The Hospice journal最新文献

{"title":"Development of a Home-Based Family Caregiver Cancer Education Program","authors":"M. Pickett, F. Barg, M. P. Lynch","doi":"10.1080/0742-969X.2000.11882960","DOIUrl":"https://doi.org/10.1080/0742-969X.2000.11882960","url":null,"abstract":"ABSTRACT Introduction: This article describes a home-based educational program developed specifically for family caregivers of cancer patients who receive hospice and home care. The overall aim of this educational program is to specifically address family caregivers’ needs for acquisition of necessary knowledge and skills to meet the physical and psychosocial demands associated with caring for a patient with advanced cancer. Program Development: Originally, components of this program were offered in a small group discussion format within hospital and community settings. The educational program was transformed to accommodate the unique needs and constraints of homebound family caregivers who have very limited time and/or opportunities for support and education outside of the home. The program is comprised of educational modules that provide hospice and home care professionals with written and audiovisual materials designed to facilitate brief, structured, educational encounters with family caregivers in the home setting. Discussion: Two hundred thirty-seven educational module kits were distributed to professionals affiliated with twenty-four home care and hospice agencies in the Greater Philadelphia area. Results of a telephone survey designed to elicit evaluation data from professional staff members who had used the educational modules are presented. Limitations, plans for future program evaluation, cost implications, and implementation recommendations related to this educational program are described. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: Website: ©2001 by the Haworth Press, Inc. All rights reserved.]","PeriodicalId":77421,"journal":{"name":"The Hospice journal","volume":"15 1","pages":"19 - 40"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0742-969X.2000.11882960","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59937317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Someone You Love is Dying: Making Wise Decisions at the End of Life. David Clark and Peter Emmett","authors":"J. Sweers","doi":"10.1080/0742-969X.2000.11882964","DOIUrl":"https://doi.org/10.1080/0742-969X.2000.11882964","url":null,"abstract":"","PeriodicalId":77421,"journal":{"name":"The Hospice journal","volume":"15 1","pages":"56 - 57"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0742-969X.2000.11882964","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59937994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Dimensions of Anticipatory Mourning: Theory and Practice in Working with the Dying, Their Loved Ones, and Their Caregivers. Therese A. Rando, Ed.","authors":"A. Hecht","doi":"10.1080/0742-969X.2000.11882962","DOIUrl":"https://doi.org/10.1080/0742-969X.2000.11882962","url":null,"abstract":"(2000). Clinical Dimensions of Anticipatory Mourning: Theory and Practice in Working with the Dying, Their Loved Ones, and Their Caregivers. Therese A. Rando, Ed. The Hospice Journal: Vol. 15, No. 4, pp. 53-55.","PeriodicalId":77421,"journal":{"name":"The Hospice journal","volume":"137 1","pages":"53 - 55"},"PeriodicalIF":0.0,"publicationDate":"2000-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0742-969X.2000.11882962","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59938093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Massage on Pain Intensity, Analgesics and Quality of Life in Patients with Cancer Pain: A Pilot Study of a Randomized Clinical Trial Conducted Within Hospice Care Delivery","authors":"D. Wilkie, Janice Kampbell, S. Cutshall, Heather Halabisky, Hilda Harmon, Linda P. Johnson, Lynn Weinacht, Mark Rake-Marona","doi":"10.1080/0742-969X.2000.11882956","DOIUrl":"https://doi.org/10.1080/0742-969X.2000.11882956","url":null,"abstract":"ABSTRACT Aims: In a randomized controlled clinical trial (RCCT), we examined the effects of four massages on pain intensity, prescribed IM morphine equivalent doses (IMMSEQ), hospital admissions, and quality of life (QoL). Methods: Of 173 referred patients, 29 (14 control, 15 massage) completed this pilot study. Subjects were 69% male and aged 63 years on average. Licensed therapists administered four, twice-weekly massages. Baseline and outcome measurements were obtained by other team members before the first and after the fourth massages. Results: Pain intensity, pulse rate, and respiratory rate were significantly reduced immediately after the massages. At study entry, the massage group reported higher pain intensity (2.4 ± 2.8 vs. 1.6 ± 2.1) which decreased by 42% (1.4 ± 1.5) compared to a 25% reduction in the control group (1.2 ± 1.3) (p > .05). IMMSEQ doses were stable or decreased for eight patients in each group and increased for seven massage and six control group patients. One massage group and two control group patients were hospitalized. All initial QoL scores were higher in the massage group than in the control group, but only current QoL was statistically significant. Both groups reported improved global QoL. The control group reported slight improvement in current QoL and satisfaction with QoL whereas these two aspects of QoL declined in the massage group even though their average QoL scores were higher than the control group at the end of the study. Conclusions: We demonstrated feasibility of conducting an RCCT in which we systematically implemented massage as a nonpharmacologic comfort therapy along with our usual hospice care. The massage intervention produced immediate relaxation and pain relief effects. A power analysis based on trends in the longer-term effects indicate that a study with 80 subjects per group is likely to detect statistically significant effects of usual hospice care with twice-weekly massage therapy sessions on pain intensity, analgesic dosages, and quality of life. Lessons we learned from conducting this pilot study are being used to improve documentation of our hospice program outcomes and to plan a definitive study. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com ]","PeriodicalId":77421,"journal":{"name":"The Hospice journal","volume":"15 1","pages":"31 - 53"},"PeriodicalIF":0.0,"publicationDate":"2000-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0742-969X.2000.11882956","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59937426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospice Family Caregivers: An Experience in Coping","authors":"Stephenie V. Brinson, Q. Brunk","doi":"10.1080/0742-969X.2000.11882954","DOIUrl":"https://doi.org/10.1080/0742-969X.2000.11882954","url":null,"abstract":"ABSTRACT The purpose of this phenomenological study was to identify coping strategies of rural family caregivers who were caring for an elderly relative in a home hospice situation. Each of the six participants were interviewed on two occasions exploring their caregiving experience with a focus on coping strategies. Colaizzi’s six step phenomenological method was employed for data analysis. Participant caregivers specifically identified coping strategies of support, adaptive activities, spiritual means, and avoidance. The collected data were analyzed and the findings compared to related caregiving literature. Implications for nursing practice and future research opportunities are discussed. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com ]","PeriodicalId":77421,"journal":{"name":"The Hospice journal","volume":"15 1","pages":"1 - 12"},"PeriodicalIF":0.0,"publicationDate":"2000-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0742-969X.2000.11882954","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59937356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the Solution Focused Brief Therapy Model with Bereavement Groups in Rural Communities: Resiliency at Its Best","authors":"Susan W. Gray, Marilyn R. Zide, H. Wilker","doi":"10.1080/0742-969X.2000.11882955","DOIUrl":"https://doi.org/10.1080/0742-969X.2000.11882955","url":null,"abstract":"ABSTRACT The major goals of bereavement groups are to help resolve the conflicts of separation, facilitate the completion of grief tasks, provide a social support system, and give permission to mourn. This article describes how the Solution Focused Brief Therapy (SFBT) model can be applied to bereavement groups. In addition, the authors’ provide examples of techniques useful for setting the beginning foundation for bereavement group work in the rural community. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com ]","PeriodicalId":77421,"journal":{"name":"The Hospice journal","volume":"35 1","pages":"13 - 30"},"PeriodicalIF":0.0,"publicationDate":"2000-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0742-969X.2000.11882955","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59937413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Administrative and Ownership Characteristics of Hospices and Their Proportion of Inpatient Deaths","authors":"C. Ryan","doi":"10.1080/0742-969X.2000.11882958","DOIUrl":"https://doi.org/10.1080/0742-969X.2000.11882958","url":null,"abstract":"ABSTRACT Hospice patients are more likely to die at home than patients involved in conventional medical care, but the proportion of home deaths varies between programs. A study of the effect of hospice administrative characteristics on inpatient death rates is presented. Data from hospice programs that operated in New York State between 1993 and 1995 were obtained from the State Health Department and from publications of the National Hospice Organization. Inpatient death rates varied significantly between different operating structures: 11% for hospices that were divisions of home health care agencies; 34% for hospices that were divisions of hospital corporations; and 20% for hospices that were independent hospice corporations. This difference was explained by the presence of dedicated inpatient hospice units: Programs with such units demonstrated higher inpatient death rates than those without (42% versus 11%; P < .00001). Though not necessarily causal, these associations should be of interest to patients, physicians, families, and policymakers. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com ]","PeriodicalId":77421,"journal":{"name":"The Hospice journal","volume":"15 1","pages":"63 - 74"},"PeriodicalIF":0.0,"publicationDate":"2000-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0742-969X.2000.11882958","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59937659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between administrative and ownership characteristics of hospices and their proportion of inpatient deaths.","authors":"C. Ryan","doi":"10.1300/J011V15N03_05","DOIUrl":"https://doi.org/10.1300/J011V15N03_05","url":null,"abstract":"Hospice patients are more likely to die at home than patients involved in conventional medical care, but the proportion of home deaths varies between programs. A study of the effect of hospice administrative characteristics on inpatient death rates is presented. Data from hospice programs that operated in New York State between 1993 and 1995 were obtained from the State Health Department and from publications of the National Hospice Organization. Inpatient death rates varied significantly between different operating structures: 11% for hospices that were divisions of home health care agencies; 34% for hospices that were divisions of hospital corporations; and 20% for hospices that were independent hospice corporations. This difference was explained by the presence of dedicated inpatient hospice units: Programs with such units demonstrated higher inpatient death rates than those without (42% versus 11%; P < .00001). Though not necessarily causal, these associations should be of interest to patients, physicians, families, and policy-makers.","PeriodicalId":77421,"journal":{"name":"The Hospice journal","volume":"23 1","pages":"63-74"},"PeriodicalIF":0.0,"publicationDate":"2000-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85916117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participatory Action Research and Hospice: A Good Fit","authors":"P. Kovacs","doi":"10.1080/0742-969X.2000.11882957","DOIUrl":"https://doi.org/10.1080/0742-969X.2000.11882957","url":null,"abstract":"ABSTRACT While research has always been an important component of the hospice movement in this country, increasingly hospices are involved in research as a result of demands for outcome measures and greater accountability. In addition to the more traditional research strategies, hospice researchers are encouraged to use participatory action research (PAR) in their efforts to better understand, document, and evaluate services. This article describes PAR and provides an example of a modified usage of PAR with a hospice program serving persons with AIDS. Whether used primarily in the planning phase of research or in conducting and reporting results as well, PAR maximizes input from those who know hospice best-staff, volunteers, patients, and caregivers. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com ]","PeriodicalId":77421,"journal":{"name":"The Hospice journal","volume":"15 1","pages":"55 - 62"},"PeriodicalIF":0.0,"publicationDate":"2000-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0742-969X.2000.11882957","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59937544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermittent Subcutaneous Injections for Symptom Control in Hospice Care: A Retrospective Investigation","authors":"M. Letizia, J. Shenk, T. D. Jones","doi":"10.1080/0742-969X.2000.11882949","DOIUrl":"https://doi.org/10.1080/0742-969X.2000.11882949","url":null,"abstract":"ABSTRACT An alternative route to oral medications used by some hospice programs is intermittent injections of medications using an indwelling subcutaneous butterfly needle. The nurse places the infusion sets and instructs caregivers on medication administration. Although this method has become more common in hospice care, it has not received much attention in part because of a lack of data to support its efficacy. This study describes the use of intermittent subcutaneous medications for symptom relief in a home hospice program. A chart review was conducted of the 191 patients who received medications by this route during three calendar years; 77% had cancer. The average duration of hospice care was 25 days; on average, intermittent subcutaneous medications were instituted 4 days prior to the patient’s death. The main indications for this route were inability to swallow/somnolence (65%), and pain unresponsive to oral medication (19%). Symptoms to be controlled by this method were pain (88%), anxiety (72%), and dyspnea (4%). Morphine was used most frequently for pain, and Ativan was used most frequently for anxiety. Side effects from the medications and problems with this route of administration were rarely reported, thereby supporting the practicality of this method in hospice care. These results form the foundation for a prospective study that is documenting staff, patient, and caregiver variables that impact on the effectiveness and manageability of this method of symptom management in hospice care. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworthpressinc.com ]","PeriodicalId":77421,"journal":{"name":"The Hospice journal","volume":"15 1","pages":"1 - 11"},"PeriodicalIF":0.0,"publicationDate":"2000-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/0742-969X.2000.11882949","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"59936985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}