The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Sep 2003
Satisfaction of families using end-of-life care: current successes and challenges in the hospice industry.
This study examined the satisfaction of family members with the end-of-life care their loved ones received. Data were collected from 1,839 individuals receiving care from 17 different care agencies nationwide. ⋯ The timing of the referral was critical, with families rating services lower almost across the board when the referral to hospice was deemed "too late." Additionally, families expressed greater satisfaction when the patient's care was overseen by the hospice director, rather than a personal physician. Each of these findings has important implications for physicians, patients, and families as they begin to plan for end-of-life care.
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Am J Hosp Palliat Care · Sep 2003
An analysis of provider attitudes toward end-of-life decision-making.
The explosion of technological and biomedical interventions over the past half century appears to have enhanced the medical profession's ability to prolong life at a faster pace than society's ability to develop comprehensive bioethical laws governing end-of-life decisions. This study was conducted to determine if there was a correlation between educational and occupational backgrounds and participants' perceptions of end-of-life care. ⋯ Respondents were classified by type of education or background (technical, professional, or medical) and by level of involvement with patient care (direct or indirect). While the results showed a general consensus about the importance of respecting patients' end-of-life wishes, there were differences among respondents in regard to specific issues.
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Hospice and palliative care have undergone dramatic changes in the past 30 years. Educational initiatives and certification programs for physicians (American Board of Hospice and Palliative Medicine) and nurses (National Board for Certification of Hospice and Palliative Nurses) have further delineated this area of practice as distinct from geriatrics, neurology, anesthesiology, or oncology. As other professions assess their own practices of hospice and end-of-life (EOL) care education in their respective schools and colleges, the pharmacy profession must also ensure that its future graduates are prepared to adequately participate in this type of care. ⋯ Sixty-two percent of respondents indicated EOL care education was provided didactically (3.89 +/- 1.91 lecture hours per year). Fifty-eight percent of respondents indicated that EOL care experiential clerkships were available (4.97 +/- 1.25 weeks in duration). These data indicate that over half of US pharmacy students receive some exposure to EOL care education.
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Am J Hosp Palliat Care · Sep 2003
The business of palliative medicine--Part 3: The development of a palliative medicine program in an academic medical center.
Palliative medicine is the total continuing care of patients with cancer. Most resources for cancer care focus on curative attempts while often ignoring the symptoms created by the disease and its treatment. Attempts at curative treatment of the malignancy must be coupled with pain and symptom relief psychosocial and spiritual care, and support for the patient and family extending from the time of diagnosis through the bereavement period. ⋯ These programs must include education, research, and patient care and must work through an interdisciplinary team. The Cleveland Clinic Foundation palliative medicine program (PMP) is composed of a primary inpatient service, consult service, outpatient clinic, hospice homecare, and cancer homecare services. In this article, we describe the structure and development of the program and suggest future avenues for growth.