Journal of pain and symptom management
-
J Pain Symptom Manage · Apr 2008
Bereaved family members' evaluation of hospice care: what factors influence overall satisfaction with services?
As patients near the end of life, bereaved family members provide an important source of evaluation of the care they receive. A study was conducted to identify which processes of care were associated with greater satisfaction with hospice services from the perception of bereaved family members. A total of 116,974 surveys from 819 hospices in the United States were obtained via the 2005 Family Evaluation of Hospice Care, an online repository of surveys of bereaved family members' perceptions of the quality of hospice care maintained by the National Hospice and Palliative Care Organization. ⋯ Using multivariate logistic regression, the association between overall satisfaction and the individual item problem scores that compose the Family Evaluation of Hospice Care were examined. Bereaved family members were more likely to rate overall satisfaction with hospice services as "excellent" if they were regularly informed about their loved one's condition (adjusted odds ratio [AOR]=3.76, 95% confidence interval [CI]=3.61-3.91), they felt the hospice team provided the right amount of emotional support to them (AOR=2.21, 95% CI=2.07-2.38), they felt that the hospice team provided them with accurate information about the patient's medical treatment (AOR=2.16, 95% CI=2.06-2.27), and they could identify one nurse as being in charge of their loved one's care (AOR=2.02, CI=1.92-2.13). These four key processes of care appear to significantly influence an "excellent" rating of overall satisfaction with hospice care.
-
J Pain Symptom Manage · Apr 2008
The Schedule for Meaning in Life Evaluation (SMiLE): validation of a new instrument for meaning-in-life research.
The Schedule for Meaning in Life Evaluation (SMiLE) is a respondent-generated instrument for the assessment of individual meaning in life (MiL). In the SMiLE, the respondents list three to seven areas that provide meaning to their lives before rating the current level of importance and satisfaction of each area. Indices of total weighting (IoW; range, 20-100), total satisfaction (IoS; range, 0-100), and total weighted satisfaction (IoWS; range, 0-100) are calculated. ⋯ There was no correlation of the SMiLE with the Idler Index of Religiosity. Preliminary data indicate good feasibility and acceptability of the SMiLE in palliative care patients. The psychometrics of the SMiLE are reported according to the recommendations of the Scientific Advisory Committee of the Medical Outcomes Trust.
-
J Pain Symptom Manage · Apr 2008
Action research: developing a pediatric cancer pain program in jordan.
Children's pain is undertreated worldwide. Using a model of pediatric cancer pain management in Amman, Jordan, the authors demonstrated that an action research approach to pain service development resulted in a sustainable program of pain control. Barriers to care were due more often to health professionals' misconceptions concerning pain and opioid use than to concerns related to cultural, religious, or societal beliefs. ⋯ Role-modeling and mentorship are important factors. Established knowledge translation theories explained some but not all of the findings. Outcomes included consistent pain assessment and documentation by nursing staff, increased consultation for pain management, and increased use of intravenous opioids.
-
J Pain Symptom Manage · Apr 2008
Screening for discomfort as the fifth vital sign using an electronic medical recording system: a feasibility study.
Late referral to a specialized palliative care service hinders quality symptomatic management. The aim of this article is to describe the feasibility and clinical usefulness of screening for patient discomfort as the fifth vital sign using an electronic medical recording system to identify patients with undertreated physical symptoms. For the electronic medical recording system, all admitted patients received routine nurse assessment of discomfort (defined as any physical symptom) at every vital signs check using Item 2 of the Support Team Assessment Schedule Japanese version (STAS). ⋯ In the remaining 10 cases (11% of symptomatic patients, 1.7% of all screened patients), the palliative care team recommended potentially useful interventions for symptom control; seven patients were referred to the palliative care team within one week. The time required for all screening processes was about 30 minutes per week. This experience demonstrates that screening for patient discomfort as the fifth vital sign using an electronic medical recording system can be successfully implemented and may be useful in facilitating early referral of distressing patients to the specialized palliative care service.