The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Jun 2011
The frequency and correlates of spiritual distress among patients with advanced cancer admitted to an acute palliative care unit.
Limited research is available on the frequency of spiritual distress and its relationship with physical and emotional distress. We reviewed patients admitted to our acute palliative care unit (APCU) and determined the association between patient characteristics, symptom severity using the Edmonton Symptom Assessment scale (ESAS), and spiritual distress as reported by a chaplain on initial visit. ⋯ Spiritual distress was associated with age (OR = 0.96, P = .012) and depression (OR = 1.27, P = .020) in multivariate analysis. Our findings support regular spiritual assessment as part of the interdisciplinary approach to optimize symptom control.
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Am J Hosp Palliat Care · Jun 2011
Developing and testing a web-based survey to assess educational needs of palliative and end-of-life health care professionals in Connecticut.
Institute of Medicine reports have identified gaps in health care professionals' knowledge of palliative and end-of-life care, recommending improved education. Our purpose was to develop and administer a Web-based survey to identify the educational needs of multidisciplinary health care professionals who provide this care in Connecticut to inform educational initiatives. We developed an 80-item survey and recruited participants through the Internet and in person. ⋯ Disciplines reported greater agreement on items related to their routine tasks. Reported needs included dealing with cultural and spiritual matters and having supportive resources at work. Focus groups confirmed results that are consistent with National Consensus Project guidelines for quality palliative care and indicate the End-of-Life Nursing Education Consortium modules for education.
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Am J Hosp Palliat Care · Jun 2011
Exploring the relationship between the frequency of documented bowel movements and prescribed laxatives in hospitalized palliative care patients.
Retrospective analysis of 211 admissions to a palliative care unit was undertaken to explore the relationship between prescribed laxatives and the frequency of documentation of bowel movements. Bivariate analysis flailed to identify relationships between laxatives and the frequency of bowel movements. Relationships were identified between less frequent bowel movements and type and duration of illness phase. ⋯ People in longer illness phases were more likely to have regular bowel movements (Z = 3.02, P = .003). The second significant result was that, even accounting for the short duration of the terminal phase, people who were dying were 13 times less likely to have any bowel movements documented than those in the stable phase (OR = 13.2, 95%CI = 2.0-89.2). The lack of relationship between laxatives and documentation of bowel movements suggests alternative approaches to understanding and managing the symptom of constipation in palliative care are necessary.
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Hospice programs have emerged over the last 40 years as both an effective and humane practice for responding to terminal illnesses in the free society. More recently, hospice has diffused throughout state, federal, and municipal correctional systems. ⋯ Our findings suggest that prison hospices have a more stringent screening process for volunteers and require more volunteer training prior to interacting with a hospice patient. Prison hospice programs tend to follow both the National Prison Hospice Association and the GRACE Project guidelines.