The American journal of hospice & palliative care
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Death and dying in America has received limited attention in medical education. The Southern Arizona VA Health Care System and the University of Arizona have collaborated with three nonprofit community hospice programs to develop an end-of-life care curriculum. This formal and comprehensive program is offered as a one-month elective to senior medical students, residents and fellows. The goal of the program is to improve clinical skills in caring for the dying patient and foster research in palliative and supportive care.
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Am J Hosp Palliat Care · Mar 2000
Elderly hospice cancer patients' descriptions of their pain experiences.
A qualitative research design was used to identify and describe the pain experience of elderly hospice patients with cancer. Eleven participants over the age of 65 receiving hospice services from a for-profit hospice in east Texas were interviewed in their homes. ⋯ Pain was described as a hierarchy of chronic, acute, and psychological pain, with psychological being the worst. Pharmacological and nonpharmacological strategies were used to decrease their "physical" pain, but participants perceived that there was little they could do about their "psychological" pain.
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Am J Hosp Palliat Care · Jan 2000
Comparative StudyThanatophobia and opiophobia of hospice nurses compared with that of other caregivers.
In meeting national needs for our terminally ill, health care educators need to become more aware of their students' aptitudes for hospice work. For these reasons we measured hospice nurses' attitudes toward caring for the terminally ill and their views on using opioids, and compared them to those of other health care personnel and their students. Thirty-eight hospice nurses, 64 other nurses, 93 physicians, and 676 senior medical students participated in this study. ⋯ In caring for the terminally ill, hospice nurses' other personal traits were also less maladaptive than those of the other health professionals. Psychiatrists exhibited the most opiophobia, not only scoring higher than physicians practicing oncology, but also higher than senior medical students. To assure cancer patients that they can expect to live their lives free of pain, medical educators can use these thanatophobia and opiophobia scales to develop better teaching, counseling, and monitoring strategies.
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Am J Hosp Palliat Care · Jan 2000
A pilot program to evaluate pain assessment skills of hospice nurses.
A program was developed to evaluate pain assessment skills of hospice nurses in the home setting, utilizing standardized patients (SPs). Hospice nurses were sent on a routine visit to a "patient's" home to evaluate someone dying of pancreatic cancer. They were not informed in advance that the "patient" was actually an SP, who had undergone intensive training from the staff to prepare him for his role. ⋯ A second part of the program included a written examination of their pain assessment and treatment skills, followed by a didactic presentation. This is the first report we know of that has utilized SPs in the home setting to evaluate pain assessment skills in a blind fashion. Our findings indicate that this can be an effective method for measuring pain assessment skills as well as a valuable teaching device.