Current Search: end of life (x)
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- Title
- BLACK CAREGIVER RESPONSES TO AND PERCEPTIONS OF SIGNS, SYMPTOMS, AND TREATMENTS AT THE END OF LIFE.
- Creator
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Sermarini, Samantha M, Connor, Norma E., University of Central Florida
- Abstract / Description
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Individuals in the final stages of life are often cared for by informal caregivers whose interpretation of the patient�s signs, symptoms and treatment needs and options may be incongruent with that of healthcare providers (Docherty et al., 2008). Nurses need to fully understand the scope of this disparity. The purpose of this study was to determine how Black caregivers interpreted signs, symptoms, and treatments for symptom relief during the last months of their loved one�s life. The effect...
Show moreIndividuals in the final stages of life are often cared for by informal caregivers whose interpretation of the patient�s signs, symptoms and treatment needs and options may be incongruent with that of healthcare providers (Docherty et al., 2008). Nurses need to fully understand the scope of this disparity. The purpose of this study was to determine how Black caregivers interpreted signs, symptoms, and treatments for symptom relief during the last months of their loved one�s life. The effect on caregiver decision making was explored. This project is a secondary analysis of preexisting qualitative data. Transcripts from 5 focus groups encompassed 53 participants. All participants were Black and informal caregivers or decision makers for a loved one at their loved one�s end of life. Eighty-seven percent of caregivers were female, and a majority had a high school education. The mean age was 66. Transcripts were coded for themes independently by two researchers. To allow for the most open interpretation, no a priori set of codes was utilized. 3 main categories of signs, 4 main categories of symptoms, 4 themes of the interpretation of signs and symptoms, 4 main categories of treatments and interventions, 5 themes of the interpretation of treatments, and 3 themes describing the effect of signs, symptoms, and treatments on decision making were identified. Case examples of the caregiver interpretation process are included. Health care providers need to provide time, clear and simplified language, and additional explanation in communication. Further research combining health literacy measures and qualitative data on interpretations should be conducted.
Show less - Date Issued
- 2016
- Identifier
- CFH2000017, ucf:45584
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH2000017
- Title
- NURSING INTERVENTIONS THAT FACILITATE END-OF-LIFE DECISION-MAKING IN PEDIATRIC ONCOLOGY.
- Creator
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Baeringer, Lauren, Wink, Diane, University of Central Florida
- Abstract / Description
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Nearly one-third of all pediatric oncology patients die from their disease, so nurses need to have an evidence-based standard of practice to guide their role in end-of-life decision-making. The purpose of this integrative review is to analyze current research on end-of-life decision-making within pediatric oncology to create a practice guideline for nurses working with this patient population. Eleven studies were examined to identify nursing interventions regarding the role of the nurse in...
Show moreNearly one-third of all pediatric oncology patients die from their disease, so nurses need to have an evidence-based standard of practice to guide their role in end-of-life decision-making. The purpose of this integrative review is to analyze current research on end-of-life decision-making within pediatric oncology to create a practice guideline for nurses working with this patient population. Eleven studies were examined to identify nursing interventions regarding the role of the nurse in end-of-life care, the role of the nurse in end-of-life decision-making, parent involvement in end-of-life decision-making, and child involvement in end-of-life decision-making, including the child's ability to participate in end-of-life decision-making. Based on the findings, the researcher identified several interventions that can be used by nurses to facilitate end-of-life discussion and decision-making that includes both parent and, when appropriate, the child.
Show less - Date Issued
- 2013
- Identifier
- CFH0004443, ucf:45081
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0004443
- Title
- ASSESSING ADULT ATTITUDES TOWARD END-OF-LIFE ISSUES AND ADVANCED DIRECTIVES AFTER IMPLEMENTING AN EDUCATIONAL INTERVENTION IN A WORKPLACE SETTING.
- Creator
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Tolbert-Jones, Marchina, Chase, Susan, University of Central Florida
- Abstract / Description
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Purpose: There is a lack of discussion regarding end-of-life care planning which results in low advanced directive execution (AD) rates. This can lead to decision making by family, friends, and the health care team on behalf of patients whose end-of-life care wishes are unknown. The purpose of this study was to determine the effectiveness of an educational intervention in the work setting to increase end-of-life discussions and the execution of advanced directives. Methods: A descriptive...
Show morePurpose: There is a lack of discussion regarding end-of-life care planning which results in low advanced directive execution (AD) rates. This can lead to decision making by family, friends, and the health care team on behalf of patients whose end-of-life care wishes are unknown. The purpose of this study was to determine the effectiveness of an educational intervention in the work setting to increase end-of-life discussions and the execution of advanced directives. Methods: A descriptive design was used in an occupational workplace setting at a local bottling company after appropriate IRB approval was obtained. An educational intervention based on the Five Wishes document was presented in an occupational health setting covering all shifts and employment categories. A pre-program questionnaire measured a lack of knowledge and understanding of end-of-life planning and advanced directives. A post-program questionnaire measured the increase in knowledge and understanding of end-of-life planning and advanced directives. A focus group was conducted with audio recording to describe personal experiences. The quantitative analysis used statistical procedures to describe and synthesize data and content analysis was conducted on the focus group data. Results: A sample of 78 participants was used to gather the quantitative data. Of the total participants, an overwhelming majority were male with ethnic backgrounds evenly represented. Most of the participants either were married and either were drivers, salespeople, or warehouse workers. More participants indicated no religious affiliation than any other affiliation, and the majority of participants indicated that they had a high school diploma. When questioned about their 1) knowledge of advanced directives, 2) whether or not they would consider executing an advanced directive, 3) whether or not they were likely to discuss end-of-life care with other, 4) whether they would be comfortable having someone make end-of-life decisions on their behalf, and 5) whether or not they believed that advanced directives were important, the majority of participants indicated that they strongly agreed or agreed. However, none of the participants had executed an advanced directive. Only 10.3% of participants had ever discussed ADÃÂ's with a healthcare provider. When the same participants were asked the same questions after the education portion of the study, data analysis of the pre- and post-program questionnaire mean scores, revealed a significant increase in scores on questions 1,2 and 3 (p <.05), and no significant increase on question 4 and 5 (p > .05). The implication of these findings suggest that an education intervention program in a workplace setting significantly increases end-of-life discussions and advanced directive execution rates. The Jones model of end-of-life education intervention and interpretation of the study are presented. Limitations of the study, as well as implications for nursing professionals and health care providers that will improve patient outcomes are presented. Discussion/Implication: The study shows that workplace education regarding Advanced Directives can lead to increase end-of-life discussions and increase advanced directive execution rates. Therefore, this education program at a worksite merits further research and may serve as a model program for other worksite settings.
Show less - Date Issued
- 2010
- Identifier
- CFE0003275, ucf:48564
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0003275
- Title
- Evolution Through the Search for Novelty.
- Creator
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Lehman, Joel, Stanley, Kenneth, Gonzalez, Avelino, Wiegand, Rudolf, Hoffman, Eric, University of Central Florida
- Abstract / Description
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I present a new approach to evolutionary search called novelty search, wherein only behavioral novelty is rewarded, thereby abstracting evolution as a search for novel forms. This new approach contrasts with the traditional approach of rewarding progress towards the objective through an objective function. Although they are designed to light a path to the objective, objective functions can instead deceive search into converging to dead ends called local optima.As a significant problem in...
Show moreI present a new approach to evolutionary search called novelty search, wherein only behavioral novelty is rewarded, thereby abstracting evolution as a search for novel forms. This new approach contrasts with the traditional approach of rewarding progress towards the objective through an objective function. Although they are designed to light a path to the objective, objective functions can instead deceive search into converging to dead ends called local optima.As a significant problem in evolutionary computation, deception has inspired many techniques designed to mitigate it. However, nearly all such methods are still ultimately susceptible to deceptive local optima because they still measure progress with respect to the objective, which this dissertation will show is often a broken compass. Furthermore, although novelty search completely abandons the objective, it counterintuitively often outperforms methods that search directly for the objective in deceptive tasks and can induce evolutionary dynamics closer in spirit to natural evolution. The main contributions are to (1) introduce novelty search, an example of an effective search method that is not guided by actively measuring or encouraging objective progress; (2) validate novelty search by applying it to biped locomotion; (3) demonstrate novelty search's benefits for evolvability (i.e. the abilityof an organism to further evolve) in a variety of domains; (4) introduce an extension of novelty search called minimal criteria novelty search that brings a new abstraction of natural evolution to evolutionary computation (i.e. evolution as a search for many ways of meeting the minimal criteria of life); (5) present a second extension of novelty search called novelty search with local competition that abstracts evolution instead as a process driven towards diversity with competition playing a subservient role; and (6) evolve a diversity of functional virtual creatures in a single run as a culminating application of novelty search with local competition. Overall these contributions establish novelty search as an important new research direction for the field of evolutionary computation.
Show less - Date Issued
- 2012
- Identifier
- CFE0004398, ucf:49390
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0004398
- Title
- THE EXPERIENCES OF HEALTH CARE PROVIDERS PROVIDING COMFORT FOR NURSING HOME PATIENTS AT THE END OF LIFE.
- Creator
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Baker, Herma, Rash, Elizabeth, University of Central Florida
- Abstract / Description
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Research shows that healthcare providers (HCPs) are not adequately prepared to provide comfort care for patients who are at the end of life. Since the 1990s, numerous legislative, research, and clinical initiatives have addressed concerns about improving care at the end of life. The purpose of this study was to describe the experiences of HCPs providing comfort for patients in the nursing home who are at the end of life. This study focused on physicians, nurse practitioners, nurses and nurses...
Show moreResearch shows that healthcare providers (HCPs) are not adequately prepared to provide comfort care for patients who are at the end of life. Since the 1990s, numerous legislative, research, and clinical initiatives have addressed concerns about improving care at the end of life. The purpose of this study was to describe the experiences of HCPs providing comfort for patients in the nursing home who are at the end of life. This study focused on physicians, nurse practitioners, nurses and nursesÃÂÃÂÃÂÃÂ' aides at a central Florida nursing home. A descriptive qualitative design was done utilizing a focus group discussion, individual interviews, and a self-administered questionnaire. The findings indicated that a lack of facility support, inadequate staffing, inadequate end of life care education, family and patient denial of prognosis, as well as decreased primary care physician involvement affect the delivery of comfort care for patients at the end of life in the nursing home. This study supports the need for end of life education to HCPs and the need for adjustments in staffing to meet the complex needs of patients in the nursing home who are at the end of life. A new finding of this study reflects the use of an angel cart to aid in the provision of comfort care for patients at the end of life. Recommendations for future research were made based on study results
Show less - Date Issued
- 2010
- Identifier
- CFE0003305, ucf:48505
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0003305
- Title
- Determinants of Health-related Quality of Life of Patients with End-stage Renal Disease.
- Creator
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Varghese, Shabu, Dziegielewski, Sophia, Burg, Mary Ann, Zhang, Ning, Jacinto, George, University of Central Florida
- Abstract / Description
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End-stage Renal Disease (ESRD) or Chronic Kidney Disease (CKD) constitutes a serious public health problem in the United States. According to the United States Renal Data System (USRDS), in 2013, Medicare spending alone accounts for $30.9 billion for the treatment-related expenses for ESRD. The purpose of this study was to examine the causal relationship of two important determinants, perceived social support and treatment adherence with health-related quality of life (HRQOL) of ESRD patients...
Show moreEnd-stage Renal Disease (ESRD) or Chronic Kidney Disease (CKD) constitutes a serious public health problem in the United States. According to the United States Renal Data System (USRDS), in 2013, Medicare spending alone accounts for $30.9 billion for the treatment-related expenses for ESRD. The purpose of this study was to examine the causal relationship of two important determinants, perceived social support and treatment adherence with health-related quality of life (HRQOL) of ESRD patients. Using the health belief model and Bandura's self-efficacy theory, the study explained the theoretical underpinnings of the causal relationships of the patient's perspectives of perceived social support and treatment adherence in predicting the HRQOL of ESRD patients. The study utilized a non-experimental research design and the statistical tool Structural Equation Modeling (SEM), in evaluating the causal relationships between the variables. With a convenience sample size of 413 ESRD patients from the Central West region of Florida, the findings of the study validated a statistically significant relationship between perceived social support and HRQOL as well as between perceived social support and treatment adherence in ESRD patients. However, the study didn't find any significant relationships between treatment adherence and HRQOL. The results of the study enhanced the body of knowledge relating to HRQOL of ESRD patients, provided foundation for interventions and policy formation in improving the HRQOL of patients with ESRD.
Show less - Date Issued
- 2016
- Identifier
- CFE0006512, ucf:51366
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0006512