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1
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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Damm, Kathryn. "Social support and mental health for terminally ill patients and their caregivers." Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2008. http://wwwlib.umi.com/cr/ucsd/fullcit?p3307164.
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Thesis (Ph. D.)--University of California, San Diego, 2008.<br>Title from first page of PDF file (viewed July 9, 2008). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 86-103).
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Dunbar, Pervell Velethia. "Nursing Care of Terminal patients in Intensive Care Units." ScholarWorks, 2015. https://scholarworks.waldenu.edu/dissertations/1379.
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Nursing Care for Terminal Patients in Intensive Care Units
by
Pervell Dunbar
Project Submitted in Partial Fulfillment
of the Requirements for the Degree of
Doctor of Nursing Practice
Walden University
August 2015
Although the goal of the ICU has always been to save lives, ICU now additionally provides end-of life (EOL) care. The objective of this project was to provide ICU nurses with a comprehensive awareness of physical, emotional, and spiritual EOL care issues of patients and their families in order to be better equipped to handle EOL care. The framework used was Jean Watson's Caring model (10 Caritas). A literature review revealed a poster previously used by a major health organization as a conversation starter to facilitate decision-making among ICU nurses, EOL patients, and their families related to EOL issues. The purpose of this quality improvement initiative was to introduce and implement an educational EOL tool that would engage patients and family members in meaningful and useful conversations with ICU nurses. Twenty seven ICU nurses were selected by the unit's director to attend a PowerPoint presentation on the use of the EOL educational poster. Four ICU nurses were chosen by the director to be champions for this project. After the presentation, there was a period for questions and answers, and the ICU nurses were requested to give feedback on the presentation. The result from the feedback revealed that EOL care is outside previous practice and may require extra education and support. These comments substantiated similar conclusions from other researchers as described in this paper. With an increase in EOL training for ICU nurses and the implementation of EOL teaching tools like the poster used in this study, ICU nurses may be better able to have conversations with EOL patients and families, thus improving patient care.
4
Webb, Nicole Marie. "Factors affecting young adults' opinions about hospice and home death." Birmingham, Ala. : University of Alabama at Birmingham, 2009. https://www.mhsl.uab.edu/dt/2009p/webb.pdf.
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Thesis (Ph. D.)--University of Alabama at Birmingham, 2009.<br>Title from PDF title page (viewed Sept. 2, 2009). Additional advisors: Virginia G. (Wadley) Bradley, Elizabeth A. Kvale, Kathryn L. Burgio, Edwin W. Cook III. Includes bibliographical references.
5
Li, Sarah. "Symbiotic niceness : a study of psychosocial care in palliative care settings." Thesis, Goldsmiths College (University of London), 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.275638.
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Chemane, Bonginkosi Reginald. "Integrating spirituality and psychotherapy : experiences of a sample of terminally ill patients." Thesis, Rhodes University, 2013. http://hdl.handle.net/10962/d1008217.
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The general aim of this study was to determine the experiences of a sample of terminally ill patients in using spiritually focused psychotherapy. This was a qualitative study conducted to a sample of 2 terminally ill patients from hospice in Grahamstown, South Africa. The research was conducted in 3 phases: an initial in-depth interview conducted to determine the participants' level of spirituality as well as the extent to which their terminal illnesses had affected their functioning. This was followed by a minimum of 6 spiritually focused therapy (SFT) sessions as a second phase of the research. To determine the participants' experiences of SFT, 2-3 in-depth interviews were conducted during the 3m phase of the research study. The research revealed that a belief in a higher power helps terminally ill patients cope better with their illness and that social disconnectedness is related to HIV / AIDS stigma. It also revealed that terminal illness is co-morbid with other psychiatric symptoms such as depression, evokes existential concerns, results in a change in the level of spirituality and affects the whole family. Participants blamed themselves for their illness, but found that engaging in the process of forgiveness of self and others brought about psychological healing for them. They experienced SFT as a coping resource that assisted them to deal with the fear of death as well as increased insight into the development of psychopathology and spiritual blockages. It is recommended that a comprehensive and holistic assessment during intake be undertaken so that where spiritual needs are available, therapy can be spiritually augmented to ensure that such needs/ struggles are addressed.<br>KMBT_363<br>Adobe Acrobat 9.54 Paper Capture Plug-in
7
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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Chapman, Ysanne B. "The lived experience of nursing dying or dead people /." View thesis, 1994. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030617.120150/index.html.
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Walker, Helen M. "The experience of care assistants who care for residents in the final stage of life in residential aged care facilities." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2007. https://ro.ecu.edu.au/theses/278.
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This thesis presents the results of a study that explores the experience of care assistants who care for residents in the final stages of life in residential aged care facilities in metropolitan Perth. Care assistants, with little formal training and no regulation, play a pivotal role in the direct care of dying residents in these facilities. Yet little was known about the palliative care role and the impact that caring for residents in the final stage of life has on this health care group. The literature relating to end of life care in residential aged care facilities revealed limited research in this area. In particular, there is a lack of studies that relate specifically to the care assistants' role and their experiences of end of life care. Research to date has focused on the context of palliative care in residential aged care facilities, the workplace environment, how to provide a dignified death, relationships and the central role of the care assistant. This study used a qualitative narrative inquiry research design.
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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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Shirley, Jamie L. "Autonomy at the end of life : a discourse analysis /." Thesis, Connect to this title online; UW restricted, 2005. http://hdl.handle.net/1773/7231.
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Eichhorn, Eva Christina. "Terminal care as life care : a pastoral approach to death and dying." Thesis, Stellenbosch : Stellenbosch University, 2007. http://hdl.handle.net/10019.1/17748.
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Thesis (M. Th.)--University of Stellenbosch, 2007.<br>ENGLISH ABSTRACT: The thesis introduces a spiritual understanding of terminal care as life care
within a pastoral approach to death and dying. The presupposition is that life
and death are unavoidably connected, and that a meaningful approach to death
and dying in terms of a Christian theological hermeneutics needs to start with
the question “What is life?”
The concept of a theological hermeneutics serves as an overall
paradigm, which is implied within the interplay of life and death. The aim of a
hermeneutical approach is to find meaning in living and dying in the
fundamental God-human relationship. The eschatological perspective plays a
significant role, as it emphasises the already and not yet of eschatology that
become evident in every life event.
An analysis of the theoretical paradigms and philosophical
presuppositions behind a widespread “psychology of death and dying” shows
that the phenomenological, client-centred models suffer from an overreliance on
inner human potentials in coping with dying. Although these models provide
valuable insights into the needs of the dying, they fail to equip individuals with a
meaningful paradigm that lasts despite the reality of death.
As a result, I propose a “theology of death and dying” that opts for a
much more holistic approach to terminal care. Based on the impact of a
Christian spiritual concept of life and a pastoral anthropology on a pastoral
approach to terminal care, I argue that we do not have to cope with dying by
ourselves but can trust in the faithfulness of God who will keep us strong to the
end (1 Cor 1:8). As fear of death can effectively only be coped with by caring for
life, pastoral care to the dying needs to emphasise the fundamental God-human
relationship that guarantees life in spite of death. A unique stance of hope
follows from a Christian spiritual understanding of life that overcomes the
paradigmatic gap left by psychological approaches to death and dying, and
makes us aware that the new life in the Spirit is a quality that we already
possess.
Eventually, the life care approach is applied to a pastoral prevention
strategy in the context of the HIV pandemic. I argue the thesis that prevailing HIV prevention programmes suffer from a lack of an overall frame of reference
from which to reflect on the necessity for behavioural change. To fill this gap, a
spiritual life care approach to the HIV pandemic emphasises the development of
a Christian ethos based on an internalised assurance of the purpose and
destiny of human life, which can function as an overall paradigm behind a
prevention strategy. This pastoral prevention strategy is based on the
assumption that positive change, the anticipation of a better future and true
hope derive from an understanding of who we are as human beings before and
in relationship with God.<br>AFRIKAANSE OPSOMMING: Hierdie tesis stel ʼn spirituele begrip van terminale sorg as lewensorg binne ʼn
pastorale benadering tot dood en sterfte bekend. Die voorveronderstelling is dat
lewe en dood onlosmaakbaar verbind is, en dat ʼn betekenisvolle benadering tot
dood en sterfte in terme van ʼn Christelike teologiese hermeneutiek met die
vraag “Wat is lewe?” ’n aanvang moet neem.
Die konsep van teologiese hermeneutiek dien as 'n oorkoepelende
paradigma, wat geïmpliseer word binne die wisselwerking van lewe en dood
met die doelwit om betekenis te vind in lewe en dood in die fundamentele Godmens-
verhouding. ’n Eskatologiese perspektief speel ’n beduidende rol,
aangesien dit die alreeds en die nog nie van eskatologie beklemtoon, wat in
elke lewensgebeurtenis duidelik word.
’n Ontleding van die teoretiese paradigmas en filosofiese
voorveronderstellings rakende die wydverspreide “sielkunde van dood en
sterfte” toon aan dat die fenomenologiese, kliëntgesentreerde modelle gebrek
lei as gevolg van hul heftige aanspraak op die innerlike menslike potensiaal om
sterfte te hanteer. Alhoewel hierdie modelle kosbare insigte ten opsigte van die
behoeftes van die sterwendes bied, faal hulle daarin om individue toe te rus met
’n betekenisvolle paradigma wat volhoubaar is, afgesien van die werklikheid van
die dood.
Ek staan dus ’n “teologie van dood en sterfte” voor wat ’n veel meer
holistiese benadering tot terminale sorg meebring. Gegrond op die impak van ’n
Christelike, spirituele konsep van lewe en ’n pastorale antropologie op ’n
pastorale benadering tot terminale sorg, argumenteer ek dat ons nie nodig het
om die dood op ons eie te hanteer nie omdat ons op die getrouheid van God,
wat ons sterk sal hou tot die einde (1 Kor 1:8), kan vertrou. Aangesien die vrees
vir die dood slegs deur die omgee vir lewe hanteer kan word, is dit noodsaaklik
dat pastorale sorg aan die sterwende die God-mens-verhouding, wat lewe te
midde van dood waarborg, beklemtoon. ’n Unieke gesigspunt van hoop volg
vanuit ’n Christelike, spirituele begrip van lewe, wat die paradigmatiese gaping
wat gelaat word deur psigologiese benaderings tot dood en sterfte vul. Dit maak
ons bewus dat die nuwe lewe in die Gees ’n kwaliteit is wat ons alreeds besit. Die lewensorg-benadering word uiteindelik in ’n pastorale
voorkomingstrategie in die konteks van die MIV-pandemie toegepas. Ek
argumenteer in die tesis dat heersende MIV-voorkomingsprogramme gestrem
word deur ’n tekort aan ’n algehele verwysingsraamwerk, vanwaar oor die
noodsaaklikheid van gedragsverandering nagedink kan word. Om hierdie
gaping te vul, stel ek ’n spirituele lewensorg-benadering voor, wat die
ontwikkeling van ’n Christelike etos beklemtoon, gegrond op ’n inwendige
sekerheid van die doel en bestemming van menslike lewe, wat as ’n algehele
paradigma vir ’n pastorale voorkomingstrategie kan funksioneer. Hierdie
voorkomingstrategie is gegrond op die veronderstelling dat positiewe
verandering, die verwagting van ’n beter toekoms, en ware hoop voortspruit uit
’n begrip van wie ons as mense voor en in verhouding met God is.
13
Law, Chi-ching. "Can integrated palliative care services enhance the quality of end-of-life cancer care?" Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42994949.
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Garchar, Kimberly Kay. "A dying community : a Roycean critique of the medical community at the end of life /." view abstract or download file of text, 2006. http://proquest.umi.com/pqdweb?did=1232405801&sid=3&Fmt=2&clientId=11238&RQT=309&VName=PQD.
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Thesis (Ph. D.)--University of Oregon, 2006.<br>Typescript. Includes vita and abstract. Includes bibliographical references (leaves 175-179). Also available for download via the World Wide Web; free to University of Oregon users.
15
Swenson, Denise Lyn Parker-Oliver Debra. "Designated hospice rooms in nursing homes a new model of end-of-life care /." Diss., Columbia, Mo. : University of Missouri--Columbia, 2009. http://hdl.handle.net/10355/6157.
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Title from PDF of title page (University of Missouri--Columbia, viewed on Feb 16, 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.
16
Kuhl, David R. "Exploring spiritual and psychological issues at the end of life." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape10/PQDD_0015/NQ46369.pdf.
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Norton, Sally Ann. "Reconciling decisions near the end of life a grouded theory study /." Full text available online (restricted access), 1999. http://images.lib.monash.edu.au/ts/theses/Norton.pdf.
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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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Garossino, Candance Jo. "Nurses' attitudes towards the care of the dying." Thesis, University of British Columbia, 1991. http://hdl.handle.net/2429/29709.
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Terminally ill patients and their families describe hospital care as nonsupportive to their needs during the final phase of life. Nurses generally are not comfortable with a supportive role when caring for the dying and tend to adhere to a curative role. The purpose of this descriptive, correlational study therefore was to describe the attitudes of general staff nurses working on medical-surgical units in hospitals towards the care of the dying and to ascertain the relationship between these attitudes and the education and experience of the nurses.
An adaptation of the model for role episode, conflict, and ambiguity by Kahn, Wolfe, Quinn, Snoek and Rosenthal (1964) was the applied theoretical framework. The sample consisted of 197 randomly selected registered nurses employed full or part-time on general adult medical-surgical hospital units in British Columbia. The majority of the sample were married, Protestant females, between the ages of 26 and 45 years who were prepared at the diploma level in nursing. The mean length of time worked as a nurse was 8.5 years with a mean of 7.5 years on medical-surgical units.
Attitudes towards the care of the dying were generally ambiguous, neither negative nor positive as measured by scores obtained on the ‘Questionnaire for Understanding the Dying Person and His Family’. Additionally, half the respondents did not believe that nurses should be the primary health care professionals equipped to deal with the emotional reactions of the dying yet three-quarters of the sample believed that patients turned to
nurses to discuss such emotional issues.
Data revealed that close to two-thirds of the respondents had received structured death and dying content in their basic nursing education yet less
than half furthered their death and dying education since graduation. Overall death education for the sample was low. A small positive correlation (r=-0.26) was found between respondents' death education and their attitudes towards the care of the dying; no significant association was found between respondents' level of general nursing education and their attitudes. Although there was variability in the amount of professional and personal death experience, over half of the respondents experienced between one and three terminally ill patient deaths on their medical-surgical units per month. Additionally, the majority of respondents had experienced the death of an immediate family member. Overall death experience was low to moderate. A small, but significant positive correlation (r=0.24) was found between overall death experience and attitudes' towards the care of the dying; no significant association was found between general experience and attitude.
Findings suggest that supportive nursing care is not being demonstrated with dying patients and their families. However, the influencing natures of death education and death experience on nurses' attitudes are positive, thereby providing the nursing profession with two possible ways of positively influencing nurses' attitudes to the care of the dying.<br>Applied Science, Faculty of<br>Nursing, School of<br>Graduate
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Kandasamy, Sekar Sabarish. "A Point Of Care Terminal For COPD Home Management." Thesis, Mälardalens högskola, Akademin för innovation, design och teknik, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-33329.
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Chronic Obstructive Pulmonary Disease (COPD) is currently one of the most prevalent lung diseases around the world, which runs an insidious course, measured over years, with an often-undiagnosed initial phase. Present clinical treatment approach for COPD results in repeated clinical visits and extended hospital stays burdening the available healthcare infrastructures, economy, and also impacting patient quality of life. To alleviate this burden, modern healthcare approaches focus on developing patient-centric solutions in which the patients should be able to request and receive quality medical assistance at their convenience, if possible from their respective homes. In this thesis work, a medical perspective on the treatment and managing of COPD is first understood in order to enunciate the functional requirements of a developing home healthcare system as an alternative to clinical treatment of COPD. Thereafter, an investigative study is carried out to explore recent developments in ICT technologies and their role in healthcare. Later, suitable sensing platforms and communication standards are identified in order to develop a working prototype of a Point of Care (POC) terminal as a proof-of-concept. The POC comprising of a breathing training device and a care application running on an android based smart device is used to measure and monitor breathing patterns of the patients and motivate them for better results and continuous improvement. An optimization exercise for low power consumption is performed on the breathing training device to facilitate additional mobility and long-term monitoring for the same. Through the observations and evaluations, scope for improvement in future versions of the device is also identified.
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Law, Chi-ching, and 羅志清. "Can integrated palliative care services enhance the quality of end-of-life cancer care?" Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B42994949.
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Grande, Gunn Eli. "Evaluation of the impact of a 'hospice at home' service on place of death." Thesis, Open University, 2000. http://oro.open.ac.uk/58055/.
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Fewer patients are able to die at home than would wish to do so. A literature review showed that palliative home care patients are more likely to die at home than others. However, findings may be due to case mix differences, as variables which are positively associated with home death, are also positively associated with access to palliative home care. The thesis investigated the impact of a hospice at home (HAH) service on place of death. An observational, case control study compared 121 patients referred to HAH with 206 patients not referred. Multivariate logistic regression analysis showed that HAH care was strongly positively associated with home death. However, case mix effects could not be discounted. A randomised controlled trial (RCT) compared 186 patients allocated to HAH care with 43 controls. Analysis was intention to treat. Intervention patients were not significantly more likely to die at home than control patients (67% versus 58%). The RCT suffered loss of power and dilution of the treatment effect. Post hoc multivariate logistic regression analysis showed a positive association between actual HAH input and home death. However, this association was no stronger than that between less intensive home care services and home death. Concerns about case mix effects remained. Content analysis of professional and family carers' explanations of endstage inpatient admissions for RCT patients suggested such admissions were mainly perceived to result from factors unrelated to insufficient home care. While some patients may have benefited from added home support, this may not have affected place of death. Additional home care introduced on top of good existing provision, among patients who are already likely to die at home, may have little impact on home deaths. Careful consideration of service aims, target group, other health service context is required before introduction of further hospice at home services.
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Felix, Zirleide Carlos. "Vivência de enfermeiros no cuidar de pacientes na terminalidade: um enfoque bioético." Universidade Federal da Paraíba, 2014. http://tede.biblioteca.ufpb.br:8080/handle/tede/5158.
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Previous issue date: 2014-02-27<br>Coordenação de Aperfeiçoamento de Pessoal de Nível Superior<br>INTRODUCTION: With technological advances, the field of bioethics emerged as reflection to guide professionals in the health care context , in particular the practice of caring for terminally ill patients. OBJECTIVES: This study aimed to investigate the experiences of nurses in caring for patients in terminally; to analyze the experiences of nurses in caring for terminally ill patients highlighted by the principles of bioethics. METHODS: This was an exploratory study, with qualitative approach, developed in the Intensive Care Unit of the Hospital Lauro Wanderley, Federal University of Paraíba located in the city of João Pessoa (PB). The sample consisted of fifteen clinical nurses from the institution selected for the study. The research project was submitted to the Committee in Ethics Research of the hospital, which received approval certificate, with CAAE registration under paragraph 13289213.1.0000.5183. Data collection occurred from March till July 2013 by applying a formulary containing questions relevant to the proposed objectives. The empirical material was analyzed qualitatively using the technique of content analysis, following phases: pre -analysis, material exploration and using the results, inference and interpretation. RESULTS AND DISCUSSION: From the qualitative analysis emerged the following thematic categories: Category I: the experience of nurses in caring for terminally ill patients: coping and care before death; Category II: The practice of nursing care to patients in the terminally ill: bioethical principles. CONCLUSION: The study shows the commitment of nurses participating in the study regarding the care of terminally ill patients, especially with regard to bioethical principles surrounding this practice. Therefore, due the reduced amount of researches focusing on this topic in the national literature, it is expected that this study will contribute to further investigations under the care of the terminally ill patients .<br>INTRODUÇÃO: Com os avanços tecnológicos, a bioética surge como campo de reflexão para nortear os profissionais da área da saúde no âmbito assistencial, em especial na prática do cuidar de pacientes em fase terminal. OBJETIVOS: Esse estudo teve como fio condutor os seguintes objetivos: Investigar a vivência de enfermeiros no cuidar de pacientes na terminalidade; Analisar a vivência de enfermeiros no cuidar de paciente terminal à luz dos princípios da bioética. METODOLOGIA: Trata-se de um estudo exploratório, de natureza qualitativa, desenvolvido na Unidade de Terapia Intensiva do Hospital Universitário Lauro Wanderley, da Universidade Federal da Paraíba, localizado na cidade de João Pessoa (PB). A amostra foi constituída por quinze enfermeiros assistenciais da instituição selecionada para o estudo. O projeto de pesquisa foi submetido ao Comitê de Ética em Pesquisa do mencionado hospital, do qual recebeu certidão de aprovação, com registro CAAE, sob nº 13289213.1.0000.5183. A coleta de dados ocorreu no período de março a julho de 2013, mediante aplicação de um formulário contendo questões pertinentes aos objetivos propostos. O material empírico foi analisado qualitativamente, por meio da técnica de análise de conteúdo, seguindo as fases: pré-análise, exploração do material e tratamento dos resultados, inferência e interpretação. RESULTADOS E DISCUSSÕES: Da análise qualitativa emergiram as seguintes categorias temáticas: Categoria I: Vivência de enfermeiros no cuidar de pacientes em fase terminal: assistência e enfrentamento diante da morte; Categoria II: A prática do cuidar de enfermagem aos pacientes na terminalidade: princípios bioéticos. CONSIDERAÇÕES FINAIS: O estudo revela o compromisso dos enfermeiros participantes do estudo no que concerne ao cuidar de pacientes em fase terminal, especialmente no que diz respeito aos princípios bioéticos que circundam a referida prática. Ademais, devido ao quântico reduzido de estudos direcionados a essa temática na literatura nacional, espera-se que essa pesquisa possa contribuir para novas investigações no âmbito do cuidar de pacientes na terminalidade.
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Price, Jayne Elizabeth. "Parents' experiences of palliative and terminal care for children (PATCH)." Thesis, Queen's University Belfast, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.534600.
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Costa, Ana Patrícia Pereira da. "Palliative care, terminal illness and the model of human occupation." Master's thesis, Faculdade de Medicina da Universidade do Porto, 2010. http://hdl.handle.net/10216/62326.
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Costa, Ana Patrícia Pereira da. "Palliative care, terminal illness and the model of human occupation." Dissertação, Faculdade de Medicina da Universidade do Porto, 2010. http://hdl.handle.net/10216/62326.
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Leung, Edward. "An examination of biblical and Confucian teachings on end-of-life decisions." Fort Worth, TX : Southwestern Baptist Theological Seminary, 2008. http://dx.doi.org/10.2986/tren.049-0495.
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Cisneros, Francisco. "Terminally ill and hospice residential settings." Theological Research Exchange Network (TREN), 1996. http://www.tren.com.
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Tanner, Carolyn A. "Perception of palliative care practice of health care professionals in a mental institution : a descriptive study." Thesis, University of British Columbia, 1991. http://hdl.handle.net/2429/29703.
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The purpose of this descriptive study is to investigate the perception of practice of health care professionals at a mental institution, as it pertains to their work with dying patients, and also to identify areas of change. The conceptual framework is constructed of six factors important to palliative care that have been identified from the literature. These are personal death anxiety, organizational structure of the hospital system, role expectations of professionals, teamwork, education and training for care of the dying, and conveyance and exchange of diagnostic information. The sample surveyed by a written questionnaire included physicians, psychiatrists, health care workers, social workers and pastoral care workers from the Geriatric Division of Riverview Hospital, Port Coquitlam. The findings indicate that age, sex, marital status and length of working experience at Riverview Hospital had no significant association with personal death anxiety. Informal education such as workshops and in-services had a significant correlation with personal death anxiety, as did perception of being competent and/or confident about working with the dying. The study also raised concerns that not all was being done for the dying patients and their families at this institution. Suggestions such as education and training, support mechanisms, and less stereotyping of professional roles were
offered to improve this situation. As well, findings indicated that there was a need for palliative care service either in the form of a team or separate unit, or simply the practicing of the palliative care philosophy.<br>Arts, Faculty of<br>Social Work, School of<br>Graduate
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Granlund, Lucie. "Det vårdande mötet när döden närmar sig." Thesis, Blekinge Tekniska Högskola, Sektionen för hälsa, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:bth-1795.
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Att vårda en patient i livets slutskede innebär att bekanta sig med känslomässiga situationer som ofta påverkar sjuksköterskans omvårdnadshandling exempelvis effektiv symtomlindring. Syfte: Syftet med denna studie var att beskriva sjuksköterskans upplevelse av det vårdande mötet med patienten i samband med palliativ vård. Metod: Metoden var en litteraturstudie med kvalitativa ansatser. Sex vetenskapliga artiklar samlade in och användes som analysmaterial av denna studie. Innehållanalysen inspirerad av Graneheim och Ludman (2003) användes för att analysera insamlade data. Resultat: Resultatet visade att sjuksköterskan upplever tillfredställelse och välbefinnande om hon lyckas med att tillgodose patientens behov exempelvis smärta. Effektiv smärtlindring upplevdes som meningsfull och det innebar att hon hade betytt något för patienten och dess närstående. Däremot upplevdes hon stress, frustration, maktlöshet och konflikt när hennes omvårdnadshandling inte mött patientens behov. Samverkan mellan arbetsteamen och stöd från kollegor upplevdes som viktigt i den palliativa vården. Sjuksköterskan höll distans för att kunna hjälpa patienten. Slutsatsen: Sjuksköterskan behöver kunskap om smärtlindring samt kunskap om palliativ vård för att effektivt lindra patientens smärta. För att tillgodose patientens behov i sin helhet behöver hon tillräcklig med tid och frihet att själv planerar sitt arbete. Samarbetet med andra vårdteam och kollegornas stöd måste stärkas och ha ett gemensamt mål: patientens välbefinnande då kan sjuksköterskan uppleva välbefinnande.
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Richards, Allison. "Use of the 'physician orders for life sustaining treatment' form in the emergency department setting : the providers' experience." Online access for everyone, 2007. http://www.dissertations.wsu.edu/Thesis/Summer2007/A_Richards_072307.pdf.
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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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James, Veronica. "Care and work in nursing the dying : a participant study of a continuing care unit." Thesis, University of Aberdeen, 1986. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=215733.
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The hospices attempted to offer a way of dying with dignity which would counter the growing lobby for euthenasia legislation by taking account of 'total pain' (mental, social, spiritual, physical). Participation on an NHS/Macmillan Continuing Care Unit indicated that the nurses were committed to giving 'total patient care', but were conscious of their inability to fulfil their principles. They explained their care of the dying in terms of a tension between 'care' and 'work'. The practical outcome of the tension on the terminal care unit is analysed as 'carework'. This emergent nursing practice, where physical care tends to overshadow 'emotional care', is observed in the routines and rituals of the Unit, of which 'normal death' is one example. The two separate social frameworks of 'care' and 'work' reflect a gender division of labour in which 'caring' is commonly domestically based and carried out by women, and 'work' is in the public domain and dominated by men. Public service 'people work' requires that the two frameworks be amalgamated. The tension between 'care' and 'work' is described as a failure of accommodation between the two which is exacerbated by a science based model of illness. It is suggested that these effects combine in a pattern of resistance which opposes the full implementation of hospice movement aims.
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Kugler, Neil. "When curing stops and caring begins : a study of the need for end-of-life care education of future health care workers /." ProQuest subscription required:, 2003. http://proquest.umi.com/pqdweb?did=990270731&sid=1&Fmt=2&clientId=8813&RQT=309&VName=PQD.
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Henn, J. W. "Psychological care of the terminally ill : theory and application." Thesis, University of East Anglia, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.302199.
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Choi, Yin-yin Alice. "Attitudes and practices of oncology physicians and nurses towards end-of-life care." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31971659.
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White, Mary Kathryn. "Certified nursing assistants' feelings of preparedness in caring for nursing home residents at the end of life." Laramie, Wyo. : University of Wyoming, 2007. http://proquest.umi.com/pqdweb?did=1445048331&sid=8&Fmt=2&clientId=18949&RQT=309&VName=PQD.
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Wainaina, Alexander Mark. "The Dignity of the Human Person in the Face of Competing Interests: Prudent Use of Resources in the End-of-Life Care." Thesis, Boston College, 2016. http://hdl.handle.net/2345/bc-ir:107481.
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Thesis advisor: Andrea Vicini<br>Thesis advisor: James Keenan<br>In this thesis, I am going to explore some of the significant legal and medical activities that have had a great influence on the healthcare delivery in the United States of America, focusing on the care of people that are severely sick or those whose death is imminent. Then I will discuss how the application of virtues, particularly the cardinal virtues, can inspire people not to neglect the needs of patients whenever some helpful procedures could be done, and also to enable people to desist from engaging in medical procedures that could be deemed futile. Patients and their caregivers can all benefit from cultivating virtue and hence create a way of life that respects the human dignity of patients and also uses the available resources prudently for the sake of the common good. Ultimately, I hope to suggest some theologically sound proposals that are helpful to a patient, the patient’s family and the rest of the country’s health system, with a particular focus on an ethical way of delivering healthcare services. I will show how the developments in the Western world can be applied to develop some protocols of healthcare delivery that could be helpful to Kenya. It is my belief that the universal applicability of virtues can ensure that healthcare activities uphold the human dignity of patients, provide respect for healthcare work, and also use a country’s limited resources prudently<br>Thesis (STL) — Boston College, 2016<br>Submitted to: Boston College. School of Theology and Ministry<br>Discipline: Sacred Theology
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Lu, Chen. "Improving communication with terminally Ill patients in the end-of-life care: a volunteers' perspective." HKBU Institutional Repository, 2014. https://repository.hkbu.edu.hk/etd_oa/122.
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Communication is an important component in care for the patients. As human beings, we are all mortal, thus, communication at the end of life is a topic that is significant for all of us. Research on communication with dying patients who suffered from incurable illness is relatively insufficient in China given the fact that palliative care originated in the West. Moreover, previous research focused more on the communication between patients and medical staff who shoulder the majority work for taking care of the patients. There is relatively little research looking into volunteers' experience in communicating with dying patients. Communicating with dying patients is the experience that can cause anxiety and stress. As patients with advanced and incurable cancers have exhausted their social contacts due to the prolonged illnesses and people's general anxiety to communicate with dying people, their shrinking social contacts will result in isolation, which will trigger emotional pain in addition to the physical pain. Volunteers come to assist in caring for them as a form of social support for the dying people, and their communication experience is valuable for any caregivers of dying patients. The researcher of the study directly engaged with the activities of a group of volunteers in Shenzhen for six months, doing ethnography and semi- structured interviews, so as to understand the practices and meanings of volunteers' communication with dying patients. The results showed that three main dimensions emerged, namely, isolation and connection, dependence and autonomy, discontinuity and continuity. Volunteers adopted various communication skills so as to make patients feel that they are still connected to others, enjoy certain degree of autonomy over their body like the healthy people and let them move on in the last phase of their life. They also suggest that there should be more investigations in the end-of-life communication
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Pevey, Carolyn Frances. "God, flesh, death and other : comfort and culture among hospice patients /." Full text (PDF) from UMI/Dissertation Abstracts International, 2001. http://wwwlib.umi.com/cr/utexas/fullcit?p3008420.
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Hafey, Sandra M. "Exploring end of life issues a four part workshop for adult Catholics /." Chicago, IL : Catholic Theological Union at Chicago, 2006. http://dx.doi.org/10.2986/tren.033-0847.
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Smith, Paula Caroline. "Family caregivers in palliative care : perception of their role and sources of support." Thesis, University of Southampton, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.340333.
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Oruč, Mirza. "Comparative Analysis in Palliative Care Competencies." Doctoral thesis, Universidad de Alicante, 2020. http://hdl.handle.net/10045/110519.
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According to the WHO cancer is one of the leading causes of morbidity and mortality in the world. In 2012 there was 14 million of new cases worldwide. A number of new cases is expected to rise in future. An increasing number of cases demanding a new approach from health care systems regarding the staff education, hospital equipment and interprofessional cooperation in order to give full service to the customers (patients). For several years palliative care education is a top priority in the education of nurses due to the fact that there are serious deficiencies in that area (Komaromy et al. 2000, Miller et al. 2004, Goodridge et al. 2005, Hasson et al. 2008). Nurses are the forefront of caring for terminally ill patients and their families approaching the end of life, which does not minimize role of other healthcare professionals, but nurses have main role in this process. Definition and competencies of nurses involved in this process must be precisely identified and measured from time to time in order to improve the process of end of life care and palliative care nursing. Continuous development of guidelines and protocols for palliative care nursing is particularly relevant (Watts, 2013; Gambles et al 2009, Hockey et al 2005, Jack et all 2003). Development of competencies is one of key issues in contemporary education it and can be achieved with development of proper curriculum and education schedule, especially development of a proper instrument for measurement of competencies. This research has identified most important 10 competencies in accordance with WHITE paper for EAPC and WHO. General objective. This research has one general objective and it is creation and validation of new questionnaire about competencies in field of palliative care nursing with aspect of realization of core competences in developed and under developing systems. This questionnaire is a new instrument in field of competence measurement in palliative care nursing. Specific objectives of the research are based on evaluation and comparison of competences among nurses from Bosnia and Herzegovina and Spain (Valencia area). Methodology. Methodology comprises research, cross – section, analytical method of research. Actions taken in this process were literature review, analysis of data available curricula of nursing schools, literature research, development of new instruments for measurement of competences in palliative care nursing, interviews with nurses in Bosnia and Herzegovina, development of online platform for nurses in Spain, translation of instruments to Spain language, data processing, Comparison of results from both group were done by every single item of instrument and by every competences. Results. Results are presented in two different parts: Part I (one) of results is about development of instrument PALCOM and part II (two) is about the data collected from Bosnia and Herzegovina and Spain. All results are shown in proper table and graphs that are reflecting research process. Results show the significant statistical difference between groups in Bosnia and Herzegovina and Spain (Valencia area) in some aspects, while in several aspect there is no difference. Working experience and level of education are in directly linked with self-competence measurement. There is a high statistical difference between groups with different level of education, and working experience, which has a direct impact on development of competence of nurses. Conclusion. Need for measurement of competencies is expressed in the daily development of palliative care, community palliative care, hospice care and subspecialty palliative care. Questionnaire that can measure all competencies does not exist but using general competencies in PALCOM questionnaire can cover this entire field with measurement of various domains and competencies specific to that domains. PALCOM as an instrument for evaluation of competencies in the field of palliative care, is, for the time being, a reliable instrument. With the development of palliative care, improvement can be done in the area of competencies in palliative care nursing. PALCOM is applicable in various health care systems and educational systems and it does not depended on external factors. PALCOM as instrument measures the competence level of nurses and preparedness for work in palliative care settings. First scale measure knowledge, while second scale is self-measurement of competences in accordance with the level of education and work experience. Need for the appropriate instrument for measuring competences in palliative care nursing leads us to this instrument following most economical and reasonable way of developing.
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Page, William D. "Ministering to the shepherd a guide for when terminal illness strikes the pastor's family /." Theological Research Exchange Network (TREN), 2007. http://www.tren.com/search.cfm?p002-0837.
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Chapman, Ysanne B. "The lived experience of nursing dying or dead people." Thesis, View thesis, 1994. http://handle.uws.edu.au:8081/1959.7/26159.
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This phenomenological study describes the experiences of twelve registered nurses who have nursed a dying or dead patient. These registered nurses come from a variety of backgrounds, not only personally, but also educationally and socially. The study primarily focuses on these registered nurses' most significant experience with death in a professional capacity. Twelve registered nurses were invited to share their stories by means of taped interviews and/or written narrative which attempted to discover the underlying meaning of their experiences. However, in relating their stories, many of the registered nurses wished to describe other death experiences which were of significance for them. The study is grounded in Heideggerian phenomenology and analysis of the transcripts revealed the emerging essences of connectedness, aloneness, questioning and accepting. The study further reveals that these essences align themselves to the four fundamental existentials of spatiality, corporeality, temporality and relationality as described by Merleau-Ponty (1962). Additionally, these essences are related back to the principles of Parse's (1987) theory of Human-Becoming and provide some insights for nursing practice when caring for the dying or the dead patient. Some discussion on how these insights may be related to contemporary nursing practice in Australia is highlighted. Each participant's transcript is followed by a poem which intends to capture the essence of their relationship with the situation(s) they have shared with the author.
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Sampaio, Anita Isabel da Costa. "Cuidar do doente em fase terminal: vivências e estratégias adoptadas pelos enfermeiros." Bachelor's thesis, [s.n.], 2011. http://hdl.handle.net/10284/2763.
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Trabalho apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em Enfermagem<br>A morte é um fenómeno extremamente complexo: por um lado parece estar presente ao longo de toda a nossa vida por outro parece manter-se radicalmente ausente enquanto vivemos. A morte é-nos simultaneamente próxima e distante. (Pacheco, 2004, p.1)
A morte faz parte intrínseca da condição humana. Morrer é a única certeza absoluta que todos temos na vida.
A definição de morte é controversa mas, independentemente de como se interpreta, é um facto natural ainda que cada um a vive e a interpreta à sua maneira.
Falar de morte continua a ser tabu e incómodo pois cada um de nós pensa ser imortal e inconscientemente não queremos aceitar a ideia de morrer porque, o simples pensamento causa angústia e sofrimento. O problema não reside somente em sermos mortais e que temos de morrer algum dia mas, que a morte parece algo irracional, ilógico e incompreensível. A mortalidade inclui além disto dois aspectos muito importantes: o ter necessariamente de morrer e o não saber como, nem quando.
A escolha deste tema deve-se ao interesse que o mesmo desperta, uma vez que é inerente a um aspecto que nos toca a todos profundamente a morte, (Hennezel, 2002) e por permitir a compreensão do modo como funciona o próprio enfermeiro, enquanto ser humano perante a morte das pessoas de quem cuida.
Através desta investigação verificou-se que os enfermeiros desenvolvem, efectivamente, distintos mecanismos de defesa ao cuidar do doente terminal. E, numa avaliação geral os enfermeiros acreditam que cuidar de doentes terminais torna-os mais sensíveis e humanos.
Os maiores desafios que se colocam aos enfermeiros, quer a nível pessoal, quer a nível profissional é o cuidar de doentes em fase terminal. O enfermeiro deverá ajudar o doente a viver o melhor possível até morrer. Isto passa por uma assistência humana e compreensiva, pelo estabelecimento de uma comunicação e relação empática. Se todos nós, e muito concretamente os enfermeiros pensássemos, ou melhor, começássemos a pensar na possibilidade da nossa morte, certamente seríamos capazes de realizar muitas coisas e uma das mais importantes seria, sem dúvida, conseguir um maior bem – estar, dos doentes e suas famílias. Death is an extremely complex phenomenon: on one hand seems to be present throughout our lives for others seem to stay away while we live radically. The death we are both close and distant (Pacheco, 2004, p.1)
Death is an intrinsic part of the human condition. Dying is the only absolute certainty that we all have in life.
The definition of death is controversial, but, regardless of how it is interpreted, it is still a natural fact that each of the lives and interpreted in various ways.
Talking about death is still taboo and cumbersome because each of us thinks he is immortal and do not want to unconsciously accept the idea of dying because the mere thought causes anguish and suffering. The problem lies not only in being mortal and that we have to die someday, but that death seems something irrational, illogical and incomprehensible. Mortality addition includes two important aspects: the necessarily having to die and not knowing how or when.
The choice of this theme is due to the interest that he wakes up, since it is inherent in an issue that deeply concerns us all to death (Hennezel, 2002) and enables understanding of how nurses work himself, while human beings to death of people he cares for.
Through this investigation it was found that nurses develop, indeed, different defense mechanisms to take care of the terminally ill. And, upon the whole the nurses believed that caring for terminally ill patients makes them more sensitive and human.
The major challenges to nurses, both at personal or professional level is caring for the terminally ill. The nurse should help the patient live the best you can until you die. This involves a comprehensive and human assistance, the establishment of a communication and empathic. If all of us, and specifically the nurses think, or better, we started to think about the possibility of our death, certainly we would be able to accomplish many things and one of the most important would undoubtedly achieve a greater good - being patient and their families.
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Iverson, P. Dianne. "Spiritual care of the dying : a community nursing perspective /." View thesis, 2003. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20031009.093517/index.html.
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Thesis (M. N.) (Hons.) -- University of Western Sydney, 2003.<br>A thesis submitted in total fulfillment of the requirements for the degree of Master of Nursing (Honours), Faculty of Nursing and Community Health, Department of Nursing, University of Western Sydney, February, 2003. Bibliography : leaves 190-205.
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Cranfill, Timothy D. "Giving sorrow words turning mourning into dancing : improving the quality of life of terminally ill children, adolescents, and adults through the use of therapeutic videography /." Online full text .pdf document, available to Fuller patrons only, 2004.
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Ministry research project (D. Min.)--Midwestern Baptist Theological Seminary, 2004.<br>Submitted in partial fulfillment of the requirements for the Doctor of Ministry Degree. Includes bibliographical references (leaves 184-188).
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Khandelwal, Nikhil Krueger Kem P. Berger Bruce A. "Developing condition-specific hospice formularies for congestive heart failure and depression conditions and the evaluation of their economic impact." Auburn, Ala., 2006. http://repo.lib.auburn.edu/2006%20Summer/Dissertations/KHANDELWAL_NIKHIL_24.pdf.
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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.