Abstract
This paper reviews the article "A Longitudinal Study of Palliative Care: Patient-Evaluated Outcome and Impact of Attrition," which was written from a nursing perspective by several well-known practitioners. This detailed analysis of the article begins with a description of the authors' credentials. The work answers several research questions associated with palliative care that are essential to the development of positive patient outcomes in this field. The literature review from the article is described including what the reviewer sees as possible shortcomings. The review continues by focusing on the research design and methods used in the article as they relate to successful outcomes in palliative care. The nurse's role in this approach is central to the review and the article.

Outline
Introduction
Problem/Purpose
Study Framework or Theoretical Perspective
Research Objective/Questions
Attribute/Demographic Variables
Sample/ Setting
Research Design
Measurement Methods & Tools
Procedures
Statistical Analysis
Researcher's Interpretations
Nursing Implications
Researcher Suggestions For Further Study
References

From the Paper
"Palliative care is an understudied and largely ignored but essential aspect of patient care as despite medical technology and procedural advances there is still always a point where patients bodies fail and death becomes the most likely outcome. Physicians in the US and elsewhere often stress that they practice medicine to save lives which gives them particular disdain for openly placing a patient in a category of the end of life and therefore sometimes results in a patient being or feeling neglected and possibly even ignored when palliative care decisions such as pain and comfort management need to be addressed. The end of life can carry with it a long list of emotional and social barriers and obstacles which can effect patient outcomes and challenge patients excessively, without the feeling of neglect and or avoidance of medical care entering into the picture, while the palliative care process when addressed and dealt with openly and appropriately can be a peaceful and calm experience that ushers individuals out of this life comfortably and with the feeling that they were cared for and respected as individuals."

Tags:end-of-life issues, hospice, nursing care

Abstract
With end-stage renal disease, the question of dialysis treatment must be viewed in the context of end-of-life issues. The largest proportion of hemodialysis patients consists of older adults (Moulton, 2007). When patients are in palliative care, dialysis whether it be hemodialysis or peritoneal dialysis is often of little or no benefit, is a serious burden on the patient, and is performed at high financial cost. Most of all, many patients in palliative care decide to forgo dialysis because they regard the procedure as a life-sustaining treatment (Rabetoy & Bair, 2007). Issues of patient autonomy and choice and particularly clients who know their own need best are involved in decisions about dialysis.

From the Paper
Implementation of BPG for Dialysis/Palliative Care Introduction With end-stage renal disease, the question of dialysis treatment must be viewed in the context of end-of-life issues. The largest proportion of hemodialysis patients consists of older adults (Moulton, 2007). When patients are in palliative care, dialysis whether it be hemodialysis or peritoneal dialysis is often of little or no benefit, is a serious burden on the patient, and is performed at high financial cost. Most of all, many patients in palliative care decide to forgo dialysis because they regard the procedure as a life-sustaining treatment (Rabetoy & Bair, 2007).

Tags:bpg, dialysis, palliative

Abstract
This paper deals with a presentation of the benefits to the hospital and the patient in the development of a palliative care program within a hospital setting. The implications for nursing and nursing leadership are primary focuses. This paper is presented as the beginnings of a research project, inclusive of survey and interview questions attached in the appendix.

From the Paper
""Establishing a palliative care service can improve patient care and ease family concerns for patients who are hopelessly ill. For the hospital such services can improve utilization outcomes" (Meier, 2001). In hospitals that offer palliative care programs, emphasizing dignity and comfort over disease emphasis and medical treatment (Burton, 1998) substantial improvements in symptoms of pain, nausea, digestive upset, diarrhea, constipation and shortness of breath were demonstrated, as well as increased ratings of level of medical and supportive services (Meier, 2001). The World Health Organization defines palliative care as "the active, total care of patients whose disease is not responsive to curative treatment" (World Health Organization, 1990 as cited in Chrystal-Frances, 2003)."

Tags:palliative, hospital, benefits

Abstract
This paper takes a look at palliative care, the union of medical, spiritual, and cultural considerations into a holistic, compassionate approach geared toward reducing the severity of symptoms. According to the paper, palliative care focuses on comfort and pain management rather than on curative measures and emphasizes care for terminal patients and their families. The paper reviews the video 'On Our Own Term: Moyer on Dying', part of a series called "A Different Kind of Care".

Outline:
On Our Own Terms
Hospice and Palliative Care
Spirituality, an Aspect of Palliative Care
Reflection

From the Paper
"In most cases, death brings the terminally-ill patient toward spirituality; indeed, this is the essence of existence for the majority of people. Whether or not we have strayed from our religious backgrounds, most people when close to death seek to understand the big questions of life. As a nursing student from a Catholic university, I have studied a curriculum that encompasses many aspects of life, including spirituality. However, most student nurses at the developmental age of college students focus on careers and relationships which can distance them from spirituality, probably the most important issue for a terminally-ill patient. How can we, as nursing students, discuss spirituality with patients at the end of life when some of us are either too young for spiritual awareness or too old and cynical? More importantly, how can we use spirituality in our nursing practice if our training has concentrated on oxygenation, safety, nutrition, and other health issues?"

Tags:denial, anger, bargaining, depression, acceptance, Elisabeth, Kubler-Ross

Abstract
This paper discusses palliative care, care that involves an active approach related to comfort and support for patients who are either living with or dying of a life threatening condition. The paper further discusses how according to the World Health Organization, palliative care enhances quality of life through prevention and relief of suffering while employing a holistic approach so that physical psychosocial and spiritual issues are addressed. This paper then elucidates the goals of palliative care in terms of a particular patient and addresses the issues of spirituality, coping and the role of the nurse.

Tags:nurse, patient, family

Abstract
This paper discusses palliative care, focusing on the ethical and practical considerations that must be taken into account. The paper also explores the ways in which individuals living with life limiting conditions, receive and experience palliative care services.

Outline:
Introduction
Statement of Problem
Background of Problem
Literature Review
Medicare Hospice Benefit
Barriers Associated With Receiving Palliative Care

From the Paper
"According to Foley (2005) the terms palliative care and hospice care are often used interchangeably. In the United States palliative care was once known only as hospice care and it started at the grassroots level to enhance the quality of care for patients that were dying in their homes. Today hospices are often referred to as palliative care and it is a fully funded entitlement program that provides care for half of the people in America that die of cancer and 30% of those that die of a myriad of other chronic diseases (Foley, 2005). The new palliative care movement has been created in an effort to improve the care of those that are dying of a terminal illness. The philosophy of this new palliative care movement aims to improve the quality of life for the terminally ill and their families (Foley, 2005). "

Tags:therapy, occupational, speech, illness

Abstract
The paper discusses the competencies necessary for nurses in providing high-quality care to patients and families of patients during the transition at the end-of-life stage of care. The paper reveals that a critical aspect of palliative care is support on the psychological level and preparing the patient and family members to cope with the factors associated with impending death. The paper emphasizes that only the nurse who possesses the stated competencies and whom has prepared the family in anticipation of the progressive stages of the disease, is capable of minimizing the experienced psychological stress for both the patient and their family members.

Outline:
Introduction
Palliative care Nursing Competencies
Correlation of End-Of-Life Factors and Psychological Stress
Summary and Conclusion

From the Paper
"There was little in earlier centuries that the health care professional could actually do to help patients during the end-of life period except to attempt to ease the pain and suffering experienced by the individual however, recent research has identified specific competencies and best practices for the individual who acts as a nurse to patients during this transition period. Since people live longer in today's world and the elderly population only continues to grow, there are more people with chronic illness in need of care."

Tags:communication, dementia, competencies, neurodegenerative, diseases, depression

Abstract
This paper attempts to affirm the hypothesis that spirituality plays a major role in contemporary palliative care. The paper attempts to affirm the hypothesis via a topical survey of recent nursing, medical and sociology journals. A conclusion is reached which suggests that spirituality is a valuable part of palliative care.

From the Paper
"When speaking of the end of life, quantitative research is relatively easy to obtain. It is easy to find out how many people die, when, and from what causes. What is less accessible, however, is information regarding the nature of that death, whether it was a so-called 'good death,' or not. Recently, there has been increasing interest, according to Christina M. Puchalski, MD, an associate at the Center to Improve Care of the Dying, "in the spiritual aspects of palliative care" Puchalski designed a course in spirituality in end-of-life care in 1992, amid predictions by her superiors that it would not attracted students or attention."

Tags:health, need, distress, culturally, sensitive, interactions, spiritual, growth, chaplains

Abstract
As our society ages, palliative care nursing will become more and more significant. With that in mind, healthcare professionals need to develop ways of dealing humanely with individuals at the end of the life-cycle whose values, religious tenets and world-views may differ from the professional's own. As American society ages and becomes more diverse, this need for cultural sensitivity at the end of life becomes more pressing than ever.

From the Paper
End of Life Care or Palliative Care: The Problem Statement, a Critique Using Polit & Beck's Criteria, and a Critique of the Problem Statement Using McEwen & Wills Problem Statement As our society ages, palliative care nursing will become more and more significant. With that in mind, healthcare professionals need to develop ways of dealing humanely with individuals at the end of the life-cycle whose values, religious tenets and world-views may differ from the professional's own. As American society ages and becomes more diverse, this need for cultural sensitivity at the end of life becomes more

Tags:critique, polit, beck

Abstract
This paper takes an in-depth look at how clinical teachers produce an impact on the entire nursing g profession by how well they prepare future nurses. In particular, the paper focuses on clinical teaching in palliative care units. As advanced illness progresses, adaptational challenges are exacerbated both for patients and family members. An increased need for support from others as well as needing to make complex end-of-life decisions can result in feelings of vulnerability as well as relational problems

From the Paper
"Clinical teachers produce an impact on the entire nursing profession by how well they prepare future nurses (Duke, 1996). As advanced illness progresses, adaptational challenges are exacerbated both for patients and family members. An increased need for support from others as well as needing to make complex end-of-life decisions can result in feelings of vulnerability as well as relational problems (Tan, Zimmerman & Rodin, 2005). The theory informing my teaching is primarily constructivist but..."

Tags:teaching, learning, culture