Page 276 - Encyclopedia of Nursing Research

HOSpIce n 243

length of survival in hospice continues yorkshire puddings, yogurt, eggs, fruit
to be an area of concern given that refer- juices, and beer. Three major comments con-
rals are often made closer to the death of the cerned the size of the portions (too large), H
patient. younnis and colleagues in a study of the foods not the right temperature (not hot
180 patients with cancer referred from a com- enough), and the time of food service (pre-
prehensive cancer center found that both low ferred later in the day). This study, although
palliative performance Scores and male gen- used to help nurses understand the research
der were associated with shorter lengths of process, had an impact on patient care in the
stay. Although participation in prior clinical facility where the research was conducted.
trials did not affect the results of this retro- Although not commented on by the authors,
spective study, the authors note the impor- it would be helpful in future research if a
tance of a prospective study to investigate larger sample of patients were included in
the impact of clinical trial participation on the study where closeness to death was taken
length of hospice stay. into account in examining food preferences
The factors that affect whether a certi- of hospice care recipients.
fied Medicare hospice is present in a rural The needs of family caregivers also
community were examined by campbell, have been of concern to hospice providers.
Merwin, and yan (2009). They found that Harrington, lackey, and Gates (1996) studied
rural communities were less likely to have a the needs of caregivers of both hospice and
Medicare-certified hospice. The higher the rate clinic patients. results indicated that the top
of physicians in the area, however, the more information need of the caregivers of clinic
likely a Medicare-certified hospice would be patients was for honest and updated informa-
present. The authors note that the requirement tion and specifically information regarding
of the Medicare hospice benefit for physician treatment side effects. In contrast, the infor-
certification of terminal illness may constitute mation needs of hospice caregivers concerned
a barrier to the presence of hospices in rural the symptoms to be expected. These needs
areas, an absence that may impede quality represent the differences in the point in the
end-of-life care for residents of rural areas. illness trajectory of the two sets of patients.
Volunteers constitute an important pro- Spiritual needs were the second most fre-
grammatic aspect of hospice. In a study of 32 quently noted for both groups of caregivers.
hospices in the southwestern United States, personal needs included the need for adequate
351 volunteers responded to a mailed sur- rest for both groups of family caregivers, but
vey (planalp & Trost, 2009). Their motivation these were not considered to be as important
for volunteering included helping others and by the family caregivers as the need for care
learning, fostering social relationships, feel- of the patient. The authors recommend a lon-
ing better, and pursuing career goals. Age had gitudinal study on this subject.
an impact on these motivations with younger Tang (2009) examined hospice care-
volunteers being more career oriented and giver quality of life (QOl) with an emphasis
older volunteers more socially oriented. on those providing care at home. As Tang
Another example of program-related observes, the caregivers both provide sup-
research is a study on patient-focused port and need support placing those provid-
menu planning (Fairtlough & closs, 1996). ers of care in a somewhat unique position in
Over a 4-week period, 108 interviews were health care but an acknowledged aspect of
conducted related to specific meals. Foods hospice care. The focus by hospice programs
not liked included those difficult to swal- on the family care provider is essential to the
low, tough or fried foods, or those with effective provision of hospice care and par-
bones. patients indicated they wanted sea- ticularly home care and thus is an important
food including salmon and prawns, beef, area of investigation.