Caring for the suffering, dying patients and giving support to relatives is probably one of the toughest jobs a nurse can encounter. Palliative caring is, with different measures, the prolonging of life whereas hospice caring is giving patients a meaningful and natural journey toward death. The hospice philosophy is grounded on comfort, communication and peace. The expectation is that patients will have a dignified, peaceful death. The purpose of this study was to describe the nurse's role in palliative care. A literature study was used to analyze previously publicized scientific articles within the field. Relieving of pain was primary in palliative caring in hospice as well as in hospital. An earnest relationship between nurse, patient and relatives was of utmost importance. This relationship gave a sense of safety and had positive effects on patient's quality of life and well-being although death was near. An empathic nurse was aware and sensitive, showing respect, patience, and integrity, giving time needed to patients and was accessible, while simultaneously keeping a certain distance. The nurse was observant to the patient's facial expressions as well as body language, giving room for spiritual needs and a caring hand to both patient and relatives.

Abstract When it comes to the management of non-profit organizations, our country¡¦s academic sector has always placed an emphasis on the organization¡¦s decision making nuclei or those in command, and their effects on the fulfillment of organizational goals, resources placed into operation, efficiency, satisfaction, and other such self-management analysis. Seldom did they adopt an ¡§ethically-oriented¡¨ method of management. Instead they viewed the medical industry as a for-profit business, stressing business strategies and marketing, and therefore regarded patients as customers. This Study¡¦s Characteristics: 1. Focuses on medical and religious philosophies for investigation. Unlike single-issue studies, this study uses medicine as the primary basis for its perspective, and adds religious beliefs (Buddhism) to probe each health care morality issue. Health care morality issues include: abortion, cloning, euthanasia, organ transplants, and hospice care. In addition to ethical standpoints on medicine, using the sorted investigations on religious documents, we looked deeper into the viewpoints of Buddhism. 2. Feature: Besides investigating the morality of the body and flesh of ordinary medicine, we probed further into the root of the ethics of the mind. In retrospect to ¡§Medical Ethics¡¨, and the viewpoints of eastern and western medicine, we went beyond the perceptions of ordinary medicine, and explored a deeper plane of the mind, so as to increase the depth of health care ethics. Results: Through a factor analysis, we ended up with 10 factors: (hospice care, euthanasia, surrogate mothers, cloning and genetic issues, therapeutic art, religious care, stem cells, medical ethics, and abortion issues) and analyzed them according to 3 morality decision models to identify which is the best suited. Results: efficiency model and ethics model had positive effects on hospice care and therapeutic ethics, while as liability model had negative effects; liability model and ethics model had positive effects on religious care, medical ethics, and abortion issues; all 3 models, efficiency model, ethics model, and liability model, had positive effects on genetic issues and stem cells; efficiency model had positive effects on euthanasia, while as ethics model had negative effects; liability model had positive effects on surrogate mothers; liability model had positive effects on cloning issues, while as efficiency model and ethics model had opposite effects. Did people have different attitudes towards health care ethics? Results: the general public and medical personnel had significantly different attitudes towards hospice care, genetic issues, and therapeutic ethics; medical personnel, religious personnel, and the general public had significantly different attitudes towards religious care, stem cells, and abortion issues; medical personnel, patients, religious personnel, and the general public had significantly different attitudes towards medical ethics; medical personnel and religious personnel had significantly different attitudes towards euthanasia; the opinions of the groups were unanimous towards surrogate mothers and cloning issues. As to individual orientation, the higher the person¡¦s education level, the less he or she places emphasis on health care morality issues. Perhaps since medical ethics is only beginning to be drawn attention to in our country, most people with a higher degree of education have not yet concerned themselves to this level. In summary, this is worth the attention of our current education ministry. Key words¡GMedical Ethics¡AHuman Cloning¡AHospice

Thesis (M. S.)--Florida State University, 2005. / Advisor: Dr. Jeanne Flannery, Florida State University, School of Nursing. Title and description from dissertation home page (viewed June 17, 2005). Document formatted into pages; contains xii, 145 pages. Includes bibliographical references.

Title from PDF of title page (University of Missouri--Columbia, viewed on March 30, 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 Parker Oliver. Vita. Includes bibliographical references.

Thesis (M.A.)--Gordon-Conwell Theological Seminary, South Hamilton, Mass., 1999. / Abstract and vita. Includes bibliographical references (leaves 101-114).

Psycho-social factors of terminal illness were explored with 36 terminally ill hospice patients. These findings were compared with staff accounts to assess whether staff held different perceptions of terminal illness from patients. The dynamic nature terminal illness was explored by re-interviewing thirteen of the original patient-staff dyads 4-6 weeks later. Psychological responses to cancer have been shown to be affected by a variety of psycho-social factors, including age, length of illness and social support. The experience of terminal illness may be different from previous stages of cancer, possibly due to the patient's realisation of the nearness of death (Yalom, 1980). Models of dying highlight the patient's perspective and social environment in the determination of the dying process. Possible communication difficulties between patient and staff and the use of 'proxy data' in clinical and research settings highlights the need to explore patient and staff perspectives more fully. A measure which described positive and negative experiences of terminal illness was developed (POTIS) and administered with the Hospital Anxiety and Depression Scale to terminally ill patients within a hospice. Staff were identified with a patient and their ratings of the patient's experience gathered. Thirteen patients/staff pairs were re-interviewed using the above procedure. Results indicated that staff rated patients as being more anxious than patient's own ratings. There was no difference between staff and patient ratings of depression. Cluster analysis was used to describe natural groups occurring within patient responses to the POTIS and patient demographic data used to describe these groups. Small sample numbers limited conclusions regarding change of perceptions over time. Issues regarding staff and patient perceptions were discussed in terms of the clinical and research use of proxy data. Possible problems with the internal reliability of measures and sample bias which occur with this population were discussed.

Background-Heart failure (HF) is the leading cause for hospital readmission. Hospice care may help palliate HF symptoms but its association with 30-day all-cause readmission remains unknown. Methods and Results-Of the 8032 Medicare beneficiaries hospitalized for HF in 106 Alabama hospitals (1998-2001), 182 (2%) received discharge hospice referrals. Of the 7850 patients not receiving hospice referrals, 1608 (20%) died within 6 months post discharge (the hospice-eligible group). Propensity scores for hospice referral were estimated for each of the 1790 (182+1608) patients and were used to match 179 hospice-referral patients with 179 hospice-eligible patients who were balanced on 28 baseline characteristics (mean age, 79 years; 58% women; 18% non-white). Overall, 22% (1742/8032) died in 6 months, of whom 8% (134/1742) received hospice referrals. Among the 358 matched patients, 30-day all-cause readmission occurred in 5% and 41% of hospice-referral and hospice-eligible patients, respectively (hazard ratio associated with hospice referral, 0.12; 95% confidence interval, 0.06-0.24). Hazard ratios (95% confidence intervals) for 30-day all-cause readmission associated with hospice referral among the 126 patients who died and 232 patients who survived 30-day post discharge were 0.03 (0.04-0.21) and 0.17 (0.08-0.36), respectively. Although 30-day mortality was higher in the hospice referral group (43% versus 27%), it was similar at 90 days (64% versus 67% among hospice-eligible patients). Conclusions-A discharge hospice referral was associated with lower 30-day all-cause readmission among hospitalized patients with HF. However, most patients with HF who died within 6 months of hospital discharge did not receive a discharge hospice referral.

No / Background: Non-medical prescribing is well established within the British health service, with increasing numbers of nurses practicing within children’s hospices. Aim: To identify the context of non-medical prescribing in children’s hospices in the UK, focusing on the perceived benefits and challenges. Method: Internet-based questionnaires were sent to 55 UK children’s hospices, exploring the practice and context of prescribing. Results: Of the 55 invited, 20 children’s hospices responded to the questionnaire, 14 of which employed a total of 39 non-medical prescribers (NMPs). Sixteen individual NMPs responded, of which half (50%) prescribed to enable the continuation of existing medicines, 37.5% prescribed independently surrounding symptom management and control and 31.3% in end-of-life care. Perceived benefits of prescribing included timely access to medicines, increased efficiency and accuracy in the admissions process and medicine reconciliation and the increased ability to offer choice in the place of palliative and hospice care. Perceived barriers to prescribing surrounded opportunities to develop confidence, defining the scope of practice and the time required to assess, diagnose and treat. Conclusion: NMPs are making a significant contribution to the prescribing workforce within hospices; however, a number of challenges need to be addressed to enable hospices to realise the benefits.

No description available.

The ultimate threshold state of a human life is the time preceding death. Hospice care provides a gateway environment for many people for their transition to the other side. Societies throughout history have had rituals and traditions to support the dying and their loved ones, but for modern society, few of these rituals remain. Death has become a topic to avoid "no one wants to look at it or speak about it. This taboo treatment of death often results in the isolation of people at the end of their lives. It also has a major impact on those who are losing their loved ones, as well as the caregivers that deal with death on a daily basis. Through the lens of hospice, this thesis will explore spaces of transition in architecture - the idea of thresholds, both physical and emotional. It seeks to develop a design that considers all of its users and their experience of death and dying. / Master of Architecture