Journal of Hospice & Palliative Nursing最新文献

Undergraduate nursing students require adequate primary palliative care education in their formal education to prepare them to care for the growing population of individuals living with serious illness and their families. This paper aggregates results from 3, nationwide cross-sectional, descriptive, needs assessment studies and one single-institution needs assessment study to explore faculty perceptions and the integration of primary palliative care content in undergraduate nursing programs in the United States. Each study's design and needs assessment survey are described, followed by aggregated results from 137 respondents related to faculty demographics, nursing program details and primary palliative care integration, and faculty perceptions of primary palliative care education. Results from the local needs assessment are presented independently. Findings identify strengths related to faculty perceptions and preparedness. Key curricular gaps and opportunities in primary palliative care education pertain to alignment with competence expectations, supporting the need for academic-practice partnerships.

In the year 2000, leaders with the American Association of Colleges of Nursing joined with Dr. Betty Ferrell and her colleagues at City of Hope to address gaps in how nurses are educated to care for patients at the end-of-life and their families. The collaborators launched a far-reaching train-the-trainer initiative, the End-of-Life Nursing Education Consortium (ELNEC), which resulted in competencies, guidelines, and nursing curricula developed to prepare nurses to provide evidence-based, skilled, and compassionate palliative care. The 25th anniversary of ELNEC celebrates the tremendous efforts of the stakeholders in academia and practice, who share a commitment to transforming nursing education and elevating health care across settings. To date, more than 1.7 million nurses have been educated with the ELNEC curriculum, and more than 1200 undergraduate and 440 graduate schools of nursing offer ELNEC training in palliative end-of-life care. The remarkable academic-practice partnership at the heart of ELNEC has dramatically changed nursing care for patients with serious illnesses and their families in the United States and globally.

Palliative care is a critical component of high-quality healthcare, yet graduate nursing education has historically underemphasized its integration into advanced practice and scholarly training. This article outlines an innovative, evidence-informed approach to embedding palliative care education throughout graduate nursing curricula, aligned with national guidelines. This exemplar model demonstrates how primary and specialty palliative care can be woven into core coursework, clinical training, and interdisciplinary collaboration to build clinical, ethical, and leadership competencies. Strategies include simulation-based training, reflective writing, interprofessional intensives, and leadership development through scholarly presentations and quality improvement projects. These multimodal methods are grounded in national standards, emphasizing communication, symptom management, ethical decision-making, and culturally responsive care. Faculty partnerships, national resources, and curricular tools support implementation across a range of academic programs. Integrating palliative care throughout graduate nursing education fosters a workforce equipped to deliver person-centered, compassionate care for individuals with serious illness and their caregivers. The curriculum model presented offers a replicable framework for nursing programs seeking to expand their capacity to meet the growing global demand for palliative care.

This project aimed to address a gap in nurses' awareness of spiritual care and comprehensive spiritual support of patients in a breast oncology clinic at a National Cancer Institute (NCI)-designated Comprehensive Cancer Center through interdisciplinary collaboration with chaplaincy. Measures of nurses' comfort and understanding of spiritual care were assessed at baseline and monthly, utilizing a validated tool. Following education, nurses screened patients during their initial visit to the breast surgical oncology clinic who were experiencing moderate to severe distress for related existential themes of distress using an assessment tool and referred them to chaplaincy or social work based on the screening results. Nurse-initiated chaplain referrals increased significantly during the study period, with the most common distress themes being stress, hopes/fears, and assistance/help. Patient acceptance of referrals averaged 18.7% for chaplaincy and 33.1% for social work. By enhancing nurses' understanding of spiritual care and the role of chaplaincy, the clinic was able to improve the provision of comprehensive spiritual support, contributing to holistic patient care. Due to spirituality being a component of quality of life, this approach is transferable to other clinical settings. Future research could explore the impact of chaplain interventions on patient distress and quality of life for patients and caregivers.

Nurses are important in delivering comfortable care and serve as central figures in patient-centered care in hospice and palliative care units. Nurse burnout negatively affects organizational outcomes by threatening patient safety and reducing the quality of nursing care. This study aimed to identify the factors influencing burnout among nurses in hospice and palliative care units. This descriptive correlational study investigated the effects of nursing practice environment, resilience, and nurses' character on burnout among hospice and palliative care ward nurses. The participants were 217 nurses working in hospice wards of 20 institutions selected from the 88 inpatient hospice and palliative care institutions designated by the Ministry of Health and Welfare in South Korea, as of 2021. The results showed that a better nursing practice environment and higher resilience were positively associated with lower burnout. Among hospice and palliative care nurses, being in their 30s and having fewer than 5 years of total clinical experience were associated with higher burnout. The explanatory power of the model is 43.6%. These findings suggest that multidimensional interventions are required to prevent burnout among nurses in hospice and palliative care settings.

Palliative care is underutilized in sickle cell disease despite it being a serious, inherited condition plagued by severe pain, other symptoms, and frequent death in young adulthood. We sought feedback from individuals with sickle cell disease (Sickle Cell Warriors) to inform the design of a palliative care intervention. In a qualitative descriptive approach, 12 adults participated in a 90-minute virtual focus group. The session was audio-recorded, transcribed verbatim, and thematically analyzed using a structured coding process. Participants provided insights on the preferred format, delivery, and content of an intervention aimed at improving symptom management and quality of life. Three themes were identified: (1) intervention design, delivery, and check-ins, reflecting preferences for hybrid delivery, consistency, and engagement; (2) successful aging with sickle cell disease, highlighting the importance of self-care, emotional well-being, and social connection; and (3) "palliative care" is foreign, illustrating the stigma and misunderstanding surrounding the term "palliative care." Participants expressed a strong need for mental health support, education, and flexible programming tailored to their lived experiences. Future palliative care interventions need to be culturally aligned with terminology and delivery strategies. This study offers guidance for developing patient-centered, nurse-led interventions to improve symptom management and supportive care among adults with sickle cell disease.

Grief and bereavement support are essential for patients and family members facing serious illness and the end of life. In total, 126 participants attended a 2-day palliative care training for oncology, the End-of-Life Nursing Education Consortium Oncology advanced practice registered nurse course, supported by a grant from the National Cancer Institute. Participants were asked to complete 3 open-ended questions and an 11-item survey assessing their confidence in providing bereavement support for patients and family members facing serious illness and end of life in postcourse evaluations. Results indicated that the lowest confidence scores were related to basic assessment of grief in adults and pediatrics and the highest confidence scores were providing emotional support for patients/families in their grief and supporting colleagues in their grief. Six themes emerged from the open-ended question that asked participants to share case studies describing a patient or family member that they had cared for who was experiencing grief and nurse interventions: (1) treatment failure/out of options, (2) unexpected death or recent loss, (3) impending death, (4) multiple or overlapping losses, (5) coping, and (6) anticipatory grief. Hospice and Palliative Care nurses can provide bereavement support for oncology patients, their families, and the oncology nurses who care for them.

Throughout history, end-of-life has posed profound ethical and emotional challenges. Today, the growing desire for control has led to two interconnected phenomena: death tourism and palliative care. Hopelessness and loss of control drive some patients to seek euthanasia or physician-assisted suicide abroad, especially where these practices are illegal in their home countries. For them, this difficult decision represents reclaiming agency in the face of unbearable suffering. In contrast, palliative care provides an alternative focused on improving quality of life for patients with life-threatening illnesses and their families. Its holistic approach-addressing physical, psychological, social, and spiritual needs-ensures dignity, comfort, and support. Expanding access to comprehensive palliative services can significantly reduce feelings of despair and diminish the demand for death tourism. By fostering a sense of being valued and supported, palliative care helps individuals face their final stages with meaning rather than fear. This underscores the critical role of nurses, whose professional preparedness is essential in addressing global ethical dilemmas and disseminating palliative practices effectively. Ultimately, the solution to protecting human dignity lies not in hastening death, but in alleviating suffering so that life, even in its final chapter, remains meaningful..

This article reports on the item construction of a new screening scale to measure coping and communication among adolescents with a parent enrolled in hospice. The aim of this study was to use cognitive interviewing methodology to determine the validity and reliability of the Adolescent Coping and Communication Scale (ACCS). The young adults in this study identified the need for a consistent point person on the hospice care team to discuss their concerns and provide information and support. The ACCS is a concise 15-question tool using a 5-point Likert scale to monitor the adolescent's coping and communication needs in real time. It can easily be formatted electronically or in paper format and completed in less than 10 minutes. It can be used as a clinical screening tool by health professionals who seek to help adolescents navigate this critical time when their parent is near the end of life. These results can also be used to inform the development of interventions that assist families with strategies tailored to an adolescent's specific needs. Additional research is needed to assess the psychometric properties of scale items. Future research should investigate the use of this tool in other age groups and populations.

Although patient falls in the acute care setting have been thoroughly studied, published studies exploring falls for patients receiving hospice care remain limited. Patients receiving hospice care present with considerable risk factors for falls, including physical and cognitive changes associated with a terminal diagnosis. An increasing pattern of patient fall rates was identified at the organization and a quality initiative was developed to address this aspect of patient care. The SMART aim of this project was to establish a sustainable process to decrease the percentage of patient falls from 5% to 3% in an organization's hospice regional branch within a 3-month period. This project adopted the Plan-Do-Study-Act process as its change model. A bundled intervention was introduced including early referrals to the therapy team for newly admitted patients, staff education, and providing supplemental patient education. The measurable outcome was to achieve a decrease in fall rates. Although the goal was not achieved within the 3-month timeframe, data did indicate a positive trend toward the intended goal. Results indicated ongoing opportunities for nurses to enhance reliability in making therapy referrals. However, nurses demonstrated consistency in providing supplemental education.