Improving the quality of remaining life for individuals who are terminally ill and their families is an issue that has become increasingly important in recent years. This issue has evolved from perceived deficiencies of conventional health care institutions in meeting the needs of people who are in the final stages of their life, when curative measures are no longer deemed appropriate. In response to deficiencies in care of the terminally ill and their families, there has been a movement toward humanizing conventional health care and making it more holistic. Hospice care, which is consistent with this movement, has evolved as an alternative to hospitals and nursing homes. The purpose (of this study was to investigate the physical environment (building and grounds) of a free-standing hospice facility to identify the features that would contribute to the design and renovation of other hospices and health care facilities that plan to adopt a hospice program of care. In this study, an attempt was made to examine how architectural factors combine in a hospice setting to meet the needs of the dying and their families and those who work in hospices. Specifically, this study used a qualitative, case study approach to describe and develop an understanding of the feelings and experiences of the users of a particular hospice facility concerning the physical environment of that facility. Post Occupancy Evaluation Methodology, which is a process to assess the performance of the built environment after it has been occupied for some time, was employed. Qualitative analysis of the data revealed three distinct environments within the facility to be of major importance to the users when discussing the physical surroundings. The three separate areas of importance were the grounds, the administrative offices, and the patient care unit. The findings of the study will be of use to designers, architects, and planners, as well as hospice advocates, as they will assist them in conceptualizing essential components of hospice design and in creating better hospice facilities in the future.

No / The number of children in the UK with life-limiting conditions and the demand for home-based palliative care is increasing. Children's hospices remain a dominant provider of palliative care. This study aimed to determine the approaches taken by children's hospices across the UK in meeting the planned and unplanned health needs of children and their families who receive palliative care at home. In addition, the survey aimed to identify the professional composition of community teams and the number of children and families supported by each service. An internet-based questionnaire survey was sent to all children's hospices in the UK, comprising ten questions exploring the size of the team, geographical areas covered, workforce composition, services offered and approaches to managing unplanned, out of hours care. Responses were received from 14 (26%) of the hospices. A total of 1,618 children and their families were being cared for by these hospices, of whom 825 received care at home. Registered nurses constituted the greatest proportion of staff and were employed by all teams. Care provided at home was broadly split into two categories: planned short breaks and responsive palliative nursing. The latter comprised advance care planning, anticipatory prescribing and active symptom control. Out of hours care was usually offered in the form of telephone support. Models of community-based care are evolving to include nurses practising at specialist and advanced levels, allowing more children with increasingly complex conditions to be cared for at home.

Summary Aim of the study: to assess the need for palliative care services in care hospital and to examine the possibilities of satisfying patients need for palliative care. Objectives: 1.) to analize patients applying for services according to social, demographic and medical factors; 2.) to assess patients relatives oppinion about the quality of received services; 3.) to analise financial side of applied services and to realistically assess costs of services; 4.) to compare recourses granted by government with actual costs of services 5.) to analize the possibilities of applying palliative care services in palliative care hospital. Methods: the research was executed with the help of qualitive and quantitive methods in few stages: I. patients applying for services were analised according to social, demographic and medical factors using data from KCH registering books of year 2001- 2003. II. Patient's relatives oppinion about the palliative care and quality of received services were analised. The relatives of patients in last stages of oncological and neuromothorical illnesses received questionnaires concerning this research. Research was executed 2004 July - December. 46 questionnaires were distributed. The response rate – 95,7%. The biggest part of respondens were women (61,4%). Data analysis was performed with the help of the statistical package SPSS 10.03. Statistical procedures: chi- square's test c2, the degree of freedom (df) and statistical value (p). The results... [to full text]

Thesis (M.S.)--University of Michigan, 1992.

Thesis (doctoral)--Universität, Freiburg/Schweiz, 2005.

published_or_final_version / Architecture / Master / Master of Architecture

Cette thèse a pour objet l’étude des hôpitaux dans les villes du duché de Brabant, depuis leur apparition, à l’aube du XIIe siècle, jusqu’au XVe siècle, époque de transition dans l’organisation de la bienfaisance urbaine. L’accent est mis particulièrement sur l’analyse de l’environnement social, économique et politique qui encourage la fondation de ces établissements et en accompagne le développement.Une première partie envisage les fondations de manière chronologique, distinguant plusieurs périodes de croissance, entrecoupées de longues pauses. Chaque période voit l’intervention d’acteurs particuliers qui prennent en main fondation, dotation et gestion de ces établissements. La seconde partie étudie de manière plus transversale la fondation, la gestion et l’utilisation d’une série d’établissements du XIVe siècle destinés à l’accueil de courte durée, qualifiés ici de gasthuizen. Les acteurs de leur existence sont répartis en trois segments :le groupe fondateur, les administrateurs et la communauté, au sens large, de l’hôpital.Tout au long de la thèse, une place centrale est donnée à la question de l’usage de l’hôpital. Depuis sa fondation ou son administration, jusqu’à l’emploi de son patrimoine ou la mobilisation de sa confrérie, l’hôpital peut en effet servir des objectifs très divers qu’ils soient religieux, politiques, économiques ou d’ascension sociale. Il apparait que, pour qui sait s’en servir, l’hôpital est un outil à multiples facettes. / This PhD thesis studies the hospitals in the cities of the Duchy of Brabant, from their emergence in the early 12th century until the 15th century. The emphasis lies mostly on the analysis of the economic, political and social context from which they rise and where they thrive. Through the thesis, the main actors of the hospital's life are identified and their motives scrutinised. The hospital appears to be indeed a very convenient tool, to use according various economic, political or social purposes. / Doctorat en Histoire, histoire de l'art et archéologie / info:eu-repo/semantics/nonPublished

Thesis (M. Tech.) -- Central University of Technology, Free State, 2010 / South Africa currently faces one of the highest HIV prevalence rates in the world. As this prevalence rises, the strain placed on its hospitals is likely to increase due to the shortage of beds. The devastating effects of HIV/AIDS initiated the establishment of a hospice which is a non-governmental organisation whose goal is the provision of care for terminally ill patients, either in their homes, in hospitals or in a hospice’s own in-patients wards. Part of the hospice’s mission is to offer palliative care without charge to anyone who requires it. The basic elements of hospice care include pain and symptom management, provision of support to the bereaving family and promoting a peaceful and dignified death. This also includes the provision of cooked foods to the patients using the kitchen facilities of the hospices for this activity. It is well known that the kitchen is particularly important in the spread of infectious disease in the domestic environment due to many activities that occur in this particular setting. Food and water safety is especially important to the persons infected with the human immunodeficiency virus (HIV) or with immunodeficiency syndrome (AIDS).It is estimated that food-borne pathogens (disease–causing agents) are responsible for 76 million illnesses, some resulting in death, in the United States alone every year. In one study of patients with AIDS, two-thirds had diarrhoeal disease and in two-thirds of these, the following enteric pathogens were identified: Salmonella, Shigella, Listeria, Yersnia, Cryptosporidium, Entamoeba histolylica and Campylobacter sp. In an epidemiological study of patients with HIV infection a close association was found between consumption of raw or partially cooked fish and antimicrobial-resistant Mycobacterium avium complex. Antibiotic resistance in food-borne pathogens has become a reality and this poses a serious threat to the medical fraternity since it diminishes the effectiveness of treatment. This study was undertaken to determine the prevalence of foodborne pathogens including bio aerosols isolated from the kitchen surfaces and food handler’s before and after cooking. The antibiotic resistance of the isolated pathogens was further determined to assess their impact on treatment. The following microbiota were isolated: Total viable counts (TVC), Coliforms, Escherichia coli, Staphylococcus aureus, Pseudomonas and presumptive Salmonella. The hospices had high counts of E.coli and S.aureus on the cutting boards for the breakfast session compared to the traditional home based kitchens. It was speculated that this could have originated from crosscontamination via the foodhandler’s hands and the food served. It is evident from the results that hospices lack a management system regarding the prevalence of E. coli as it was present on the cutting boards throughout the food preparation sessions. Gram negative organisms (coliform and P. aeruginosa) were in particular both resistant to oxacillin and this pose a great challenge in this particular setting. This can be addressed by putting emphasis on hygiene as a strategy per se for reducing antibiotic resistance.

This diploma thesis deals with clients suffering from mental and sense disease staying in hospices in the Czech Republic. The first chapter is aimed to the history and the present of hospice and palliative care. The second chapter presents specifics of communication and approach to the clients with mental and sense disease. The third chapter deals with professional qualification of the staff working in hospices with such clients. The fourth chapter is aimed to satisfying of existence and existential needs of clients with mental and sense disease. This chapter also indicates some differences in the ways of satisfying these needs in relation to other dying people. The last part of this diploma thesis presents research project which deals with mapping of experiences of hospice staff with clients with mental and sense disease. The research also identifies the specificity of care provided to these clients and describes how the existence and existential needs of these clients are satisfied. It tries to understand how the hospice workers are given their professional competence. Qualitative type of research was used for the project; quantitative part includes semistructured dialogues and group discussion. The research part is based on analysis of seven dialogues and three group discussions with hospice...