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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

The lived experiences of Taiwanese hospice nurses caring for dying patients

Wu, Hung-Lan January 1900 (has links)
Thesis (Ph. D.)--University of Texas at Austin, 2008. / Vita. Includes bibliographical references.
2

Strategic asset or optional extra? : the impact of volunteers on hospice sustainability

Scott, Rosalind January 2013 (has links)
Volunteering is a vital and integral part of UK independent hospices. Volunteers were the founders of many, if not all, UK hospices. Today, hospices are still heavily dependent on volunteers to raise funds and undertake a wide range of roles which help to support the patients and their families. Trustees, who are seen very differently to volunteers, also work in a voluntary capacity on hospice Boards. In this role they are responsible for the governance of hospices, carrying significant legal responsibility and setting the strategic direction. Yet volunteering is often overlooked at a strategic level and there are barriers to involvement in key areas, such as care. The purpose of this research was to explore the relationship between volunteering and the future sustainability of UK independent hospices. This was carried out by developing and testing a theoretical model of organisational sustainability in adult and children’s hospices to explore how volunteering is understood by UK independent hospice senior staff, volunteers and trustees; to consider the influence of volunteers on four key organisational sustainability factors: governance; service delivery; hospice economy; and community engagement and explore whether there is a link between volunteering and hospice sustainability. As this study had a strategic focus, the views of senior staff, trustees and volunteers were sought. Findings suggest that there is little understanding of the role of volunteers in governance, that there is a lack of planning for volunteer involvement and that volunteering has a strong influence on the sustainability of independent hospices. This is the first study of its kind and makes an original contribution to knowledge by producing evidence to demonstrate the relationship between hospice sustainability and volunteering. It has the potential to influence and develop thinking about volunteering in UK independent hospices
3

Maine hospice volunteers : a study of motivations, death awareness and religious beliefs /

Donovan, Anne F. Baranowski, Marc D. Schilmoeller, Gary L. Bicknell, Elizabeth. January 2001 (has links)
Thesis (M.S.) in Human Development--University of Maine, 2001. / Includes vita. Advisory Committee: Marc D. Baranowski, Assoc. Prof. of Human Development, Advisor; Gary L. Schilmoeller, Assoc. Prof. of Child Development & Family Relations; Elizabeth H. Bicknell, Assoc. Prof. of Nursing. Includes bibliographical references (leaves 47-50).
4

Understanding Quality of Care in a Hospice Setting

Taylor, Sarah Fese 01 January 2018 (has links)
Assuring quality of care for patients who face the end of life has been a major concern for those in hospice settings. Limited research is available that has a focus on understanding what quality of care in a hospice setting looks like. This research is important to provide insight into hospice health care providers' perceptions of the quality of care in the hospice setting and on the indicators that influence care quality. A qualitative phenomenological approach was used to answer the research questions on the perspectives of the health care providers in the hospice care setting regarding the quality of care and the factors that health care providers perceive as important to the quality of care in the hospice setting. Kolcaba's comfort theory served as the theoretical framework that guided the preparation of the questions used for the interviews and for interpreting the findings. Data collection was conducted through structured interviews with a sample of 15 hospice health care providers. Interviews were held in a private office of the hospice setting. After Walden Institutional Review Board approval, participants consented and interviews commenced. Data were transcribed and Nvivo software was used to assist with identifying major themes. Recommendations from the study reflect Kolcaba's comfort theory providing patient-centered care and enhanced quality of care for patients in a hospice setting. The research findings and recommendations will help promote a positive social change by raising awareness for effective provider communication, staffing, education and adequacy of resources in the hospice setting.
5

Medication Cost and Utilization in Hospice Care: An Analysis of 2007 Claims Data

Parekh, Rachi 18 April 2013 (has links)
Objectives:<br>1. Describe patient-related and hospice-related characteristics such as gender, average length of hospice stay, primary diagnoses, average daily census, number of admissions per year, net operating revenues, inpatient unit (IPU) operating costs, and medication expenditures of hospices in Ohio and compare it with NHPCO data.<br>2. Identify and analyze therapeutic drug classes and medications with the most frequent utilization rates and largest percentage of expenditures in hospice care.<br><br>Method:<br>Hospice Pharmacy Benefit Managers (PBM) employ pharmacists to provide comprehensive pharmaceutical care services for patients under hospice care and one component of pharmacist provided services include comprehensive medication review. To study the impact of pharmacist-led medication review on hospice costs and medication utilization, PBM claims data for year 2007 were obtained from five hospices in Ohio. The data included information on utilization and costs of medications, patient-related (gender, average length of hospice service, and primary diagnoses) and hospice-related (number of admissions per year, average daily census, net operating revenues, inpatient unit [IPU] operating costs and pharmacy costs) characteristics. Claims data were analyzed to identify the most frequently used therapeutic drug classes and those classes which contributed to the largest percentage of pharmacy expenditures. Prescription drug count and total cost for medications under the identified therapeutic drug classes were also obtained. For benchmarking purposes, analysis was conducted to compare patient and hospice-related data obtained from the five hospices to the 2007 NHPCO data.<br><br>Results:<br>The average number of admissions per hospice for the year 2007 was 627 patients. Average daily census (136 patients) and total patient days (51,350 days) in these five hospices were 1.5 times higher as compared to that of NHPCO data (90 patients and 31,300 days, respectively.). Annual drug expenditures per hospice ranged from $67,580 to $763,413 while average hospice medication cost per patient per day (PPPD) was $11.12 ($12.43 PPPD for home care and $8.5 PPPD for nursing care). Average PPPD excluding outliers such as enoxaparin was $10.72 ($12.05 PPPD for home care and $8.25 PPPD for nursing care).<br>Approximately 1,020 different drugs under 246 therapeutic classes were utilized in the five hospices. The most frequently utilized therapeutic class of drugs, based on prescription drug volume included analgesic-narcotics (15.6%) followed by laxatives-cathartics (7.5%), and anti-anxiety drugs (7%). Therapeutic classes contributing to the majority of drug expenditures, included analgesics-narcotics (16.5%), SSRIs (4.7%), and anti-anxiety drugs (4.5%). Medications whose frequency of use accounted for high expense included morphine sulfate (5.3% - utilization, 4.4% - expenditure), lorazepam (4.4%, 3.1%), furosemide (4%, 0.6%), methadone (3%, 0.9%), and prednisone (3.1%, 0.5%). Medications such as enoxaparin injections whose frequency of utilization was low (0.01%), contributed to 3.1% of total medication expenditure. Likewise, fentanyl and oxycodone contributed to 3.5% and 3.7%, respectively to the total medication expenditure, but their frequency of utilization was only 0.9% and 1.9%, respectively.<br><br>Conclusion:<br>The five hospices in Ohio utilized preferred drugs recommended by pharmacists following a medication review to identify potential drug related problems (DRPs) and encourage cost-effective drug utilization. As a result of these interventions, the utilization of expensive medications is low. Pharmacists specializing in hospice and palliative care are able to recommend preferred medications in end-of-life care thus producing cost-savings. More importantly, hospice pharmacists frequently identify DRP's which can improve patient outcomes. Hospices should consider interventions made by pharmacists and place emphasis on the utilization of cost effective drugs that can be used among terminally ill patients to provide a high level of quality care with fiscal responsibility. / Mylan School of Pharmacy and the Graduate School of Pharmaceutical Sciences; / Pharmacy Administration; / MS; / Thesis;
6

The lived experiences of Taiwanese hospice nurses caring for dying patients

Wu, Hung-Lan 12 October 2012 (has links)
Hospice nurses are primary professional caregivers providing end-of-life care to dying patients and their families. The terminal care practices often place heavy physical, emotional, and spiritual demands on hospice nurses. The purpose of this hermeneutic phenomenological study was to explore the experiences of Taiwanese nurses who care for dying patients in hospices. The research question that guided this study was: What is the lived experience of Taiwanese hospice nurses who caring for dying patients? The conceptual orientation of this study was based on Paterson and Zderad’s (1976) Humanistic Nursing Theory, which is rooted in phenomenology, intersubjectivity, and existential thought. A snowball sampling technique was employed to recruit 14 female participants who worked in six different hospices in central and southern Taiwan. Semi-structured, face-to-face interviews were conducted and transcribed by the researcher. The data analysis was based on Colaizzi’s (1978) guidelines. Four main themes and three sub-themes emerged from thematic analysis. The four main themes are: (1) entering the specialty of hospice, (2) managing everyday work, (3) living with the challenges, and (4) reaping the rewards. Three sub-themes of managing everyday work include providing holistic, meaningful care through close relationships; confronting and managing negative beliefs about hospice; and managing the dying process. These main themes and subthemes constituted the fundamental structure of these hospice nurses’ caregiving experiences which was an evolving journey. The results of this study provide nursing educators, students, staff and administrators insights into the hospice nurses’ experience and hospice care in Taiwan. They can use these data to improve nursing education and change nursing practice. Additionally, researchers can design further studies to expand nursing knowledge to advance staff development and improve quality care for dying patients and their families. / text
7

Hospice care in the United Kingdom and in the United States of America

Behr, Macrina. January 1990 (has links)
Thesis (M.A.)--St. Vladimir's Orthodox Theological Seminary, 1990. / Includes bibliographical references (leaf 29).
8

Barriers Among Primary Care Providers to Utilizing Palliative/Hospice Care for Patients with Non-Cancerous Terminal Illness

Ellis, Susan Eileen January 2016 (has links)
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.
9

Hospice Interdisciplinary Team Processes and Effectiveness

Hale, Beth Ann January 2007 (has links)
The purpose of this research was to test a causal model of interdisciplinary hospice processes and effectiveness. This research examined the impact of organization and team level structure constructs (organizational culture, team complexity, and team leadership) on hospice interdisciplinary team processes and subsequent influence on perceived team effectiveness. The relationships among perceived team effectiveness, team task satisfaction, and family satisfaction with hospice care were also examined.The sample consisted of 41 hospice interdisciplinary teams drawn from two hospice organizations in a southwestern city of the United States. Participants included 410 interdisciplinary team members and 32 hospice team leaders. Measures used in this research were adapted from instruments previously used in non-hospice settings. Data were collected through self-report surveys. Psychometric properties of all instruments were performed at the individual and group level. Psychometric properties of all but three scales (Hospice Organizational Culture: Group Culture, Hierarchical Culture, and Developmental Culture) exhibited reliability and evidence of validity as group measures.Four hypothesized relationships were supported, and six nonhypothesized relationships were significant in the model. All team processes except conflict management had positive direct effects on perceived team effectiveness. Perceived team effectiveness had a positive direct effect on team task satisfaction, and team task satisfaction was positively correlated with family satisfaction with hospice care in a limited sample. The proposed structural factors (hospice organizational culture, team complexity, and team leadership) did not impact hospice interdisciplinary team processes or team effectiveness. Approximately sixty-five percent of the variance in team effectiveness was explained by team hospice experience and team processes (leadership, communication, and coordination). Nearly fifty percent of variance in team task satisfaction was explained by the processes used for conflict management and perceived team effectiveness.Relationships identified in this research are viewed as preliminary. Future research should modify and re-examine model relationships with a larger sample drawn from diverse hospice organizations. In addition, structural variables influencing the hospice interdisciplinary team need to be re-examined for appropriateness and conceptual relevance. However, this study provided a foundation for understanding hospice interdisciplinary team processes and the influence of these processes on team and family satisfaction.
10

Family caregivers in palliative care : perception of their role and sources of support

Smith, Paula Caroline January 2000 (has links)
No description available.

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