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nursing ethics; palliative care; hospice care

Kay De Vries, Marek Plaskota
OBJECTIVE: Palliative sedation is a method of symptom management frequently used in hospices to treat uncontrolled symptoms at the end of life. There is a substantial body of literature on this subject; however, there has been little research into the experiences of hospice nurses when administering palliative sedation in an attempt to manage the terminal restlessness experienced by cancer patients. METHOD: Semistructured interviews were conducted with a purposive sample of seven hospice nurses who had cared for at least one patient who had undergone palliative sedation within the past year in a hospice in the south of England in the United Kingdom...
June 21, 2016: Palliative & Supportive Care
Maryam Aghabarary, Nahid Dehghan Nayeri
BACKGROUND: Despite their negative consequences, evidence shows that futile medical treatments are still being provided, particularly to terminally ill patients. Uncovering the reasons behind providing such treatments in different religious and sociocultural contexts can create a better understanding of medical futility and help manage it effectively. RESEARCH OBJECTIVES: This study was undertaken to explore Iranian nurses' and physicians' perceptions of the reasons behind providing futile medical treatments...
March 21, 2016: Nursing Ethics
Hui-Ju Chang, Li-Ling Hsu, Suh-Ing Hsieh, Tsung-Lan Chu, Wen-Pin Yu
BACKGROUND: Nurses play pivotal roles on palliative care teams and are able to spend more time with patients and their families than are other healthcare professionals. As a consequence, assessing the needs for palliative care education in connection with in-service classes for nurses is clearly extremely important and can help in the planning of appropriate palliative care classes to enhance the quality of care. OBJECTIVES: The goals of this study were to investigate the content needs of nurses with regard to a palliative care in-service education program and to perform exploratory factor analysis on those needs...
May 2016: Cancer Nursing
Sydney Morss Dy, Kasey B Kiley, Katherine Ast, Dale Lupu, Sally A Norton, Susan C McMillan, Keela Herr, Joseph D Rotella, David J Casarett
CONTEXT: Measuring quality of hospice and palliative care is critical for evaluating and improving care, but no standard U.S. quality indicator set exists. OBJECTIVES: The Measuring What Matters (MWM) project aimed to recommend a concise portfolio of valid, clinically relevant, cross-cutting indicators for internal measurement of hospice and palliative care. METHODS: The MWM process was a sequential consensus project of the American Academy of Hospice and Palliative Medicine (AAHPM) and Hospice and Palliative Nurses Association (HPNA)...
April 2015: Journal of Pain and Symptom Management
Alfredo Pompili, Stefano Telera, Veronica Villani, Andrea Pace
OBJECT: Glioblastoma multiforme (GBM) is a rare tumor whose prognosis has remained poor over the years despite innovative radio- and chemotherapies, and important technical advances in neurosurgery such as intraoperative imaging, fluorescence, Cavitron ultrasonic surgical aspirator, and neuronavigation. Particular attention has been dedicated in the last years to the end of life (EOL) period in cancer patients for both ethical and socioeconomic issues. Good palliative care at home avoids improper and expensive hospitalizations, and helps and trains families, caregivers, and patients in facing a difficult situation...
December 2014: Neurosurgical Focus
Lianne Longo, Serena Slater
Being diagnosed with a metastatic brain tumour can be devastating as it is characterized by very low cure rates, as well as significant morbidity and mortality. Given the poor life expectancy and progressive disability that ensues, patients and family members experience much turmoil, which includes losses that bring about changes to family roles, routines and relationships. Crisis and conflict are common during such major disruptions to a family system, as individual members attempt to make sense of the illness experience based on cultural and spiritual beliefs, past experiences and personal philosophies...
2014: Canadian Journal of Neuroscience Nursing
K Laryionava, P Heu├čner, W Hiddemann, E C Winkler
BACKGROUND: Many patients with advanced cancer receive aggressive chemotherapy close to death and are referred too late to palliative or hospice care. AIM: The aim of this study was to investigate oncologists' and oncology nurses' perceptions of the optimal timing for discussions about forgoing cancer-specific therapy at the End-of-Life (EOL) and the reasons that might hinder them. DESIGN: Qualitative in-depth interviews with oncologists and oncology nurses were carried out...
March 2015: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Helen Smith
Caring for a dying child and the family is one of the greatest nursing challenges. The way in which care is delivered will shape the experience they are about to face. Hope plays a crucial role in helping people cope, and healthcare professionals can foster appropriate hopes ethically, while maintaining open and honest communication. If palliative care is discussed with clients and families from the time of diagnosis, they can face realistic decisions better and not feel that they are 'giving up'. They need to know that everything possible is being done to improve the quality of the time left to them...
June 2014: Nursing Children and Young People
Lauren Gurschick, Deborah K Mayer, Laura C Hanson
PURPOSE: To describe the suggested clinical practice of palliative sedation as it is presented in the literature and discuss available guidelines for its use. METHODS: CINAHL, PubMed, and Web of Science were searched for publications since 1997 for recommended guidelines and position statements on palliative sedation as well as data on its provision. Keywords included palliative sedation, terminal sedation, guidelines, United States, and end of life. Inclusion criteria were palliative sedation policies, frameworks, guidelines, or discussion of its practice, general or oncology patient population, performance of the intervention in an inpatient unit, for humans, and in English...
September 2015: American Journal of Hospice & Palliative Care
Helene Eriksson, Gisela Andersson, Louise Olsson, Anna Milberg, Maria Friedrichsen
In Sweden, individuals affected by severe stroke are treated in specialized stroke units. In these units, patients are attended by a multiprofessional team with a focus on care in the acute phase of stroke, rehabilitation phase, and palliative phase. Caring for patients with such a large variety in condition and symptoms might be an extra challenge for the team. Today, there is a lack of knowledge in team experiences of the dilemmas that appear and the consequences that emerge. Therefore, the purpose of this article was to study ethical dilemmas, different approaches, and what consequences they had among healthcare professionals working with the dying patients with stroke in acute stroke units...
June 2014: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Harleah G Buck, Beth Fahlberg
No abstract text is available yet for this article.
March 2014: Nursing
Judith L Hold, Elizabeth N Ward, Barbara J Blake
Nursing education faces several challenges in providing quality and meaningful education. Providing such an education is most important in teaching end-of-life care, as nurses are pivotal in helping patients to achieve a good death. A good death is often based on physical comfort, preparation for death, and completion of social and emotional tasks. Many obstacles hinder a patient's wishes about dying, including how nurses perceive their role in end-of-life care situations and knowing how to intervene on behalf of the patient...
February 2014: Journal of Nursing Education
Aasif A Kazi, W Jeffrey Flowers, Jeanna M Barrett, Ashli K O'Rourke, Gregory N Postma, Paul M Weinberger
OBJECTIVES/HYPOTHESIS: To improve understanding of aspects of end-of-life care that may not be intuitive to the otolaryngology community. DATA SOURCES AND REVIEW METHODS: A comprehensive review of the literature was performed by searching Medline, Embase, and Google Scholar databases. Primary manuscripts' bibliographies were reviewed to identify any nonindexed references. Prospective consultation by means of one-on-one interviews was sought from nonotolaryngology key stakeholders in the areas of hospice nursing care and patient advocacy in order to identify pertinent issues...
July 2014: Laryngoscope
Siri Andreassen Devik, Ingela Enmarker, Ove Hellzen
Registered nurses (RNs) working in homecare encounter severely ill and palliative patients whose expressions may cause ethical challenges and influence their daily work. The aim of this qualitative study was to illuminate and interpret the meaning of nurses' lived experiences when meeting these patients. Narrative interviews were conducted with 10 RNs working in home nursing care. These interviews were audiotaped and transcribed verbatim to a text and interpreted by a phenomenological-hermeneutic method inspired by Ricoeur...
2013: International Journal of Qualitative Studies on Health and Well-being
Jamilla Hussain, Debi Adams, Colin Campbell
BACKGROUND: People with advanced neurological conditions (ANCs) face complex problems and needs that are often unrecognised and undertreated.Their last year of life may be characterised by unplanned hospital admissions and an unexpected death. A National End-of-Life Care Programme (NEoLCP) 2010 framework made recommendations to aid timely and appropriate end-of-life care for people with ANCs. OBJECTIVES: Assessment of key outcomes of a UK nurse-led palliative neurology service against the NEoLCP standards...
April 2013: International Journal of Palliative Nursing
Maurice Nagington, Karen Luker, Catherine Walshe
Ethical care is beginning to be recognised as care that accounts for the views of those at the receiving end of care. However, in the context of palliative and supportive district nursing care, the patients' and their carers' views are seldom heard. This qualitative research study explores these views. Data were collected through semi-structured interviews with 26 patients with palliative and supportive care needs receiving district nursing care, and 13 of their carers. Participants were recruited via community nurses and hospices between September 2010 and October 2011...
December 2013: Nursing Ethics
Jessica Jannette, Marcia Sue DeWolf Bosek, Betty Rambur
UNLABELLED: Patient-directed dying (PDD) (also known as physician-assisted suicide) has been a heavily debated issue in the United States since the passing of the Death With Dignity Act in Oregon in 1997. Previous research surrounding PDD has been limited to assessing the attitudes of physicians, nurses, and patients. The purpose of this study was to describe the intended actions of advanced practice registered nurses (APRNs) toward initiating PDD discussions and prescribing a lethal dose of medication under PDD legislation...
April 2013: JONA'S Healthcare Law, Ethics and Regulation
Shigeko Izumi, Hiroko Nagae, Chihoko Sakurai, Emiko Imamura
Despite increasing interests and urgent needs for quality end-of-life care, there is no exact definition of what is the interval referred to as end of life or what end-of-life care is. The purpose of this article is to report our examination of terms related to end-of-life care and define end-of-life care from nursing ethics perspectives. Current terms related to end-of-life care, such as terminal care, hospice care, and palliative care, are based on a medical model and are restrictive in terms of diagnosis and prognosis...
September 2012: Nursing Ethics
Michelle Hadjiconstantinou, Liz Forbat
The process of obtaining ethical permission for medical research is particularly complex in multicentre studies. This article explores the experience of seeking approval for a mixed-method study of children's palliative care in the UK. The study recruited participants through the NHS (nurses and consultants) and third sector (hospice staff and families). The stringent checks and balances that are discussed here apply to any medical research, and can reassure all interested parties of consistently high ethical standards...
February 2012: Nursing Children and Young People
Thomas H Scott, Jonathan R Gavrin
Palliative care in the United States has made tremendous strides in the last decade. One of the most perplexing issues arises when a palliative care patient presents to the operating room with an already existing do-not-resuscitate (DNR) order. This article describes the most common conflicting issues that may arise and provides guidance to surgeons, anesthesiologists, patients, and their primary physicians to reach satisfactory resolution and optimal care. Anesthesia departments should appoint a liaison to surgical and perioperative nursing departments to provide education and create an atmosphere conducive to discussions with palliative care patients about goals of care, including DNR status...
March 2012: Anesthesiology Clinics
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