Pub Date : 1989-03-01DOI: 10.1177/104990918900600214
P Storey
Madam, As authors of ‘Emotional intelligence and the occupational therapist’, published in the September issue of the journal (McKenna and Mellson 2013), we write in response to the subsequent letters (Chaffey 2013, Healey 2013). We thank the authors for their interest in this article and their acknowledgement of the importance of discussion around the emotional aspects of our practice. Whilst we accept that cultural literacy is essential for our holistic practice and that overreliance on assumptive conceptual tenets is undesirable, it is important to acknowledge that emotional intelligence (EI) draws on evidence from established psycholological theory. This theory describes emotion by linking thinking, emotion, and behaviour from an individual perspective, thus taking account of contextual and cultural influences. The ability to identify, express, and discriminate feelings, and then use them to prioritize, understand multiple viewpoints, problem solve, reflect, and monitor emotional demand and function must include individual context and experiences in order to be effective (Goleman 2004, Mayer and Salovey 1997). Evidence exists to suggest that abilities are malleable, and that lifelong learning is both possible and desirable. The evidence base for EI within the disciplines of psychology, medicine, nursing, and social work is well developed, and supports application of this concept in the facilitation of emotional competence for a range of individuals (Por et al 2011, Smith 2005, Weng et al 2011). This support for the potential of an EI score as an indicator of personal and professional success is growing and in simple terms we cannot ignore it. In line with the National Health Service [NHS] Constitution (Department of Health 2012), our professional education programmes are required to produce practitioners who are fit for practice with compassion; we must be able to satisfy all stakeholders that we can evidence our ability to do this. Many stakeholders, including the potential employers of our students, are advocating values-based recruitment and the utilization of EI measures and training as a tool for selection of staff and for senior staff /leadership development. This supports the need to recognize the emotional demands of our profession and to measure and develop the ability to utilize emotion with intelligence with service users, carers, colleagues, and students, ensuring their success in the workplace and to support competence in profession. We acknowledge the work of Chaffey et al (2012) in exploring emotion management and its influence on good practice, and appreciate the work done in raising awareness of the links between intuition and emotional intelligence. Notwithstanding these studies, the authors contend that this area has not been well explored to date by our profession. We, too, wish to see an increase in research in this area, and we welcome this vigorous approach to a discourse which is both timely and essential.
{"title":"Quality of care for dying patients.","authors":"P Storey","doi":"10.1177/104990918900600214","DOIUrl":"https://doi.org/10.1177/104990918900600214","url":null,"abstract":"Madam, As authors of ‘Emotional intelligence and the occupational therapist’, published in the September issue of the journal (McKenna and Mellson 2013), we write in response to the subsequent letters (Chaffey 2013, Healey 2013). We thank the authors for their interest in this article and their acknowledgement of the importance of discussion around the emotional aspects of our practice. Whilst we accept that cultural literacy is essential for our holistic practice and that overreliance on assumptive conceptual tenets is undesirable, it is important to acknowledge that emotional intelligence (EI) draws on evidence from established psycholological theory. This theory describes emotion by linking thinking, emotion, and behaviour from an individual perspective, thus taking account of contextual and cultural influences. The ability to identify, express, and discriminate feelings, and then use them to prioritize, understand multiple viewpoints, problem solve, reflect, and monitor emotional demand and function must include individual context and experiences in order to be effective (Goleman 2004, Mayer and Salovey 1997). Evidence exists to suggest that abilities are malleable, and that lifelong learning is both possible and desirable. The evidence base for EI within the disciplines of psychology, medicine, nursing, and social work is well developed, and supports application of this concept in the facilitation of emotional competence for a range of individuals (Por et al 2011, Smith 2005, Weng et al 2011). This support for the potential of an EI score as an indicator of personal and professional success is growing and in simple terms we cannot ignore it. In line with the National Health Service [NHS] Constitution (Department of Health 2012), our professional education programmes are required to produce practitioners who are fit for practice with compassion; we must be able to satisfy all stakeholders that we can evidence our ability to do this. Many stakeholders, including the potential employers of our students, are advocating values-based recruitment and the utilization of EI measures and training as a tool for selection of staff and for senior staff /leadership development. This supports the need to recognize the emotional demands of our profession and to measure and develop the ability to utilize emotion with intelligence with service users, carers, colleagues, and students, ensuring their success in the workplace and to support competence in profession. We acknowledge the work of Chaffey et al (2012) in exploring emotion management and its influence on good practice, and appreciate the work done in raising awareness of the links between intuition and emotional intelligence. Notwithstanding these studies, the authors contend that this area has not been well explored to date by our profession. We, too, wish to see an increase in research in this area, and we welcome this vigorous approach to a discourse which is both timely and essential.","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 2","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"1989-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13853636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-01-01DOI: 10.1177/104990918900600108
A G Lipman
Great progress has been made in the management of cancer pain during the last twenty years. The hospice movement has been a major force for recognizing the importance ofimproving the level of symptom control for patients with advanced disease. However, many patients still suffer greatly from cancer pain, unnecessarily. Inadequate doses of analgesics, inappropriate dosing schedules, extrapolation from acute pain management models and from single dose studies to the management of chronic, malignant pain and failure to individualize drug therapy contribute to these treatment failures.
{"title":"Opioid analgesics in the management of cancer pain.","authors":"A G Lipman","doi":"10.1177/104990918900600108","DOIUrl":"https://doi.org/10.1177/104990918900600108","url":null,"abstract":"Great progress has been made in the management of cancer pain during the last twenty years. The hospice movement has been a major force for recognizing the importance ofimproving the level of symptom control for patients with advanced disease. However, many patients still suffer greatly from cancer pain, unnecessarily. Inadequate doses of analgesics, inappropriate dosing schedules, extrapolation from acute pain management models and from single dose studies to the management of chronic, malignant pain and failure to individualize drug therapy contribute to these treatment failures.","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 1","pages":"13-23"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600108","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13685339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-01-01DOI: 10.1177/104990918900600106
D Lescohier
7. Be open to opportunities for other organizations, civic groups, churches, to sponsor an event for you. Ordinarily, that group will provide the idea and the volunteers, and take care of all the details, while your hospice will receive all or part of the proceeds. Be visible in the community so you will attract such opportunities. Relationships between community organizations can be developed by hospice outreach and public relations efforts to describe program goals.
{"title":"Hospice--is it effective?","authors":"D Lescohier","doi":"10.1177/104990918900600106","DOIUrl":"https://doi.org/10.1177/104990918900600106","url":null,"abstract":"7. Be open to opportunities for other organizations, civic groups, churches, to sponsor an event for you. Ordinarily, that group will provide the idea and the volunteers, and take care of all the details, while your hospice will receive all or part of the proceeds. Be visible in the community so you will attract such opportunities. Relationships between community organizations can be developed by hospice outreach and public relations efforts to describe program goals.","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13853624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-01-01DOI: 10.1177/104990918900600112
M R Andrews, A M Levine
Recent discussion about the care of the terminally il patient has focused on the appropriateness of with holding and with drawing food and fluid and on the discomfort of the dehydrated state. Evidence is mounting that suggests that dehydration in this group of people is not painful, but rather may be more comfortable than hydration by means of IV fluids or enteral and parenteralfeedings. This study examines the relationship between the experience of hospice nurses in observing terninal dehydration and their perception of this state. The scores for the degree of positive perception of dehydration are compared for the experienced and nonexperienced groups of nurses. This study suggests that those hospice nurses who have observed terminal dehydration have a more positive perception of this state than those who have not.
{"title":"Dehydration in the terminal patient: perception of hospice nurses.","authors":"M R Andrews, A M Levine","doi":"10.1177/104990918900600112","DOIUrl":"https://doi.org/10.1177/104990918900600112","url":null,"abstract":"Recent discussion about the care of the terminally il patient has focused on the appropriateness of with holding and with drawing food and fluid and on the discomfort of the dehydrated state. Evidence is mounting that suggests that dehydration in this group of people is not painful, but rather may be more comfortable than hydration by means of IV fluids or enteral and parenteralfeedings. This study examines the relationship between the experience of hospice nurses in observing terninal dehydration and their perception of this state. The scores for the degree of positive perception of dehydration are compared for the experienced and nonexperienced groups of nurses. This study suggests that those hospice nurses who have observed terminal dehydration have a more positive perception of this state than those who have not.","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 1","pages":"31-4"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13853625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-01-01DOI: 10.1177/104990918900600109
D Kerr
centrations ofmorphine. Clin Pharmacokinetics 1982;7:266-279 23. Sawe J, Dahlstrom B, Paazlow L, Rane A: Morphine kinetics in cancer patients. Clin Pharmacol Ther 1981; 30: 629-635 24. SAwe J, Hansen J, Ginman C, Hartvig P, Jakobsson PA, NilssonMi et al: Patient-controlled dose regimen ofmethadone for chronic cancer pain. Br Med J 1981; 282: 771-779 25. Kaiko RF: Age andmorphine analgesia in cancer patients with postoperative pain. Clin Pharamacol Therap 1980;28:823-826 26. Berkowitz BA, Ngai SH, Yang JC, Hempstead J, Spector S. The disposition of morphine in surgical patients. Clin Pharm Therap 1975;17:629-635 27. Owen JA, Sitar DS., Berger L, Brownwell L, Duke PC, Mitensk PA: Age related morphine kinetics. Clin Pharmacol Ther 1983; 34:364368 28. Lipman AG: Drug therapy in terminally ill patients. Am J Hosp Pharm 1975;32:270-276 29. Hansen J, Ginman C, Hartvig P, Jakobsson A, Nilsson MI, Rane Aet al: Clinical evaluation of oral methadone in treatment of cancer pain. Acta Anaesth Scand 1982;(Suppl 74):124-127 30. White PF: use of patient-controlled analgesia for the treatment of acute pain. JAMA 1988;259:242-247 31. Klieman RL, Lipman AG, Hare BD, MacDonald SD: A comparison of morphine administered by patient-controlled analgesia and regularly scheduled intramuscular injection in severe, postoperative pain. J Pain SymptManag 1988;3:15-22 32. Findler G, Olshwang D, Hadani, M: Continuous epidural morphine treatment for intractable pain in terminal cancer patients. Pain 1982;14:311-315 33. Greenberg HS, Taren J, Ensminger WD, Doan K: Benefit from and tolerance to continuous intrathecal infusion of morphine for intractable cancer pain. J. Neurosurgery 1982;57:360-364 34. Leavans ME, Hill CS, Cech DA, Weyland JB, Weston JS: Intrathecal and intraventricular morphine for pain in cancer patients: Initial study. J Neurosurg 1982;56: 241-245 35. Coombs DW, Saunders RL, Gaylor MS, Block AR, Harbaugh R et al: Relief of continuous chronic pain by intraspinal narcotics via an implanted reservoir. JAMA 1983;250, 23362339 36. Porter J, Jick H: Addiction rare in patients treated with narcotics. New Eng J Med (letter) 1980;302:123 37. Twycross RG: Clinical experience with diamorphine in advanced malignant disease. Int J Clin Pharmacol 1974;9:184-198 38.Twycross RG, Lack SA: Symptom control in far advanced cancer: Pain Relief. Pitman, London, England, 1983 39. Walsh TD: Oral morphine in chronic cancer pain. Pain 1984;8:1-11 40. Twycross RG, Fairfield S: Pain in far-advanced cancer. Pain 1982;14:303-310 41. Liebeskind JC, Melzack R: The International Pain Foundation: Meeting a need for education in pain management. Pain (editorial) 1987;30:1-2
{"title":"Mouth care for the dying.","authors":"D Kerr","doi":"10.1177/104990918900600109","DOIUrl":"https://doi.org/10.1177/104990918900600109","url":null,"abstract":"centrations ofmorphine. Clin Pharmacokinetics 1982;7:266-279 23. Sawe J, Dahlstrom B, Paazlow L, Rane A: Morphine kinetics in cancer patients. Clin Pharmacol Ther 1981; 30: 629-635 24. SAwe J, Hansen J, Ginman C, Hartvig P, Jakobsson PA, NilssonMi et al: Patient-controlled dose regimen ofmethadone for chronic cancer pain. Br Med J 1981; 282: 771-779 25. Kaiko RF: Age andmorphine analgesia in cancer patients with postoperative pain. Clin Pharamacol Therap 1980;28:823-826 26. Berkowitz BA, Ngai SH, Yang JC, Hempstead J, Spector S. The disposition of morphine in surgical patients. Clin Pharm Therap 1975;17:629-635 27. Owen JA, Sitar DS., Berger L, Brownwell L, Duke PC, Mitensk PA: Age related morphine kinetics. Clin Pharmacol Ther 1983; 34:364368 28. Lipman AG: Drug therapy in terminally ill patients. Am J Hosp Pharm 1975;32:270-276 29. Hansen J, Ginman C, Hartvig P, Jakobsson A, Nilsson MI, Rane Aet al: Clinical evaluation of oral methadone in treatment of cancer pain. Acta Anaesth Scand 1982;(Suppl 74):124-127 30. White PF: use of patient-controlled analgesia for the treatment of acute pain. JAMA 1988;259:242-247 31. Klieman RL, Lipman AG, Hare BD, MacDonald SD: A comparison of morphine administered by patient-controlled analgesia and regularly scheduled intramuscular injection in severe, postoperative pain. J Pain SymptManag 1988;3:15-22 32. Findler G, Olshwang D, Hadani, M: Continuous epidural morphine treatment for intractable pain in terminal cancer patients. Pain 1982;14:311-315 33. Greenberg HS, Taren J, Ensminger WD, Doan K: Benefit from and tolerance to continuous intrathecal infusion of morphine for intractable cancer pain. J. Neurosurgery 1982;57:360-364 34. Leavans ME, Hill CS, Cech DA, Weyland JB, Weston JS: Intrathecal and intraventricular morphine for pain in cancer patients: Initial study. J Neurosurg 1982;56: 241-245 35. Coombs DW, Saunders RL, Gaylor MS, Block AR, Harbaugh R et al: Relief of continuous chronic pain by intraspinal narcotics via an implanted reservoir. JAMA 1983;250, 23362339 36. Porter J, Jick H: Addiction rare in patients treated with narcotics. New Eng J Med (letter) 1980;302:123 37. Twycross RG: Clinical experience with diamorphine in advanced malignant disease. Int J Clin Pharmacol 1974;9:184-198 38.Twycross RG, Lack SA: Symptom control in far advanced cancer: Pain Relief. Pitman, London, England, 1983 39. Walsh TD: Oral morphine in chronic cancer pain. Pain 1984;8:1-11 40. Twycross RG, Fairfield S: Pain in far-advanced cancer. Pain 1982;14:303-310 41. Liebeskind JC, Melzack R: The International Pain Foundation: Meeting a need for education in pain management. Pain (editorial) 1987;30:1-2","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 1","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600109","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13853623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-01-01DOI: 10.1177/104990918900600113
L F Paradis
Including hospice, as a concept of care, into existing allied health curricula is very important. Hospice should be integrated into the curricula of allied health programs. In addition to offering courses on hospice care, there are many novel ideas for exposing students to aspects of hospice care including grand rounds, self-instruction packets, journal clubs, honors program presentations, monthly forums, and clerkships. Federal funding is important to support and develop hospice training as well as other resources.
{"title":"Introducing hospice into allied health curricula: a challenge for educators.","authors":"L F Paradis","doi":"10.1177/104990918900600113","DOIUrl":"https://doi.org/10.1177/104990918900600113","url":null,"abstract":"<p><p>Including hospice, as a concept of care, into existing allied health curricula is very important. Hospice should be integrated into the curricula of allied health programs. In addition to offering courses on hospice care, there are many novel ideas for exposing students to aspects of hospice care including grand rounds, self-instruction packets, journal clubs, honors program presentations, monthly forums, and clerkships. Federal funding is important to support and develop hospice training as well as other resources.</p>","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 1","pages":"35-40"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13853631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-01-01DOI: 10.1177/104990918900600111
L L Graham, J A Cates
Care for the terminally ill has greatly expanded. Humor and play, however, remain largely unexplored, surrendered to the cultural expectation of dignity and respect for the dying. This paper suggests several uses of humor and play with the dying, and the benefits of these interventions with patients, families, and care givers.
{"title":"Responding to the needs of the terminally ill through laughter and play.","authors":"L L Graham, J A Cates","doi":"10.1177/104990918900600111","DOIUrl":"https://doi.org/10.1177/104990918900600111","url":null,"abstract":"<p><p>Care for the terminally ill has greatly expanded. Humor and play, however, remain largely unexplored, surrendered to the cultural expectation of dignity and respect for the dying. This paper suggests several uses of humor and play with the dying, and the benefits of these interventions with patients, families, and care givers.</p>","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 1","pages":"29-30"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13853626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-01-01DOI: 10.1177/104990918900600104
J K Ufema
{"title":"Is this hospice?","authors":"J K Ufema","doi":"10.1177/104990918900600104","DOIUrl":"https://doi.org/10.1177/104990918900600104","url":null,"abstract":"","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 1","pages":"7-8"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13853628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1989-01-01DOI: 10.1177/104990918900600114
S Byrd, K Taylor
The rapid growth of hospice care in this country has precipitated a need for ensuring quality through administrative program evaluation. Over the past few years a number of studies have been undertaken to evaluate the effects ofhospice care in relation to cost effectiveness, benefit, and utility. The question, "Is hospice effective?" is being examined by hospice administrators and researchers. These investigators are beginning to explore what kinds of terminal care interventions, by whom, and in what combinations, work best for particular hospice patients and their families under a specific set of circumstances.1 Studies like the New Haven and St. Christopher's Hospice evaluation have utilized self report questionnaires obtained from patients or their spouses to assess phenomena such as depression, anxiety, and pain in reponse to hospice care interventions.3A4 Other comprehensive evaluations have been attempted through the review of patient records, and personal interviews with staff and families of deceased hospice patients. 5,6 There is a growing need for data that addresses overall hospice program services from a recipient or family perspective. The federal government has identified specific evaluation criteria for hospices choosing to participate in the hospice Medicare benefit. According to the Hospice Conditions of Participation: "It is anticipated that critiques by patients' families provide a useful means to measure the degree to which patients' symptoms were managed." 7 Certainly, program evaluation is desirable and necessary. However, few hospices in this country have the expert knowledge needed to develop complex research designs and methodologies
{"title":"Evaluating a hospice program: a practical approach.","authors":"S Byrd, K Taylor","doi":"10.1177/104990918900600114","DOIUrl":"https://doi.org/10.1177/104990918900600114","url":null,"abstract":"The rapid growth of hospice care in this country has precipitated a need for ensuring quality through administrative program evaluation. Over the past few years a number of studies have been undertaken to evaluate the effects ofhospice care in relation to cost effectiveness, benefit, and utility. The question, \"Is hospice effective?\" is being examined by hospice administrators and researchers. These investigators are beginning to explore what kinds of terminal care interventions, by whom, and in what combinations, work best for particular hospice patients and their families under a specific set of circumstances.1 Studies like the New Haven and St. Christopher's Hospice evaluation have utilized self report questionnaires obtained from patients or their spouses to assess phenomena such as depression, anxiety, and pain in reponse to hospice care interventions.3A4 Other comprehensive evaluations have been attempted through the review of patient records, and personal interviews with staff and families of deceased hospice patients. 5,6 There is a growing need for data that addresses overall hospice program services from a recipient or family perspective. The federal government has identified specific evaluation criteria for hospices choosing to participate in the hospice Medicare benefit. According to the Hospice Conditions of Participation: \"It is anticipated that critiques by patients' families provide a useful means to measure the degree to which patients' symptoms were managed.\" 7 Certainly, program evaluation is desirable and necessary. However, few hospices in this country have the expert knowledge needed to develop complex research designs and methodologies","PeriodicalId":77805,"journal":{"name":"The American journal of hospice care","volume":"6 1","pages":"41-6"},"PeriodicalIF":0.0,"publicationDate":"1989-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/104990918900600114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13853630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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