Palliative Care Commons^™

United States Acculturation And Cancer Patients’ End-Of-Life Care, Alexi A. Wright, Heather Stieglitz, Yankel M. Kupersztoch, M. Elizabeth Paulk, Yookyung Kim, Ingrid T. Katz, Francisco Munoz, Rachel B. Jimenez, Jan Mutchler, Lorna Rivera, Anthony L. Back, Holly G. Prigerson

Women’s and Gender Studies Faculty Publication Series

Background: Culture shapes how people understand illness and death, but few studies examine whether acculturation influences patients’ end-of-life treatment preferences and medical care.

Methods and Findings: In this multi-site, prospective, longitudinal cohort study of terminally-ill cancer patients and their caregivers (n = 171 dyads), trained interviewers administered the United States Acculturation Scale (USAS). The USAS is a 19- item scale developed to assess the degree of ‘‘Americanization’’ in first generation or non-US born caregivers of terminally-ill cancer patients. We evaluated the internal consistency, concurrent, criterion, and content validity of the USAS. We also examined whether caregivers’ USAS scores predicted patients’ …

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 …

Gently Into The Good Night: Toward A Compassionate Response To End-Stage Illness, George P. Smith Ii

Scholarly Articles

End-of-life decision making by health care providers must respect individual patient values. Indeed, these values must always be viewed as the baseline for developing and pursuing patient-centered palliative care for those with terminal illness. Co-ordinate with this fundamental bioethics principle is that of beneficence or, in other words, respect for conduct which benefits the dying patient by alleviating end-stage suffering — be it physical or existential. Compassion, charity, agape and/or just common sense, should be a part of setting normative standards and of legislative and judicial responses to the task of managing death. Aided by the principles of medical futility, …

Assessing Depression In Cancer Patients : A Longitudinal Comparison Of Three Questionnaires., Patrick Possel, Kerstin Knopf

Faculty and Staff Scholarship

The article by Johns et al. (1) compares the Hopkins Symptom Checklist 20-item depression scale (HSCL-20) (2), the Short-Form 36 Mental Health Inventory five-item distress scale (MHI-5) (3), and the Patient Health Questionnaire nine-item depression scale (PHQ-9) (4) in 309 adults with cancer in a longitudinal study.

Music Therapy To Sever The Silence Of A Childhood Holocaust Survivor, Amy Clements-Cortés

Music Faculty Publications

No abstract provided.

Integrating Spiritual Care Within Palliative Care: An Overview Of Nine Demonstration Projects, Shirley Otis-Green, Betty Ferrell, Tami Borneman, Christina Puchalski, Gwen Uman, Andrea Garcia

Medicine Faculty Publications

No abstract provided.

Holistic Comfort And Bereavement Of Families Receiving Prenatal Hospice Support During The Loss Of An Unborn Child With Lethal Anomalies, Sally S. Smith

Nursing Theses and Capstone Projects

The purpose of this descriptive study was to explore the grieving process and coping mechanism of families that was faced with the impeding loss of their unborn child. Grief is a very lonely process.

The aim of this research is to examine how parents cope with the lost of an unborn child with the aid of perinatal hospices. Giving families a broader range of options in regards to continuing their pregnancy. Each family has a right to choice what option is right for them. Choices should be in the hands of the family in regards to continuing with their pregnancy …

Refractory Pain, Existential Suffering, And Palliative Care: Releasing An Unbearable Lightness Of Being, George P. Smith Ii

Scholarly Articles

Since the beginning of the hospice movement in 1967, “total pain management” has been the declared goal of hospice care. Palliating the whole person’s physical, psycho-social, and spiritual states or conditions is central to managing the pain which induces suffering. At the end-stage of life, an inextricable component of the ethics of adjusted care requires recognition of a fundamental right to avoid cruel and unusual suffering from terminal illness. This Article urges wider consideration and use of terminal sedation, or sedation until death, as an efficacious palliative treatment and as a reasonable medical procedure in order to safeguard the “right” …

Americans' Attitudes Toward Euthanasia And Physician-Assisted Suicide, 1936-2002, Jen Allen, Sonia Chavez, Sara Desimone, Debbie Howard, Keadron Johnson, Lucinda Lapierr, Darrel Montero, Jerry Sanders

The Journal of Sociology & Social Welfare

Public opinion polls conducted from 1936 to 2002 found that Americans support both euthanasia and physician-assisted suicide. Although public opinion regarding end-oflife decisions appears to have been influenced by the events of the times, Americans have consistently favored the freedom to end one's life when the perceived quality of life has significantly diminished, either by one's own hand or with the assistance of a physician. This paper indicates that existing policy regarding euthanasia and physician-assisted suicide conflicts with the American public's attitudes regarding the matter, as well as examines implications for social workers who serve clients facing end-of-life decisions.

Paediatric Palliative And Supportive Care: Caring For Life: The Needs Of Children And Families In Western Australia, Leanne Monterosso, Linda Kristjanson, Marianne Phillips, Sue Rowell

Research outputs pre 2011

Palliative care is the relief of symptoms, regardless of their impact on the underlying disease process. The philosophical underpinning of current international paediatric palliative and supportive care models is that palliative and supportive care should be offered to all children with life threatening or chronic illnesses/disabilities with complex care needs. This approach allows the integration of cure-directed treatment and palliative care. allowing children to benefit from both philosophies of care. In Australia, there is increasing recognition of the need for the development of appropriate paediatric palliative care services, especially in Western Australia where supportive care services for children with life-limiting …

Update - July 2002, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Having Enough Faith Not To Be Healed
-- Theological Warrants for Palliative Care
-- Congratulations (master program graduates)

General Practitioners' Attitudes To Palliative Care : A Regional Perspective, Richelle Lee-Steere

Theses : Honours

The study explores regional general practitioners' attitudes to palliative care through semi- structured interviewing using a qualitative methodology. Attitudes to palliative care were examined using the general practitioners' accounts of their experiences and perceptions of caring for terminally ill patients. The participants were ten registered general practitioners located within the Greater Sunbury Division of General Practice in the South West of Western Australia. A semi-structured interview schedule containing ten open-ended questions was used to assess regional general practitioners' attitudes to palliative care. Examples of the research questions included: What are regional general practitioners' attitudes to palliative care? What supports are …

Communication About End Of Life For Patients Living With Amyotrophic Lateral Sclerosis: A Scoping Review Of The Empirical Evidence, Shelagh K. Genuis, Westerly Luth, Sandra Campbell, Tania M. Bubela, Wendy S. Johnston

Office of the Provost

Background: Communication about end of life, including advance care planning, life-sustaining therapies, palliative care, and end-of-life options, is critical for the clinical management of amyotrophic lateral sclerosis patients. The empirical evidence base for this communication has not been systematically examined.
Objective: To support evidence-based communication guidance by (1) analyzing the scope and nature of research on health communication about end of life for amyotrophic lateral sclerosis; and (2) summarizing resultant recommendations.
Methods: A scoping review of empirical literature was conducted following recommended practices. Fifteen health-related and three legal databases were searched; 296 articles were screened for inclusion/exclusion criteria; and quantitative …

Euphemistic Codes And Tell-Tale Hearts: Human Assistance In End-Of-Life Cases, George P. Smith Ii

Scholarly Articles

A euphemism is defined as the substitution of an agreeable or inoffensive word or expression for one that is harsh, indelicate, or otherwise unpleasant taboo; allusion to an offensive thing by an inoffensive expression. This article deals with medical euphemisms used commonly through medical codes in hospitals for end-of-life patient care. It examines the extent to which fear shapes decision making in critical care units - fear of medical failure, and fear of litigation if not "everything" is done to prolong life, no matter how agonizing. Furthermore, being trained to save lives, health care providers often lack the courage to …

Terminal Sedation As Palliative Care: Revalidating A Right To A Good Death, George P. Smith Ii

Scholarly Articles

Not everyone finds a “salvific meaning” in suffering. Indeed, even those who do subscribe to this interpretation recognize the responsibility of each individual to show not only sensitivity and compassion but render assistance to those in distress. Pharmacologic hypnosis, morphine intoxication, and terminal sedation provide their own type of medical “salvation” to the terminally ill patient suffering unremitting pain. More and more states are enacting legislation that recognizes this need of the dying to receive relief through regulated administration of controlled substances. Wider legislative recognition of this need would go far toward allowing physicians, in the exercise of their reasonable …

Identification Of Factors That Influence Physician Generated Referrals To Hospice Programs, Cheryl A. Hoerner

Dissertations and Theses @ UNI

The hospice movement is just over 20 years old in this country. Hospice programs are dependent on physicians to educate and refer their terminal patients to hospice care. The purpose of this study was to identify factors which influence physicians in rural Iowa to refer terminal patients to selected hospice programs. The study involved Medicare-certified hospice programs and non-certified programs located in rural communities in Iowa. One hundred and fifty licensed physicians were randomly selected to complete a 14-item questionnaire. A total of 86 questionnaires were returned. The survey tool addressed demographic information, as well as identifying factors that influenced …

Restructuring The Principle Of Medical Futility, George P. Smith Ii

Scholarly Articles

This essay surveys the need for a clear and objective definition of medical futility. It is urged that once agreement is obtained for structuring operational guidelines for determining futility, a three-tier decisional structure can be developed for testing whether a given treatment falls within the scope of these guidelines.

Under the first tier, the treating physician would be given the primary responsibility for the making the determination to withhold treatment on the grounds of futility. While the physician would be under a duty not to prescribe treatment deemed futile, he would be obliged to inform the patient and his family …

Book Review, Mitchell M. Simon

RISK: Health, Safety & Environment (1990-2002)

Review of: MARSHALL A. KAPP, ETHICAL ASPECTS OF HEALTH CARE FOR THE ELDERLY: AN ANNOTATED BIBLIOGRAPHY. (Greenwood Press 1992). [200 pp.] Number 17 in series, Bibliographies and Indices in Gerontology. Author index; foreword by Erdman B. Palmore, series editor; preface; subject index. LC: 92-17776; ISBN: 0-313-27490-8. [Cloth $45.00. P.O. Box 5007, Westport CT 06881.]

Good Grief! Coping With Death And Dying In A Hospice Situation, Pegg Warnick

Masters Theses

The purpose of this qualitative study is to discover and examine the coping strategies concerning death and dying from the perspectives of hospice patients and hospice volunteers. A review of applicable literature, informal but structured interviews and participant observation are procedures for the study. The focus of the study lies in three areas: what are the internal attributes used to cope?; what are the external support systems used to cope? and, what are the adjustments in personal goals? Research for this study was patterned after Hegge's study (1991) who surveyed the coping strategies of the recently widowed elderly. The instruments …

Recognizing Personhood And The Right To Die With Dignity, George P. Smith Ii

Scholarly Articles

Death cannot be viewed properly as either an event or a configuration. Indeed, multiple parts of the body can continue to live long after the disintegration of its central organization is recorded. Instead of collapsing at a moment in time, technological mechanisms are capable of sustaining the major bodily processes indefinitely--all designed to allow for the harvesting of needed organs for transplantation. State legislative efforts have been undertaken in America to define those specific circumstances when death occurs legally. Although always allowed to exercise reasonable discretion in their decision making, attending physicians will nonetheless be aided by these laws that …

Ua12/2/1 Magazine, Wku Student Affairs

WKU Administration Documents

Special magazine edition of the College Heights Herald.

• Poore, Chris. The Jovial Judge – District Court Judge Tom Lewis
• White, Douglas. Dealing with Death
• White, Douglas. Hospice Eases Death Crisis
• Albrecht, Dana. Friends Forever – short story

Ua12/2/1 College Heights Herald, Vol. 58, No. 29 Magazine, Wku Student Affairs

WKU Administration Documents

Special magazine issue of the College Heights Herald. This issue contains articles:

• Mitchell, Cyndi. Being With Hospice of Bowling Green
• Wright, Sharon. The Two Week Semester - Will It Ever End?
• Smith, Erica. A Social Awareness - Dean Nason

Ua35/11 Student Honors Research Bulletin, Wku Honors Program

WKU Administration Documents

The WKU Student Honors Research Bulletin is dedicated to scholarly involvement and student research. These papers are representative of work done by students from throughout the university.

• Garvin, Catherine. The Recognition of Anticipatory Grieving and Associated Needs of the Family of a Critically Ill Patient
• Parks, Barbara. Energy Properties of Textiles
• Martin, Lanna. A Historical Approach to the Understanding of Civil Disobedience
• Atwood, Tammy. The Computer Manufacturing Industry and the Burroughs Corporation
• Allen, Christopher. The Battle of Marathon: Athens' Magnificent Triumph
• Martin, Lanna. Melville's Creation of Captain Vere as Pontius Pilate in Billy Budd
• Boles, Barbara. Emerson's Uriel and the …

Changing Physician Ideologies On The Care Of The Dying: Themes And Possible Explanations, John Macdougall

The Journal of Sociology & Social Welfare

An analysis of changing physician ideologies regarding the care of elderly dying patients, as expressed in technical journals read by American physicians. Markedly more titles concerning terminal care are found in Index Medicus in 1968- 78 than in 1960-67. In one journal, physicians are only after 1964 urged to tell patients openly about their condition and after 1969, to improve cooperation within professional teams. Two explanations of these data are tentatively explored: 1) a Parsonian explanation, whereby medical ideologies reflect professional autonomy and the influence of internalized moral norms; 2) a Marxist explanation, whereby medical ideologies reflect physicians' transformation from …