Social and Behavioral Sciences Commons^™

Racial Disparities In Palliative Care Utilization In The Covid-19 Pandemic, Margaret S. Bove, Benjamin Huber, Myles Hardeman, Daniel Harris, Areeba Jawed, Amber Comer

Medical Student Research Symposium

BACKGROUND

Palliative care is a vital resource for the critically or terminally ill. It has myriad benefits such as improved quality of life, reduced depressive symptoms, and decreased scarce resource utilization. Self-identified Black/African patients, however, are less likely to utilize advanced care directives or engage in hospice/comfort care measures and are more likely to prefer intensive treatment at the end of life. There is no research, however, on how the COVID-19 pandemic may have affected these trends.

METHODS

A retrospective cohort study of patients who experienced in hospital mortality or in hospital hospice due to COVID-19 between March 2020 – …

Impact Of The Built Environment On The End-Of-Life Journey, Kelechi Akwazie

Masters in Architecture Program: Theses

Several research studies and personal anecdotes show that home-based hospice care patients report better quality of life than their inpatient care counterparts – suggesting that the location of care/built environment is a critical component of hospice care. As a result, other research studies have attempted to provide evidence-based design recommendations for inpatient hospice facilities; however, several of these recommendations either conflict with each other or are vaguely prescribed – which may dull any attempts to implement them.

This literature review takes a unique approach to the provision of evidence-based design recommendations for inpatient hospice facilities by holistically assessing hospice care, …

What Is The Importance Of Social Work Involvement In Hospice Care Transitions For Ill Children And Their Families, Natalie Rodas, Guillermina Morales

Electronic Theses, Projects, and Dissertations

Thousands of children who face terminal illnesses die annually in the United States, 10% of those children and their families have hospice care services available. Through this study, the importance of social work involvement in hospice care transitions for ill children and their families were examined. Due to the scarcity of social work in hospice care settings, this study helped amplify research on the importance of social workers in hospice care for ill children and their families. The study consisted of individual interviews held via Zoom with medical social workers that have experience working in pediatric hospice care. The individual …

A Paramedic’S Field Guide To Community Hospice, Destiny D. Rogers

IPS/BAS 495 Undergraduate Capstone Projects

A capstone project focused on integrating hospice care with paramedicine through an existing emergency response system (EMS). This project aimed to serve as a training “field guide” for paramedics interested in supplementing hospice care needs within their community. The guide includes the variety of ways in which paramedic skills could assist with a hospice patient and their family, including patient assessment, pain relief, emotional support, and other comfort measures common in hospice care. The guide was submitted to my local EMS agency in Yolo County, CA with the intent of adding it to local paramedic scope protocols pending approval by …

“That’S What Hospice Is Supposed To Do”: How U.S. Hospice Care Staff Bridge Philosophy And Institutions, Morgan Alexa Leff

Senior Honors Papers / Undergraduate Theses

Hospice founder Cicely Saunders wrote that “the dignity and worth of each individual patient [are] central to Hospice philosophy—an idea closely tied to anthropological personhood (Saunders and Clark 2002). As dying in hospice becomes an increasing reality of life in the United States, we must grapple with how the ideals, costs, and challenges of hospice care play out in the healthcare system. The institutional structures meant to ensure a ‘good death’ (while protecting the interests of the state) can fracture care of the dying. As hospice staff work within and around these structures, they build meaning in care strategies that …

Barriers To The Use Of Palliative And Hospice Care Among The Latino Population, Diana Ramirez

Electronic Theses, Projects, and Dissertations

Patients suffering from irreversible and terminal illnesses may benefit from the services provided by Palliative and Hospice Care to control any symptom burden and assist in navigating complex medical decisions. Many patients may express hesitation in accepting and enrolling to this service due to misconceptions. Language barriers may add an additional layer of complexity. This study explored the challenges Palliative Care providers encounter when introducing concept of hospice to Spanish-speaking patients their families for the first time. This study implemented qualitative research methods by using semi-structured one-on-one interviews. Ten members of an In-patient Palliative Care Team at a University Hospital …

The Importance Of Self-Care Among Hospice Social Workers, Lillianna Gomez, Divina Perez

Electronic Theses, Projects, and Dissertations

Social workers in general face daily challenges, but social workers in the field of hospice face unique daily stressors. The purpose of this study was to investigate what self-care methods hospice social workers use to combat burnout and compassion fatigue. One hundred hospice social workers were surveyed. Researchers used two scales to measure participants’ current self-care methods and their current quality of life. Researchers used two tailed Pearson test to analyze relationships between self-care and burnout as well as self-care and compassion satisfaction. Researchers also utilized various SPSS tests to analyze the relationship between demographics and self-care method. Participants reported …

Pastoral Care And The Alleviation Of Compassion Fatigue In Staff At St. Mary's Hospice, Ellen Chloe Gardner-Cook

Doctoral Dissertations and Projects

This action research project studied compassion fatigue in hospice staff and the ways that Christian prayer practices can mitigate compassion fatigue symptoms and contribute to resiliency. The sample population included forty employees and the sample size was N=6. The participants answered four anonymous, self-report assessments to measure six areas, compassion satisfaction, self-compassion, secondary traumatic stress, burnout, perceived stress, and spirituality at the first of eight weekly sessions. These assessments included the Professional Quality of Life Scale (ProQOL), the Perceived Stress Scale, the Spiritual Intelligence Self-Report Inventory, and the Self-Compassion Scale. Six weeks of prayer interventions followed the initial assessments then …

Exploring The Relationship Between Faith And The Experience Of Burnout, Compassion Fatigue, And Compassion Satisfaction For Hospice Workers During A Global Pandemic: A Multidisciplinary Study, Sarah Jo Spiridigliozzi

Doctoral Dissertations and Projects

Individuals who work within hospice and palliative care experience unique stressors while providing care to patients and families at the end of life. The COVID-19 global pandemic provides additional stressors, personal and professional, which may affect these individuals. Research lacks data to understand how this pandemic affects individuals working in hospice care. Most current research focuses on individual disciplines, with the highest number of studies focusing on a nurse's experiences. Additionally, the recent research provides conflicting relationships on faith's influence on burnout, compassion fatigue, and compassion satisfaction. Biblical guidance on burnout and compassion highlights the importance of addressing this phenomenon …

The Use Of A Pediatric Palliative And Hospice Education Module To Enhance The Knowledge And Practice Of Emergency Room Providers, Morgan Garrett

DNP Projects

Background: Palliative and hospice care resources are underutilized in pediatric patients with chronic and life-limiting illnesses. One contributing factor is the lack of formalized education for medical providers regarding the differences and scope of palliative and hospice care models. Without adequate education about these services, providers are not able to effectively utilize otherwise available resources to provide holistic care.

Purpose: The purpose of this study was to assess the current perception of knowledge among providers pertaining to pediatric palliative and hospice care. The study investigated improvements in educational outcomes in ten categories after participation in a web-based training. A secondary …

Appreciation Day For Clinical Staff At Vna Hospice, Melody Nguyen

Capstone Projects and Master's Theses

VNA Hospice of the Central Coast is a nonprofit that was created back in 1951. The staff at VNA are visiting about 75,000 homes per year. Throughout the years the staff have been seeing patients who reached the requirement of having 6 months or less to live. Working with Hospice patients can be hard for everyone but, the staff at VNA are seeing the patients from good days and bad days. Depression is known to negatively impact the clinical staff at VNA Hospice. Staff are working long hours which leads to sleep disturbance and chronic stress. Some staff are also …

Beyond Bingo: Enhancing Quality Of Life In The Face Of Death For Hospice Patients With Dementia Through Integrated Expressive Arts Therapies, Development Of A Method, Jeanie Cooper Carson

Expressive Therapies Capstone Theses

This paper explores ways integrated expressive arts therapies (EAT) used with individuals with dementia in hospice can help facilitate living well in the face of dying. While research is limited regarding use of EAT with this population specifically, much significant research has been conducted to support the effectiveness of the employment of various creative arts modalities with individuals with dementia and also on hospice. Building on this research, the author developed and implemented an integrated EAT method with members of this population living in long-term care facilities in Greater Boston in the context of the pandemic of 2020-21. This paper …

Understanding The Role Of Hospice Care: Reflections From A Service-Learning Project, Avery Mccutcheon

The Eleanor Mann School of Nursing Undergraduate Honors Theses

There is little known about the part end-of-life care plays in patient care. This paper examines the role of end-of-life care in the care of a dying patient and consists of findings from a service-learning project with Circle of Life hospice. To be able to effectively care for those in the end stages of life, healthcare professionals must turn away from the curative aspects of medicine, to treating symptoms and improving quality of whatever life remains for the patient. In order to normalize EOL Care and consequently make it more accessible, we must educate our healthcare practitioners regarding the benefits …

The Essential Characteristics Of An Effective Hospice And Palliative Care Nurse, Alexis Doyle

The Eleanor Mann School of Nursing Undergraduate Honors Theses

The first portion of this paper includes a self-reflection of the writer's service-learning experience while volunteering at a hospice center. The following portion is a literature review.

This study is a literature review that examines the characteristics of an effective hospice and palliative care nurse. The purpose of this study is to discover what qualities make a satisfactory hospice and palliative care nurse; therefore, characterizing it as a qualitative study. It is concluded that the following attributes are beneficial for a hospice and palliative care nurse: compassion, knowledge, confidence, and support. When delivering end-of-life care, a nurse should use therapeutic …

Coping With Death, Quality Of Life, And Compassion Fatigue Among Hospice Social Workers, Virgen L. Dominguez

Walden Dissertations and Doctoral Studies

Research indicates that working with dying patients and their families could causeemotional reactions that not only affect their well-being but their quality of life and desire to continue in their profession. Although researchers have examined compassion fatigue among other professionals, there is a gap in research on the phenomenon among hospice social workers. The purpose of this generic qualitative study was to obtain a richer understanding about how hospice social workers cope with death, what their experiences are with compassion fatigue, and how their quality of life is impacted by their work. The conceptual framework was the transactional theory of …

Hospice Social Workers Beliefs, Ethics, And Values: How Do They Affect Terminal Clients Requesting Physician Assisted Suicide?, Jazmine Camacho, Jessica Huver

Electronic Theses, Projects, and Dissertations

Since the enactment of California’s End of Life Option Act in 2016, physician assisted suicide (PAS) has become increasingly relevant within the field of medical social work. As a result, social workers will find themselves educating and assisting clients on EOLO. Research suggests that the amount of education and training received regarding PAS all had an impact on social workers’ perceived preparedness to discuss PAS as and EOLO. Additionally, research indicates that social workers collectively support and have a positive attitude towards PAS; however, there is little research that explores the extent to which a social worker’s personal values and …

Exploring Nurses' Attitudes Toward Assisted Suicide: A Study Of Nurses Working With Terminally Ill Patients, Marjie L. Schoolfield

Scholar Week 2016 - present

Physician-assisted suicide, legalized in many states is becoming an option for patients diagnosed with a terminal illness. Nurse participation in physician-assisted suicide is not supported through state nurse practice acts or national nursing organizations, causing potential contradictions in practice rights for advanced practice nurses. The purpose of this study was to examine the attitudes of registered and advanced practice nurses who work with the terminally ill regarding the patient option of physician-assisted suicide. This quantitative research was conducted with hospice registered nurses employed by a hospice organization in the Midwest and included participants from states where physician-assisted suicide is legal, …

The Impact Of Grief Work On Hospice Mental Health Providers Through A Bowen Family Systems Lens, Joshua Hernandez

Department of Family Therapy Dissertations and Applied Clinical Projects

Marriage and family therapists and other mental health professionals and clients can be thought of as their own, divine emotional unit, generating and distributing the anxiety of one to the other. In fact, Kerr and Bowen (1988) described anxiety as a driving force exchanged by every living organism, and the energy surrounded by every human relationship. Within a hospice setting, anxiety can be heightened due to catering to end-of-life care, which can potentially affect the emotional response and reactivity of the mental health professional, changing the course of treatment for the patient and their family. Emerging research within healthcare has …

Hospice Interdisciplinary Use Of The Social Work Assessment Tool For Military Families, Miranda Lishell Rankin

Walden Dissertations and Doctoral Studies

The development of the social work assessment tool (SWAT) was an initiative designed by members of the National Hospice and Palliative Care Organization to move hospice and palliative care social workers into the arena of viewing the family as an extension of the patient. Of those dying in the United States, 1 out of 4 is a military veteran (vet) in need of assessments, culturally relevant interventions, and/or supports at the end of life. For military families, caring for vets at the end of life can prompt stressors that may require culturally unique assessments and/or interventions. Tsai’s (2003) theory of …

Home Health Care Resource Binder: A User-Friendly Guide For Crossroads Hospice And Palliative Care, Deanna Eder

Williams Honors College, Honors Research Projects

Patients and families searching for home health care need accurate information regarding the community resources available to them to promote aging in place and to maintain their quality of life. In connection to the social workers at Crossroads Hospice and Palliative Care, the researcher identified a need for a centralized source of up-to-date information regarding local home health care agencies due to the current resource deficit. Social workers and other health care professionals are expected to benefit from a concise list of resources readily available to provide their patients and families with adequate support to make informed decisions about a …

End Of Life Care, Ana Mederos

Capstone Projects and Master's Theses

Central Coast Visiting Nurses Association is a non-profit agency that provides home health care as well as hospice care for individuals in the counties of Monterey, San Benito, Santa Cruz and Santa Clara. In this region, the Latino/ Hispanic communities are underutilizing the services for end of life care. According to statistics provided by VNA 2019, only around 20% of the populations they serve are Latino/ Hispanics. Education on end of life care services is necessary for an individual to have a better understanding and quality of life during the end stage or confronted with a life limiting illness. In …

Chapter 14: Hospice And End-Of-Life Care, Sally Pelon, Brandon Youker, M. Paola Leon

Books and Contributions to Books

This chapter explores end-of-life issues and concerns as well as the hospice movement’s role in assisting terminally ill individuals. Specific social work assessment and interventions tools are offered considered as well as controversial issues in end-of-life care.

Using Dance/Movement Therapy To Educate Hospice Providers On Preventing Burnout: A Method, Victoria G. Powell

Expressive Therapies Capstone Theses

Burnout is a clinical condition that an individual may experience whenever they are in a constant state of stress. It is categorized by three groups of symptoms: emotional exhaustion, depersonalization, and negative self-evaluation of personal achievement (Rizo-Baeza et al., 2017, p. 19). This inquiry investigated the impact of burnout on hospice professionals and volunteers through researching previous literature. The research led to the development of a psychoeducational, body-based method with a Dance/Movement Therapy (DMT) foundation. This preventative method was implemented in two separate workshops for hospice professionals and volunteers at a Massachusetts-based hospital system. Results indicate a need for training …

How To Support Caregivers And The Bereaved: Psychoeducation And Personal Coping Techniques, Vanessa Eva Marie Eyre

Electronic Thesis and Dissertation Repository

Canada has an increasing and ageing population and because of this it is experiencing an increase in its rate of deaths. Because of this the requirement for hospice and end-of-life support will likely increase. This creates the need for research on best practices regarding supporting individuals in the caregiving role, but also how they personally cope with the challenges they face. The first segment of this study looked at caregivers of individuals with life-limiting illnesses’ experiences of receiving a psychoeducation grief resource package that contained a variety of educational materials that fall into the following categories of support: emotional, spiritual, …

Implementing Aromatherapy For Falls Reduction In The Inpatient Hospice Population, Kimberly Kay Pistek

Walden Dissertations and Doctoral Studies

Falls among the elderly is a health concern affecting multiple patients annually. Hospice patients and those with multiple comorbidities are at the greatest risk of falling and sustaining injuries from falls. Aromatherapy has been used for reducing multiple symptoms as well as for decreasing falls. The practice-focused question explored whether an education program on using aromatherapy for fall prevention would increase knowledge of this intervention for an interdisciplinary group of hospice staff. The design was developed using Knowles's theory of andragogy and Bloom's taxonomy. Thirteen staff members from the same facility participated in the education program. The program was targeted …

Exploring Prayer Functions And Posttraumatic Growth Among Informal Caregivers In Hospice Settings, Nicole Beth Fortin

Walden Dissertations and Doctoral Studies

Posttraumatic growth is a positive psychological transformation resulting from the struggle to cope with a challenging life event. There is a significant association between prayer coping functions and posttraumatic growth, but its process remains unclear and studies on informal hospice caregivers are scarce. The purpose of this quantitative, correlational, cross-sectional study was to explore the relationship between prayer functions and posttraumatic growth among informal caregivers while considering differences due to the caregiving environment and prayer practices. The shattered assumptions theory and model of growth in grief were used as a theoretical framework to evaluate the relationship between prayer functions, using …

Exploring Social Worker Knowledge, Conceptualization, And Use Of Cultural Humility In Hospice, Shelby L. Schiller

Walden Dissertations and Doctoral Studies

This capstone project examined social workers’ knowledge, values, and beliefs as related to the concept of cultural humility to determine how hospice care professionals treat patients’ cultural preferences and traditions with respect and sensitivity at the end of life; as such practices have the ability to improve the hospice experience. Research questions addressed in the study (a) how social workers in Nevada define cultural humility in the context of hospice social work practice, (b) the values or principles hospice social workers in Nevada consider most important in providing culturally appropriate care to hospice patients, and (c) the ways hospice social …

Hospice Social Workers’ Attitude On Physician-Assisted Suicide And Practice Under California’S End Of Life Option Act, Veronica Lorraine Fausto Melchor

Electronic Theses, Projects, and Dissertations

Currently in the United States, five states have enacted physician-assisted suicide as a legal end of life option for terminal patients. Research indicates that most patients who have died under this mean have been enrolled in hospice services. With the recent enactment of California’s End of Life Option Act, hospice social workers will find themselves educating and assisting patients and/or their families with this and other end of life decisions. Research has thoroughly examined physician and nurses’ involvement and attitude in the matter, but little has been researched regarding social workers. This study aimed to identify the factors that affect …

“We Make Death Look Pretty”: A Qualitative Study Analyzing Reported Effects Of Compassion Fatigue On Hospice Nurse-Patient Communication, Katherine Harville

Masters Theses, 2010-2019

Rationale: Compassion fatigue is present in multiple nursing fields, but hospice poses a significant threat to nurses working within that specific environment. This is due to their consistent proximity with patient suffering, death and dying, and constant communication with patients regarding their death. The hospice nurse-patient relationship requires a deeper connection between nurse and patient which often results in consistent emotional labor for hospice nurses, further amplifying the threat of compassion fatigue. While the effects of compassion fatigue can manifest in many forms, it is typically characterized by a nurses’ decline in job satisfaction, which they do not tend to …

Grief Off-The-Clock: Supporting Hospice Professionals Through Personal Loss, Rachel A. Guimond

Scholar Week 2016 - present

Working with clients who die can have a major impact on the way professionals address their own grief. Daily exposure to the possibility of death alters the process of mourning and can leave professionals feeling disconnected from family and friends during times of grief. This presentation will look at the challenges that hospice workers, clergy members, social workers and other professionals face when they experience grief in their own lives. Evidence-based strategies for supporting professionals in their grief will also be explored.