project, Luis Daniel San Miguel, Mary Jo Clark

Doctor of Nursing Practice Final Manuscripts

Background: Hispanics utilize more aggressive medical treatment at the end of life and are less likely to receive end-of-life care consistent with their wishes than nonHispanic Whites. Hispanics are less likely than nonHispanic Whites to have an advance directive (AD). Increasing AD completion among Hispanics can promote end-of-life care consistent with their wishes, diminish healthcare disparities, and eliminate unnecessary healthcare spending. Objectives: To promote completion of advance directives by increasing knowledge, positive attitudes, and comfort with advance care planning (ACP) among Hispanics through culturally sensitive interventions. Intervention: The project was conducted in Spanish and implemented among a …

Spiritual Perspective, Mindfulness, And Spiritual Care Practices Of Hospice And Palliative Care Nurses, Patricia Ricci-Allegra

Seton Hall University Dissertations and Theses (ETDs)

Spiritual care is an ethical obligation of the nursing profession and an essential component of palliative care, but is often misunderstood. Lack of conceptual clarity is problematic, for each nurse will provide spiritual care based on his or her understanding of what this care should include.

Regardless of how a nurse defines spiritual care, an important element of spiritual care is what nurses bring of themselves to the patient encounter. Findings from several studies have shown a positive relationship between a nurse’s spiritual perspective and spiritual care practices. Spiritual perspective has increased as a result of participating in programs designed …

End-Of-Life Care: Crossing The Bridge From Treatment To Support, Martha C. Romney Bsn, Ms, Jd, Mph

Population Health Matters (Formerly Health Policy Newsletter)

No abstract provided.

Choices Related To Maximizing Quality Of Life At End Of Life, Theresa Lynn

Dissertations

Humans, including those residing in the United States, can live in denial of their own mortality. Because of this, futile care is sometimes provided, often at great monetary expense and for little or no return in terms of quality or length of life. At least two opportunities exist for making choices regarding care at the end of life in the U.S.: completing advance directives and choosing hospice care. This dissertation consists of three studies related to this topic. The first is a quantitative study about advance directives and attitude toward death. The advance directive completion rate among adults in the …

Hospice Home Immersion Project: Advancing Medical Education, Marilyn R. Gugliucci, Himanshu Malhotra, Andrea Gaul

Geriatric Medicine Faculty Publications

The University of New England College of Osteopathic Medicine (UNECOM) Hospice Immersion project was piloted in 2014 in southern Maine. It was designed and implemented as an experiential medical education learning model whereby medical students were “admitted” into the local Hospice Home to live there for 48 hours. Until this project, palliative and end of life care education at US Medical Schools and specifically UNECOM were accomplished through traditional medical education methods. The Hospice Immersion project utilizes qualitative ethnographic and autobiographic research designs, whereby a unique environment or “culture” (Hospice Home) is observed and life experiences of the medical student …

Integration Of Palliative Care In The Context Of Rapid Response A Report From The Improving Palliative Care In The Icu Advisory Board, J. E. Nelson, K. S. Mathews, D. E. Weissman, K. J. Brasel, M. Campbell, J. R. Curtis, J. A. Frontera, M. Gabriel, R. M. Hays, D. R. Lustbader, +7 Additional Authors

Journal Articles

Rapid response teams (RRTs) can effectively foster discussions about appropriate goals of care and address other emergent palliative care needs of patients and families facing life-threatening illness on hospital wards. In this article, The Improving Palliative Care in the ICU (IPAL-ICU) Project brings together interdisciplinary expertise and existing data to address the following: special challenges for providing palliative care in the rapid response setting, knowledge and skills needed by RRTs for delivery of high-quality palliative care, and strategies for improving the integration of palliative care with rapid response critical care. We discuss key components of communication with patients, families, and …

Integrating Palliative Care Into The Care Of Neurocritically Ill Patients: A Report From The Improving Palliative Care In The Icu Project Advisory Board And The Center To Advance Palliative Care, J. A. Frontera, J. R. Curtis, J. E. Nelson, M. Campbell, M. Gabriel, A. C. Mosenthal, D. R. Lustbader, K. J. Brasel, S. P. Weiss, D. E. Weissman, +5 Additional Authors

Journal Articles

OBJECTIVES: To describe unique features of neurocritical illness that are relevant to provision of high-quality palliative care; to discuss key prognostic aids and their limitations for neurocritical illnesses; to review challenges and strategies for establishing realistic goals of care for patients in the neuro-ICU; and to describe elements of best practice concerning symptom management, limitation of life support, and organ donation for the neurocritically ill. DATA SOURCES: A search of PubMed and MEDLINE was conducted from inception through January 2015 for all English-language articles using the term "palliative care," "supportive care," "end-of-life care," "withdrawal of life-sustaining therapy," "limitation of life …

Uncovering Meanings Of Death, Trauma, And Loss As Experienced By Hospice Bereavement Coordinators: A Phenomenological Study, Rochelle S. Clarke

Department of Family Therapy Dissertations and Applied Clinical Projects

This study examined the experiences of Hospice Bereavement Coordinators (HBCs) and Hospice Chaplains working with grief narratives from patient-family units exhibiting signs of anticipatory or complicated grief. While a significant amount of research has been conducted on Hospice employees, no qualitative studies have examined the interpretation of meaning from employees whose primary role focused on the psychosocial-spiritual aspects of clients exhibiting anticipatory or complicated grief. The researcher identified shared meaning of death, trauma, and loss from six participants in the context of a high stress and high loss environment. This study‘s findings revealed ten central themes: Death is an earthly …

Integrating Spirituality As A Key Component Of Patient Care, Suzette Bremault-Phillips, Joanne Olson, Pamela Brett-Maclean, Doreen Oneschuk, Shane Sinclair, Ralph Magnus, Jeanne Weis, Marjan Abbasi, Jasneet Parmar, Christina M. Puchalski

Medicine Faculty Publications

Patient care frequently focuses on physical aspects of disease management, with variable attention given to spiritual needs. And yet, patients indicate that spiritual suffering adds to distress associated with illness. Spirituality, broadly defined as that which gives meaning and purpose to a person’s life and connectedness to the significant or sacred, often becomes a central issue for patients. Growing evidence demonstrates that spirituality is important in patient care. Yet healthcare professionals (HCPs) do not always feel prepared to engage with patients about spiritual issues. In this project, HCPs attended an educational session focused on using the FICA Spiritual History Tool …

Existential Suffering And Cura Personalis: Dilemmas At The End-Of-Life, George P. Smith Ii

Scholarly Articles

Existential, or non-somatic suffering, is often associated with the management of refractory pain at the end-stage of life. Because of misleading sympathologies, this condition is often either mis-diagnosed or even ignored. When diagnosed as a part of a futile medical condition, this Paper argues that deep, palliative, or terminal sedation be offered to the distressed, dying patient as an efficacious and ethical response to preserving a semblance of human dignity in the dying process. Not only is this option of care humane and compassionate, it is consistent with the ideal of best patient care. The notion of care should not …

The Role Of Occupational Therapy In Primary Care, Priti Patel

Occupational Therapy Doctorate Capstone Projects

The Capstone Project is focused on communicating, influencing and educating other health care professionals regarding the role of occupational therapy in the future model of primary care delivery initiated by the adoption of the Affordable Care Act and the Triple Aim Initiative. Currently, primary care, the largest health care platform in United States, is not inclusive of occupational therapy services. Occupational therapists have the scope, knowledge and understanding to be part of the redesigned team model of primary care. Educating those currently working in primary care about adding occupational therapy services can have a significant impact on the profession of …

The Influence Of Positive And Negative Death Attitudes On Medical Students' Empathy And Attitudes Toward End-Of-Life Care, Elizabeth Palumbo

PCOM Psychology Dissertations

This quantitative study employed a cross-sectional survey research design in order to examine the relationships between medical students’ death attitudes, empathy, and attitudes toward end-of-life care. The participants were 206 medical students currently enrolled in the Doctor of Osteopathic Medicine program at the Philadelphia College of Osteopathic Medicine, Philadelphia campus. Results indicated that there were no significant differences in the level of empathy between medical students who held strong positive death attitudes and medical students with strong negative death attitudes. However, results indicated that significant differences existed in attitudes toward end-of-life care between medical students who held strong positive death …

Use Of Low-Dose Ketamine For Pain Management In An Emergency Department, Joseph Ladd, Winifred Pardo

All Publications

Background/Purpose: In the emergency department (ED), many barriers exist to pain management. Non-steroidal anti-inflammatory drugs and acetaminophen often cannot provide enough relief, while opioid analgesics are hindered by side effects, dependency, and tolerance. A non-competitive NMDA receptor antagonist, ketamine has historically been used for sedation and anesthesia in rural settings or in those with limited resources. Ketamine's unique safety profile and variety of dosage forms indicate its potential role in pain management. An evaluation was conducted of ketamine's use in low doses to treat pain in an emergency department with the third-greatest annual census in Miami-Dade county.

Methodology: A retroactive …

A Narrative Inquiry: Case Leaders' Perspectives On Resilience In Hospice Care, Gail Renee Ahern

Antioch University Dissertations & Theses

This study is a qualitative inquiry examining the perspective of team leaders within hospice organizations on resilience. The goal of this study was to examine how hospice leaders build resilience for themselves and within the interdisciplinary teams they lead. A framework of three key theories of leadership—servant, spiritual and authentic—was used to help in understanding the similarities and differences of the interviewed leaders and their key themes and practices. The eight leaders interviewed were from a range of hospices in diverse settings and all were directly responsible for leading interdisciplinary teams. In-depth phenomenological interviewing was undertaken until the study reached …