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Hospice care compliance of nurses working at a hospice ward in Korea  [PDF]
Hyun Gu Lee, Heeok Park, Young Mi Chun
Open Journal of Nursing (OJN) , 2014, DOI: 10.4236/ojn.2014.42009
Abstract:


Purpose: The purpose of this study was to investigate the hospice care compliance of nurses working at a hospice ward and provide meaningful data to improve the hospice care compliances. Methods: Participants included 104 nurses working at the hospice ward of the hospital located at P and D cities. Data was collected from February to March 2012. The level of hospice care compliance was measured using Bae (2000)’s questionnaires. Data were analyzed with descriptive statistics, t-test, one-way ANOVA and Scheffè test using SPSS/WIN 18.0 program. Results: The level of hospice care compliance in hospice nurses working at a hospice ward was high (3.25 out of 4). In hospice care compliance, the physical area was highest, followed by the emotional, spiritual, and social areas. Hospice care compliance was significantly different according to age, marital status, education, religion, importance of religion, job position, job satisfaction and life satisfaction. Hospice care compliance was also significantly different according to the nurses’ experience of death, having license or certification related to hospice care and experiences related to clients’ death. Conclusions: The findings of this study showed that the level of hospice care compliance was high and the hospice care compliance in South Korea was primarily focused on physical care. Considering that spiritual needs are important needs in hospice clients, hospice nurses need to focus on those aspects more. To improve the quality of hospice care compliance in the hospice nurses, programs to increase hospice nurses’ job and life satisfaction are needed.


Music Therapy in Hospice and Palliative Care: a Review of the Empirical Data  [PDF]
Russell E. Hilliard
Evidence-Based Complementary and Alternative Medicine , 2005, DOI: 10.1093/ecam/neh076
Abstract: Although music therapy is an established allied health profession and is used with increasing frequency in the treatment of those with a terminal illness, there is a real dearth of empirical research literature supporting the use of music therapy in end-of-life care. This article reviews the empirical studies found in the literature and documents the emergence of an evidenced-based approach to the use of music therapy in hospice and palliative care. A total of 11 studies are reviewed; of these, six show significant differences supporting the use of music therapy in this area. Dependent variables positively affected by music therapy include pain, physical comfort, fatigue and energy, anxiety and relaxation, time and duration of treatment, mood, spirituality and quality of life. Guidelines for future research are considered, and variables that need to be controlled are presented. The need to create an evidence-based approach to hospice and palliative care music therapy is articulated, and future researchers are empowered to continue to conduct investigations among this population.
Characteristics of Nursing Care for Terminally Ill Patients in Hospice/Palliative Care Unit  [PDF]
Kaori Tsutsumi, Keiko Sekido, Tetsuya Tanioka
Health (Health) , 2014, DOI: 10.4236/health.2014.616246
Abstract: The purpose of this study was to clarify the characteristics of nursing care for patient with terminally ill in the hospice/palliative care units. Semi-structured interviews on “communication, care, spiritual pain care and prediction of worsening of symptoms” were conducted, incorporating items indicated as important principles of palliative care by Lugton et al. Sixteen nurses at five hospice/ palliative care facilities in urban areas of Japan were surveyed in 2013, and results were analyzed qualitatively. Following characteristics by hospice/palliative care nurses (HPN) were categorized as [HPN sharing meaningful time with the patient] and [HPN’s continual attempts to understand the world in which the patient lives] in the communication; as [HPN providing comfortable care so that patients can value their last moments] and [HPN’s efforts to attend to patients so they can die as they hope to] in the care; and as [HPN’s observation in a range that does not interfere with the patient’s comfort] and [HPN senses that something is different from before] in the prediction of worsening of symptoms. Common characteristic was <HPN’s support for patients approaching a natural death>. In this study, spiritual pain care was included in the communication and care, and could not be extracted alone. It was suggested that an HPN provides communication, care and prediction of worsening of symptoms with excellent judgment and technological competency, while placing importance on offering support for the patient’s natural death.
Relationship of Clinical Nursing Competence to Nursing Occupational Experience in Hospice/Palliative Care Nurses in Japan  [PDF]
Kaori Tsutsumi, Keiko Sekido
Health (Health) , 2015, DOI: 10.4236/health.2015.72032
Abstract: Aim: The purpose of this research is to examine the relationship between the clinical nursing competence and nursing occupational experience in hospice/palliative care nurses (HPN) in Japan. Methods: A mail survey using an anonymous self-administered questionnaire was conducted on clinical nursing competence regarding communication, care and prediction of worsening of symptoms with the authors’ previous research as a framework. The subjects were nurses working in hospice/palliative care units in Japan, and the period of survey was January to February, 2014. Results: In this study, the relationship between the clinical nursing competence and nursing occupational experience of HPNs in hospice/palliative care which was clarified in the authors’ previous research was examined. The results showed that the amount of clinical nursing experience as a nurse was related to clinical nursing competence in the care of end-of-life patients and worsening of symptoms. The abundance of specialized nursing experience was also related to clinical nursing competence in communication in addition to care and prediction of worsening of symptoms. Training experience was also shown to be effective for hospice/palliative care. Conclusion: From these results, clinical nursing competence of HPNs in care of end-of-life patients and prediction of worsening of symptoms are possibly learned through the accumulation of clinical nursing experience as a nurse. However, HPN’s clinical nursing competence in communication was suggested to be developed through nursing practice in hospice/palliative care.
Ethical Dilemmas in Hospice and Palliative Care Units for Advanced Cancer Patients  [cached]
Beyhan Bag,Nesrin Reis
Arsiv Kaynak Tarama Dergisi , 2013,
Abstract: Ethical dilemmas that face heathcare team members referring patients to hospice programs include the ability of clinicians to predict accurately a patient bad prognosis. They affect day-to-day patient management in palliative care programs including healthcare team members concern over the use of morphine because possible respiratory depression in the patient, the question of providing enteral or parenteral nutritional support to patients who refuse to eat and the question of providing parenteral fluids to patients who are unable to take fluids during the terminal phrases of illness. A final ethical dilemma concerns the methodology for quality of life research in palliative care. Understanding and resolving these ethical dilemmas is an important factor determining the quality of the caring for the patient. The ethical dilemmas that are discussed in the article likely to occur in this period can be prevented through his/her participation in the decisions concerning his or her treatment. [Archives Medical Review Journal 2013; 22(1.000): 65-79]
A Study on Locations of Death and Factors Associated with Death among Cancer Patients in South Korea  [PDF]
Yong Joo Rhee, Yoon-Hee Tae, Yong Joo Lee, Soomok Jang, Joachim Cohen, Young-Soon Choi
Journal of Biosciences and Medicines (JBM) , 2019, DOI: 10.4236/jbm.2019.72003
Abstract: Background: Location of death has been used to examine an indicator for good death. This study aims to examine location of death among patients with three major cancers (gastric, liver, and lung) and other factors associated with location of death in South Korea. Methods: We selected the medical and pharmacy claims data for health services and location of death among the 42,596 decedents with cancer (lung 16,632, liver 15,872, gastric 10,092) from 2009 to 2013. We used logistic regressions to identify factors associated with home death. Outcome measures are locations of death (hospital, outpatient clinics or emergency room and home). Results: Only 8.9% died at home whereas 46.5% died in hospital as inpatients. Patients with more than one comorbid cancer or receivers for any supportive care were significantly more likely to die in hospital. Female and younger than 55 years old liver cancer patients were associated with home death. Patients living in metropolitan area, or paying more insurance premium, or being public aid beneficiaries, were associated with home death. Conclusions: The supportive care service use prior to death was significantly associated with increasing odds to hospital death. Being older than 75, or having multiple cancers was significant factors associated with hospital death, whereas living in metropolitan area, lower income or emergency visit were significant factors with home death. These findings are opposite to what is found, as the palliative care and hospice is predominantly hospital-centered. The findings emphasize a need to available end-of-life care in community for dying patients.
Keeping hospice palliative care volunteers on board: Dealing with issues of volunteer attrition, stress, and retention  [cached]
Claxton-Oldfield Stephen,Claxton-Oldfield Jane
Indian Journal of Palliative Care , 2008,
Abstract: This article explores the issues of hospice palliative care volunteer attrition and retention (i.e., why volunteers leave and how to keep them interested). In addition, common sources of stress for volunteers will be identified and suggestions for alleviating stress will be offered. Volunteers are special people; patients and families greatly appreciate the care and support they provide and the other staff members′ (e.g., nurses) jobs are often made easier because of them. Thus, maintaining a committed group of volunteers is an extremely important task for volunteer coordinators. The literature reviewed in this article focused mostly on North American studies and was limited to research that specifically involved hospice palliative care volunteers as participants.
A comparative analysis of computer based hospice palliative care datasets in Canada
Craig E Kuziemsky, Francis Lau
BMC Palliative Care , 2008, DOI: 10.1186/1472-684x-7-6
Abstract: The data sources consisted of data element names and their definitions collected in a computer based format from seven HPC centres and one surveillance dataset. The data elements were structured into five themes: demographic, patient death, support, contact or informal caregiver; program/consultations/service request, and clinical. Each theme contains a number of data elements with a total of 40 elements included in the analysis. Comparative analysis was done on the data elements to compare their names and definitions.Much variation exists in data collection around HPC delivery. Such variation prevents any timely and meaningful comparison of service and care delivery across HPC centres. Patient death data, service/program data and clinical data is particularly varied.Developing a common minimum data set is a logical starting point to help overcome data variations between care centres. Greater coordination is needed between care centres and the development of national standards and policies. Moving towards electronic data collection would help facilitate common policy and practice norms.Although modern hospice palliative care (HPC) is still an emerging field of medicine, our aging population and increased onset and survival time of patients with chronic illness will increase the need for access to HPC services. In Canada there have been national initiatives over the past five years including a 2000 report from the Senate Subcommittee for End-of life Care [1] and its 2005 follow up [2] that have acknowledged both the need for increased HPC delivery as well as the need for new approaches to delivering HPC.As a response to such initiatives Canada has seen an increase in HPC programs, and the ability to deliver HPC. HPC is delivered through a number of venues including acute care hospitals, long-term care centres and specialist HPC services such as hospices, and homecare services. Along with variations in where and how HPC is delivered are variations in what data is coll
Hospice utilization during the SARS outbreak in Taiwan
Tzeng-Ji Chen, Ming-Hwai Lin, Li-Fang Chou, Shinn-Jang Hwang
BMC Health Services Research , 2006, DOI: 10.1186/1472-6963-6-94
Abstract: The data sources were the complete datasets of inpatient admissions during 2002 and 2003 from the National Health Insurance Research Database. Before-and-after comparisons of daily and monthly utilizations were made. Hospice analyses were limited to those wards that offered inpatient services throughout these two years. The comparisons were extended to total hospital bed utilization and to patients who were still admitted to hospice wards during the peak period of the SARS epidemic.Only 15 hospice wards operated throughout the whole of 2002 and 2003. In 2003, hospice utilization began to decrease in the middle of April, reached a minimum on 25 May, and gradually recovered to the level of the previous November. Hospices showed a more marked reduction in utilization than all hospital beds (e.g. -52.5% vs. -19.9% in May 2003) and a slower recovery with a three-month lag. In total, 566 patients were admitted to hospice wards in May/June 2003, in contrast to 818 in May/June 2002. Gender, age and diagnosis distributions did not differ.Hospice inpatient utilization in Taiwan was indeed more sensitive to the emerging epidemic than general inpatient utilization. A well-balanced network with seamless continuity of care should be ensured.The severe acute respiratory syndrome (SARS) epidemic threw the world into turmoil during the first half of 2003 [1,2]. Since then, thousands of papers had been devoted to this novel virus, many have addressed its impact on health service utilization [3-8], but few have focused on hospice palliative care [9]. When the fears declined and utilization data became available, we were able retrospectively to review the broad hospice situation during the SARS epidemic in Taiwan, one of the most heavily affected countries.The first inpatient hospice ward in Taiwan was established in 1990 [10]. By the end of 2004, there were 26 hospice wards with 424 beds and 42 units for hospice home care [11]. All hospice care programs in Taiwan until then had been h
Death and dying in the US: the barriers to the benefits of palliative and hospice care  [cached]
Albert J Finestone,Gail Inderwies
Clinical Interventions in Aging , 2008,
Abstract: Albert J Finestone, Gail InderwiesSchool of Medicine, Temple University, Philadephia, PA, USAIn August 2006, after a trip to the New Jersey Shore, Peggy was having great difficulty catching her breath. In consultation with her children, Peggy decided that she was ready for hospice care. But, she did not want to relinquish her independence just because shortness of breath and a weakening heart overtook her daily stride. However, a single episode at home had thrown Peggy into crisis. Since Peggy lived alone, hospice care at home presented a host of challenges including safety and how to manage her unstable cardiopulmonary condition. Peggy was an ideal candidate for the hospice’s TeleCare (see box) monitoring program which provided a passive monitoring system, a medication dispenser, and vital signs monitoring for blood pressure, weight, and blood oxygen levels. In addition, the hospice authorized routine draws of BNP (beta naturetic peptide) and BMP (basic metabolic profi le) with GFR (glomerular filtration rate) to manage her symptoms aggressively. Medications were adjusted accordingly to maximize quality of life and minimize symptoms. Though some would consider this treatment aggressive, it was the aggressive treatment of Peggy’s symptoms that allowed for an extended quality of life. There was sufficient evidence to support this action based on the concept of risk and reward, especially as there was a minimum of invasive therapies required. In Peggy’s case she went from being homebound and short of breath to living her life up to her final days.
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