The role of ethics committees in responding to the moral outrage of unrelieved pain.
Explore the source record for details and available documents.
Ethics Committees↗
Biomedical subjects
Betty R Ferrell
Publications and source records attributed to Betty R Ferrell.
A qualitative analysis of social concerns of women with ovarian cancer.
A diagnosis of ovarian cancer requires a woman to reevaluate her interactions with family, friends, and employers, and cope with unexpected and unwanted changes in areas spanning from financial stability to sexuality and fertility. Social well-being is the aspect of a patient's overall quality of life that encompasses these topics, as it has evolved to represent activities related to roles and relationships at work and at home. The purpose of this study was to explore the social well-being of women with ovarian cancer to better define their needs for the health care community. Data consisted of all correspondence (n = 21,806) sent to 'Conversations!: The newsletter for those fighting ovarian cancer' by women with ovarian cancer from 1994 to 2000. Using ethnographic, qualitative research methods, statements related to the impact of disease were bracketed and coded within physical, psychological, social, and spiritual domains according to the City of Hope Quality of Life Ovarian Cancer Instrument. Comments reflecting social well-being were categorized in sub-themes and reviewed for content. Statements related to social support were most common (n = 251) reflecting the need for support from family, friends, and other women with ovarian cancer. Distress regarding the genetic association of the disease comprised a major theme (n = 73). Family relationships were also discussed (n = 146) in light of the stress of changing roles and relationships at home. Issues related to employment and returning to work (n = 74) focused on both the difficulties in taking time off work to receive treat-ment and sense of achievement felt upon returning to work and regaining normalcy. The themes identified in this study challenge healthcare professionals to provide increased disease-specific support, as well as concomitant sup-port for husbands/partners and children of patients. Additional information on genetic testing and counseling for women at-risk due to a family history of ovarian cancer is also needed.
Adult↗
Graduate nursing education regarding end-of-life care.
Explore the source record for details and available documents.
Communication↗
Community implementation of home care palliative care education.
PURPOSE: The purpose of this National Cancer Institute-funded training project was to improve end-of-life care agencies through implementation of a palliative care curriculum. The Home Care Outreach for Palliative Care Education (HOPE) program was designed to improve the knowledge and skills of home healthcare professionals who provide care to the terminally ill and their families at home. DESCRIPTION OF PROGRAM: A five-module palliative care education curriculum was designed and implemented in five home care agencies in the Los Angeles area. One hundred twenty-five nurses and 28 home health aides participated. The methods of data collection included two written surveys conducted before and after intervention, chart audit tool and a case study analysis form. RESULTS: The precourse data revealed deficiencies in home-care agency staff knowledge in and clinical aspects of end-of-life care. Regarding agency nurses' knowledge on end-of-life issues, the overall percentage scores from preeducation to posteducation rose from 84.6% to 89.0% (P =.0001). Participants rated the education program as extremely valuable for the home care agency staff. CLINICAL IMPLICATIONS: As home care will likely continue to be a primary setting for end-of-life healthcare, improvement of palliative care education in home health agencies is needed. The HOPE project provided insight and experience in the education of nonhospice home care staff in end-of-life care. Participant responses and evaluations indicated that end-of-life care education can improve the quality of care provided by home health agencies. Finally, this education program may result in a heightened awareness of hospice care and, although not objectively quantified, perhaps an increase in referrals to hospice.
Health Services Research↗
Teaching symptom management in end-of-life care: the didactic content and teaching strategies based on the end-of-life nursing education curriculum.
Relief of symptoms for patients and families throughout the illness trajectory requires that palliative care practitioners have knowledge and skill, both in assessment and use of pharmacologic and complementary therapies. This article presents the didactic content of symptom assessment and management, and the experiential experiences used in a nondrug laboratory within the End-of-Life Nursing Education Consortium (ELNEC) curriculum.
Anxiety↗
Preparation and care at the time of death: content of the ELNEC curriculum and teaching strategies.
Nurses are exposed to death across the lifespan ranging from stillbirths to neonatal deaths to deaths of children, adolescents, or adults from trauma or various acute or chronic illnesses. To provide quality care at the end of life, nurses must not only possess the knowledge and skills to provide effective end-of-life care, but must also develop the attitudes and interpersonal competence to provide compassionate care. The purpose of this article is to present the key content and teaching strategies related to preparation and care at the time of death based on the End-of-Life Nursing Education Consortium (ELNEC) curriculum. As nurses are educated regarding end-of-life care in undergraduate nursing curriculums and through continuing education programs, the expectation is that quality care will be provided and the suffering of patients and families alleviated. Clearly, nurses play a key role in improving the care of the dying in America.
Attitude to Death↗
Evaluation of end-of-life nursing education for continuing education and clinical staff development educators.
This article presents data from the 1-year follow-up of the three conferences targeted toward continuing education (CE) providers and staff development (SD) educators and reviews the train-the-trainer model used in disseminating the End-of-Life Nursing Education Consortium (ELNEC) curriculum. The analysis has implications for educators to promote improved end-of-life (EOL) care in their own institutions.
Curriculum↗
An overview of palliative nursing care.
Studies tell us that most people fear a protracted, painful death; unfortunately, this is what many experience. Palliative nursing care seeks to change this. This new series challenges nurses to think differently about caring for people when cure isn't possible.
Case Management↗
Meaning of illness and spirituality in ovarian cancer survivors.
PURPOSE/OBJECTIVES: To describe spirituality and meaning of illness in survivors of ovarian cancer. DESIGN: Ethnographic study based on seven years of natural correspondence among survivors of ovarian cancer and a support newsletter. SAMPLE: 21,806 letters, cards, and e-mails received from survivors of ovarian cancer from 1994-2000. METHODS: Analysis was based on the Quality of Life (QOL) Ovarian Cancer Instrument. Data were bracketed and assigned within a table according to QOL themes. MAIN RESEARCH VARIABLES: Spirituality, meaning, QOL, and cancer survivorship. FINDINGS: Spirituality was relied on heavily as a coping mechanism, as well as a method of deriving meaning from the cancer experience. Data from survivors of ovarian cancer validated previously established meaning in cancer themes and identified eight new themes specific to meaning in ovarian cancer survivorship. CONCLUSIONS: The nature of ovarian cancer implicates specific characteristics that alter the meaning of QOL and survivorship. Spirituality is an important component of QOL and contributes to the process of deriving meaning from the ovarian cancer experience. IMPLICATIONS FOR NURSING: Knowledge of the unique survivorship issues of patients with ovarian cancer can enable nurses to improve their care for these women.
Female↗
The role of oncology nursing to ensure quality care for cancer survivors: a report commissioned by the National Cancer Policy Board and Institute of Medicine.
PURPOSE: To examine the roles of oncology nurses in improving quality care for cancer survivors. DATA SOURCES: A content analysis of textbooks, journals, and key documents; surveys of graduate oncology nursing programs and the Oncology Nursing Society's Survivorship Special Interest Group; review of the nursing licensure examination and oncology nursing certification; review of undergraduate and graduate nursing standards; and review of currently funded nursing research. DATA SYNTHESIS: Ten critical content areas of cancer survivorship were used for the analysis: description of population of cancer survivors, primary care, short- and long-term complications, prevention of secondary cancer, detecting recurrent and secondary cancers, treatment of recurrent cancer, quality-of-life issues, rehabilitative services, palliative and end-of-life care, and quality of care. Although findings within each source indicated significant information related to the roles of nurses in caring for cancer survivors, deficits also were identified. CONCLUSIONS: Review of key literature and resources suggests significant contributions by oncology nursing over the past two decades to the area of cancer survivorship. IMPLICATIONS FOR NURSING: Support is needed to expand education and research to ensure quality care for future cancer survivors.
Certification↗
Online exclusive: patient and surgeon decision making regarding surgery for advanced cancer.
PURPOSE/OBJECTIVES: To describe a program of research related to outcomes of palliative surgery and focus on one phase of this research involving decision making by patients and surgeons considering surgery for advanced disease. DESIGN: Descriptive. SAMPLE: 10 patients undergoing surgery and 3 oncology surgeons. METHODS: Qualitative interviews were conducted with patients and their surgeons pre- and postoperatively. Transcripts were content analyzed to identify major themes in patient and surgeon interviews based on study questions. MAIN RESEARCH VARIABLES: Decision making, palliative surgery, quality of life. FINDINGS: The study findings highlight the issues of greatest concern to patients and surgeons considering palliative surgery. This phase was an important component of the overall program of palliative surgery research. CONCLUSIONS: Comprehensive care for patients with advanced cancer seeks to achieve a balance of providing aggressive care, ensuring optimum symptom management, and maintaining a focus on comfort. Further study of palliative surgery as an aspect of interdisciplinary care is warranted. IMPLICATIONS FOR NURSING: Patients undergoing surgery for advanced disease require expert nursing care to address quality-of-life concerns. Further research is needed in this area.
Adult↗
Pain management: a moral imperative.
Explore the source record for details and available documents.
Humans↗