Page 275 - Encyclopedia of Nursing Research

242 n HOSpIce

dying and, in the United States, the evalua- In an attempt to validate the impact of a
tion of whether hospice care improved such hospice palliative care unit on perceived fam-
H care and was fiscally sound so as to be wor- ily satisfaction and to examine the demograph-
thy of a new benefit to fund such care. These ics of patients, Kellar, Martinez, Finis, Bolgar,
studies were conducted by researchers from and von Gunten (1996) surveyed 240 families
a number of disciplines. of patients of the program. The most frequent
Nursing research about hospice has been response to an opened-ended question about
conducted using a variety of methodologi- the advantage of the program was the profes-
cal approaches including qualitative ones— sional nursing care. Few remarks were made
ethnography, observations, semistructured about disadvantages, and these had to do with
interviews, and interviews—and quantitative the parking facility expenses, the distance
ones—quasi-experimental, questionnaires/ families had to travel, and the potential for
surveys, and audit as well as a combination patient transfer because of the facility’s desig-
of methods. research about hospice covers nation as an acute-care facility. Of the 92 eli-
an array of topics. Topics include organiza- gible surveys returned, the researchers found
tional methodologies, demographic data, that 88% (81/92) considered the hospice to be
social support, physiological, psychosocial, very helpful to the patient, 9% (8/92) found
and spiritual issues, self-care, how patients the program to be helpful, and 1% (1/92) were
spend their time, grief, bereavement, stud- neutral. This type of study is representative
ies of nurses and their knowledge, and the of a host of studies conducted by hospice pro-
impact of hospice care. Some of these top- grams to assess their audience and the satis-
ics use hospice as a setting for research but faction with the program.
are not about hospice per se. Topics for such Hospice referral remains crucial to the
studies include an examination of cancer viability of such programs. Although interest
pain in home hospice patients, a comparison is usually expressed in the attitudes of physi-
of nurses’ knowledge about AIDS by prac- cians, Schim, Jackson, Seely, Gruinow, and
tice setting, training, and educational pro- Baker (2000) examined the attitudes of home
grams where the focus is the program and care nurses to hospice referral. Attitudes of 160
not the hospice patients and nurses, and the nurses were assessed with a 15-item survey
grief experience of older women. In this case, that was completed by 75 nurses for a response
the husbands had received hospice care, but rate of 46.9%. Home care nurses saw little dif-
that was not the focus of the study. Indeed ference between home care and hospice ser-
the researcher suggested that a future study vices. Many (42.6%) of the respondents thought
might compare the experience of women insurance with a hospice benefit was necessary
whose husbands had received such care and for referral. These and other misperceptions
those who had not (Jacob, 1996). A similar underscored the importance of home care
study in Finland examined the adjustment of nurses understanding the requirements and
relatives after the death of a hospice patient. components of hospice care. The importance
Again the focus was on the adjustment and of attitudes as well as knowledge was under-
not the differential impact of the hospice scored by a study investigating the factors that
program on such adjustment. An examina- increased the likelihood that nurses would
tion of the relationship between depressive discuss terminal illness care and hospice care
symptoms and symptom distress in patients with patients and families. cramer, Mccorkle,
with cancer who are newly admitted to hos- cherlin, Johnson-Hurzeler, and Bradley (2003)
pice home care does not compare the effect of found that prior experience with hospice,
settings on the variables of interest. rather, greater knowledge, and religiosity as well as
hospice home care is irrelevant to the analy- greater comfort in initiating such discussions
sis (McMillan & rivera, 2009). were related to their initiation by nurses.