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Dissertations / Theses on the topic 'Standards of hospice care'

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Published: 4 June 2021
Last updated: 15 February 2022

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1

Sharifi, Nahal Alsadat. "Children's Hospice Care." Thesis, Virginia Tech, 2016. http://hdl.handle.net/10919/71772.

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With advancements in medical technology, the mechanics of dying and death has changed significantly. Centuries ago, people mostly died of infectious diseases. From the time they were diagnosed, to the time of their death did not take long. Today, public health has improved remarkably. We have a better control over infectious diseases, but we have to deal with cancer and other chronic illnesses. The long period of treatment for such illnesses makes us spend a lot of our time in healthcare facilities such as hospitals, hospices, and care homes. Unfortunately, in many cases, these facilities do not pay much attention to emotional and spiritual needs of their patients and are mostly designed around their own institutional and technological needs. In that regard, these buildings become pretty awful places with no natural light and long corridors. Today, due to the nature of chronic diseases that we mostly deal with, hospice care facilities are becoming more popular. The idea of a hospice is to focus on quality of the place for families and patients who have already spent a lot of their time in a hospital setting. The goal is provide humane care for patients who do not have much time left, to make sure that they live the remainder of their lives as comfortably and as fully as possible. It is important to remember that when such facilities are designed for children, we need to pay extra attention to their unique needs. It is important to provide opportunities for children with terminal illnesses to continue to learn and grow. This thesis is exploration of an architectural setting in which children with a terminal prognosis would spend the last few weeks of their lives. Located in Old Town Alexandria, Virginia, this project takes advantage of the existing nature of the site to create an oasis for families who have gone through an exhausting battle with an untreatable disease. The goal is to shift the focus from curing to healing and to create a nurturing place that helps to bring normalcy back to the lives of patients and their families.
Master of Architecture
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2

Cho, Yuen-yee Christine. "Hospice." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B2595099x.

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3

Cho, Yuen-yee Christine, and 曹婉怡. "Hospice." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B3198454X.

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4

Ho, Man-chuen Anthony. "A hospice in Sandy Bay." Hong Kong : University of Hong Kong, 1995. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25946043.

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5

Mak, Kiu-yan Wayne. "Towards nirvanna : a Buddhist hospice /." Hong Kong : University of Hong Kong, 1996. http://sunzi.lib.hku.hk/hkuto/record.jsp?B25955585.

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6

Moran, Karen Ann. "The experiences of hospice patients and the music therapy clinician in hospice care." Scholarly Commons, 2011. https://scholarlycommons.pacific.edu/uop_etds/765.

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This thesis reports on a phenomenological inquiry into the experiences of hospice patients and music therapy clinician in end of life care. Three total participants were included in this study, two hospice patients and the music therapy clinician. Interventions included singing familiar songs, music for relaxation and Music and Imagery, an adaptation of the Bonny Method of Guided Imagery and Music. Each hospice patient participated in two music therapy sessions, plus an interview. Data included audio recorded sessions and interview, a process journal kept by music therapist, clinical observations, and one of the participant's mandala. Data was analyzed according to Moustakas' modification of the Stevick - Colaizzi - Keen method of Transcendental Phenomenology. Experiences for the hospice patients include themes of Positive Experience with Music, Positive Experience with Music and Pain, Negative Experience with Music, Music and Imagery, The Artist, Coping, The Mandala, Processing Music and Imagery and Transcendence. Experiences for the therapist include Feelings, Clinical Awareness, Meeting my Own Needs, Desire to Help, Ebb and Flow, and the Guide Following. Implications for further research are given.
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7

Ferrel, Cynthia Lynn. "The experience of critical care nurses in initiating hospice care." abstract and full text PDF (free order & download UNR users only), 2008. http://0-gateway.proquest.com.innopac.library.unr.edu/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1453534.

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8

Taylor, Sarah Fese. "Understanding Quality of Care in a Hospice Setting." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5272.

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Assuring quality of care for patients who face the end of life has been a major concern for those in hospice settings. Limited research is available that has a focus on understanding what quality of care in a hospice setting looks like. This research is important to provide insight into hospice health care providers' perceptions of the quality of care in the hospice setting and on the indicators that influence care quality. A qualitative phenomenological approach was used to answer the research questions on the perspectives of the health care providers in the hospice care setting regarding the quality of care and the factors that health care providers perceive as important to the quality of care in the hospice setting. Kolcaba's comfort theory served as the theoretical framework that guided the preparation of the questions used for the interviews and for interpreting the findings. Data collection was conducted through structured interviews with a sample of 15 hospice health care providers. Interviews were held in a private office of the hospice setting. After Walden Institutional Review Board approval, participants consented and interviews commenced. Data were transcribed and Nvivo software was used to assist with identifying major themes. Recommendations from the study reflect Kolcaba's comfort theory providing patient-centered care and enhanced quality of care for patients in a hospice setting. The research findings and recommendations will help promote a positive social change by raising awareness for effective provider communication, staffing, education and adequacy of resources in the hospice setting.
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9

Gore, Maria. "LGBT affirming environments in hospice care settings." Honors in the Major Thesis, University of Central Florida, 2013. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/848.

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The documented experiences and perceptions of lesbian, gay, bisexual, and transgender (LGBT) patients receiving hospice or palliative care gives merit to the need for the implementation of LGBT affirming environments in hospice care settings. The guidelines for creating these affirming environments are described in this paper. Applying the Donabedian (1988) model of structure, process, and outcome this thesis project analyzes identified interventions relevant to the implementation of LGBT affirming environments in hospice care settings. Utilizing a formal PICO questioning method, a search strategy was devised and studies were identified based on established criteria. The results suggest that there is a paucity of data in relation to the implementation of LGBT affirming environments in hospice care settings. In an effort to assist in identifying existing interventions that have not been studied this project also includes a recommended survey tool to measure the active efforts of hospice organizations to implement LGBT affirming environments.
B.S.W.
Bachelors
Health and Public Affairs
Social Work
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10

Parker-Oliver, Debra. "The diffusion of hospice care in Missouri /." free to MU campus, to others for purchase, 2000. http://wwwlib.umi.com/cr/mo/fullcit?p9988689.

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11

Savage, Sharalee Brown. "Resiliency in the family receiving hospice care." Oklahoma City : [s.n.], 2009.

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12

Montoya, Ian M. "HISPANICS' UNDER-UTILIZATION OF HOSPICE CARE SERVICES." CSUSB ScholarWorks, 2015. https://scholarworks.lib.csusb.edu/etd/177.

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The purpose of this project was to learn about Hispanics’ utilization of hospice care and to increase knowledge about under-utilization of hospice services by the Hispanic community. Research in hospice services indicates that the Hispanic community underutilizes end-of-life resources when compared to their majority counterparts, European Americans. Research that has controlled for variables such as socio-demographic characteristics, medical history, prognosis, and access to health care demonstrate Hispanics significantly under-utilizing hospice services. This project was conducted within Southern California in the cities of Riverside and Anaheim which are predominantly Hispanic communities. A quantitative design was used to explore the perspectives of Hispanic individuals and their views on hospice care services. Data was collected through questionnaires. Results indicated correlations between language preferences and gender as possibly having an impact on knowledge and cultural acceptance of hospice care services.
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Phinazee, Teresa Y. "BELIEFS ABOUT HOSPICE CARE AMONG HELPING PROFESSIONALS." CSUSB ScholarWorks, 2015. https://scholarworks.lib.csusb.edu/etd/214.

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ABSTRACT Centered on interviews with 13 hospice care professionals from two large hospice organizations in Southern California, this thesis project examines the challenges that arise in hospice work. Hospice’s delivery of end-of-life care is becoming even more significant as the population lives longer. According to the National Institute on Aging (2014), the face of aging in the United States is changing dramatically. This examination discloses some of the challenges that hospice workers face in a continuously changing health care system, while trying to provide extraordinary service to the terminally ill. Hospice regards dying as a conventional progression, and neither hastens nor defers death. Hospice health care professions are essential in providing care. This thesis uses a qualitative method and examined beliefs about hospice care among hospice professionals using compassion fatigue also known as burnout, job satisfaction and religion and spirituality as a foundation. The findings of this thesis found that compassion fatigue is a real phenomenon and has been experienced by nine or 69% of participants, and of the 69%, six or 67% that experienced compassion fatigue are paid employees who work a forty hour work week. The remaining three participants or 33% who have experienced compassion fatigue are volunteers who commit to volunteering more than two days a week. Frequent contact with individuals who are terminally ill increases the likelihood of compassion fatigue. The iv findings also indicate that 100% of participants experienced job satisfaction while working in patient care, despite the length of time working in the field of hospice. Job satisfaction is contributed to the belief that participants have regarding hospice care, and that belief is the work they do in hospice is a "calling" and they all consider working with the terminally ill as a privilege. Lastly, the findings indicate that religion and spirituality play a major role in how participants deal with the ongoing death of patients. Ninety two percent or 12 out of the 13 participants claim a belief in a higher power, and they use this belief to cope with the suffering and death of patients. They also use religion and spirituality as a way to decrease stress and to have a piece of mind that when a patient dies they are in a much better place and relieved of their suffering. Taken as a whole, this study concentrated on hospice professionals and the correlation of compassion fatigue, job satisfaction and religion and spiritually which can have a pronounced impact on the overall quality of service delivery. The purpose of this study was to bring mindfulness to the hospice social professional. What has been provided in this study is empirical support for advanced research in the field of hospice care. Additional research is necessary in order to understand more about the beliefs of hospice care among helping professionals and the motivations they use in order to deliver optimal service to the terminally ill.
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14

Cisneros, Francisco. "Terminally ill and hospice residential settings." Theological Research Exchange Network (TREN), 1996. http://www.tren.com.

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15

Behr, Macrina. "Hospice care in the United Kingdom and in the United States of America." Theological Research Exchange Network (TREN), 1990. http://www.tren.com.

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16

何敏泉 and Man-chuen Anthony Ho. "A hospice in Sandy Bay." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1995. http://hub.hku.hk/bib/B31982414.

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17

Goodwyn, Robin H. "A study of the relationship between the misconceptions of hospice care and the influence on the utilization of hospice care services." DigitalCommons@Robert W. Woodruff Library, Atlanta University Center, 2009. http://digitalcommons.auctr.edu/dissertations/99.

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This study examines the misconception issues that influence the underutilization of hospice services by African Americans. This descriptive study was based on the premise that there is no relationship between African Americans’ knowledge of hospice and their decision to utilize hospice. The results revealed that African Americans who completed the survey indicated they understand what hospice is; however the answers provided in the survey were not congruent. The conclusions drawn from the findings suggest that African Americans have misconceptions about hospice, and not a true understanding of what hospice is or how to use the service.
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18

Day, Michele Oliver Debra. "Team communication and collaboration in hospice pain management." Diss., Columbia, Mo. : University of Missouri--Columbia, 2008. http://hdl.handle.net/10355/6632.

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Title from PDF of title page (University of Missouri--Columbia, viewed on Feb 25, 2010). The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Dissertation advisor: Dr. Debra Oliver. Vita. Includes bibliographical references.
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19

Wilson, Monika Anne. "Accompanying them home : the ethics of hospice palliative care." Queensland University of Technology, 2009. http://eprints.qut.edu.au/20536/.

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This inquiry, which employed a narrative research approach, critically explored the ethical dimension of hospice palliative care. Hospice palliative care is the profession specifically developed to care for the dying. The development of this practice has grown significantly since the 1980s in Australia, yet ethical inquiry into this professional practice has largely focused on particular issues, problems or dilemmas, such as euthanasia. Although particular ethical issues are important considerations, a broader investigation of the ethics of hospice palliative care practice has not been given sufficient consideration in the growing accumulation of the research literature in Australia. Jennings (1997) surmises that “systematic reflection on ethics in the hospice field is curiously underdeveloped” (p. 2). This study goes someway towards filling this gap. In building upon the Pallium research by European scholars and integrating a social practice framework (Isaacs, 1998) this inquiry provides an alternative account of the ethical agenda and one which has privileged an internal exploration, rather than assume that the ethics would be the same as any other health care modality or to simply adopt a dominant, principles-based approach. These internal explorations were located in the storied accounts of thirty interdisciplinary hospice palliative care professionals. This thesis provides a thorough, textual conversation into the realm of ethical caregiving at the end of life. Several key insights were illuminated. Firstly, total care must be central to the philosophy underpinning hospice palliative care practice, but this concept and practice of total care was being eroded and contested. Secondly, a predominantly modernist account of personhood was located in the narrative accounts. This modernist account of personhood was thought to be insufficient for the practice of total care and needed to be reconceptualised. An embedded ontological account was provided which would assist with the understanding and practice of total care. Thirdly, initially it was thought that there was no common, shared understanding of the purpose of the practice. It was suggested that the profession was “wandering in the wilderness” when it came to the aim of its practice. However, the professionals did share a common telos (aim towards a good) and it was overwhelmingly relational. This led to the proposal of a new telos for hospice palliative care practice centered on the creation and maintenance of unique relationships which would assist people in their final stage of life. Lastly, the ethical frameworks which guided practice for the professionals were presented. In these frameworks it was significant values (acceptance of human mortality, total care and honest and open communication) and relationships (how we treat each other) which played the main role in what constituted hospice palliative care ethics. An account of a hospice palliative care ethical relationship was provided which included a proximity stance of in-between. Overall, any ethic for hospice palliative care must have at the heart the relationship between professional caregiver and living-dying person. The relationships in this social practice, between each other, accompanying one another, are our ethical compass. This thesis concluded that hospice palliative care, as a social practice, has a rich ethical dimension as understood and articulated by its professional members. These insights have resulted in the construction of a new ethical framework reflecting, formalising and adapting the ethical dimension as understood by its professional members. This ethical framework - A Relational Ethic of Accompanying - is needed to help maintain, sustain and protect the unique identity of this profession. This framework adds to the “moral vocabulary” (Jennings, 1997) and “moral specificity” (ten Have & Clark, 2002) of hospice palliative care practice. In addition, it would provide important guidance to palliateurs reflecting on how best to provide quality, compassionate and ethical care at the end of life.
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Battle, Rachael Florita. "Family Caregivers' Perspectives on Establishing Hospice Care in Belize." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/6970.

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End-of-life (EOL) care decisions present a challenge for family caregivers. Despite the increasing number of terminally ill patients in need of pain management and comfort care, there is limited qualitative data about how populations in the developing world can access culturally appropriate resources and EOL support. In this phenomenological study, 17 Garifuna family caregivers in southern Belize were interviewed about their experience caring for terminally family members. The conceptual frameworks were Kübler-Ross’s hospice approach and Watson’s theory of human caring. The two theories were selected based on their significance to this process: Kübler Ross’s hospice approach and its impact on the family system during the end stage of life and Watson’s theory of human caring for its emphasis on the impact of the importance of meeting the basic needs of individuals. NVivo 12 was used to code and generate themes for further analysis. Caregivers who said they would not utilize support outside of the home were those who were committed not do so at the request of the patient. Caregivers who cared for their family member and those who could financially afford to hire caregivers in their home to assist with their relative said they would not utilize nonfamily support. All others, regardless of relationship to the patient, indicated they would have accepted care if the environment were safe, caring, and culturally sensitive. Additionally, the caregivers saw their needs as secondary and insignificant compared to the comfort and care of the patient. This study may contribute to positive social change by revealing strategies and services that could be included in the design of a health services delivery system to meet the needs of individuals facing EOL decisions.
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Jaskiewicz, John Gerald Jr. "Dignity In Palliative Care: The Hospice at Skogafoss Falls." Thesis, Virginia Tech, 2011. http://hdl.handle.net/10919/33165.

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Hospice is a place of caring, a place where life is measured in quality, not quantity. During a terminally ill patientâ s final weeks, days or hours, it is important that hospice facilities provide comfort through any and every means possible. The physician administers pain relief, the building has the ability to administer a kind of relief the patient may not even cognitively perceive. Through the eyes of a terminally ill patient, the architect should consider the views, connections and relationships the patient has with their surroundings. Keeping the patientsâ experiences at the forefront of all design decisions, the architect can promote a sense of dignity within the patients that seems to be lost in most modern health care facilities. This thesis proposes a 30-bed hospice to be built along the Skógafoss falls in Skógar, Iceland. The hospice design addresses the patientsâ connections to the physician, structure and natural surroundings through articulation of spaces based on these relationships. The placement of every element within the hospice, from the patientsâ bed to the physiciansâ offices, can have a drastic effect on the patientsâ experiences in many ways. Exploring layouts and forms not common in traditional health care design, the hospice at Skógafoss falls provides an experience unique to any hospice in the world. The spatial connections and materiality of the hospice allow the patients to determine their own relationships to the facility and the natural world beyond. Through simplicity and mindfulness, the hospice can be more than a place to die. Rather it is a place for one to spend their final hours with both comfort and dignity.
Master of Architecture
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22

Evans, Alison. "A pilot study into the functioning of families with a member who is a hospice patient to determine whether hospice families require family therapy." Thesis, Rhodes University, 1993. http://hdl.handle.net/10962/d1011767.

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The aim of this pilot study, which was carried out under the auspices of the Grahamstown Hospice, is to evaluate the functioning of families with a terminally ill member, in order to establish whether these families require family therapy. The Family Assessment Device (FAD), based on the McMaster Model of Family Functioning, was used. Data from 20 families was analysed and the extent to which these families constitute a clinical sample is highlighted. In terms of the dimension of General Functioning, 15 families emerged as functioning at a problematic level. Communication emerged as the most dysfunctional of the seven dimensions of the FAD, with 17 families functioning at a problematic level. As a result of these findings it is argued that family therapy should be incorporated into the range of services offered by hospices. Limitations of this study and directions for future research are also discussed.
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Ellis, Susan Eileen. "Barriers Among Primary Care Providers to Utilizing Palliative/Hospice Care for Patients with Non-Cancerous Terminal Illness." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/612875.

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Patients with terminal illness may benefit greatly from hospice and palliative care. Studies of patients with chronic terminal illness revealed that those who did not received palliative or hospice care experienced poor quality medical care characterized by untreated symptoms, unmet spiritual and personal care needs, increased burden for the caregiver, and low patient and family satisfaction (Meier, 2011). According to the World Health Organization (2011), palliative care is offered at the time of diagnosis alongside potentially curative treatment and can be utilized during the trajectory of illness until death. Hospice is a Medicare benefit considered the model for quality, compassionate care during the last 6 months of life and is available to all patients regardless of age, religion, race, or illness (Medicare Hospice, 2011). This study examined why patients with non-cancerous terminal illness were not receiving timely palliative or hospice care by interviewing primary care providers. A systemic literature review suggested possible barriers including confusion between palliative and hospice care, lack of understanding about the scope and intent of hospice care (McAteer & Wellberry, 2013), prognostic uncertainty, timing, and no clear point to originate a referral (LeMond & Allen, 2011). Insufficient training for primary care providers, including the lack of familiarity with various prognostic tools that aid in determining eligibility for the patient with a non-cancerous, terminal diagnosis might also be a barrier to referral (McAteer & Wellberry, 2013). Lastly, primary care providers lacked confidence in communicating the need for advanced care planning in non-cancerous terminal illnesses according to a survey done by Karlekar, Collier, Paish, Olson, & Elsay (2014). The findings of this study confirmed the available literature. Much work is needed to educate providers and incorporate palliative care and hospice guidelines in academic institutions and in practice. Regulatory issues need continuous attention as the landscape of coverage, payment, and reimbursement changes rapidly. Further research is needed so that this vulnerable population will benefit from early interventions and a better understanding and acceptance of their non-cancerous terminal illness.
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Mak, Kiu-yan Wayne, and 麥喬恩. "Towards nirvanna: a Buddhist hospice." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B31983546.

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25

Kaufman, Isabel Esther. "Assessing Spirituality Among Hospice Patients: A Phenomenological Study of Hospice Nurses." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1518.

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The shift in health care and nursing philosophy and practice from a holistic approach to a highly technological, cure-oriented approach has been attributed to effective pharmaceuticals made to prolong life. Recently medical professionals have shifted their focus to a combination of spiritual healing and medicine. Hospice care in particular have taken a key interest in integrating spirituality within their health care. The problem is that due to the complications in defining spirituality and appropriate training and education of spirituality within nursing curriculum, assessing patients' spiritual distress may be difficult for many hospice nurses which may be at a loss when attempting to integrate spirituality within their practice. This study used a phenomenological approach to explore the infusion of spirituality in nursing practice and the hospice nurses perceptions of assessing spiritual distress needs of terminally ill patients. Frankl's existential theory and Kubler- Ross's stages of grief theory framed the study. Participants included 8 hospice nurses working in a Pacific Northwestern state. Face-to-face interviews were conducted to explore the essence of the experience of integrating spirituality as well as their views and concerns regarding assessment instruments used to assess spiritual distress. Data was analyzed for content themes. The study found that spiritual courses were merged into hospice nursing as a teaching unity making it difficult for hospice nurses in a Pacific Northwestern State to fully grasp the concept of spirituality. Further findings suggested that only a handful of schools had spiritual nursing as an independent course. The study may impact social change by informing the advancement of hospice nurses and hospice administrators in the practice of including spirituality within healthcare and integrating extensive existential support training within nurses' curriculum.
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McDonald, Ray. "End of Life Care: African Americans' Disproportionate Use of Hospice." Thesis, University of North Texas, 2010. https://digital.library.unt.edu/ark:/67531/metadc33185/.

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The United States of America is a country composed of various ethnicities. This country is considered to be a multi-cultural society. There are various cultural traditions values, norms and superstitious practices within each ethnic group. Attitudes toward end of life care are complex and vary differently across each ethnic group. This study explored factors that explained African Americans' disproportionate use of hospice. Access to hospice care was address, experience with hospice was explored, and recommendations were provided. This study conducted non-experimental research. The design of this exploratory study was quantitative in nature. A survey approach was utilized to collect data that was statistically analyzed. The important concept was African American disproportionate use of hospice. The variable willingness to use was employed to try to explain African Americans' disproportionate use of hospice. The independent variables African Americans who mistrust formal healthcare providers and knowledge about hospice services were operationalized using multiple indicators. The independent variable experience with hospice services did not use a scale. The research findings supported all three study hypotheses. This research results recommend that an important focus of the future be to counsel persons on the availability of hospice as an option for end-of-life care. Well-structured programs of training in cultural awareness and cultural competence throughout the ranks of the health care system must be instituted. Such an effort will pay dividends in reducing cultural mistrust and push closer to eliminating health disparities between minority groups and the rest of society.
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Wright, David. "Delirium and the Good Death: An Ethnography of Hospice Care." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23606.

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Delirium is a disturbance of consciousness and cognition that affects many terminally ill patients before death. It can manifest as confusion, hallucinations, and restlessness, all of which are known to be distressing to patients, families, and professional caregivers. Underlying the contemporary palliative care movement is a belief in the idea that a good death is possible; that dying can be made better for patients and families through the proper palliation of distressing symptoms and through proper attention to psychological, social, and spiritual issues that affect wellbeing at the end of life. Given that delirium is potentially disruptive to all that the good death assumes, i.e., mental awareness, patient-family communication, peace and comfort, the question was asked: What is the relationship between end-of-life delirium and the good death in hospice care? Ethnographic fieldwork was conducted at a freestanding residential hospice over a period of 15 months in a suburban community in eastern Canada. The research methods included participant observation (320 hours over 80 field visits), interviews with 28 hospice caregivers, and document analysis. The findings of this study provide an in-depth examination of the nature of caregiving relationships with patients and with families in end-of-life care. They illustrate how a commitment toward providing for the good death prevails within the cultural community of hospice, and how the conceptualization, assessment, and management of end-of-life delirium are organized within such a commitment. In this setting, experiences of conscious and cognitive change in dying are woven by hospice caregivers into a coherent system of meaning that is accommodated into prevailing scripts of what it means to die well. At the same time, delirium itself provides a facilitative context whereby processes of supporting families through the patient’s death are enabled. This study highlights the relevance of considering the contextual and cultural features of individual end-of-life care settings that wish to examine, and perhaps improve, the ways in which care of delirious patients and their families is provided.
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Wagner, Joan. "Hospice affirming life, a sanctuary for palliative care and bereavement." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ47657.pdf.

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29

Moore, Andrew. "Space, place and home : lived experiences of hospice day care." Thesis, University of Central Lancashire, 2010. http://clok.uclan.ac.uk/2476/.

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Up to a third of cancer patients have been shown to use some form of complementary or alternative medicine (CAM), with hospices being the largest provider of this care in the UK. The high demand for CAM among UK cancer patients and increasing political pressure to develop CAM services has led to a more integrative approach to cancer care, though progress is hindered by a narrow focus on medical determinants of efficacy. Subsequently, calls for a wider research perspective have been made in order to encourage a more complex and multi-dimensional analysis of this provision. The importance of setting and in particular, ‘place’, is recognised by the field of health geography, and it is suggested there is a need for a focus on how ‘place’ affects CAM and vice versa. There is little mention of hospice as a place for such research, yet as the largest provider of complementary therapies (CT) to cancer patients in the UK, hospices represent an important area for research. Though some studies have engaged with geographical perspectives and metaphors, there has been no consideration of hospices as places in themselves, which have utilised a humanistic geographical framework. This study explores patient, staff and therapist interpretations of their experiences of a hospice day care unit as a place. It seeks an understanding of how space and place affects, and is affected by the use and provision of complementary therapies within a hospice day care unit. The concept of therapeutic landscapes (TL) was initially proposed as an analytical framework. However, through the analysis of the data it was evident that concepts from humanistic geography combined with a phenomenology of medicine provided a more fitting conceptual framework for a critical examination of the data. A hermeneutic phenomenological approach has been adopted. The sample incorporates day care patients, complementary therapists and healthcare professionals. Photo-elicitation interviews, semi-structured interviews, participant observation and postcard diaries have been used. Twenty-three participants (6 therapists – 6 health care staff and 11 patients) were interviewed using a combination of these data collection methods. I propose three existential modes of being that characterised the patients’ experiences of hospice day care as a place. Drifting - characterised by states of uncertainty and anxiety; Sheltering characterised by homeliness, familiarity, and security; and Venturing, characterised by seeking and exploring new experiences, places and spaces. Through an examination of these modes, it was discovered that patients found ‘home’, both within the self and within the world. This was possible through various facets of the hospice including complementary therapies, which were seen as an integral part of the holistic landscape of care.
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Mullan, D. A. "The influence of social processes upon hospice care : an ethnography." Thesis, Queen's University Belfast, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368479.

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31

Cooley, Laura. "Patient-Centered Care and Mindfulness in Hospice Volunteer Communication Experiences." Bowling Green State University / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=bgsu1334844506.

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32

Munene, Grace N. "An Assessment of a Hospice and Palliative Care Partnership Program." Thesis, University of North Texas, 2014. https://digital.library.unt.edu/ark:/67531/metadc699969/.

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This project attempts to describe how a hospice and palliative care partnership program works. Through the assessment of one such program, the researcher sought to find out the essential components of the partnership including how the two partner organizations interact and work together. Data was collected using various methods: document review of organization documents such as newsletters, annual or quarterly reports, brochures and other available literature e.g. materials on organizations’ website and on social media; in-depth interviews with stakeholders of both organizations that included staff and board members; observation of staff working; and participant observation during organization events. The findings of the research shows that in order for organizations to have an effective partnership program in place, both partners need to have strong leadership in place, possess a willingness to learn from each other, maintain regular communication, and visit each other regularly. With this in place, several outcomes of the program are likely such as: increasing advocacy for hospice and palliative care, increasing visibility of the organizations both nationally and internationally, and provides an opportunity for organizations to network with other organizations in their locality in order to achieve partnership objectives. The study further reveals that global collaborations in the field of hospice and palliative care began with the advent of the international hospice movement. The assessment of this hospice partnership demonstrates how organizations can establish working relationships and the results likely to come out of such an initiative.
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Dawson, Patricia Shelagh Jean. "An exploration of bereavement intervention in palliative/hospice care programming." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/28712.

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Bereavement intervention is subsumed within palliative programme philosophy which encompasses the family as the unit of care and provides a continuum of care that extends beyond the death of a family member. There is no available research on the effect of post-bereavement intervention within palliative programming, and very limited research exists that evaluates the effect of intervention on bereavement outcome. This exploratory study endeavors to differentiate bereavement outcome between two populations having palliative/hospice program support but only one choosing to participate in bereavement follow-up. A mixed strategy of quantitative and grounded theory approaches provided an expanded analysis through which meaning structures and time/process parameters for grieving individuals were explored. The study extended from idiosyncratic data into the realm of larger systemic interactions. An important finding was that the amount of time for preparation for the death of a family member is crucial. Other mitigating factors influencing the grief outcome were social support, network viability, and age.
Arts, Faculty of
Social Work, School of
Graduate
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34

Garcia, Maria J. "Systematic Review of the Literature on Why There is Hospice Underutilization." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5009.

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Despite hospice and palliative care services being available for patients at the end-of-life, it remains an easily accessible health care service which has been mostly underutilized and/or misunderstood. For this project, the practice problem was underutilization of hospice and palliative care services. A systematic review of the literature which focused on under usage of end-of-life care was conducted. MEDLINE, CINAHL, and ProQuest Nursing and Allied Source databases were searched (2005 to 2017). Studies that evaluated interventions for increasing hospice and palliative care services were selected. Conceptual variables included studies that addressed the under usage of end-of-life care. Kolcoba's comfort theory, Parse's theory of human becoming and Chochinov's dignity model was included to identify the issue, gather the data, and help transfer researched data into practice. The tools applied for analysis and synthesis were the appraisal of guidelines research and evaluation and the grading of recommendations, assessment, development and evaluation. The under usage of hospice and palliative care according to this systematic review, has resulted in (a)suffering negative effects on patients at the end of life, who do not receive adequate palliative or comfort care, (b) additional distress for families dealing with grief and denial, and (c) may result in unneeded acute care, adding significantly to the cost of care. This doctoral project formed a cogent set of recommendations consisting of, communication guidance and community education for a local hospice agency and the community. The contribution of positive social change in this community was through education and knowledge to bridge the gap into practice and improve end-of-life care in the community.
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Miller, Amie Jacqueline. "Hospice Nurses- Attitudes and Knowledge about Pain Management." Scholar Commons, 2012. http://scholarcommons.usf.edu/etd/4165.

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It has been well established that many people will suffer with pain at the end of life, and untreated pain contributes to reduced quality of life. Many barriers contribute to this issue including a lack of knowledge in nurses who care for dying patients. Many nurses in general practice settings do not possess adequate knowledge about basic pain management principles; and the same may be true about hospice nurses despite the assumption that hospice nurses are more adept at pain management. Contributing to this problem may be the attitudes that nurses, including hospice nurses, have regarding pain and its management. This study sought to identify the knowledge levels of hospice nurses. Because attitudes may affect the delivery of effective pain management, the study also sought to determine attitudes of hospice nurses regarding pain and its management. Thirty-five hospice nurses completed two instruments: The Pain Management Principles Assessment Test measured levels of knowledge and the Nurses Pain Management Attitude Survey determined attitudes. Data was analyzed using means, standard deviations, frequencies and percentages. A correlation between knowledge level and attitude was also calculated, along with a correlation between knowledge level and certification status. The overall mean knowledge score for the nurses studied was 21.74 (72.3%), which falls below accepted standards. The mean attitude score found was 82.34, which demonstrates only slightly positive attitudes. These findings support the idea that knowledge and attitude are not synonymous and that a nurse may have a positive attitude about the management of pain, without sufficient knowledge to effectively alleviate pain. It is often said that hospice nursing is a calling, and these are the nurses who are at the forefront of pain management. This study demonstrates that slightly more positive attitudes may indicate that this group of nurses is motivated to gain a better knowledge base. This should motivate hospices and other education institutions to incorporate more specific instruction regarding pain management into their curricula. Despite some common misconceptions pain does not have to be an unavoidable part of life, and with a better knowledge base hospice nurses could more effectively deliver compassionate, expert care.
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Jenkins, Todd M. "Hospice use in Alabama a cross-sectional assessment /." Thesis, Birmingham, Ala. : University of Alabama at Birmingham, 2008. https://www.mhsl.uab.edu/dt/2009r/jenkins.pdf.

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Nilsson, Stina, and Sofie Wirén. "Copingstrategier hos vårdpersonal på Hospice." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-192600.

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Syfte: Syftet med studien var att ta del av hur vårdpersonal på Hospice beskriver sina olika känslor som uppstår i vården av patienter i livets slutskede, vilka copingstrategier de använder sig av för att bearbeta dessa känslor samt vilka faktorer som de upplever påverkar valet av copingstrategier. Metod: En kvalitativ metod med semistrukturerade intervjuer användes. Åtta kvinnliga deltagare ur vårdpersonalen på Hospice (lika fördelade mellan sjuksköterskor och undersköterskor med varierande ålder och erfarenhet) blev intervjuade. Resultat: Känslor av skuld, frustration, maktlöshet, stress och otillräcklighet upplevdes betungande. För att bearbeta dessa användes främst aktiv och problemfokuserad coping, framförallt samtal och stöd. Vårdpersonalen lägger stor vikt vid att kunna separera privatlivet från arbetslivet. Även känslofokuserad coping i form av distraktion eller avskärmning användes ibland. Detta för att uthärda i stunden och vid senare tillfälle bearbeta dessa upplevelser. Faktorer som påverkade bearbetningen var samarbetet i arbetsgruppen, tidsbrist, samt individuella egenskaper. Slutsats: Klimatet på arbetsplatsen, det vill säga organisation, attityder samt tid för gemensam reflektion är viktigt för bearbetningen. Det är också viktigt att blivande vårdpersonal får kunskap om palliativ vård och olika copingstrategier för att hantera sina känslor. Vårdutbildningar behöver ses över inom detta område. Hur coping används påverkar personalhälsan och även i förlängningen patientvården. Kunskap om copingstrategier måste finnas även på avdelningar där inte specifik palliativ vård bedrivs.
Objective: The aim of this study was to learn how the healthcare personnel at Hospice describes their emotions during work with patients in palliative care, which coping strategies they use to deal with these emotions as well as factors they experience affects the choice of strategies. Methods: A qualitative approach with semi-structured interviews was used to collect data. Eight female participants with varying age and work experience from the Hospice nursing staff were interviewed. Results: Feelings of guilt, frustration, powerlessness, stress and inadequacy were perceived as difficult. To cope with these emotions active and problem-focused coping was used mainly for ventilation and social support seeking. They find it important to separate their private life from work. Emotion-focused coping was used at times for distraction or to distance themselves, to endure in the moment and later on process these emotions. Factors affecting the coping strategies were cooperation in the work group, time constraints and individual qualities. Conclusion: The workplace climate regarding organization, attitudes and times for group reflection, is significant for coping. It is important that aspiring health professionals learn about palliative care and coping strategies to manage their emotions. Nursing programs need to be reviewed in this area. How coping is used affect health among the staff and ultimately also the patient care. Knowledge of coping strategies is important in all areas of healthcare.
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Wong, Lai-cheung. "A study of hospice care : [factors affecting] communication between the health care professionals and the patients /." [Hong Kong : University of Hong Kong], 1992. http://sunzi.lib.hku.hk/hkuto/record.jsp?B13409475.

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39

Higginson, Irene Julie. "The development, validity, reliability and practicality of a new measure of palliative care : the Support Team Assessment Schedule." Thesis, University College London (University of London), 1992. http://discovery.ucl.ac.uk/1317889/.

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Hospices and support teams offering palliative care have increased by over four fold in the U.K. during the last decade. However, evaluations have been limited, often because of a lack of suitable outcome measures. This study aimed to develop and test the validity and reliability of a measure of palliative care provided by support teams. Through detailed discussion of work objectives with care staff, assisted by review of the literature, the Support Team Assessment Schedule (STAS) was developed. STAS has 17 items, each scaled 0 (best) to 4 (worst), with definitions for each scale point. Median time to complete a STAS rating was 2 minutes (range <1- 15). Face validity was demonstrated by use in five settings. Criterion validity was assessed by comparing team ratings with ratings from patients and family members (or other carers) collected through interview. Patient and team ratings showed moderate correlations (rho ranging 0.45 - 0.66 for 5 out of 7 items): team ratings were usually closer to those of patients than those of family members. As a test of construct validity, quality of life (HCRA-QL) index items were shown to correlate with similar STAS items in patients more than four weeks before death (a STAS sub-scale of six items was correlated with the total HRCA-QL, Spearman rho -0.45). Reliability of STAS was assessed by comparing the ratings of different staff. Out of a total of 45 patient assessments, 16 items showed agreement or ratings within one score in 88% or more cases, Cohen's Kappas were greater than 0.48 (up to 0.87) and were highly significant (p < 0.0005). There were high correlation coefficients (Spearman's rho ranged 0.65 - 0.94). Split-half reliability and internal consistency was assessed using Spearman Brown coefficients and Cronbach's alpha for ratings at referral, at death or discharge, and on all weeks (combined). The coefficients ranged 0.68 - 0.89: slightly higher than the coefficients found for the HRCA-QL index. Serial scores of patients that improved (the majority) and deteriorated (a minority) under care, and results from first and last assessments of patients under the care of five support teams, indicate that the STAS was discriminating in practice. Although STAS was used to audit support team care the items are relevant to the assessment and evaluation of palliative care in other settings.
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40

Wong, Lai-cheung, and 黃麗彰. "A study of hospice care: [factors affecting] communication between the health care professionals and thepatients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1992. http://hub.hku.hk/bib/B31977182.

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41

Cain, Cindy L. "Heart Work: Challenges and Adaptations of Hospice Workers." Diss., The University of Arizona, 2013. http://hdl.handle.net/10150/293534.

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This dissertation analyzes the everyday work experiences of hospice, a type of end-of-life care. The following chapters integrate micro-sociological perspectives with meso- and macro- level explanations of organizational behavior to account for workers' performances of emotional labor, care-related identities, constraints on their daily work, and ultimately hospice workers' strong commitment to their jobs and the hospice philosophy. Using a mixed methodological approach, I argue that hospice workers engage in emotional labor, but that instead of feeling dissonance or alienation, hospice workers develop a positive identity around their work. Their identities and work experiences are still constrained by institutional forces, however. Hospice workers' experiences highlight two tensions in the administration of caring labor: keeping commitment during times of organizational change and balancing the needs of the self with the needs of the care recipient. The main contributions of this work include new understandings of the relationships between identity, emotions, and work; a novel combination of theories that better explain care workers' behaviors and constraints on their action; and, a refined approach to thinking about emotional labor.
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Jumah, Anne Mukeli. "The nature and extent of palliative care in the Nairobi Hospice." Diss., Pretoria : [s.n.], 2008. http://upetd.up.ac.za/thesis/available/etd-11202008-163831.

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43

Bergquist, Adam. "Evaluation of the pathways palliative care program at the Denver hospice." [Denver, Colo.] : Regis University, 2008. http://165.236.235.140/lib/ABergquist2008.pdf.

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44

Ahern, Gail Renee. "A Narrative Inquiry: Case Leaders' Perspectives on Resilience in Hospice Care." Antioch University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=antioch1432544718.

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45

McHenry, Kristen L. "Professional and Ethical Standards in Respiratory Care." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/2538.

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46

Dobies, Pamela A. Roffol Herman Robert D. "Organizational design issues of establishing palliative care services in an acute care hospital." Diss., UMK access, 2005.

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Thesis (Ph. D.)--Henry W. Bloch School of Business and Public Administration and Dept. of Sociology. University of Missouri--Kansas City, 2005.
"A dissertation in public affairs and administration and sociology." Advisor: Robert D. Herman. Typescript. Vita. Title from "catalog record" of the print edition Description based on contents viewed June 23, 2006. Includes bibliographical references (leaves 194-204 ). Online version of the print edition.
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47

Beck, Ellen Dennison. "The revitalization of hospice nurses : implications for the structure of renewing experiences /." The Ohio State University, 1986. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487265555440175.

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48

Schaeffer, Sharon F. "The impact of music listening on hospice patients' acceptance of a good death| A qualitative study of hospice caregivers' perceptions." Thesis, Capella University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3559908.

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The current study served to provide new knowledge that may benefit future researchers, policy makers, health care leaders, and health care professionals who aspire to improve the delivery status for quality end of life care. A missing link in the hospice care continuum was identified as the need for the use of music listening by patients and caregivers as a low cost viable non-invasive alternative intervention that can be effectively utilized in real life situations. The researcher chose the current study's generic qualitative design to enhance understanding of how informal hospice patients' caregivers perceived music listening as a means for the patients to accept the state of a good death. Generic qualitative research design offered the researcher with an opportunity to hear and inductively analyze the hospice patients' vulnerable voices per their caregivers. Data was collected during a semi-structured face-to-face interview process and was reflective of the perceptions of hospice caregivers (N = 4). The researcher incorporated an axial coding process with the use of NVivo 9 software to analyze the data. A priori coding method incorporated the use of four predetermined themes: three domains for the concept of a good death and one for music and a good death. Overall, the findings indicated that music listening had a positive effect on the hospice patients, according to their caregivers' perceptions. The study limitations reflected the use of a small sample size from one Southwestern city that consisted of four female caregivers and the study results were dependent upon the perceptions of these caregivers. Consequently, due to the study's limitations, health care researchers and health care administrators should cautiously generalize the study's findings and decide for themselves if the study benefits outweigh its limitations. Further studies are indicated to enhance and supplement the knowledge presented in this study. One suggestion to further research is to broaden the scope of recruitment to include younger hospice patients, including children, who receive care either in their own home or in a medical facility. Another suggestion to further research would be to compare the effects of different types of music preferred by hospice patients.

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Grantham, Darlene. "Preparedness of Manitoba palliative care nurses to practice using Canadian hospice palliative care nursing standards." 2004. http://hdl.handle.net/1993/22950.

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Adámková, Naděžda. "Domácí hospicová péče - možnost využití australských standardů při příjmu pacienta." Master's thesis, 2018. http://www.nusl.cz/ntk/nusl-383907.

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Home hospice care - applicability of Australian Standards on patient admission This master thesis inspects topic of home hospice care in the context of the Czech Republic. It aims to provide the reader with consistent overview regarding home hospice and palliative care as dealt with by particular organization, understanding of the topic in a broader context, and further information about the system and practical information. The thesis consists of a theoretical and practical section. The former introduces the general topic, mapping its history from initial thoughts up until the current day home and residential hospices while defining numerous terms applied in the latter. The empirical section then focuses on examining the process of admission of terminally ill patients into home hospice care. Firstly, the approach taken by concerned organization is examined, selecting appropriate Australian Standards for implementation. A three-month implementation period follows, which is reflected on through interviews with team members. The conclusion offers suggestions for improvements in the ways of working and hence the provided care on the whole, applicable across all home hospice teams. The text is targeted at an adult reader. Keywords: Home hospice. Palliative care. Patient admission. Standards. Australian...
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