Omega
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Research on end-of-life treatment preferences has documented robust racial differences, with African-Americans preferring more life-prolonging treatment than Whites. Although little research has attempted to explain these racial differences systematically, speculation has centered on religiosity. We examined a dimension of religiosity frequently invoked in end-of-life research-guidance by God's will-as a potential mediator of racial differences in such treatment preferences. ⋯ The questionnaire included the five-item God's will (GW) scale, a health conditions checklist, a depression measure, and sociodemographic questions. GW mediated racial differences at least partially for most treatments and in most health scenarios. Implications are discussed for understanding end-of-life treatment preferences and why races tend to differ.
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The families of death row inmates experience grief and loss issues that have been neglected by scholars and clinicians alike. The issues found in this population are unique and require our understanding. The present study uses the concepts of disenfranchised grief and nonfinite loss to uncover the pain experienced by the children and other family members who have a loved one on death row. ⋯ This study explores virtually untapped terrain. An examination of the microlevel effects of the death penalty on families provides insight in to the area of death and dying, especially as it is related to disenfranchised loss and nonfinite grief. In addition, this study provides insight into the death penalty and its effects.
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As patients with terminal disease enter into the final stage of their illness, psychiatric symptoms and psychological responses to the disease contribute to overall suffering of both patient and family. Until recently, no nationally accepted guidelines or practices had been established to support assessment and management of this type of suffering. ⋯ While specialized care may be provided to patient and families in the context of advanced disease, all clinicians involved in palliative and end-of-life care are responsible for having a basic understanding of effectively managing psychologic and psychiatric aspects of this care. Evidence from current literature supports these best practices.
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This research sought to investigate the role of social networks in coping and adjustment to spousal bereavement. A total of 198 Xhosa-speaking participants, drawn from the rural areas of the Eastern Cape Province, South Africa, took part in the study. ⋯ Regression analyses revealed that depression contributed to increased social support appraisals, while anxiety was a significant negative predictor of the participants' experience of perceived social support. The authors highlight the need for bereavement intervention programs in the rural areas to be geared toward psycho-educating the conjugally bereaved individuals, within the socio-cultural framework, to continuously evaluate their support structures and strengthen ties with social networks that render support, instrumental assistance, and advice in times of need.
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Historical Article
Development of hospice and palliative care in the United States.
More than 30 years have passed since palliative care was introduced in the United States, and what began as a small rebellion has evolved into a fairly large health care industry. Although the palliative care movement has considerably improved the care given to those at the end of life, many challenges remain for palliative care providers in the United States. This article discusses the history of hospice and palliative care in the United States, the Medicare Hospice Benefit, the growth of hospice and palliative care, and challenges such as the need for regulatory change, workforce issues, improving access to care, and improving the quality of palliative care.