Page 277 - Encyclopedia of Nursing Research

244 n HOSpIce

The congruence between patient and in hospice spend their time. It was found
caregiver reports of symptom intensity was that family members and nurses spend
H examined by McMillan and Moody (2003). The more time with patients in hospice than in
symptom intensity of pain, dyspnea, and con- oncology units but the time nurses spend
stipation was evaluated by both patients and is concerned with “tasks.” If hospice nurses
their family caregivers. Symptom intensity of increased their time with patients because
all three symptoms were significantly overes- of the increased need for tasks, then the con-
timated by caregivers (p = .000). This overesti- text has had little effect on the type of care-
mation is the basis upon which hospice nurses giving. The authors note the importance of
base their clinical decisions. The authors note time spent “being with” patients, not only in
that this study has implications for the educa- “doing for” patients.
tion of hospice family caregivers. The time devoted solely to tasks raises
perceptions of the intensity of symptoms the question of whether death anxiety is a
by nurses might be expected to be closer to significant factor in hospice nurses. payne,
those of their patients than was true for family Dean, and Kalus (1998) examined death anx-
caregivers. In a study by rhodes, McDaniel, iety in hospice and emergency nurses and
and Matthews (1998), 53 hospice patients, with found that the latter had higher death anx-
a mean age of 69 years, were queried about iety and less support from their peers and
their symptom experience with the Adapted supervisors. In another study, support was
Symptom Distress Scale Form 2. The nurses also deemed to be significant for hospice
were also questioned about their patients’ nurses if they were not engaging in block-
symptom experience. like the informal care- ing behaviors when confronted with the
givers, the nurses in this study overestimated emotions of patients (Booth, Maguire, Behir,
the symptom intensity of their patients. The Butterworth, & Hillier, 1996). Death anxiety
authors note that this is congruent with some can be reduced for student nurses through
other findings of overestimation but con- educational experiences, as Mallory (2003)
flicted with findings of underestimation, par- demonstrated.
ticularly with regard to perceptions of pain. research demonstrating the interest
Indeed, McMillan (1996) demonstrated that and need for advanced education for hos-
pain was still not well managed in cancer pice nurses had the additional benefit of pro-
patients. The importance of the instrument viding information to nurses interested in
as a reliable means of assessing symptoms hospice as a career (Wright, 2001). Although
resulted in the incorporation of the Adapted education and professional development
Symptom Distress Scale Form 2 into the clin- have always been considered important for
ical practice of the nurses. hospice nurses as for all nurses, Metcalfe,
QOl is an important concept in health pumphrey, and clifford (2010) argue that
care. Hill (2002) examined both the measure- hospice nurses need education on genetics
ment of QOl and how it might be improved so as to be able to address the implications
in hospice patients. This study, like that by of various genetic disorders. In particular,
rhodes et al. (1998) underscored the impor- the authors stress the need for such educa-
tance of nurses understanding how the tion if nurses are to be aware of the psycho-
patient assessed aspects of QOl. Hill indi- social implications for families and patients
cated that this knowledge was a guide to the afflicted with such diseases. Their research
reflective practice of the nurse and assured entailed responding to a questionnaire, and
clinically significant improvements of care although the response rate was low (29%), the
for the patient. sample size of 328 provided a useful sample
In an exploration of the context for care, size for exploring issues of the importance
rasmussen and Sandman (1998) investi- and confidence to address various genetic
gated how patients in an oncology unit and disorders. The development of knowledge in