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overflow: hidden; text-overflow: ellipsis; -webkit-line-clamp: 3; -webkit-box-orient: vertical; }</style><div class="col-xs-12 clearfix"><div class="u-floatLeft"><h1 class="PageHeader-title u-m0x u-fs30">Terminal care</h1><div class="u-tcGrayDark">561 Followers</div><div class="u-tcGrayDark u-mt2x">Recent papers in <b>Terminal care</b></div></div></div></div></div></div><div class="TabbedNavigation"><div class="container"><div class="row"><div class="col-xs-12 clearfix"><ul class="nav u-m0x u-p0x list-inline u-displayFlex"><li class="active"><a href="https://www.academia.edu/Documents/in/Terminal_care">Top Papers</a></li><li><a href="https://www.academia.edu/Documents/in/Terminal_care/MostCited">Most Cited Papers</a></li><li><a href="https://www.academia.edu/Documents/in/Terminal_care/MostDownloaded">Most Downloaded Papers</a></li><li><a href="https://www.academia.edu/Documents/in/Terminal_care/MostRecent">Newest Papers</a></li><li><a class="" href="https://www.academia.edu/People/Terminal_care">People</a></li></ul></div><style type="text/css">ul.nav{flex-direction:row}@media(max-width: 567px){ul.nav{flex-direction:column}.TabbedNavigation li{max-width:100%}.TabbedNavigation li.active{background-color:var(--background-grey, #dddde2)}.TabbedNavigation li.active:before,.TabbedNavigation li.active:after{display:none}}</style></div></div></div><div class="container"><div class="row"><div class="col-xs-12"><div class="u-displayFlex"><div class="u-flexGrow1"><div class="works"><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_29771843" data-work_id="29771843" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/29771843/The_Cultural_Moral_Right_to_a_Basic_Minimum_of_Accessible_Health_Care">The Cultural Moral Right to a Basic Minimum of Accessible Health Care</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">1) The conception of a cultural moral right is useful in capturing the social-moral realities that underlie debate about universal health care. In asserting such rights, individuals make claims above and beyond their legal rights, but... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_29771843" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">1) The conception of a cultural moral right is useful in capturing the social-moral realities that underlie debate about universal health care. In asserting such rights, individuals make claims above and beyond their legal rights, but those claims are based on the society's existing commitments and moral culture. In the United States such a right to accessible basic health care is generated by various empirical social facts, primarily the conjunction of the legal requirement of access to emergency care with widely held principles about unfair free riding and just sharing of costs between well and ill. The right can get expressed in social policy through either single-payer or mandated insurance. (2) The same elements that generate this right provide modest assistance in determining its content, the structure and scope of a basic minimum of care. They justify limits on patient cost sharing, require comparative effectiveness, and make cost considerations relevant. They shed light on the status of expensive, marginally life extending, last-chance therapies, as well as life support for PVS patients. They are of less assistance in settling contentious debates about screening for breast and prostate cancer and treatments for infertility and erectile dysfunction, but even there they establish a useful framework for discussion. Scarcity of resources need not be a leading conceptual consideration in discerning a basic minimum. More important are the societal elements that generate the cultural moral right to a basic minimum.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/29771843" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="a14672c93f4e6c5e4d5e6584916b3a41" rel="nofollow" data-download="{"attachment_id":50222788,"asset_id":29771843,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/50222788/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="4089486" href="https://plu.academia.edu/PaulTMenzel">Paul T Menzel</a><script data-card-contents-for-user="4089486" type="text/json">{"id":4089486,"first_name":"Paul T","last_name":"Menzel","domain_name":"plu","page_name":"PaulTMenzel","display_name":"Paul T Menzel","profile_url":"https://plu.academia.edu/PaulTMenzel?f_ri=882903","photo":"https://0.academia-photos.com/4089486/1574817/1907008/s65_paul.menzel.jpg"}</script></span></span></li><li class="js-paper-rank-work_29771843 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="29771843"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 29771843, container: ".js-paper-rank-work_29771843", }); });</script></li><li class="js-percentile-work_29771843 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 29771843; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_29771843"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_29771843 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="29771843"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 29771843; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=29771843]").text(description); $(".js-view-count-work_29771843").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_29771843").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="29771843"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">21</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="803" rel="nofollow" href="https://www.academia.edu/Documents/in/Philosophy">Philosophy</a>, <script data-card-contents-for-ri="803" type="text/json">{"id":803,"name":"Philosophy","url":"https://www.academia.edu/Documents/in/Philosophy?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="906" rel="nofollow" href="https://www.academia.edu/Documents/in/Applied_Ethics">Applied Ethics</a>, <script data-card-contents-for-ri="906" type="text/json">{"id":906,"name":"Applied Ethics","url":"https://www.academia.edu/Documents/in/Applied_Ethics?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="941" rel="nofollow" href="https://www.academia.edu/Documents/in/Social_Policy">Social Policy</a>, <script data-card-contents-for-ri="941" type="text/json">{"id":941,"name":"Social Policy","url":"https://www.academia.edu/Documents/in/Social_Policy?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="2592" rel="nofollow" href="https://www.academia.edu/Documents/in/Human_Rights">Human Rights</a><script data-card-contents-for-ri="2592" type="text/json">{"id":2592,"name":"Human Rights","url":"https://www.academia.edu/Documents/in/Human_Rights?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=29771843]'), work: {"id":29771843,"title":"The Cultural Moral Right to a Basic Minimum of Accessible Health Care","created_at":"2016-11-09T20:22:47.424-08:00","url":"https://www.academia.edu/29771843/The_Cultural_Moral_Right_to_a_Basic_Minimum_of_Accessible_Health_Care?f_ri=882903","dom_id":"work_29771843","summary":"1) The conception of a cultural moral right is useful in capturing the social-moral realities that underlie debate about universal health care. In asserting such rights, individuals make claims above and beyond their legal rights, but those claims are based on the society's existing commitments and moral culture. In the United States such a right to accessible basic health care is generated by various empirical social facts, primarily the conjunction of the legal requirement of access to emergency care with widely held principles about unfair free riding and just sharing of costs between well and ill. The right can get expressed in social policy through either single-payer or mandated insurance. (2) The same elements that generate this right provide modest assistance in determining its content, the structure and scope of a basic minimum of care. They justify limits on patient cost sharing, require comparative effectiveness, and make cost considerations relevant. They shed light on the status of expensive, marginally life extending, last-chance therapies, as well as life support for PVS patients. They are of less assistance in settling contentious debates about screening for breast and prostate cancer and treatments for infertility and erectile dysfunction, but even there they establish a useful framework for discussion. Scarcity of resources need not be a leading conceptual consideration in discerning a basic minimum. More important are the societal elements that generate the cultural moral right to a basic minimum.","downloadable_attachments":[{"id":50222788,"asset_id":29771843,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":4089486,"first_name":"Paul T","last_name":"Menzel","domain_name":"plu","page_name":"PaulTMenzel","display_name":"Paul T Menzel","profile_url":"https://plu.academia.edu/PaulTMenzel?f_ri=882903","photo":"https://0.academia-photos.com/4089486/1574817/1907008/s65_paul.menzel.jpg"}],"research_interests":[{"id":803,"name":"Philosophy","url":"https://www.academia.edu/Documents/in/Philosophy?f_ri=882903","nofollow":true},{"id":906,"name":"Applied Ethics","url":"https://www.academia.edu/Documents/in/Applied_Ethics?f_ri=882903","nofollow":true},{"id":941,"name":"Social Policy","url":"https://www.academia.edu/Documents/in/Social_Policy?f_ri=882903","nofollow":true},{"id":2592,"name":"Human Rights","url":"https://www.academia.edu/Documents/in/Human_Rights?f_ri=882903","nofollow":true},{"id":4441,"name":"Health Care","url":"https://www.academia.edu/Documents/in/Health_Care?f_ri=882903"},{"id":5792,"name":"Social Justice","url":"https://www.academia.edu/Documents/in/Social_Justice?f_ri=882903"},{"id":11758,"name":"Health insurance","url":"https://www.academia.edu/Documents/in/Health_insurance?f_ri=882903"},{"id":32101,"name":"Clinical Ethics","url":"https://www.academia.edu/Documents/in/Clinical_Ethics?f_ri=882903"},{"id":37819,"name":"Erectile dysfunction","url":"https://www.academia.edu/Documents/in/Erectile_dysfunction?f_ri=882903"},{"id":55155,"name":"Emergency Medical Services","url":"https://www.academia.edu/Documents/in/Emergency_Medical_Services?f_ri=882903"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States?f_ri=882903"},{"id":124064,"name":"Universal Coverage","url":"https://www.academia.edu/Documents/in/Universal_Coverage?f_ri=882903"},{"id":208699,"name":"Free Riding","url":"https://www.academia.edu/Documents/in/Free_Riding?f_ri=882903"},{"id":319638,"name":"Moral Obligations","url":"https://www.academia.edu/Documents/in/Moral_Obligations?f_ri=882903"},{"id":457859,"name":"Cost Benefit Analysis","url":"https://www.academia.edu/Documents/in/Cost_Benefit_Analysis?f_ri=882903"},{"id":526146,"name":"Comparative Effectiveness Research","url":"https://www.academia.edu/Documents/in/Comparative_Effectiveness_Research?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":1212103,"name":"Antineoplastic Agents","url":"https://www.academia.edu/Documents/in/Antineoplastic_Agents?f_ri=882903"},{"id":1442661,"name":"Kennedy Institute of Ethics","url":"https://www.academia.edu/Documents/in/Kennedy_Institute_of_Ethics?f_ri=882903"},{"id":2533306,"name":"cultural characteristics","url":"https://www.academia.edu/Documents/in/cultural_characteristics?f_ri=882903"},{"id":2549475,"name":"Health Services Accessibility","url":"https://www.academia.edu/Documents/in/Health_Services_Accessibility?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_21463422" data-work_id="21463422" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/21463422/Matters_of_Spirituality_at_the_End_of_Life_in_the_Pediatric_Intensive_Care_Unit">Matters of Spirituality at the End of Life in the Pediatric Intensive Care Unit</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest">OBJECTIVE. Our objective with this study was to identify the nature and the role of spirituality from the parents' perspective at the end of life in the PICU and to discern clinical implications.</div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/21463422" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="7a6ac27c21bcb260a3ce0a1c9fba088b" rel="nofollow" data-download="{"attachment_id":41891400,"asset_id":21463422,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/41891400/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="42539982" href="https://independent.academia.edu/MaryThiel">Mary Martha Thiel</a><script data-card-contents-for-user="42539982" type="text/json">{"id":42539982,"first_name":"Mary Martha","last_name":"Thiel","domain_name":"independent","page_name":"MaryThiel","display_name":"Mary Martha Thiel","profile_url":"https://independent.academia.edu/MaryThiel?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_21463422 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="21463422"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 21463422, container: ".js-paper-rank-work_21463422", }); });</script></li><li class="js-percentile-work_21463422 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 21463422; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_21463422"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_21463422 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="21463422"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 21463422; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=21463422]").text(description); $(".js-view-count-work_21463422").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_21463422").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="21463422"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">15</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="631" rel="nofollow" href="https://www.academia.edu/Documents/in/Pediatrics">Pediatrics</a>, <script data-card-contents-for-ri="631" type="text/json">{"id":631,"name":"Pediatrics","url":"https://www.academia.edu/Documents/in/Pediatrics?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="1681" rel="nofollow" href="https://www.academia.edu/Documents/in/Decision_Making">Decision Making</a>, <script data-card-contents-for-ri="1681" type="text/json">{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="3043" rel="nofollow" href="https://www.academia.edu/Documents/in/Trust">Trust</a>, <script data-card-contents-for-ri="3043" type="text/json">{"id":3043,"name":"Trust","url":"https://www.academia.edu/Documents/in/Trust?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="3815" rel="nofollow" href="https://www.academia.edu/Documents/in/Spirituality">Spirituality</a><script data-card-contents-for-ri="3815" type="text/json">{"id":3815,"name":"Spirituality","url":"https://www.academia.edu/Documents/in/Spirituality?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=21463422]'), work: {"id":21463422,"title":"Matters of Spirituality at the End of Life in the Pediatric Intensive Care Unit","created_at":"2016-02-02T07:48:44.675-08:00","url":"https://www.academia.edu/21463422/Matters_of_Spirituality_at_the_End_of_Life_in_the_Pediatric_Intensive_Care_Unit?f_ri=882903","dom_id":"work_21463422","summary":"OBJECTIVE. Our objective with this study was to identify the nature and the role of spirituality from the parents' perspective at the end of life in the PICU and to discern clinical implications.","downloadable_attachments":[{"id":41891400,"asset_id":21463422,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":42539982,"first_name":"Mary Martha","last_name":"Thiel","domain_name":"independent","page_name":"MaryThiel","display_name":"Mary Martha Thiel","profile_url":"https://independent.academia.edu/MaryThiel?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":631,"name":"Pediatrics","url":"https://www.academia.edu/Documents/in/Pediatrics?f_ri=882903","nofollow":true},{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true},{"id":3043,"name":"Trust","url":"https://www.academia.edu/Documents/in/Trust?f_ri=882903","nofollow":true},{"id":3815,"name":"Spirituality","url":"https://www.academia.edu/Documents/in/Spirituality?f_ri=882903","nofollow":true},{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903"},{"id":10187,"name":"Love","url":"https://www.academia.edu/Documents/in/Love?f_ri=882903"},{"id":42162,"name":"Emotions","url":"https://www.academia.edu/Documents/in/Emotions?f_ri=882903"},{"id":54458,"name":"Pastoral Care","url":"https://www.academia.edu/Documents/in/Pastoral_Care?f_ri=882903"},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child?f_ri=882903"},{"id":97487,"name":"End of life","url":"https://www.academia.edu/Documents/in/End_of_life?f_ri=882903"},{"id":165585,"name":"Qualitative Study","url":"https://www.academia.edu/Documents/in/Qualitative_Study?f_ri=882903"},{"id":557260,"name":"Health surveys","url":"https://www.academia.edu/Documents/in/Health_surveys?f_ri=882903"},{"id":825253,"name":"Parent-Child Relationship","url":"https://www.academia.edu/Documents/in/Parent-Child_Relationship?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":1033015,"name":"Parent‐child Relations","url":"https://www.academia.edu/Documents/in/Parent_child_Relations?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_13328849 coauthored" data-work_id="13328849" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/13328849/Understanding_the_Will_to_Live_in_Patients_Nearing_Death">Understanding the Will to Live in Patients Nearing Death</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">This study examined concurrent influences on the will to live in 189 patients with end-stage cancer. The authors found significant correlations between the will to live and existential, psychological, social, and, to a lesser degree,... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_13328849" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">This study examined concurrent influences on the will to live in 189 patients with end-stage cancer. The authors found significant correlations between the will to live and existential, psychological, social, and, to a lesser degree, physical sources of distress. Existential variables proved to have the most influence, with hopelessness, burden to others, and dignity entering into the final model. Health care providers must learn to appreciate the importance of existential issues and their ability to influence the will to live among patients nearing death.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/13328849" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="d1b1d97036ccaca7b88ffc9427d1e6f0" rel="nofollow" data-download="{"attachment_id":45460130,"asset_id":13328849,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/45460130/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="32570316" href="https://independent.academia.edu/HackThomas">Thomas Hack</a><script data-card-contents-for-user="32570316" type="text/json">{"id":32570316,"first_name":"Thomas","last_name":"Hack","domain_name":"independent","page_name":"HackThomas","display_name":"Thomas Hack","profile_url":"https://independent.academia.edu/HackThomas?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span><span class="u-displayInlineBlock InlineList-item-text"> and <span class="u-textDecorationUnderline u-clickable InlineList-item-text js-work-more-authors-13328849">+2</span><div class="hidden js-additional-users-13328849"><div><span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a href="https://independent.academia.edu/SusanMcClement">Susan McClement</a></span></div><div><span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a href="https://umanitoba.academia.edu/HarveyChochinov">Harvey Chochinov</a></span></div></div></span><script>(function(){ var popoverSettings = { el: $('.js-work-more-authors-13328849'), placement: 'bottom', hide_delay: 200, html: true, content: function(){ return $('.js-additional-users-13328849').html(); 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container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_13328849 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="13328849"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 13328849; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=13328849]").text(description); $(".js-view-count-work_13328849").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_13328849").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="13328849"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">16</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="221" rel="nofollow" href="https://www.academia.edu/Documents/in/Psychology">Psychology</a>, <script data-card-contents-for-ri="221" type="text/json">{"id":221,"name":"Psychology","url":"https://www.academia.edu/Documents/in/Psychology?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="2599" rel="nofollow" href="https://www.academia.edu/Documents/in/Psychometrics">Psychometrics</a>, <script data-card-contents-for-ri="2599" type="text/json">{"id":2599,"name":"Psychometrics","url":"https://www.academia.edu/Documents/in/Psychometrics?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="7470" rel="nofollow" href="https://www.academia.edu/Documents/in/Quality_of_life">Quality of life</a>, <script data-card-contents-for-ri="7470" type="text/json">{"id":7470,"name":"Quality of life","url":"https://www.academia.edu/Documents/in/Quality_of_life?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="44529" rel="nofollow" href="https://www.academia.edu/Documents/in/Activities_of_Daily_Living">Activities of Daily Living</a><script data-card-contents-for-ri="44529" type="text/json">{"id":44529,"name":"Activities of Daily Living","url":"https://www.academia.edu/Documents/in/Activities_of_Daily_Living?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=13328849]'), work: {"id":13328849,"title":"Understanding the Will to Live in Patients Nearing Death","created_at":"2015-06-26T12:58:05.364-07:00","url":"https://www.academia.edu/13328849/Understanding_the_Will_to_Live_in_Patients_Nearing_Death?f_ri=882903","dom_id":"work_13328849","summary":"This study examined concurrent influences on the will to live in 189 patients with end-stage cancer. The authors found significant correlations between the will to live and existential, psychological, social, and, to a lesser degree, physical sources of distress. Existential variables proved to have the most influence, with hopelessness, burden to others, and dignity entering into the final model. Health care providers must learn to appreciate the importance of existential issues and their ability to influence the will to live among patients nearing death.","downloadable_attachments":[{"id":45460130,"asset_id":13328849,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":32570316,"first_name":"Thomas","last_name":"Hack","domain_name":"independent","page_name":"HackThomas","display_name":"Thomas Hack","profile_url":"https://independent.academia.edu/HackThomas?f_ri=882903","photo":"/images/s65_no_pic.png"},{"id":32615479,"first_name":"Susan","last_name":"McClement","domain_name":"independent","page_name":"SusanMcClement","display_name":"Susan McClement","profile_url":"https://independent.academia.edu/SusanMcClement?f_ri=882903","photo":"/images/s65_no_pic.png"},{"id":32607840,"first_name":"Harvey","last_name":"Chochinov","domain_name":"umanitoba","page_name":"HarveyChochinov","display_name":"Harvey Chochinov","profile_url":"https://umanitoba.academia.edu/HarveyChochinov?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":221,"name":"Psychology","url":"https://www.academia.edu/Documents/in/Psychology?f_ri=882903","nofollow":true},{"id":2599,"name":"Psychometrics","url":"https://www.academia.edu/Documents/in/Psychometrics?f_ri=882903","nofollow":true},{"id":7470,"name":"Quality of life","url":"https://www.academia.edu/Documents/in/Quality_of_life?f_ri=882903","nofollow":true},{"id":44529,"name":"Activities of Daily Living","url":"https://www.academia.edu/Documents/in/Activities_of_Daily_Living?f_ri=882903","nofollow":true},{"id":46406,"name":"Motivation","url":"https://www.academia.edu/Documents/in/Motivation?f_ri=882903"},{"id":73785,"name":"Personality Assessment Inventory","url":"https://www.academia.edu/Documents/in/Personality_Assessment_Inventory?f_ri=882903"},{"id":101594,"name":"Psychosomatics","url":"https://www.academia.edu/Documents/in/Psychosomatics?f_ri=882903"},{"id":123230,"name":"Regression Analysis","url":"https://www.academia.edu/Documents/in/Regression_Analysis?f_ri=882903"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903"},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged?f_ri=882903"},{"id":469018,"name":"Neoplasms","url":"https://www.academia.edu/Documents/in/Neoplasms?f_ri=882903"},{"id":531167,"name":"Sick Role","url":"https://www.academia.edu/Documents/in/Sick_Role?f_ri=882903"},{"id":615949,"name":"Volition","url":"https://www.academia.edu/Documents/in/Volition?f_ri=882903"},{"id":791585,"name":"Health Care Provider","url":"https://www.academia.edu/Documents/in/Health_Care_Provider?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":1262481,"name":"Pain Measurement","url":"https://www.academia.edu/Documents/in/Pain_Measurement?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_11453791" data-work_id="11453791" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/11453791/Defining_dignity_in_terminally_ill_cancer_patients_A_factor_analytic_approach">Defining dignity in terminally ill cancer patients: A factor‐analytic approach</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">The construct of 'dignity' is frequently raised in discussions about quality end of life care for terminal cancer patients, and is invoked by parties on both sides of the euthanasia debate. Lacking in this general debate has been an... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_11453791" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">The construct of 'dignity' is frequently raised in discussions about quality end of life care for terminal cancer patients, and is invoked by parties on both sides of the euthanasia debate. Lacking in this general debate has been an empirical explication of 'dignity' from the viewpoint of cancer patients themselves. The purpose of the present study was to use factor-analytic and regression methods to analyze dignity data gathered from 213 cancer patients having less than 6 months to live. Patients rated their sense of dignity, and completed measures of symptom distress and psychological well-being. The results showed that although the majority of patients had an intact sense of dignity, there were 99 (46%) patients who reported at least some, or occasional loss of dignity, and 16 (7.5%) patients who indicated that loss of dignity was a significant problem. The exploratory factor analysis yielded six primary factors: (1) Pain; (2) Intimate Dependency; (3) Hopelessness/Depression; (4) Informal Support Network; (5) Formal Support Network; and (6) Quality of Life. Subsequent regression analyses of modifiable factors produced a final two-factor (Hopelessness/Depression and Intimate Dependency) model of statistical significance. These results provide empirical support for the dignity model, and suggest that the provision of end of life care should include methods for treating depression, fostering hope, and facilitating functional independence.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/11453791" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="166ce3fe8d15fba7f1d1119c90ad6057" rel="nofollow" data-download="{"attachment_id":46699068,"asset_id":11453791,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/46699068/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="27886092" href="https://swin.academia.edu/LindaKristjanson">Linda Kristjanson</a><script data-card-contents-for-user="27886092" type="text/json">{"id":27886092,"first_name":"Linda","last_name":"Kristjanson","domain_name":"swin","page_name":"LindaKristjanson","display_name":"Linda Kristjanson","profile_url":"https://swin.academia.edu/LindaKristjanson?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_11453791 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="11453791"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 11453791, container: ".js-paper-rank-work_11453791", }); });</script></li><li class="js-percentile-work_11453791 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 11453791; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_11453791"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_11453791 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="11453791"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 11453791; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=11453791]").text(description); $(".js-view-count-work_11453791").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_11453791").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="11453791"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">14</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="221" rel="nofollow" href="https://www.academia.edu/Documents/in/Psychology">Psychology</a>, <script data-card-contents-for-ri="221" type="text/json">{"id":221,"name":"Psychology","url":"https://www.academia.edu/Documents/in/Psychology?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="7470" rel="nofollow" href="https://www.academia.edu/Documents/in/Quality_of_life">Quality of life</a>, <script data-card-contents-for-ri="7470" type="text/json">{"id":7470,"name":"Quality of life","url":"https://www.academia.edu/Documents/in/Quality_of_life?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="8974" rel="nofollow" href="https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care">Quality of Mental Health Care</a>, <script data-card-contents-for-ri="8974" type="text/json">{"id":8974,"name":"Quality of Mental Health Care","url":"https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="13513" rel="nofollow" href="https://www.academia.edu/Documents/in/Euthanasia">Euthanasia</a><script data-card-contents-for-ri="13513" type="text/json">{"id":13513,"name":"Euthanasia","url":"https://www.academia.edu/Documents/in/Euthanasia?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=11453791]'), work: {"id":11453791,"title":"Defining dignity in terminally ill cancer patients: A factor‐analytic approach","created_at":"2015-03-16T01:30:48.842-07:00","url":"https://www.academia.edu/11453791/Defining_dignity_in_terminally_ill_cancer_patients_A_factor_analytic_approach?f_ri=882903","dom_id":"work_11453791","summary":"The construct of 'dignity' is frequently raised in discussions about quality end of life care for terminal cancer patients, and is invoked by parties on both sides of the euthanasia debate. Lacking in this general debate has been an empirical explication of 'dignity' from the viewpoint of cancer patients themselves. The purpose of the present study was to use factor-analytic and regression methods to analyze dignity data gathered from 213 cancer patients having less than 6 months to live. Patients rated their sense of dignity, and completed measures of symptom distress and psychological well-being. The results showed that although the majority of patients had an intact sense of dignity, there were 99 (46%) patients who reported at least some, or occasional loss of dignity, and 16 (7.5%) patients who indicated that loss of dignity was a significant problem. The exploratory factor analysis yielded six primary factors: (1) Pain; (2) Intimate Dependency; (3) Hopelessness/Depression; (4) Informal Support Network; (5) Formal Support Network; and (6) Quality of Life. Subsequent regression analyses of modifiable factors produced a final two-factor (Hopelessness/Depression and Intimate Dependency) model of statistical significance. These results provide empirical support for the dignity model, and suggest that the provision of end of life care should include methods for treating depression, fostering hope, and facilitating functional independence.","downloadable_attachments":[{"id":46699068,"asset_id":11453791,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":27886092,"first_name":"Linda","last_name":"Kristjanson","domain_name":"swin","page_name":"LindaKristjanson","display_name":"Linda Kristjanson","profile_url":"https://swin.academia.edu/LindaKristjanson?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":221,"name":"Psychology","url":"https://www.academia.edu/Documents/in/Psychology?f_ri=882903","nofollow":true},{"id":7470,"name":"Quality of life","url":"https://www.academia.edu/Documents/in/Quality_of_life?f_ri=882903","nofollow":true},{"id":8974,"name":"Quality of Mental Health Care","url":"https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care?f_ri=882903","nofollow":true},{"id":13513,"name":"Euthanasia","url":"https://www.academia.edu/Documents/in/Euthanasia?f_ri=882903","nofollow":true},{"id":93443,"name":"Psycho","url":"https://www.academia.edu/Documents/in/Psycho?f_ri=882903"},{"id":135265,"name":"Psycho Oncology","url":"https://www.academia.edu/Documents/in/Psycho_Oncology?f_ri=882903"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903"},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged?f_ri=882903"},{"id":469018,"name":"Neoplasms","url":"https://www.academia.edu/Documents/in/Neoplasms?f_ri=882903"},{"id":489727,"name":"Prognosis","url":"https://www.academia.edu/Documents/in/Prognosis?f_ri=882903"},{"id":532278,"name":"Cancer Patient","url":"https://www.academia.edu/Documents/in/Cancer_Patient?f_ri=882903"},{"id":587281,"name":"Right to Die","url":"https://www.academia.edu/Documents/in/Right_to_Die?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":1034181,"name":"Cross Sectional Studies","url":"https://www.academia.edu/Documents/in/Cross_Sectional_Studies?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_77555129" data-work_id="77555129" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/77555129/Pain_Management_in_Palliative_Care">Pain Management in Palliative Care</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">D efinition of Palliative care: "Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_77555129" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">D efinition of Palliative care: "Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by interdisciplinary team taking into consideration physiological, psychosocial, and spiritual needs" (WHO, 2003) Suffering: Suffering is loss of meaning. Suffering occurs when there is a gap between expectation and reality. Principles of Palliative Care: Focus on quality rather than quantity of life. Effective communication at all levels. Respect for autonomy and choice. Effective symptom management. Holistic, multi-professional approach. Caring about the person and family. Palliative care is adding life to days, not adding days to life. It is the right of the patients not to feel pain, suffering or fear at all stages of the disease. Holistic approach is essentials for the relieve of suffering. Pain Management: Pain is an important and undertreated symptom of life-threatening illness. Correct use of analgesic medication, following the guidelines of the WHO step ladder, with the addition of adjuvant analgesics, should control the pain in nearly all cases. Attention should also be given to other aspects of pain, psychosocial or spiritual; Sometimes called "total pain". Bringing pain under control and keeping it there means assessing each aspect of pain and monitoring it. These are core skills of palliative care doctors and nurses. Medications are the foundation of pain control. Anti-inflammatory, anti-depressant and steroid medication may also have a complementary role for some patients and some sources of pain. Complementary measures are used as well as medical treatments. Wafa Qasem Ahmad has completed her Medical degree from Kuwait University in June 1989. She is working as a Consultant, Internist in a Private Clinic.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/77555129" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="7d479460a04430a54cb69d1e2233b3be" rel="nofollow" data-download="{"attachment_id":84927891,"asset_id":77555129,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/84927891/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="137493591" href="https://independent.academia.edu/PhillipRodgers1">Phillip Rodgers</a><script data-card-contents-for-user="137493591" type="text/json">{"id":137493591,"first_name":"Phillip","last_name":"Rodgers","domain_name":"independent","page_name":"PhillipRodgers1","display_name":"Phillip Rodgers","profile_url":"https://independent.academia.edu/PhillipRodgers1?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_77555129 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="77555129"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 77555129, container: ".js-paper-rank-work_77555129", }); });</script></li><li class="js-percentile-work_77555129 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 77555129; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_77555129"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_77555129 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="77555129"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 77555129; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=77555129]").text(description); $(".js-view-count-work_77555129").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_77555129").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="77555129"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">14</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="2898" rel="nofollow" href="https://www.academia.edu/Documents/in/Pain">Pain</a>, <script data-card-contents-for-ri="2898" type="text/json">{"id":2898,"name":"Pain","url":"https://www.academia.edu/Documents/in/Pain?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="4482" rel="nofollow" href="https://www.academia.edu/Documents/in/Palliative_Care">Palliative Care</a>, <script data-card-contents-for-ri="4482" type="text/json">{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="26327" rel="nofollow" href="https://www.academia.edu/Documents/in/Medicine">Medicine</a>, <script data-card-contents-for-ri="26327" type="text/json">{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="40165" rel="nofollow" href="https://www.academia.edu/Documents/in/Pain_Management">Pain Management</a><script data-card-contents-for-ri="40165" type="text/json">{"id":40165,"name":"Pain Management","url":"https://www.academia.edu/Documents/in/Pain_Management?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=77555129]'), work: {"id":77555129,"title":"Pain Management in Palliative Care","created_at":"2022-04-25T04:41:44.844-07:00","url":"https://www.academia.edu/77555129/Pain_Management_in_Palliative_Care?f_ri=882903","dom_id":"work_77555129","summary":"D efinition of Palliative care: \"Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by interdisciplinary team taking into consideration physiological, psychosocial, and spiritual needs\" (WHO, 2003) Suffering: Suffering is loss of meaning. Suffering occurs when there is a gap between expectation and reality. Principles of Palliative Care: Focus on quality rather than quantity of life. Effective communication at all levels. Respect for autonomy and choice. Effective symptom management. Holistic, multi-professional approach. Caring about the person and family. Palliative care is adding life to days, not adding days to life. It is the right of the patients not to feel pain, suffering or fear at all stages of the disease. Holistic approach is essentials for the relieve of suffering. Pain Management: Pain is an important and undertreated symptom of life-threatening illness. Correct use of analgesic medication, following the guidelines of the WHO step ladder, with the addition of adjuvant analgesics, should control the pain in nearly all cases. Attention should also be given to other aspects of pain, psychosocial or spiritual; Sometimes called \"total pain\". Bringing pain under control and keeping it there means assessing each aspect of pain and monitoring it. These are core skills of palliative care doctors and nurses. Medications are the foundation of pain control. Anti-inflammatory, anti-depressant and steroid medication may also have a complementary role for some patients and some sources of pain. Complementary measures are used as well as medical treatments. Wafa Qasem Ahmad has completed her Medical degree from Kuwait University in June 1989. She is working as a Consultant, Internist in a Private Clinic.","downloadable_attachments":[{"id":84927891,"asset_id":77555129,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":137493591,"first_name":"Phillip","last_name":"Rodgers","domain_name":"independent","page_name":"PhillipRodgers1","display_name":"Phillip Rodgers","profile_url":"https://independent.academia.edu/PhillipRodgers1?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":2898,"name":"Pain","url":"https://www.academia.edu/Documents/in/Pain?f_ri=882903","nofollow":true},{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true},{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine?f_ri=882903","nofollow":true},{"id":40165,"name":"Pain Management","url":"https://www.academia.edu/Documents/in/Pain_Management?f_ri=882903","nofollow":true},{"id":95655,"name":"Pharmaceutical","url":"https://www.academia.edu/Documents/in/Pharmaceutical?f_ri=882903"},{"id":99651,"name":"Community health nursing","url":"https://www.academia.edu/Documents/in/Community_health_nursing?f_ri=882903"},{"id":144052,"name":"Patient Satisfaction","url":"https://www.academia.edu/Documents/in/Patient_Satisfaction?f_ri=882903"},{"id":405483,"name":"Sustained Drug Release","url":"https://www.academia.edu/Documents/in/Sustained_Drug_Release?f_ri=882903"},{"id":469018,"name":"Neoplasms","url":"https://www.academia.edu/Documents/in/Neoplasms?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":1180715,"name":"Abdominal Pain","url":"https://www.academia.edu/Documents/in/Abdominal_Pain?f_ri=882903"},{"id":1435137,"name":"Emergency Department","url":"https://www.academia.edu/Documents/in/Emergency_Department?f_ri=882903"},{"id":1666580,"name":"Extended release","url":"https://www.academia.edu/Documents/in/Extended_release?f_ri=882903"},{"id":2303288,"name":"Patient Controlled Analgesia","url":"https://www.academia.edu/Documents/in/Patient_Controlled_Analgesia?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_72396809" data-work_id="72396809" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/72396809/End_of_Life_Care_Consensus_Statement_by_Indian_Academy_of_Pediatrics">End-of-Life Care: Consensus Statement by Indian Academy of Pediatrics</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">The right to life has been accepted as one of the fundamental rights in our constitution. Resuscitation is a procedure performed for all patients suffering from cardiac or respiratory arrest irrespective of the clinical condition. There... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_72396809" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">The right to life has been accepted as one of the fundamental rights in our constitution. Resuscitation is a procedure performed for all patients suffering from cardiac or respiratory arrest irrespective of the clinical condition. There are no legal guidelines defining process to be adopted in situations where resuscitation is unlikely to be useful. There are no guidelines on withdrawal of care or end of life (EOL) decisions, accepted by the Government, judiciary, professionals, academicians or the community. A National Consultative meet was organized by Indian Medico-Legal and Ethics Association and the Medico-legal group of Indian Academy of Pediatrics (IAP) to formulate the guidelines on &#39;Do Not Resuscitate&#39; (DNR), and &#39;End of Life Support&#39;. The meeting was organized on 30th May, 2014 at Ram Manohar Lohia Hospital, New Delhi. The meeting involved professionals from legal and various medical fields as well as administrators, and members from Medical Council of Indi...</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/72396809" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="44d248e50b9a5b50b4f04d4deab2528b" rel="nofollow" data-download="{"attachment_id":81338048,"asset_id":72396809,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/81338048/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="32633935" href="https://independent.academia.edu/SatishTiwari4">Satish Tiwari</a><script data-card-contents-for-user="32633935" type="text/json">{"id":32633935,"first_name":"Satish","last_name":"Tiwari","domain_name":"independent","page_name":"SatishTiwari4","display_name":"Satish Tiwari","profile_url":"https://independent.academia.edu/SatishTiwari4?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_72396809 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="72396809"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 72396809, container: ".js-paper-rank-work_72396809", }); });</script></li><li class="js-percentile-work_72396809 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 72396809; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_72396809"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_72396809 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="72396809"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 72396809; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=72396809]").text(description); $(".js-view-count-work_72396809").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_72396809").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="72396809"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">11</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="631" rel="nofollow" href="https://www.academia.edu/Documents/in/Pediatrics">Pediatrics</a>, <script data-card-contents-for-ri="631" type="text/json">{"id":631,"name":"Pediatrics","url":"https://www.academia.edu/Documents/in/Pediatrics?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="6574" rel="nofollow" href="https://www.academia.edu/Documents/in/Family">Family</a>, <script data-card-contents-for-ri="6574" type="text/json">{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="26327" rel="nofollow" href="https://www.academia.edu/Documents/in/Medicine">Medicine</a>, <script data-card-contents-for-ri="26327" type="text/json">{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="43838" rel="nofollow" href="https://www.academia.edu/Documents/in/India">India</a><script data-card-contents-for-ri="43838" type="text/json">{"id":43838,"name":"India","url":"https://www.academia.edu/Documents/in/India?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=72396809]'), work: {"id":72396809,"title":"End-of-Life Care: Consensus Statement by Indian Academy of Pediatrics","created_at":"2022-02-24T03:10:09.506-08:00","url":"https://www.academia.edu/72396809/End_of_Life_Care_Consensus_Statement_by_Indian_Academy_of_Pediatrics?f_ri=882903","dom_id":"work_72396809","summary":"The right to life has been accepted as one of the fundamental rights in our constitution. Resuscitation is a procedure performed for all patients suffering from cardiac or respiratory arrest irrespective of the clinical condition. There are no legal guidelines defining process to be adopted in situations where resuscitation is unlikely to be useful. There are no guidelines on withdrawal of care or end of life (EOL) decisions, accepted by the Government, judiciary, professionals, academicians or the community. A National Consultative meet was organized by Indian Medico-Legal and Ethics Association and the Medico-legal group of Indian Academy of Pediatrics (IAP) to formulate the guidelines on \u0026#39;Do Not Resuscitate\u0026#39; (DNR), and \u0026#39;End of Life Support\u0026#39;. The meeting was organized on 30th May, 2014 at Ram Manohar Lohia Hospital, New Delhi. The meeting involved professionals from legal and various medical fields as well as administrators, and members from Medical Council of Indi...","downloadable_attachments":[{"id":81338048,"asset_id":72396809,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":32633935,"first_name":"Satish","last_name":"Tiwari","domain_name":"independent","page_name":"SatishTiwari4","display_name":"Satish Tiwari","profile_url":"https://independent.academia.edu/SatishTiwari4?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":631,"name":"Pediatrics","url":"https://www.academia.edu/Documents/in/Pediatrics?f_ri=882903","nofollow":true},{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true},{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine?f_ri=882903","nofollow":true},{"id":43838,"name":"India","url":"https://www.academia.edu/Documents/in/India?f_ri=882903","nofollow":true},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child?f_ri=882903"},{"id":83306,"name":"Consensus","url":"https://www.academia.edu/Documents/in/Consensus?f_ri=882903"},{"id":134346,"name":"Infant","url":"https://www.academia.edu/Documents/in/Infant?f_ri=882903"},{"id":253560,"name":"Newborn Infant","url":"https://www.academia.edu/Documents/in/Newborn_Infant?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool?f_ri=882903"},{"id":3789883,"name":"Paediatrics and reproductive medicine","url":"https://www.academia.edu/Documents/in/Paediatrics_and_reproductive_medicine?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_9736770" data-work_id="9736770" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/9736770/Mental_health_in_significant_others_of_patients_dying_from_lung_cancer">Mental health in significant others of patients dying from lung cancer</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Objective: Definitions and measures of significant others' mental health vary, but stress processes have been associated with caregiver outcomes of this kind. Thus, various mental health outcomes probably appear, either as specific... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_9736770" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Objective: Definitions and measures of significant others' mental health vary, but stress processes have been associated with caregiver outcomes of this kind. Thus, various mental health outcomes probably appear, either as specific responses to particular types of caregiver stressors, or as part of a general response resulting from an accumulation of various stressors. The present study explores the occurrence of symptoms of strain with regard to depression, exhaustion, and emotional well-being in significant others of patients dying from lung cancer, and how these symptoms coexist.Methods: Measures used were the Montgomery Åsberg Depression Rating Scale, the OLdenburg Burnout Inventory, and the Swedish Health-Related Quality of Life Survey. Data from 84 significant others of patients dying from lung cancer were collected at a time-point during the last 4 months before the patients died and subsequently analysed. The occurrence of symptoms of strain was established by creating cut-off scores from the general population. To explore how the different symptoms coexisted, hierarchical agglomerative cluster analyses were conducted using Ward's method.Results: Approximately 40% of the significant others reported symptoms of strain for each of the three outcomes, and a coexistence was found since the significant others clustered as subgroups, ranging from ‘high on all scales’ to ‘low on all scales’.Conclusion: A considerable proportion of the significant others were thus negatively affected in terms of mental health. We conclude that being a significant other of a person dying from lung cancer most likely results in a general response to this major life event. Copyright © 2009 John Wiley & Sons, Ltd.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/9736770" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="1bedd41196c4f70d683a8bf75e719a82" rel="nofollow" data-download="{"attachment_id":47661834,"asset_id":9736770,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/47661834/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="23405179" href="https://sophiahemmethogskola.academia.edu/AgnetaWennmanLarsen">Agneta Wennman-Larsen</a><script data-card-contents-for-user="23405179" type="text/json">{"id":23405179,"first_name":"Agneta","last_name":"Wennman-Larsen","domain_name":"sophiahemmethogskola","page_name":"AgnetaWennmanLarsen","display_name":"Agneta Wennman-Larsen","profile_url":"https://sophiahemmethogskola.academia.edu/AgnetaWennmanLarsen?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_9736770 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="9736770"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 9736770, container: ".js-paper-rank-work_9736770", }); 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$(".js-view-count[data-work-id=9736770]").text(description); $(".js-view-count-work_9736770").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_9736770").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="9736770"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">16</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="221" rel="nofollow" href="https://www.academia.edu/Documents/in/Psychology">Psychology</a>, <script data-card-contents-for-ri="221" type="text/json">{"id":221,"name":"Psychology","url":"https://www.academia.edu/Documents/in/Psychology?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="2599" rel="nofollow" href="https://www.academia.edu/Documents/in/Psychometrics">Psychometrics</a>, <script data-card-contents-for-ri="2599" type="text/json">{"id":2599,"name":"Psychometrics","url":"https://www.academia.edu/Documents/in/Psychometrics?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="2827" rel="nofollow" href="https://www.academia.edu/Documents/in/Mental_Health">Mental Health</a>, <script data-card-contents-for-ri="2827" type="text/json">{"id":2827,"name":"Mental Health","url":"https://www.academia.edu/Documents/in/Mental_Health?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="4482" rel="nofollow" href="https://www.academia.edu/Documents/in/Palliative_Care">Palliative Care</a><script data-card-contents-for-ri="4482" type="text/json">{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=9736770]'), work: {"id":9736770,"title":"Mental health in significant others of patients dying from lung cancer","created_at":"2014-12-12T01:55:45.804-08:00","url":"https://www.academia.edu/9736770/Mental_health_in_significant_others_of_patients_dying_from_lung_cancer?f_ri=882903","dom_id":"work_9736770","summary":"Objective: Definitions and measures of significant others' mental health vary, but stress processes have been associated with caregiver outcomes of this kind. Thus, various mental health outcomes probably appear, either as specific responses to particular types of caregiver stressors, or as part of a general response resulting from an accumulation of various stressors. The present study explores the occurrence of symptoms of strain with regard to depression, exhaustion, and emotional well-being in significant others of patients dying from lung cancer, and how these symptoms coexist.Methods: Measures used were the Montgomery Åsberg Depression Rating Scale, the OLdenburg Burnout Inventory, and the Swedish Health-Related Quality of Life Survey. Data from 84 significant others of patients dying from lung cancer were collected at a time-point during the last 4 months before the patients died and subsequently analysed. The occurrence of symptoms of strain was established by creating cut-off scores from the general population. To explore how the different symptoms coexisted, hierarchical agglomerative cluster analyses were conducted using Ward's method.Results: Approximately 40% of the significant others reported symptoms of strain for each of the three outcomes, and a coexistence was found since the significant others clustered as subgroups, ranging from ‘high on all scales’ to ‘low on all scales’.Conclusion: A considerable proportion of the significant others were thus negatively affected in terms of mental health. We conclude that being a significant other of a person dying from lung cancer most likely results in a general response to this major life event. Copyright © 2009 John Wiley \u0026 Sons, Ltd.","downloadable_attachments":[{"id":47661834,"asset_id":9736770,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":23405179,"first_name":"Agneta","last_name":"Wennman-Larsen","domain_name":"sophiahemmethogskola","page_name":"AgnetaWennmanLarsen","display_name":"Agneta Wennman-Larsen","profile_url":"https://sophiahemmethogskola.academia.edu/AgnetaWennmanLarsen?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":221,"name":"Psychology","url":"https://www.academia.edu/Documents/in/Psychology?f_ri=882903","nofollow":true},{"id":2599,"name":"Psychometrics","url":"https://www.academia.edu/Documents/in/Psychometrics?f_ri=882903","nofollow":true},{"id":2827,"name":"Mental Health","url":"https://www.academia.edu/Documents/in/Mental_Health?f_ri=882903","nofollow":true},{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true},{"id":7470,"name":"Quality of life","url":"https://www.academia.edu/Documents/in/Quality_of_life?f_ri=882903"},{"id":23076,"name":"Fatigue","url":"https://www.academia.edu/Documents/in/Fatigue?f_ri=882903"},{"id":51698,"name":"Lung Cancer","url":"https://www.academia.edu/Documents/in/Lung_Cancer?f_ri=882903"},{"id":73785,"name":"Personality Assessment Inventory","url":"https://www.academia.edu/Documents/in/Personality_Assessment_Inventory?f_ri=882903"},{"id":93443,"name":"Psycho","url":"https://www.academia.edu/Documents/in/Psycho?f_ri=882903"},{"id":133057,"name":"Young Adult","url":"https://www.academia.edu/Documents/in/Young_Adult?f_ri=882903"},{"id":135265,"name":"Psycho Oncology","url":"https://www.academia.edu/Documents/in/Psycho_Oncology?f_ri=882903"},{"id":157943,"name":"Depressive Disorder","url":"https://www.academia.edu/Documents/in/Depressive_Disorder?f_ri=882903"},{"id":201441,"name":"Caregivers","url":"https://www.academia.edu/Documents/in/Caregivers?f_ri=882903"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":886573,"name":"Cost of Illness","url":"https://www.academia.edu/Documents/in/Cost_of_Illness?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_13287222" data-work_id="13287222" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/13287222/Non_invasive_ventilation_in_amyotrophic_lateral_sclerosis">Non-invasive ventilation in amyotrophic lateral sclerosis</a></div></div><div class="u-pb4x u-mt3x"></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/13287222" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="30dd4a4097d5c0d5de4c054d94b4abc1" rel="nofollow" data-download="{"attachment_id":45511059,"asset_id":13287222,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/45511059/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="32539556" href="https://kuleuven.academia.edu/PhilipVanDamme">Philip Van Damme</a><script data-card-contents-for-user="32539556" type="text/json">{"id":32539556,"first_name":"Philip Van","last_name":"Damme","domain_name":"kuleuven","page_name":"PhilipVanDamme","display_name":"Philip Van Damme","profile_url":"https://kuleuven.academia.edu/PhilipVanDamme?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_13287222 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="13287222"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 13287222, container: ".js-paper-rank-work_13287222", }); });</script></li><li class="js-percentile-work_13287222 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 13287222; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_13287222"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_13287222 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="13287222"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 13287222; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=13287222]").text(description); $(".js-view-count-work_13287222").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_13287222").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="13287222"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">7</a>  </div><span class="InlineList-item-text u-textTruncate u-pl9x"><a class="InlineList-item-text" data-has-card-for-ri="7470" rel="nofollow" href="https://www.academia.edu/Documents/in/Quality_of_life">Quality of life</a>, <script data-card-contents-for-ri="7470" type="text/json">{"id":7470,"name":"Quality of life","url":"https://www.academia.edu/Documents/in/Quality_of_life?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="12426" rel="nofollow" href="https://www.academia.edu/Documents/in/Treatment_Outcome">Treatment Outcome</a>, <script data-card-contents-for-ri="12426" type="text/json">{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="35712" rel="nofollow" href="https://www.academia.edu/Documents/in/Non-invasive_ventilation">Non-invasive ventilation</a>, <script data-card-contents-for-ri="35712" type="text/json">{"id":35712,"name":"Non-invasive ventilation","url":"https://www.academia.edu/Documents/in/Non-invasive_ventilation?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="42973" rel="nofollow" href="https://www.academia.edu/Documents/in/Amyotrophic_Lateral_Sclerosis">Amyotrophic Lateral Sclerosis</a><script data-card-contents-for-ri="42973" type="text/json">{"id":42973,"name":"Amyotrophic Lateral Sclerosis","url":"https://www.academia.edu/Documents/in/Amyotrophic_Lateral_Sclerosis?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=13287222]'), work: {"id":13287222,"title":"Non-invasive ventilation in amyotrophic lateral sclerosis","created_at":"2015-06-25T11:55:33.971-07:00","url":"https://www.academia.edu/13287222/Non_invasive_ventilation_in_amyotrophic_lateral_sclerosis?f_ri=882903","dom_id":"work_13287222","summary":null,"downloadable_attachments":[{"id":45511059,"asset_id":13287222,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":32539556,"first_name":"Philip Van","last_name":"Damme","domain_name":"kuleuven","page_name":"PhilipVanDamme","display_name":"Philip Van Damme","profile_url":"https://kuleuven.academia.edu/PhilipVanDamme?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":7470,"name":"Quality of life","url":"https://www.academia.edu/Documents/in/Quality_of_life?f_ri=882903","nofollow":true},{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome?f_ri=882903","nofollow":true},{"id":35712,"name":"Non-invasive ventilation","url":"https://www.academia.edu/Documents/in/Non-invasive_ventilation?f_ri=882903","nofollow":true},{"id":42973,"name":"Amyotrophic Lateral Sclerosis","url":"https://www.academia.edu/Documents/in/Amyotrophic_Lateral_Sclerosis?f_ri=882903","nofollow":true},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_68117107" data-work_id="68117107" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/68117107/Discussing_End_of_Life_Issues_in_the_Last_Months_of_Life_A_Nationwide_Study_among_General_Practitioners">Discussing End-of-Life Issues in the Last Months of Life: A Nationwide Study among General Practitioners</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Background: Communication is a necessary tool for ensuring the provision of quality patient-centered care for patients who have life-threatening illnesses, and discussing all relevant end-of-life issues should not be limited to cancer... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_68117107" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Background: Communication is a necessary tool for ensuring the provision of quality patient-centered care for patients who have life-threatening illnesses, and discussing all relevant end-of-life issues should not be limited to cancer patients. Objective: To examine the incidence and timing of general practitioners (GPs) discussing end-of-life issues with patients whose deaths were expected, and to identify the factors associated with them discussing these issues. Methods: Between January and December 2008, GPs participating in a nationally representative sentinel surveillance network of GPs were asked to register, using standardised forms, the extent of discussing 10 end-of-life issues with patients. Results: We examined 252 patients who died nonsuddenly, 38% of whom died of cancer, and 86% of whose treatment goal was palliative care. Our findings show that GPs often waited until very close to death before they discussed end-of-life issues with patients, and discussed spiritual and social issues less than physical symptoms, diagnoses, and psychological problems. In 74% of cases, the GPs were informed of their patients' preferred place of death; and 8 out of 10 patients with known preferences for place of death, died there. Being diagnosed with cancer was associated with a higher frequency of discussing all 10 end-of-life issues than diagnosis with other (noncancer) conditions, but this is a state of mind we did not explore in this study. Conclusion: Promotion of timely discussion of all relevant end-of-life issues, in patients with cancer and noncancer diagnoses, is advisable based on systematic needs assessment.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/68117107" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="b6d23bea79bf51ef515478e9f2609ff8" rel="nofollow" data-download="{"attachment_id":78708182,"asset_id":68117107,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/78708182/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="58156733" href="https://independent.academia.edu/BregjeOnwuteakaPhilipsen">Bregje Onwuteaka-Philipsen</a><script data-card-contents-for-user="58156733" type="text/json">{"id":58156733,"first_name":"Bregje","last_name":"Onwuteaka-Philipsen","domain_name":"independent","page_name":"BregjeOnwuteakaPhilipsen","display_name":"Bregje Onwuteaka-Philipsen","profile_url":"https://independent.academia.edu/BregjeOnwuteakaPhilipsen?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_68117107 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="68117107"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 68117107, container: ".js-paper-rank-work_68117107", }); 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$(".js-view-count[data-work-id=68117107]").text(description); $(".js-view-count-work_68117107").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_68117107").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="68117107"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">14</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="588" rel="nofollow" href="https://www.academia.edu/Documents/in/Nursing">Nursing</a>, <script data-card-contents-for-ri="588" type="text/json">{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="859" rel="nofollow" href="https://www.academia.edu/Documents/in/Communication">Communication</a>, <script data-card-contents-for-ri="859" type="text/json">{"id":859,"name":"Communication","url":"https://www.academia.edu/Documents/in/Communication?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="26327" rel="nofollow" href="https://www.academia.edu/Documents/in/Medicine">Medicine</a>, <script data-card-contents-for-ri="26327" type="text/json">{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="28023" rel="nofollow" href="https://www.academia.edu/Documents/in/Palliative_Medicine">Palliative Medicine</a><script data-card-contents-for-ri="28023" type="text/json">{"id":28023,"name":"Palliative Medicine","url":"https://www.academia.edu/Documents/in/Palliative_Medicine?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=68117107]'), work: {"id":68117107,"title":"Discussing End-of-Life Issues in the Last Months of Life: A Nationwide Study among General Practitioners","created_at":"2022-01-14T06:49:39.533-08:00","url":"https://www.academia.edu/68117107/Discussing_End_of_Life_Issues_in_the_Last_Months_of_Life_A_Nationwide_Study_among_General_Practitioners?f_ri=882903","dom_id":"work_68117107","summary":"Background: Communication is a necessary tool for ensuring the provision of quality patient-centered care for patients who have life-threatening illnesses, and discussing all relevant end-of-life issues should not be limited to cancer patients. Objective: To examine the incidence and timing of general practitioners (GPs) discussing end-of-life issues with patients whose deaths were expected, and to identify the factors associated with them discussing these issues. Methods: Between January and December 2008, GPs participating in a nationally representative sentinel surveillance network of GPs were asked to register, using standardised forms, the extent of discussing 10 end-of-life issues with patients. Results: We examined 252 patients who died nonsuddenly, 38% of whom died of cancer, and 86% of whose treatment goal was palliative care. Our findings show that GPs often waited until very close to death before they discussed end-of-life issues with patients, and discussed spiritual and social issues less than physical symptoms, diagnoses, and psychological problems. In 74% of cases, the GPs were informed of their patients' preferred place of death; and 8 out of 10 patients with known preferences for place of death, died there. Being diagnosed with cancer was associated with a higher frequency of discussing all 10 end-of-life issues than diagnosis with other (noncancer) conditions, but this is a state of mind we did not explore in this study. Conclusion: Promotion of timely discussion of all relevant end-of-life issues, in patients with cancer and noncancer diagnoses, is advisable based on systematic needs assessment.","downloadable_attachments":[{"id":78708182,"asset_id":68117107,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":58156733,"first_name":"Bregje","last_name":"Onwuteaka-Philipsen","domain_name":"independent","page_name":"BregjeOnwuteakaPhilipsen","display_name":"Bregje Onwuteaka-Philipsen","profile_url":"https://independent.academia.edu/BregjeOnwuteakaPhilipsen?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true},{"id":859,"name":"Communication","url":"https://www.academia.edu/Documents/in/Communication?f_ri=882903","nofollow":true},{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine?f_ri=882903","nofollow":true},{"id":28023,"name":"Palliative Medicine","url":"https://www.academia.edu/Documents/in/Palliative_Medicine?f_ri=882903","nofollow":true},{"id":157892,"name":"Netherlands","url":"https://www.academia.edu/Documents/in/Netherlands?f_ri=882903"},{"id":241361,"name":"Social Issues","url":"https://www.academia.edu/Documents/in/Social_Issues?f_ri=882903"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903"},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged?f_ri=882903"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1?f_ri=882903"},{"id":724964,"name":"Palliative","url":"https://www.academia.edu/Documents/in/Palliative?f_ri=882903"},{"id":867081,"name":"General Practitioners","url":"https://www.academia.edu/Documents/in/General_Practitioners?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":3196731,"name":"Interviews as topic","url":"https://www.academia.edu/Documents/in/Interviews_as_topic?f_ri=882903"},{"id":4045153,"name":"Physician-Patient Relations","url":"https://www.academia.edu/Documents/in/Physician_Patient_Relations?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_66856533" data-work_id="66856533" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/66856533/Active_vs_passive_euthanasia_wheres_the_distinction">Active vs passive euthanasia--where's the distinction?</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest">Active vs passive euthanasiawhere's the distinction? his article examines the concepts of active and passive euthanasia and suggests that ' 11. R Lamerton, Care of the Dying (New York City: Penguin Books, 1981).</div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/66856533" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="a8fb186bb4a3838d3f68f948375ec7c0" rel="nofollow" data-download="{"attachment_id":77890526,"asset_id":66856533,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/77890526/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="201212337" href="https://independent.academia.edu/KarinDufault">Karin Dufault</a><script data-card-contents-for-user="201212337" type="text/json">{"id":201212337,"first_name":"Karin","last_name":"Dufault","domain_name":"independent","page_name":"KarinDufault","display_name":"Karin Dufault","profile_url":"https://independent.academia.edu/KarinDufault?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_66856533 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="66856533"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 66856533, container: ".js-paper-rank-work_66856533", }); });</script></li><li class="js-percentile-work_66856533 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 66856533; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_66856533"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_66856533 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="66856533"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 66856533; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=66856533]").text(description); $(".js-view-count-work_66856533").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_66856533").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="66856533"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">6</a>  </div><span class="InlineList-item-text u-textTruncate u-pl9x"><a class="InlineList-item-text" data-has-card-for-ri="588" rel="nofollow" href="https://www.academia.edu/Documents/in/Nursing">Nursing</a>, <script data-card-contents-for-ri="588" type="text/json">{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="9435" rel="nofollow" href="https://www.academia.edu/Documents/in/Medical_Ethics">Medical Ethics</a>, <script data-card-contents-for-ri="9435" type="text/json">{"id":9435,"name":"Medical Ethics","url":"https://www.academia.edu/Documents/in/Medical_Ethics?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="13513" rel="nofollow" href="https://www.academia.edu/Documents/in/Euthanasia">Euthanasia</a>, <script data-card-contents-for-ri="13513" type="text/json">{"id":13513,"name":"Euthanasia","url":"https://www.academia.edu/Documents/in/Euthanasia?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="489423" rel="nofollow" href="https://www.academia.edu/Documents/in/Morals">Morals</a><script data-card-contents-for-ri="489423" type="text/json">{"id":489423,"name":"Morals","url":"https://www.academia.edu/Documents/in/Morals?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=66856533]'), work: {"id":66856533,"title":"Active vs passive euthanasia--where's the distinction?","created_at":"2022-01-02T06:50:41.564-08:00","url":"https://www.academia.edu/66856533/Active_vs_passive_euthanasia_wheres_the_distinction?f_ri=882903","dom_id":"work_66856533","summary":"Active vs passive euthanasiawhere's the distinction? his article examines the concepts of active and passive euthanasia and suggests that ' 11. R Lamerton, Care of the Dying (New York City: Penguin Books, 1981).","downloadable_attachments":[{"id":77890526,"asset_id":66856533,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":201212337,"first_name":"Karin","last_name":"Dufault","domain_name":"independent","page_name":"KarinDufault","display_name":"Karin Dufault","profile_url":"https://independent.academia.edu/KarinDufault?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true},{"id":9435,"name":"Medical Ethics","url":"https://www.academia.edu/Documents/in/Medical_Ethics?f_ri=882903","nofollow":true},{"id":13513,"name":"Euthanasia","url":"https://www.academia.edu/Documents/in/Euthanasia?f_ri=882903","nofollow":true},{"id":489423,"name":"Morals","url":"https://www.academia.edu/Documents/in/Morals?f_ri=882903","nofollow":true},{"id":737724,"name":"Patient Advocacy","url":"https://www.academia.edu/Documents/in/Patient_Advocacy?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_21253208 coauthored" data-work_id="21253208" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/21253208/Are_religion_and_religiosity_important_to_end_of_life_decisions_and_patient_autonomy_in_the_ICU_The_Ethicatt_study">Are religion and religiosity important to end-of-life decisions and patient autonomy in the ICU? The Ethicatt study</a></div></div><div class="u-pb4x u-mt3x"></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/21253208" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="05e335dd854ced88516c7ec7f9c49ea5" rel="nofollow" data-download="{"attachment_id":41783292,"asset_id":21253208,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/41783292/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="42378756" href="https://bgu.academia.edu/SaraCarmel">Sara Carmel</a><script data-card-contents-for-user="42378756" type="text/json">{"id":42378756,"first_name":"Sara","last_name":"Carmel","domain_name":"bgu","page_name":"SaraCarmel","display_name":"Sara Carmel","profile_url":"https://bgu.academia.edu/SaraCarmel?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span><span class="u-displayInlineBlock InlineList-item-text"> and <span class="u-textDecorationUnderline u-clickable InlineList-item-text js-work-more-authors-21253208">+1</span><div class="hidden js-additional-users-21253208"><div><span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a href="https://independent.academia.edu/HBulow">Hans-Henrik Bülow</a></span></div></div></span><script>(function(){ var popoverSettings = { el: $('.js-work-more-authors-21253208'), placement: 'bottom', hide_delay: 200, html: true, content: function(){ return $('.js-additional-users-21253208').html(); 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work_386384" data-work_id="386384" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/386384/Everyday_Death_How_Do_Nurses_Cope_With_Caring_for_Dying_People_In_Hospital">Everyday Death: How Do Nurses Cope With Caring for Dying People In Hospital?</a></div></div><div class="u-pb4x u-mt3x"></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/386384" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="c6e56f97978ab7ffcccbf6aa0141850c" rel="nofollow" data-download="{"attachment_id":51428414,"asset_id":386384,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/51428414/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="293673" href="https://soton.academia.edu/JaneHopkinson">Jane Hopkinson</a><script data-card-contents-for-user="293673" 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$(".js-view-count-work_386384").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="386384"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">15</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="588" rel="nofollow" href="https://www.academia.edu/Documents/in/Nursing">Nursing</a>, <script data-card-contents-for-ri="588" type="text/json">{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="5178" rel="nofollow" href="https://www.academia.edu/Documents/in/Phenomenology">Phenomenology</a>, <script data-card-contents-for-ri="5178" type="text/json">{"id":5178,"name":"Phenomenology","url":"https://www.academia.edu/Documents/in/Phenomenology?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="11015" rel="nofollow" href="https://www.academia.edu/Documents/in/Social_Support">Social Support</a>, <script data-card-contents-for-ri="11015" type="text/json">{"id":11015,"name":"Social Support","url":"https://www.academia.edu/Documents/in/Social_Support?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="12135" rel="nofollow" href="https://www.academia.edu/Documents/in/Qualitative_Research">Qualitative Research</a><script data-card-contents-for-ri="12135" type="text/json">{"id":12135,"name":"Qualitative Research","url":"https://www.academia.edu/Documents/in/Qualitative_Research?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=386384]'), work: 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})();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_67644092" data-work_id="67644092" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/67644092/Promoting_excellence_in_end_of_life_care_a_report_on_innovative_models_of_palliative_care">Promoting excellence in end-of-life care: a report on innovative models of palliative care</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Background: Promoting Excellence in End-of Life Care, a national program of The Robert Wood Johnson Foundation, funded 22 demonstration projects representing a wide range of health care settings and patient populations to develop... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_67644092" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Background: Promoting Excellence in End-of Life Care, a national program of The Robert Wood Johnson Foundation, funded 22 demonstration projects representing a wide range of health care settings and patient populations to develop innovative models for delivering palliative care that addressed documented deficiencies in the care of patients and families facing the final stage of life. Objective: To determine the practicality (feasibility of development and operation as well as acceptance by stakeholders) of new models of care and to determine the impact of the models on access to, quality of and financing for palliative care. Design: The program cannot report scientifically rigorous outcomes, but the grant-funded projects used a variety of methods and measures to assess acceptance of new models and their impact from the perspectives of various stakeholders, including patients and their families, clinicians, administrators and payers. While it is not possible to aggregate data across projects, the data reported to the Promoting Excellence national program office were used to describe program impact with respect to the practicality of palliative care service integration into existing clinical care settings (feasibility and acceptance by stakeholders), the availability and use of palliative care services (access), quality of care (conformance to patient expectations and accepted clinical standards) and costs of care. Settings and subjects: The 22 projects provided services in urban as well as rural settings, in integrated health systems, hospitals, outpatient clinics, cancer centers, nursing homes, renal dialysis clinics, inner city public health and safety net systems and prisons. Populations served included prison inmates, military veterans, renal dialysis patients, Native Americans, Native Alaskans, and African American patients, inner-city medically underserved patients, pediatric patients, and persons with serious mental illness patients. Results: Hosting or adopting institutions sustained or expanded twenty of the 22 models, and feedback from all stakeholders was positive. Project sites developed and utilized new palliative care services and addressed quality through implementation of new standards and clinical protocols. Costs of care, where they could be assessed, were unaffected or decreased for project patients versus historical or concurrent controls. Conclusions: The 22 Promoting Excellence in End-of Life Care projects demonstrated that by individualizing patient and family assessment, effectively employing existing resources 137</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/67644092" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="3b361994b62675097ba070bd1fdf4f3b" rel="nofollow" data-download="{"attachment_id":78387573,"asset_id":67644092,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/78387573/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="51579816" href="https://independent.academia.edu/KarynCollins1">Karyn Collins</a><script data-card-contents-for-user="51579816" type="text/json">{"id":51579816,"first_name":"Karyn","last_name":"Collins","domain_name":"independent","page_name":"KarynCollins1","display_name":"Karyn Collins","profile_url":"https://independent.academia.edu/KarynCollins1?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_67644092 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="67644092"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 67644092, container: ".js-paper-rank-work_67644092", }); 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$(".js-view-count[data-work-id=67644092]").text(description); $(".js-view-count-work_67644092").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_67644092").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="67644092"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">17</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="588" rel="nofollow" href="https://www.academia.edu/Documents/in/Nursing">Nursing</a>, <script data-card-contents-for-ri="588" type="text/json">{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="4441" rel="nofollow" href="https://www.academia.edu/Documents/in/Health_Care">Health Care</a>, <script data-card-contents-for-ri="4441" type="text/json">{"id":4441,"name":"Health Care","url":"https://www.academia.edu/Documents/in/Health_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="4482" rel="nofollow" href="https://www.academia.edu/Documents/in/Palliative_Care">Palliative Care</a>, <script data-card-contents-for-ri="4482" type="text/json">{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="8974" rel="nofollow" href="https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care">Quality of Mental Health Care</a><script data-card-contents-for-ri="8974" type="text/json">{"id":8974,"name":"Quality of Mental Health Care","url":"https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=67644092]'), work: {"id":67644092,"title":"Promoting excellence in end-of-life care: a report on innovative models of palliative care","created_at":"2022-01-08T15:20:07.324-08:00","url":"https://www.academia.edu/67644092/Promoting_excellence_in_end_of_life_care_a_report_on_innovative_models_of_palliative_care?f_ri=882903","dom_id":"work_67644092","summary":"Background: Promoting Excellence in End-of Life Care, a national program of The Robert Wood Johnson Foundation, funded 22 demonstration projects representing a wide range of health care settings and patient populations to develop innovative models for delivering palliative care that addressed documented deficiencies in the care of patients and families facing the final stage of life. Objective: To determine the practicality (feasibility of development and operation as well as acceptance by stakeholders) of new models of care and to determine the impact of the models on access to, quality of and financing for palliative care. Design: The program cannot report scientifically rigorous outcomes, but the grant-funded projects used a variety of methods and measures to assess acceptance of new models and their impact from the perspectives of various stakeholders, including patients and their families, clinicians, administrators and payers. While it is not possible to aggregate data across projects, the data reported to the Promoting Excellence national program office were used to describe program impact with respect to the practicality of palliative care service integration into existing clinical care settings (feasibility and acceptance by stakeholders), the availability and use of palliative care services (access), quality of care (conformance to patient expectations and accepted clinical standards) and costs of care. Settings and subjects: The 22 projects provided services in urban as well as rural settings, in integrated health systems, hospitals, outpatient clinics, cancer centers, nursing homes, renal dialysis clinics, inner city public health and safety net systems and prisons. Populations served included prison inmates, military veterans, renal dialysis patients, Native Americans, Native Alaskans, and African American patients, inner-city medically underserved patients, pediatric patients, and persons with serious mental illness patients. Results: Hosting or adopting institutions sustained or expanded twenty of the 22 models, and feedback from all stakeholders was positive. Project sites developed and utilized new palliative care services and addressed quality through implementation of new standards and clinical protocols. Costs of care, where they could be assessed, were unaffected or decreased for project patients versus historical or concurrent controls. Conclusions: The 22 Promoting Excellence in End-of Life Care projects demonstrated that by individualizing patient and family assessment, effectively employing existing resources 137","downloadable_attachments":[{"id":78387573,"asset_id":67644092,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":51579816,"first_name":"Karyn","last_name":"Collins","domain_name":"independent","page_name":"KarynCollins1","display_name":"Karyn Collins","profile_url":"https://independent.academia.edu/KarynCollins1?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true},{"id":4441,"name":"Health Care","url":"https://www.academia.edu/Documents/in/Health_Care?f_ri=882903","nofollow":true},{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true},{"id":8974,"name":"Quality of Mental Health Care","url":"https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care?f_ri=882903","nofollow":true},{"id":16288,"name":"Public Health","url":"https://www.academia.edu/Documents/in/Public_Health?f_ri=882903"},{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine?f_ri=882903"},{"id":28023,"name":"Palliative Medicine","url":"https://www.academia.edu/Documents/in/Palliative_Medicine?f_ri=882903"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States?f_ri=882903"},{"id":100540,"name":"Feasibility Studies","url":"https://www.academia.edu/Documents/in/Feasibility_Studies?f_ri=882903"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903"},{"id":372862,"name":"Concurrency Control","url":"https://www.academia.edu/Documents/in/Concurrency_Control?f_ri=882903"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1?f_ri=882903"},{"id":724964,"name":"Palliative","url":"https://www.academia.edu/Documents/in/Palliative?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":906536,"name":"Health Care Costs","url":"https://www.academia.edu/Documents/in/Health_Care_Costs?f_ri=882903"},{"id":2549475,"name":"Health Services Accessibility","url":"https://www.academia.edu/Documents/in/Health_Services_Accessibility?f_ri=882903"},{"id":3194761,"name":"Quality of health care","url":"https://www.academia.edu/Documents/in/Quality_of_health_care?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_59913425 coauthored" data-work_id="59913425" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" rel="nofollow" href="https://www.academia.edu/59913425/Factors_Associated_With_End_of_Life_Planning_in_Huntington_Disease">Factors Associated With End-of-Life Planning in Huntington Disease</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Knowledge of one&#39;s gene status for adult onset conditions provides opportunity to make advance end-of-life (EOL) plans. The purposes of these analyses were to (1) determine the prevalence of EOL plans, including advance directives... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_59913425" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Knowledge of one&#39;s gene status for adult onset conditions provides opportunity to make advance end-of-life (EOL) plans. The purposes of these analyses were to (1) determine the prevalence of EOL plans, including advance directives (ADs) among persons across 3 stages of Huntington disease (HD) and (2) examine factors associated with having ADs in this sample. Data are from 503 participants in the HD Quality of Life study. Participants completed an online health-related quality-of-life survey that included questions regarding EOL planning and self-reported HD symptoms. Frequencies were calculated for EOL planning by the HD stage. Bivariate analysis and logistic regression were used to identify variables associated with having ADs. A total of 38.2% of participants stated they had ADs and fewer than half had other EOL plans. Being older, increased HD stage, more years of education, lower anxiety, more swallowing symptoms, and higher meaning and purpose were associated with having AD...</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/59913425" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="212682711" href="https://independent.academia.edu/DowningNancy">Nancy Downing</a><script data-card-contents-for-user="212682711" type="text/json">{"id":212682711,"first_name":"Nancy","last_name":"Downing","domain_name":"independent","page_name":"DowningNancy","display_name":"Nancy Downing","profile_url":"https://independent.academia.edu/DowningNancy?f_ri=882903","photo":"https://0.academia-photos.com/212682711/71741081/60191911/s65_nancy.downing.png"}</script></span></span><span class="u-displayInlineBlock InlineList-item-text"> and <span class="u-textDecorationUnderline u-clickable InlineList-item-text js-work-more-authors-59913425">+1</span><div class="hidden js-additional-users-59913425"><div><span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a href="https://independent.academia.edu/StaceyBarton">Stacey Barton</a></span></div></div></span><script>(function(){ var popoverSettings = { el: $('.js-work-more-authors-59913425'), placement: 'bottom', hide_delay: 200, html: true, content: function(){ return $('.js-additional-users-59913425').html(); } } new HoverPopover(popoverSettings); })();</script></li><li class="js-paper-rank-work_59913425 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="59913425"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 59913425, container: ".js-paper-rank-work_59913425", }); });</script></li><li class="js-percentile-work_59913425 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 59913425; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_59913425"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_59913425 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="59913425"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 59913425; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=59913425]").text(description); $(".js-view-count-work_59913425").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_59913425").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="59913425"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">10</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="588" rel="nofollow" href="https://www.academia.edu/Documents/in/Nursing">Nursing</a>, <script data-card-contents-for-ri="588" type="text/json">{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="22506" rel="nofollow" href="https://www.academia.edu/Documents/in/Adolescent">Adolescent</a>, <script data-card-contents-for-ri="22506" type="text/json">{"id":22506,"name":"Adolescent","url":"https://www.academia.edu/Documents/in/Adolescent?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="133057" rel="nofollow" href="https://www.academia.edu/Documents/in/Young_Adult">Young Adult</a>, <script data-card-contents-for-ri="133057" type="text/json">{"id":133057,"name":"Young Adult","url":"https://www.academia.edu/Documents/in/Young_Adult?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="289271" rel="nofollow" href="https://www.academia.edu/Documents/in/Aged">Aged</a><script data-card-contents-for-ri="289271" type="text/json">{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=59913425]'), work: {"id":59913425,"title":"Factors Associated With End-of-Life Planning in Huntington Disease","created_at":"2021-10-25T06:29:04.662-07:00","url":"https://www.academia.edu/59913425/Factors_Associated_With_End_of_Life_Planning_in_Huntington_Disease?f_ri=882903","dom_id":"work_59913425","summary":"Knowledge of one\u0026#39;s gene status for adult onset conditions provides opportunity to make advance end-of-life (EOL) plans. The purposes of these analyses were to (1) determine the prevalence of EOL plans, including advance directives (ADs) among persons across 3 stages of Huntington disease (HD) and (2) examine factors associated with having ADs in this sample. Data are from 503 participants in the HD Quality of Life study. Participants completed an online health-related quality-of-life survey that included questions regarding EOL planning and self-reported HD symptoms. Frequencies were calculated for EOL planning by the HD stage. Bivariate analysis and logistic regression were used to identify variables associated with having ADs. A total of 38.2% of participants stated they had ADs and fewer than half had other EOL plans. Being older, increased HD stage, more years of education, lower anxiety, more swallowing symptoms, and higher meaning and purpose were associated with having AD...","downloadable_attachments":[],"ordered_authors":[{"id":212682711,"first_name":"Nancy","last_name":"Downing","domain_name":"independent","page_name":"DowningNancy","display_name":"Nancy Downing","profile_url":"https://independent.academia.edu/DowningNancy?f_ri=882903","photo":"https://0.academia-photos.com/212682711/71741081/60191911/s65_nancy.downing.png"},{"id":66903212,"first_name":"Stacey","last_name":"Barton","domain_name":"independent","page_name":"StaceyBarton","display_name":"Stacey Barton","profile_url":"https://independent.academia.edu/StaceyBarton?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true},{"id":22506,"name":"Adolescent","url":"https://www.academia.edu/Documents/in/Adolescent?f_ri=882903","nofollow":true},{"id":133057,"name":"Young Adult","url":"https://www.academia.edu/Documents/in/Young_Adult?f_ri=882903","nofollow":true},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged?f_ri=882903","nofollow":true},{"id":445306,"name":"Advance Directives","url":"https://www.academia.edu/Documents/in/Advance_Directives?f_ri=882903"},{"id":662721,"name":"Huntington disease","url":"https://www.academia.edu/Documents/in/Huntington_disease?f_ri=882903"},{"id":675314,"name":"Advance Care Planning","url":"https://www.academia.edu/Documents/in/Advance_Care_Planning?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":2345130,"name":"Socioeconomic Factors","url":"https://www.academia.edu/Documents/in/Socioeconomic_Factors?f_ri=882903"},{"id":2463800,"name":"Severity of Illness Index","url":"https://www.academia.edu/Documents/in/Severity_of_Illness_Index?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_49951694" data-work_id="49951694" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/49951694/Psychological_responses_of_terminally_ill_patients_who_are_experiencing_suffering_A_qualitative_study">Psychological responses of terminally ill patients who are experiencing suffering: A qualitative study</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Background: Suffering is not only characterized by the feeling of being threatened, but also by the feeling of impotence to deal with such a threat. Literature identifies a terminal illness as a period during which several experiences... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_49951694" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Background: Suffering is not only characterized by the feeling of being threatened, but also by the feeling of impotence to deal with such a threat. Literature identifies a terminal illness as a period during which several experiences implying an intense suffering are endured, but little attention has been paid to the psychological responses when reacting to threats. Objective: Identify the psychological responses that terminally ill patients put in place to face up to the demands of the end of life, as a foundation for future nursing interventions. Design: Qualitative methodology with an interpretative phenomenological approach. Settings: Different hospitals health centers around the region of Granada (Spain). Participants: Twenty-four participants were finally chosen to take part in the research. The sampling procedure was intentional, and it was made taking into account exclusion and inclusion criteria. Patients with a cognitive impairment, who had been diagnosed with psychiatric alterations, who at that time suffered from uncontrollable symptoms such as intense pain were excluded from the sample. Methods: The patients were interviewed following a script (semistructured interview) carried out using the suggested theoretical framework. The interviews were analyzed using the sequence suggested by Strauss and Corbin: Open, axial and selective codification. Results: The analysis of the participants' answers to the different questions of the semistructured interview has allowed us to identify a main category ''To realize that life is short''. There are three categories where the different ways of facing up to the end of life concentrate: ''Re-Evaluation of life'', ''Opportunity for growth'', ''Resignation/Acceptance''. Conclusions: Nurses, have to try to alleviate the impact the terminal illness has on the subject, not only by controlling the symptoms but also encouraging the patients responses, by promoting the feeling of satisfaction in life, providing honest and sensitive information, establishing with the patient realistic goals, and facilitating a quality communication between patients and their family.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/49951694" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="fb056bc476c424e4d2ba436298e4e234" rel="nofollow" data-download="{"attachment_id":68117624,"asset_id":49951694,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/68117624/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="152290877" href="https://independent.academia.edu/FCruzQuintana">Francisco Cruz Quintana</a><script data-card-contents-for-user="152290877" type="text/json">{"id":152290877,"first_name":"Francisco","last_name":"Cruz Quintana","domain_name":"independent","page_name":"FCruzQuintana","display_name":"Francisco Cruz Quintana","profile_url":"https://independent.academia.edu/FCruzQuintana?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_49951694 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="49951694"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 49951694, container: ".js-paper-rank-work_49951694", }); });</script></li><li class="js-percentile-work_49951694 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 49951694; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_49951694"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_49951694 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="49951694"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 49951694; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=49951694]").text(description); $(".js-view-count-work_49951694").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_49951694").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="49951694"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">9</a>  </div><span class="InlineList-item-text u-textTruncate u-pl9x"><a class="InlineList-item-text" data-has-card-for-ri="588" rel="nofollow" href="https://www.academia.edu/Documents/in/Nursing">Nursing</a>, <script data-card-contents-for-ri="588" type="text/json">{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="12135" rel="nofollow" href="https://www.academia.edu/Documents/in/Qualitative_Research">Qualitative Research</a>, <script data-card-contents-for-ri="12135" type="text/json">{"id":12135,"name":"Qualitative Research","url":"https://www.academia.edu/Documents/in/Qualitative_Research?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="40516" rel="nofollow" href="https://www.academia.edu/Documents/in/Spain">Spain</a>, <script data-card-contents-for-ri="40516" type="text/json">{"id":40516,"name":"Spain","url":"https://www.academia.edu/Documents/in/Spain?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="63288" rel="nofollow" href="https://www.academia.edu/Documents/in/Narration">Narration</a><script data-card-contents-for-ri="63288" type="text/json">{"id":63288,"name":"Narration","url":"https://www.academia.edu/Documents/in/Narration?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=49951694]'), work: {"id":49951694,"title":"Psychological responses of terminally ill patients who are experiencing suffering: A qualitative study","created_at":"2021-07-15T09:47:55.004-07:00","url":"https://www.academia.edu/49951694/Psychological_responses_of_terminally_ill_patients_who_are_experiencing_suffering_A_qualitative_study?f_ri=882903","dom_id":"work_49951694","summary":"Background: Suffering is not only characterized by the feeling of being threatened, but also by the feeling of impotence to deal with such a threat. Literature identifies a terminal illness as a period during which several experiences implying an intense suffering are endured, but little attention has been paid to the psychological responses when reacting to threats. Objective: Identify the psychological responses that terminally ill patients put in place to face up to the demands of the end of life, as a foundation for future nursing interventions. Design: Qualitative methodology with an interpretative phenomenological approach. Settings: Different hospitals health centers around the region of Granada (Spain). Participants: Twenty-four participants were finally chosen to take part in the research. The sampling procedure was intentional, and it was made taking into account exclusion and inclusion criteria. Patients with a cognitive impairment, who had been diagnosed with psychiatric alterations, who at that time suffered from uncontrollable symptoms such as intense pain were excluded from the sample. Methods: The patients were interviewed following a script (semistructured interview) carried out using the suggested theoretical framework. The interviews were analyzed using the sequence suggested by Strauss and Corbin: Open, axial and selective codification. Results: The analysis of the participants' answers to the different questions of the semistructured interview has allowed us to identify a main category ''To realize that life is short''. There are three categories where the different ways of facing up to the end of life concentrate: ''Re-Evaluation of life'', ''Opportunity for growth'', ''Resignation/Acceptance''. Conclusions: Nurses, have to try to alleviate the impact the terminal illness has on the subject, not only by controlling the symptoms but also encouraging the patients responses, by promoting the feeling of satisfaction in life, providing honest and sensitive information, establishing with the patient realistic goals, and facilitating a quality communication between patients and their family.","downloadable_attachments":[{"id":68117624,"asset_id":49951694,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":152290877,"first_name":"Francisco","last_name":"Cruz Quintana","domain_name":"independent","page_name":"FCruzQuintana","display_name":"Francisco Cruz Quintana","profile_url":"https://independent.academia.edu/FCruzQuintana?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true},{"id":12135,"name":"Qualitative Research","url":"https://www.academia.edu/Documents/in/Qualitative_Research?f_ri=882903","nofollow":true},{"id":40516,"name":"Spain","url":"https://www.academia.edu/Documents/in/Spain?f_ri=882903","nofollow":true},{"id":63288,"name":"Narration","url":"https://www.academia.edu/Documents/in/Narration?f_ri=882903","nofollow":true},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged?f_ri=882903"},{"id":413192,"name":"Sex Factors","url":"https://www.academia.edu/Documents/in/Sex_Factors?f_ri=882903"},{"id":449762,"name":"Nursing Studies","url":"https://www.academia.edu/Documents/in/Nursing_Studies?f_ri=882903"},{"id":469018,"name":"Neoplasms","url":"https://www.academia.edu/Documents/in/Neoplasms?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_30595615" data-work_id="30595615" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/30595615/Experiences_and_perceptions_of_nurses_caring_for_dying_patients_and_families_in_the_acute_medical_admission_setting">Experiences and perceptions of nurses caring for dying patients and families in the acute medical admission setting</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">This study aimed to explore the experiences and perceptions of nurses caring for dying patients and their families in the acute medical admission setting. A qualitative interpretive descriptive methodology was used to explore the... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_30595615" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">This study aimed to explore the experiences and perceptions of nurses caring for dying patients and their families in the acute medical admission setting. A qualitative interpretive descriptive methodology was used to explore the experiences and perceptions of 15 nurses recruited via purposive sampling from three acute medical wards of a hospital in Hong Kong. The nurses perceived insufficiency and experienced great mental and physiological strain regarding their caring roles in this setting. Four themes were derived from the findings: lack of preparedness for patients&#39; deaths, reflecting on their own nursing roles for dying patients, reflecting on the meaning of death and their personal experiences of the death of their own family members, and coping with caring for dying patients. There are similarities between these experiences and those of nurses in similar settings in different cultures. There is a need for further research into and educational preparation of nurses in bere...</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/30595615" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="7d40975845aa593fc1521f6069135415" rel="nofollow" data-download="{"attachment_id":51037082,"asset_id":30595615,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/51037082/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="58295926" href="https://independent.academia.edu/VicoChiang">Vico Chiang</a><script data-card-contents-for-user="58295926" type="text/json">{"id":58295926,"first_name":"Vico","last_name":"Chiang","domain_name":"independent","page_name":"VicoChiang","display_name":"Vico Chiang","profile_url":"https://independent.academia.edu/VicoChiang?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_30595615 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="30595615"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 30595615, container: ".js-paper-rank-work_30595615", }); });</script></li><li class="js-percentile-work_30595615 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 30595615; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_30595615"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_30595615 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="30595615"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 30595615; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=30595615]").text(description); $(".js-view-count-work_30595615").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_30595615").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="30595615"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">6</a>  </div><span class="InlineList-item-text u-textTruncate u-pl9x"><a class="InlineList-item-text" data-has-card-for-ri="588" rel="nofollow" href="https://www.academia.edu/Documents/in/Nursing">Nursing</a>, <script data-card-contents-for-ri="588" type="text/json">{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="6533" rel="nofollow" href="https://www.academia.edu/Documents/in/Hospice_and_Palliative_Care_Nursing">Hospice & Palliative Care Nursing</a>, <script data-card-contents-for-ri="6533" type="text/json">{"id":6533,"name":"Hospice \u0026 Palliative Care Nursing","url":"https://www.academia.edu/Documents/in/Hospice_and_Palliative_Care_Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="6574" rel="nofollow" href="https://www.academia.edu/Documents/in/Family">Family</a>, <script data-card-contents-for-ri="6574" type="text/json">{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="12135" rel="nofollow" href="https://www.academia.edu/Documents/in/Qualitative_Research">Qualitative Research</a><script data-card-contents-for-ri="12135" type="text/json">{"id":12135,"name":"Qualitative Research","url":"https://www.academia.edu/Documents/in/Qualitative_Research?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=30595615]'), work: {"id":30595615,"title":"Experiences and perceptions of nurses caring for dying patients and families in the acute medical admission setting","created_at":"2016-12-23T19:02:22.323-08:00","url":"https://www.academia.edu/30595615/Experiences_and_perceptions_of_nurses_caring_for_dying_patients_and_families_in_the_acute_medical_admission_setting?f_ri=882903","dom_id":"work_30595615","summary":"This study aimed to explore the experiences and perceptions of nurses caring for dying patients and their families in the acute medical admission setting. A qualitative interpretive descriptive methodology was used to explore the experiences and perceptions of 15 nurses recruited via purposive sampling from three acute medical wards of a hospital in Hong Kong. The nurses perceived insufficiency and experienced great mental and physiological strain regarding their caring roles in this setting. Four themes were derived from the findings: lack of preparedness for patients\u0026#39; deaths, reflecting on their own nursing roles for dying patients, reflecting on the meaning of death and their personal experiences of the death of their own family members, and coping with caring for dying patients. There are similarities between these experiences and those of nurses in similar settings in different cultures. There is a need for further research into and educational preparation of nurses in bere...","downloadable_attachments":[{"id":51037082,"asset_id":30595615,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":58295926,"first_name":"Vico","last_name":"Chiang","domain_name":"independent","page_name":"VicoChiang","display_name":"Vico Chiang","profile_url":"https://independent.academia.edu/VicoChiang?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true},{"id":6533,"name":"Hospice \u0026 Palliative Care Nursing","url":"https://www.academia.edu/Documents/in/Hospice_and_Palliative_Care_Nursing?f_ri=882903","nofollow":true},{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true},{"id":12135,"name":"Qualitative Research","url":"https://www.academia.edu/Documents/in/Qualitative_Research?f_ri=882903","nofollow":true},{"id":25021,"name":"Hong Kong","url":"https://www.academia.edu/Documents/in/Hong_Kong?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_12707942" data-work_id="12707942" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/12707942/Consensus_guidelines_on_analgesia_and_sedation_in_dying_intensive_care_unit_patients">Consensus guidelines on analgesia and sedation in dying intensive care unit patients</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">BACKGROUND: Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_12707942" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">BACKGROUND: Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia. METHODS:</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/12707942" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="a1c580300138723a2fd0822ad54a31db" rel="nofollow" data-download="{"attachment_id":37789156,"asset_id":12707942,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/37789156/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="31730724" href="https://independent.academia.edu/LouiseLemieuxCharles">Louise Lemieux-Charles</a><script data-card-contents-for-user="31730724" type="text/json">{"id":31730724,"first_name":"Louise","last_name":"Lemieux-Charles","domain_name":"independent","page_name":"LouiseLemieuxCharles","display_name":"Louise Lemieux-Charles","profile_url":"https://independent.academia.edu/LouiseLemieuxCharles?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_12707942 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="12707942"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 12707942, container: ".js-paper-rank-work_12707942", }); 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Technique","url":"https://www.academia.edu/Documents/in/Delphi_Technique?f_ri=882903"},{"id":1445770,"name":"Analgesics","url":"https://www.academia.edu/Documents/in/Analgesics?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_23341243" data-work_id="23341243" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/23341243/Parental_needs_during_end_of_life_care_One_room_for_improvement_">Parental needs during end-of-life care: One room for improvement*</a></div></div><div class="u-pb4x u-mt3x"></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" 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type="text/json">{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="70497" rel="nofollow" href="https://www.academia.edu/Documents/in/End_of_life_care">End of life care</a>, <script data-card-contents-for-ri="70497" type="text/json">{"id":70497,"name":"End of life care","url":"https://www.academia.edu/Documents/in/End_of_life_care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="303598" rel="nofollow" href="https://www.academia.edu/Documents/in/Parents">Parents</a>, <script data-card-contents-for-ri="303598" type="text/json">{"id":303598,"name":"Parents","url":"https://www.academia.edu/Documents/in/Parents?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="882903" rel="nofollow" href="https://www.academia.edu/Documents/in/Terminal_care">Terminal care</a><script 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class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/79330233/Ethik_Charta_der_Deutschen_Gesellschaft_zum_Studium_des_Schmerzes_DGSS_">Ethik-Charta der Deutschen Gesellschaft zum Studium des Schmerzes (DGSS)</a></div></div><div class="u-pb4x u-mt3x"></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/79330233" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="dd01b5539b329d72c8cbca098b15ce8b" rel="nofollow" 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type="text/json">{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="9435" rel="nofollow" href="https://www.academia.edu/Documents/in/Medical_Ethics">Medical Ethics</a>, <script data-card-contents-for-ri="9435" type="text/json">{"id":9435,"name":"Medical Ethics","url":"https://www.academia.edu/Documents/in/Medical_Ethics?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="26327" rel="nofollow" href="https://www.academia.edu/Documents/in/Medicine">Medicine</a><script data-card-contents-for-ri="26327" type="text/json">{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=79330233]'), work: {"id":79330233,"title":"Ethik-Charta der 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Ethics","url":"https://www.academia.edu/Documents/in/Medical_Ethics?f_ri=882903","nofollow":true},{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine?f_ri=882903","nofollow":true},{"id":50576,"name":"Germany","url":"https://www.academia.edu/Documents/in/Germany?f_ri=882903"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903"},{"id":396310,"name":"Codes of Ethics","url":"https://www.academia.edu/Documents/in/Codes_of_Ethics?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_25759502" data-work_id="25759502" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/25759502/Knowledge_authority_and_identity_a_prolegomenon_to_an_epistemology_of_the_clinic">Knowledge, authority and identity: a prolegomenon to an epistemology of the clinic</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Disputes about theory in bioethics almost invariably revolve around different understandings of morality or practical reasoning; I here suggest that the field would do well to become more explicitly contentious about knowledge, and start... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_25759502" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Disputes about theory in bioethics almost invariably revolve around different understandings of morality or practical reasoning; I here suggest that the field would do well to become more explicitly contentious about knowledge, and start the task of putting together a clinical epistemology. By way of providing some motivation for such a discussion, I consider two cases of resistance to shifts in clinical practice that are, by and large, not ethically controversial, highlighting how different conceptions of epistemic authority may contribute to clinicians&#39; unwillingness to adopt these changes, and sketching out some initial suggestions for epistemic analysis of clinical practice.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/25759502" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="c48001dcd17e00ca83e69d53350bbcd6" rel="nofollow" data-download="{"attachment_id":46116145,"asset_id":25759502,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/46116145/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="101874" href="https://michiganstate.academia.edu/JamesLNelson">Jamie L Nelson</a><script data-card-contents-for-user="101874" type="text/json">{"id":101874,"first_name":"Jamie L","last_name":"Nelson","domain_name":"michiganstate","page_name":"JamesLNelson","display_name":"Jamie L Nelson","profile_url":"https://michiganstate.academia.edu/JamesLNelson?f_ri=882903","photo":"https://0.academia-photos.com/101874/1118831/5666501/s65_james_l..nelson.jpg"}</script></span></span></li><li class="js-paper-rank-work_25759502 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="25759502"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 25759502, container: ".js-paper-rank-work_25759502", }); });</script></li><li class="js-percentile-work_25759502 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 25759502; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_25759502"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_25759502 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="25759502"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 25759502; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=25759502]").text(description); $(".js-view-count-work_25759502").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_25759502").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="25759502"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">11</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="906" rel="nofollow" href="https://www.academia.edu/Documents/in/Applied_Ethics">Applied Ethics</a>, <script data-card-contents-for-ri="906" type="text/json">{"id":906,"name":"Applied Ethics","url":"https://www.academia.edu/Documents/in/Applied_Ethics?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="1414" rel="nofollow" href="https://www.academia.edu/Documents/in/Bioethics">Bioethics</a>, <script data-card-contents-for-ri="1414" type="text/json">{"id":1414,"name":"Bioethics","url":"https://www.academia.edu/Documents/in/Bioethics?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="9435" rel="nofollow" href="https://www.academia.edu/Documents/in/Medical_Ethics">Medical Ethics</a>, <script data-card-contents-for-ri="9435" type="text/json">{"id":9435,"name":"Medical Ethics","url":"https://www.academia.edu/Documents/in/Medical_Ethics?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="10453" rel="nofollow" href="https://www.academia.edu/Documents/in/Feminism">Feminism</a><script data-card-contents-for-ri="10453" type="text/json">{"id":10453,"name":"Feminism","url":"https://www.academia.edu/Documents/in/Feminism?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=25759502]'), work: {"id":25759502,"title":"Knowledge, authority and identity: a prolegomenon to an epistemology of the clinic","created_at":"2016-05-31T19:33:24.386-07:00","url":"https://www.academia.edu/25759502/Knowledge_authority_and_identity_a_prolegomenon_to_an_epistemology_of_the_clinic?f_ri=882903","dom_id":"work_25759502","summary":"Disputes about theory in bioethics almost invariably revolve around different understandings of morality or practical reasoning; I here suggest that the field would do well to become more explicitly contentious about knowledge, and start the task of putting together a clinical epistemology. By way of providing some motivation for such a discussion, I consider two cases of resistance to shifts in clinical practice that are, by and large, not ethically controversial, highlighting how different conceptions of epistemic authority may contribute to clinicians\u0026#39; unwillingness to adopt these changes, and sketching out some initial suggestions for epistemic analysis of clinical practice.","downloadable_attachments":[{"id":46116145,"asset_id":25759502,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":101874,"first_name":"Jamie L","last_name":"Nelson","domain_name":"michiganstate","page_name":"JamesLNelson","display_name":"Jamie L Nelson","profile_url":"https://michiganstate.academia.edu/JamesLNelson?f_ri=882903","photo":"https://0.academia-photos.com/101874/1118831/5666501/s65_james_l..nelson.jpg"}],"research_interests":[{"id":906,"name":"Applied Ethics","url":"https://www.academia.edu/Documents/in/Applied_Ethics?f_ri=882903","nofollow":true},{"id":1414,"name":"Bioethics","url":"https://www.academia.edu/Documents/in/Bioethics?f_ri=882903","nofollow":true},{"id":9435,"name":"Medical Ethics","url":"https://www.academia.edu/Documents/in/Medical_Ethics?f_ri=882903","nofollow":true},{"id":10453,"name":"Feminism","url":"https://www.academia.edu/Documents/in/Feminism?f_ri=882903","nofollow":true},{"id":44096,"name":"Knowledge","url":"https://www.academia.edu/Documents/in/Knowledge?f_ri=882903"},{"id":62550,"name":"Pregnancy","url":"https://www.academia.edu/Documents/in/Pregnancy?f_ri=882903"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States?f_ri=882903"},{"id":106610,"name":"Natural Childbirth","url":"https://www.academia.edu/Documents/in/Natural_Childbirth?f_ri=882903"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903"},{"id":589991,"name":"Patient Participation","url":"https://www.academia.edu/Documents/in/Patient_Participation?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_40147921" data-work_id="40147921" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" rel="nofollow" href="https://www.academia.edu/40147921/End_of_Life_Treatment_Decision_Making_American_Indians_Perspective">End-of-Life Treatment Decision Making: American Indians' Perspective</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">This study explored American Indians' end-of-life experiences in treatment decision making. Scarce knowledge about this population's perspective regarding end-of-life treatments has resulted in health care providers (HCPs) functioning at... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_40147921" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">This study explored American Indians' end-of-life experiences in treatment decision making. Scarce knowledge about this population's perspective regarding end-of-life treatments has resulted in health care providers (HCPs) functioning at less than optimum levels. Using a community-based participatory research approach, open-ended interview data were collected and analyzed using a grounded theory method. Patient and family participants generally stated that the physicians made the treatment decisions for them, while HCPs believed that patients participated in informed autonomous treatment decision making. Both parties (HCPs and patients and families) were not aware of American Indian's psychological aspect that interfered with the exercise of the right of informed consent. This additional understanding would benefit them in order to result in ethically and legally sound practice of patient's autonomous treatment decision making.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/40147921" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="9adac865b01444fdb032f5384fc83670" rel="nofollow" data-download="{"attachment_id":60365604,"asset_id":40147921,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/60365604/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="7845666" rel="nofollow" href="https://montana.academia.edu/YoshikoColclough">Yoshiko Colclough</a><script data-card-contents-for-user="7845666" type="text/json">{"id":7845666,"first_name":"Yoshiko","last_name":"Colclough","domain_name":"montana","page_name":"YoshikoColclough","display_name":"Yoshiko Colclough","profile_url":"https://montana.academia.edu/YoshikoColclough?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_40147921 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="40147921"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 40147921, container: ".js-paper-rank-work_40147921", }); });</script></li><li class="js-percentile-work_40147921 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 40147921; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_40147921"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_40147921 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="40147921"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 40147921; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=40147921]").text(description); $(".js-view-count-work_40147921").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_40147921").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="40147921"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">10</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="106" rel="nofollow" href="https://www.academia.edu/Documents/in/Religion">Religion</a>, <script data-card-contents-for-ri="106" type="text/json">{"id":106,"name":"Religion","url":"https://www.academia.edu/Documents/in/Religion?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="588" rel="nofollow" href="https://www.academia.edu/Documents/in/Nursing">Nursing</a>, <script data-card-contents-for-ri="588" type="text/json">{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="1681" rel="nofollow" href="https://www.academia.edu/Documents/in/Decision_Making">Decision Making</a>, <script data-card-contents-for-ri="1681" type="text/json">{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="6574" rel="nofollow" href="https://www.academia.edu/Documents/in/Family">Family</a><script data-card-contents-for-ri="6574" type="text/json">{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=40147921]'), work: {"id":40147921,"title":"End-of-Life Treatment Decision Making: American Indians' Perspective","created_at":"2019-08-22T08:49:51.805-07:00","url":"https://www.academia.edu/40147921/End_of_Life_Treatment_Decision_Making_American_Indians_Perspective?f_ri=882903","dom_id":"work_40147921","summary":"This study explored American Indians' end-of-life experiences in treatment decision making. Scarce knowledge about this population's perspective regarding end-of-life treatments has resulted in health care providers (HCPs) functioning at less than optimum levels. Using a community-based participatory research approach, open-ended interview data were collected and analyzed using a grounded theory method. Patient and family participants generally stated that the physicians made the treatment decisions for them, while HCPs believed that patients participated in informed autonomous treatment decision making. Both parties (HCPs and patients and families) were not aware of American Indian's psychological aspect that interfered with the exercise of the right of informed consent. This additional understanding would benefit them in order to result in ethically and legally sound practice of patient's autonomous treatment decision making.","downloadable_attachments":[{"id":60365604,"asset_id":40147921,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":7845666,"first_name":"Yoshiko","last_name":"Colclough","domain_name":"montana","page_name":"YoshikoColclough","display_name":"Yoshiko Colclough","profile_url":"https://montana.academia.edu/YoshikoColclough?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":106,"name":"Religion","url":"https://www.academia.edu/Documents/in/Religion?f_ri=882903","nofollow":true},{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true},{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true},{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true},{"id":40116,"name":"Community Based Participatory Research","url":"https://www.academia.edu/Documents/in/Community_Based_Participatory_Research?f_ri=882903"},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged?f_ri=882903"},{"id":589991,"name":"Patient Participation","url":"https://www.academia.edu/Documents/in/Patient_Participation?f_ri=882903"},{"id":865641,"name":"North American Indians","url":"https://www.academia.edu/Documents/in/North_American_Indians?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":3196731,"name":"Interviews as topic","url":"https://www.academia.edu/Documents/in/Interviews_as_topic?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_32652236" data-work_id="32652236" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/32652236/Chemotherapy_Use_Performance_Status_and_Quality_of_Life_at_the_End_of_Life">Chemotherapy Use, Performance Status, and Quality of Life at the End of Life</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Although many patients with end-stage cancer are offered chemotherapy to improve quality of life (QOL), the association between chemotherapy and QOL amid progressive metastatic disease has not been well-studied. American Society for... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_32652236" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Although many patients with end-stage cancer are offered chemotherapy to improve quality of life (QOL), the association between chemotherapy and QOL amid progressive metastatic disease has not been well-studied. American Society for Clinical Oncology guidelines recommend palliative chemotherapy only for solid tumor patients with good performance status. To evaluate the association between chemotherapy use and QOL near death (QOD) as a function of patients&#39; performance status. A multi-institutional, longitudinal cohort study of patients with end-stage cancer recruited between September 2002 and February 2008. Chemotherapy use (n = 158 [50.6%]) and Eastern Cooperative Oncology Group (ECOG) performance status were assessed at baseline (median = 3.8 months before death) and patients with progressive metastatic cancer (N = 312) following at least 1 chemotherapy regimen were followed prospectively until death at 6 outpatient oncology clinics in the United States. Patient QOD was deter...</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/32652236" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="69633aefc7c3d819654b8d29648849ef" rel="nofollow" data-download="{"attachment_id":52820864,"asset_id":32652236,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/52820864/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="63415674" href="https://independent.academia.edu/MelissaGarrido1">Melissa Garrido</a><script data-card-contents-for-user="63415674" type="text/json">{"id":63415674,"first_name":"Melissa","last_name":"Garrido","domain_name":"independent","page_name":"MelissaGarrido1","display_name":"Melissa Garrido","profile_url":"https://independent.academia.edu/MelissaGarrido1?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_32652236 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="32652236"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 32652236, container: ".js-paper-rank-work_32652236", }); 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American Society for Clinical Oncology guidelines recommend palliative chemotherapy only for solid tumor patients with good performance status. To evaluate the association between chemotherapy use and QOL near death (QOD) as a function of patients\u0026#39; performance status. A multi-institutional, longitudinal cohort study of patients with end-stage cancer recruited between September 2002 and February 2008. Chemotherapy use (n = 158 [50.6%]) and Eastern Cooperative Oncology Group (ECOG) performance status were assessed at baseline (median = 3.8 months before death) and patients with progressive metastatic cancer (N = 312) following at least 1 chemotherapy regimen were followed prospectively until death at 6 outpatient oncology clinics in the United States. 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Materials and Methods Focus groups and... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_27693974" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Background The aim of this study was to explore the current status of end-of-life care and dying of people with intellectual disability based on the experiences of staff in community living services. Materials and Methods Focus groups and individual interviews were conducted, guided by grounded theory methodology.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/27693974" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="592192218eccd68740ac5862d68c625c" rel="nofollow" data-download="{"attachment_id":47959588,"asset_id":27693974,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/47959588/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="51929981" href="https://independent.academia.edu/Angeladew">Angela dew</a><script data-card-contents-for-user="51929981" type="text/json">{"id":51929981,"first_name":"Angela","last_name":"dew","domain_name":"independent","page_name":"Angeladew","display_name":"Angela dew","profile_url":"https://independent.academia.edu/Angeladew?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span><span class="u-displayInlineBlock InlineList-item-text"> and <span class="u-textDecorationUnderline u-clickable InlineList-item-text js-work-more-authors-27693974">+1</span><div class="hidden js-additional-users-27693974"><div><span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a href="https://independent.academia.edu/GlennysHowarth">Glennys Howarth</a></span></div></div></span><script>(function(){ var popoverSettings = { el: $('.js-work-more-authors-27693974'), placement: 'bottom', hide_delay: 200, html: true, content: function(){ return $('.js-additional-users-27693974').html(); 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})();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_18812711" data-work_id="18812711" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/18812711/Diagnosing_Dying">Diagnosing Dying</a></div></div><div class="u-pb4x u-mt3x"></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/18812711" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a 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data-card-contents-for-user="38899889" type="text/json">{"id":38899889,"first_name":"Stanislaw","last_name":"Stawicki","domain_name":"independent","page_name":"StanislawStawicki","display_name":"Stanislaw Stawicki","profile_url":"https://independent.academia.edu/StanislawStawicki?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_18812711 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="18812711"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 18812711, container: ".js-paper-rank-work_18812711", }); });</script></li><li class="js-percentile-work_18812711 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x 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type="text/json">{"id":2122,"name":"Death","url":"https://www.academia.edu/Documents/in/Death?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="112822" rel="nofollow" href="https://www.academia.edu/Documents/in/Physicians">Physicians</a>, <script data-card-contents-for-ri="112822" type="text/json">{"id":112822,"name":"Physicians","url":"https://www.academia.edu/Documents/in/Physicians?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="129739" rel="nofollow" href="https://www.academia.edu/Documents/in/Anesthesia">Anesthesia</a><script data-card-contents-for-ri="129739" type="text/json">{"id":129739,"name":"Anesthesia","url":"https://www.academia.edu/Documents/in/Anesthesia?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=18812711]'), work: {"id":18812711,"title":"Diagnosing Dying","created_at":"2015-11-22T11:16:40.249-08:00","url":"https://www.academia.edu/18812711/Diagnosing_Dying?f_ri=882903","dom_id":"work_18812711","summary":null,"downloadable_attachments":[{"id":40268690,"asset_id":18812711,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":38899889,"first_name":"Stanislaw","last_name":"Stawicki","domain_name":"independent","page_name":"StanislawStawicki","display_name":"Stanislaw Stawicki","profile_url":"https://independent.academia.edu/StanislawStawicki?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":2034,"name":"Anesthesiology","url":"https://www.academia.edu/Documents/in/Anesthesiology?f_ri=882903","nofollow":true},{"id":2122,"name":"Death","url":"https://www.academia.edu/Documents/in/Death?f_ri=882903","nofollow":true},{"id":112822,"name":"Physicians","url":"https://www.academia.edu/Documents/in/Physicians?f_ri=882903","nofollow":true},{"id":129739,"name":"Anesthesia","url":"https://www.academia.edu/Documents/in/Anesthesia?f_ri=882903","nofollow":true},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_47820337" data-work_id="47820337" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/47820337/Approaching_families_on_the_subject_of_organ_donation_A_phenomenological_study_of_the_experience_of_healthcare_professionals">Approaching families on the subject of organ donation: A phenomenological study of the experience of healthcare professionals</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">The aim of this study was to explore healthcare professionals' experiences and gain a deeper understanding of interactions with families when approaching the subject of organ donation. A hermeneutic phenomenological approach was used to... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_47820337" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">The aim of this study was to explore healthcare professionals' experiences and gain a deeper understanding of interactions with families when approaching the subject of organ donation. A hermeneutic phenomenological approach was used to explore the participants' experiences. Data were collected through a combination of observation and in-depth interviews with nurses, physicians and hospital chaplains recruited from two intensive care units (ICUs) in a Norwegian university hospital. A thematic analysis was used to analyse the data, and three main themes emerged from this analysis: crucial timing, challenging conversations and conflicting expectations. The results revealed that the situation was of a sensitive nature and that finding the best possible time to address the issue in a meaningful manner was a challenge. Respect for the patients' wishes and the families' decisions were an expressed value among the participants, but conflicting expectations about bringing up the subject were also present. This study contributes to the understanding of healthcare professionals' challenges when they are facing brain death as an inevitable outcome of a patient's clinical condition and must approach families on the subject of organ donation.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/47820337" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="3e0472f2796bbdfdc26a4bc31a4e2a67" rel="nofollow" data-download="{"attachment_id":66745511,"asset_id":47820337,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/66745511/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="770436" href="https://independent.academia.edu/AudOroy">Aud Oroy</a><script data-card-contents-for-user="770436" type="text/json">{"id":770436,"first_name":"Aud","last_name":"Oroy","domain_name":"independent","page_name":"AudOroy","display_name":"Aud Oroy","profile_url":"https://independent.academia.edu/AudOroy?f_ri=882903","photo":"https://0.academia-photos.com/770436/260784/308133/s65_aud.oroy.jpg"}</script></span></span></li><li class="js-paper-rank-work_47820337 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="47820337"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 47820337, container: ".js-paper-rank-work_47820337", }); 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$(".js-view-count[data-work-id=47820337]").text(description); $(".js-view-count-work_47820337").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_47820337").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="47820337"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">10</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="588" rel="nofollow" href="https://www.academia.edu/Documents/in/Nursing">Nursing</a>, <script data-card-contents-for-ri="588" type="text/json">{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="859" rel="nofollow" href="https://www.academia.edu/Documents/in/Communication">Communication</a>, <script data-card-contents-for-ri="859" type="text/json">{"id":859,"name":"Communication","url":"https://www.academia.edu/Documents/in/Communication?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="5178" rel="nofollow" href="https://www.academia.edu/Documents/in/Phenomenology">Phenomenology</a>, <script data-card-contents-for-ri="5178" type="text/json">{"id":5178,"name":"Phenomenology","url":"https://www.academia.edu/Documents/in/Phenomenology?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="6574" rel="nofollow" href="https://www.academia.edu/Documents/in/Family">Family</a><script data-card-contents-for-ri="6574" type="text/json">{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=47820337]'), work: {"id":47820337,"title":"Approaching families on the subject of organ donation: A phenomenological study of the experience of healthcare professionals","created_at":"2021-04-30T23:39:25.306-07:00","url":"https://www.academia.edu/47820337/Approaching_families_on_the_subject_of_organ_donation_A_phenomenological_study_of_the_experience_of_healthcare_professionals?f_ri=882903","dom_id":"work_47820337","summary":"The aim of this study was to explore healthcare professionals' experiences and gain a deeper understanding of interactions with families when approaching the subject of organ donation. A hermeneutic phenomenological approach was used to explore the participants' experiences. Data were collected through a combination of observation and in-depth interviews with nurses, physicians and hospital chaplains recruited from two intensive care units (ICUs) in a Norwegian university hospital. A thematic analysis was used to analyse the data, and three main themes emerged from this analysis: crucial timing, challenging conversations and conflicting expectations. The results revealed that the situation was of a sensitive nature and that finding the best possible time to address the issue in a meaningful manner was a challenge. Respect for the patients' wishes and the families' decisions were an expressed value among the participants, but conflicting expectations about bringing up the subject were also present. This study contributes to the understanding of healthcare professionals' challenges when they are facing brain death as an inevitable outcome of a patient's clinical condition and must approach families on the subject of organ donation.","downloadable_attachments":[{"id":66745511,"asset_id":47820337,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":770436,"first_name":"Aud","last_name":"Oroy","domain_name":"independent","page_name":"AudOroy","display_name":"Aud Oroy","profile_url":"https://independent.academia.edu/AudOroy?f_ri=882903","photo":"https://0.academia-photos.com/770436/260784/308133/s65_aud.oroy.jpg"}],"research_interests":[{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true},{"id":859,"name":"Communication","url":"https://www.academia.edu/Documents/in/Communication?f_ri=882903","nofollow":true},{"id":5178,"name":"Phenomenology","url":"https://www.academia.edu/Documents/in/Phenomenology?f_ri=882903","nofollow":true},{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true},{"id":9032,"name":"Interaction","url":"https://www.academia.edu/Documents/in/Interaction?f_ri=882903"},{"id":45951,"name":"Brain Death","url":"https://www.academia.edu/Documents/in/Brain_Death?f_ri=882903"},{"id":112822,"name":"Physicians","url":"https://www.academia.edu/Documents/in/Physicians?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":1436798,"name":"Observations","url":"https://www.academia.edu/Documents/in/Observations?f_ri=882903"},{"id":3766396,"name":"Tissue and organ procurement","url":"https://www.academia.edu/Documents/in/Tissue_and_organ_procurement?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_56538217" data-work_id="56538217" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/56538217/Dignity_and_the_essence_of_medicine_the_A_B_C_and_D_of_dignity_conserving_care">Dignity and the essence of medicine: the A, B, C, and D of dignity conserving care</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Kindness, humanity, and respect-the core values of medical professionalism-are too often being overlooked in the time pressured culture of modern health care, says Harvey Chochinov, and the A, B, C, and D of dignity conserving care can... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_56538217" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Kindness, humanity, and respect-the core values of medical professionalism-are too often being overlooked in the time pressured culture of modern health care, says Harvey Chochinov, and the A, B, C, and D of dignity conserving care can reinstate them dignity and the essence of medicine: the a, B, C, and d of dignity conserving care</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/56538217" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="bda0fa1ddff4a9e70c95e67284c92f6e" rel="nofollow" data-download="{"attachment_id":71876669,"asset_id":56538217,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/71876669/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="32607840" href="https://umanitoba.academia.edu/HarveyChochinov">Harvey Chochinov</a><script data-card-contents-for-user="32607840" type="text/json">{"id":32607840,"first_name":"Harvey","last_name":"Chochinov","domain_name":"umanitoba","page_name":"HarveyChochinov","display_name":"Harvey Chochinov","profile_url":"https://umanitoba.academia.edu/HarveyChochinov?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_56538217 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="56538217"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 56538217, 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window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=56538217]").text(description); $(".js-view-count-work_56538217").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_56538217").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="56538217"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">12</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="3815" rel="nofollow" href="https://www.academia.edu/Documents/in/Spirituality">Spirituality</a>, <script data-card-contents-for-ri="3815" type="text/json">{"id":3815,"name":"Spirituality","url":"https://www.academia.edu/Documents/in/Spirituality?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="4441" rel="nofollow" href="https://www.academia.edu/Documents/in/Health_Care">Health Care</a>, <script data-card-contents-for-ri="4441" type="text/json">{"id":4441,"name":"Health Care","url":"https://www.academia.edu/Documents/in/Health_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="40593" rel="nofollow" href="https://www.academia.edu/Documents/in/British_medical_history">British medical history</a>, <script data-card-contents-for-ri="40593" type="text/json">{"id":40593,"name":"British medical history","url":"https://www.academia.edu/Documents/in/British_medical_history?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="312011" rel="nofollow" href="https://www.academia.edu/Documents/in/Professional_Practice">Professional Practice</a><script data-card-contents-for-ri="312011" type="text/json">{"id":312011,"name":"Professional Practice","url":"https://www.academia.edu/Documents/in/Professional_Practice?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=56538217]'), work: {"id":56538217,"title":"Dignity and the essence of medicine: the A, B, C, and D of dignity conserving care","created_at":"2021-10-08T05:14:22.790-07:00","url":"https://www.academia.edu/56538217/Dignity_and_the_essence_of_medicine_the_A_B_C_and_D_of_dignity_conserving_care?f_ri=882903","dom_id":"work_56538217","summary":"Kindness, humanity, and respect-the core values of medical professionalism-are too often being overlooked in the time pressured culture of modern health care, says Harvey Chochinov, and the A, B, C, and D of dignity conserving care can reinstate them dignity and the essence of medicine: the a, B, C, and d of dignity conserving care","downloadable_attachments":[{"id":71876669,"asset_id":56538217,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":32607840,"first_name":"Harvey","last_name":"Chochinov","domain_name":"umanitoba","page_name":"HarveyChochinov","display_name":"Harvey Chochinov","profile_url":"https://umanitoba.academia.edu/HarveyChochinov?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":3815,"name":"Spirituality","url":"https://www.academia.edu/Documents/in/Spirituality?f_ri=882903","nofollow":true},{"id":4441,"name":"Health Care","url":"https://www.academia.edu/Documents/in/Health_Care?f_ri=882903","nofollow":true},{"id":40593,"name":"British medical history","url":"https://www.academia.edu/Documents/in/British_medical_history?f_ri=882903","nofollow":true},{"id":312011,"name":"Professional Practice","url":"https://www.academia.edu/Documents/in/Professional_Practice?f_ri=882903","nofollow":true},{"id":352686,"name":"Patient Rights","url":"https://www.academia.edu/Documents/in/Patient_Rights?f_ri=882903"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1?f_ri=882903"},{"id":475235,"name":"BMJ","url":"https://www.academia.edu/Documents/in/BMJ?f_ri=882903"},{"id":589991,"name":"Patient Participation","url":"https://www.academia.edu/Documents/in/Patient_Participation?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":1867950,"name":"Time pressure","url":"https://www.academia.edu/Documents/in/Time_pressure?f_ri=882903"},{"id":2529977,"name":"attitude to health","url":"https://www.academia.edu/Documents/in/attitude_to_health?f_ri=882903"},{"id":2723721,"name":"professional patient relations","url":"https://www.academia.edu/Documents/in/professional_patient_relations?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_49499063" data-work_id="49499063" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/49499063/Spiritual_Care_Needs_of_Hospitalized_Children_and_Their_Families_A_National_Survey_of_Pastoral_Care_Providers_Perceptions">Spiritual Care Needs of Hospitalized Children and Their Families: A National Survey of Pastoral Care Providers' Perceptions</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Objective. Although spirituality is viewed as a vital aspect of the illness experience by most Americans, little is known about this domain of pediatric health care. The objective of this study was to profile pastoral care providers'... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_49499063" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Objective. Although spirituality is viewed as a vital aspect of the illness experience by most Americans, little is known about this domain of pediatric health care. The objective of this study was to profile pastoral care providers' perceptions of the spiritual care needs of hospitalized children and their parents, barriers to better pastoral care, and quality of spiritual care in children's hospitals. Methods. A cross-sectional mail survey was conducted of pastoral care providers at children's hospitals throughout the United States, with a 67% response rate from 115 institutions. Results. Respondents estimated that, among patients they visited, 34% were chronically ill and 21% were clearly dying. Half or more of patients were thought to have spiritual care needs regarding feeling fearful or anxious, coping with pain or other physical symptoms, and regarding their relationship to their parents or the relationship between their parents. Among patients' parents, 60% to 80% were estimated to have felt fearful or anxious, had difficulty coping with their child's pain or other symptoms, sought more medical information about their child's illness, questioned why they and their child were going through this experience, asked about the meaning or purpose of suffering, and felt guilty. Respondents agreed on 3 barriers to providing spiritual care: inadequate staffing of the pastoral care office, inadequate training of health care providers to detect patients' spiritual needs, and being called to visit with patients and families too late to provide all the care that could have been provided. Overall, respondents judged that their hospitals were providing 60% of what they deemed as ideal spiritual care. Conclusions. Pastoral care providers believe that the spiritual care needs of hospitalized children and their parents are diverse and extensive. With system-level barriers cited as limiting the quality of spiritual care, considerable improvement may be possible. Pediatrics 2003;</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/49499063" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="3d17cd9112e302cde67a50792b8dded6" rel="nofollow" data-download="{"attachment_id":67837589,"asset_id":49499063,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/67837589/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="25406448" href="https://upenn.academia.edu/ChrisFeudtner">Chris Feudtner</a><script data-card-contents-for-user="25406448" type="text/json">{"id":25406448,"first_name":"Chris","last_name":"Feudtner","domain_name":"upenn","page_name":"ChrisFeudtner","display_name":"Chris Feudtner","profile_url":"https://upenn.academia.edu/ChrisFeudtner?f_ri=882903","photo":"https://gravatar.com/avatar/2397aadef28b1831b97807e8505b821a?s=65"}</script></span></span></li><li class="js-paper-rank-work_49499063 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="49499063"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 49499063, container: ".js-paper-rank-work_49499063", }); });</script></li><li class="js-percentile-work_49499063 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 49499063; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_49499063"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_49499063 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="49499063"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 49499063; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=49499063]").text(description); $(".js-view-count-work_49499063").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_49499063").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="49499063"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">15</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="631" rel="nofollow" href="https://www.academia.edu/Documents/in/Pediatrics">Pediatrics</a>, <script data-card-contents-for-ri="631" type="text/json">{"id":631,"name":"Pediatrics","url":"https://www.academia.edu/Documents/in/Pediatrics?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="3815" rel="nofollow" href="https://www.academia.edu/Documents/in/Spirituality">Spirituality</a>, <script data-card-contents-for-ri="3815" type="text/json">{"id":3815,"name":"Spirituality","url":"https://www.academia.edu/Documents/in/Spirituality?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="6574" rel="nofollow" href="https://www.academia.edu/Documents/in/Family">Family</a>, <script data-card-contents-for-ri="6574" type="text/json">{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="54458" rel="nofollow" href="https://www.academia.edu/Documents/in/Pastoral_Care">Pastoral Care</a><script data-card-contents-for-ri="54458" type="text/json">{"id":54458,"name":"Pastoral Care","url":"https://www.academia.edu/Documents/in/Pastoral_Care?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=49499063]'), work: {"id":49499063,"title":"Spiritual Care Needs of Hospitalized Children and Their Families: A National Survey of Pastoral Care Providers' Perceptions","created_at":"2021-07-01T12:03:37.751-07:00","url":"https://www.academia.edu/49499063/Spiritual_Care_Needs_of_Hospitalized_Children_and_Their_Families_A_National_Survey_of_Pastoral_Care_Providers_Perceptions?f_ri=882903","dom_id":"work_49499063","summary":"Objective. Although spirituality is viewed as a vital aspect of the illness experience by most Americans, little is known about this domain of pediatric health care. The objective of this study was to profile pastoral care providers' perceptions of the spiritual care needs of hospitalized children and their parents, barriers to better pastoral care, and quality of spiritual care in children's hospitals. Methods. A cross-sectional mail survey was conducted of pastoral care providers at children's hospitals throughout the United States, with a 67% response rate from 115 institutions. Results. Respondents estimated that, among patients they visited, 34% were chronically ill and 21% were clearly dying. Half or more of patients were thought to have spiritual care needs regarding feeling fearful or anxious, coping with pain or other physical symptoms, and regarding their relationship to their parents or the relationship between their parents. Among patients' parents, 60% to 80% were estimated to have felt fearful or anxious, had difficulty coping with their child's pain or other symptoms, sought more medical information about their child's illness, questioned why they and their child were going through this experience, asked about the meaning or purpose of suffering, and felt guilty. Respondents agreed on 3 barriers to providing spiritual care: inadequate staffing of the pastoral care office, inadequate training of health care providers to detect patients' spiritual needs, and being called to visit with patients and families too late to provide all the care that could have been provided. Overall, respondents judged that their hospitals were providing 60% of what they deemed as ideal spiritual care. Conclusions. Pastoral care providers believe that the spiritual care needs of hospitalized children and their parents are diverse and extensive. With system-level barriers cited as limiting the quality of spiritual care, considerable improvement may be possible. Pediatrics 2003;","downloadable_attachments":[{"id":67837589,"asset_id":49499063,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":25406448,"first_name":"Chris","last_name":"Feudtner","domain_name":"upenn","page_name":"ChrisFeudtner","display_name":"Chris Feudtner","profile_url":"https://upenn.academia.edu/ChrisFeudtner?f_ri=882903","photo":"https://gravatar.com/avatar/2397aadef28b1831b97807e8505b821a?s=65"}],"research_interests":[{"id":631,"name":"Pediatrics","url":"https://www.academia.edu/Documents/in/Pediatrics?f_ri=882903","nofollow":true},{"id":3815,"name":"Spirituality","url":"https://www.academia.edu/Documents/in/Spirituality?f_ri=882903","nofollow":true},{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true},{"id":54458,"name":"Pastoral Care","url":"https://www.academia.edu/Documents/in/Pastoral_Care?f_ri=882903","nofollow":true},{"id":64933,"name":"Child","url":"https://www.academia.edu/Documents/in/Child?f_ri=882903"},{"id":65981,"name":"Needs Assessment","url":"https://www.academia.edu/Documents/in/Needs_Assessment?f_ri=882903"},{"id":97269,"name":"Chronic Disease","url":"https://www.academia.edu/Documents/in/Chronic_Disease?f_ri=882903"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States?f_ri=882903"},{"id":134346,"name":"Infant","url":"https://www.academia.edu/Documents/in/Infant?f_ri=882903"},{"id":253560,"name":"Newborn Infant","url":"https://www.academia.edu/Documents/in/Newborn_Infant?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":1034181,"name":"Cross Sectional Studies","url":"https://www.academia.edu/Documents/in/Cross_Sectional_Studies?f_ri=882903"},{"id":2489700,"name":"Child preschool","url":"https://www.academia.edu/Documents/in/Child_preschool?f_ri=882903"},{"id":2922956,"name":"Psychology and Cognitive Sciences","url":"https://www.academia.edu/Documents/in/Psychology_and_Cognitive_Sciences?f_ri=882903"},{"id":3763225,"name":"Medical and Health Sciences","url":"https://www.academia.edu/Documents/in/Medical_and_Health_Sciences?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_74129111" data-work_id="74129111" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/74129111/Pain_management_within_the_palliative_and_end_of_life_care_experience_in_the_ICU">Pain management within the palliative and end-of-life care experience in the ICU</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">In the ICU where critically ill patients receive aggressive life-sustaining interventions, suffering is common and death can be expected in up to 20% of patients. High-quality pain management is a part of optimal therapy and requires... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_74129111" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">In the ICU where critically ill patients receive aggressive life-sustaining interventions, suffering is common and death can be expected in up to 20% of patients. High-quality pain management is a part of optimal therapy and requires knowledge and skill in pharmacologic, behavioral, social, and communication strategies grounded in the holistic palliative care approach. This contemporary review article focuses on pain management within comprehensive palliative and end-of-life care. These key points emerge from the transdisciplinary review: (1) all ICU patients experience opportunities for discomfort and suffering regardless of prognosis or goals, thus palliative therapy is a requisite approach for every patient, of which pain management is a principal component; (2) for those dying in the ICU, an explicit shift in management to comfort-oriented care is often warranted and may be the most beneficial treatment the health-care team can offer; (3) communication and cultural sensitivity with the patient-family unit is a principal approach for optimizing palliative and pain management as part of comprehensive ICU care; (4) ethical and legal misconceptions about the escalation of opiates and other palliative therapies should not be barriers to appropriate care, provided the intention of treatment is alleviation of pain and suffering; (5) standardized instruments, performance measurement, and care delivery aids are effective strategies for decreasing variability and improving palliative care in the complex ICU setting; and (6) comprehensive palliative care should addresses family and caregiver stress associated with caring for critically ill patients and anticipated suffering and loss.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/74129111" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="be89a9a518b48a3ed0d1c9df641edc1c" rel="nofollow" data-download="{"attachment_id":82392209,"asset_id":74129111,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/82392209/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="146127261" href="https://independent.academia.edu/Javiermedina253">Javier medina</a><script data-card-contents-for-user="146127261" type="text/json">{"id":146127261,"first_name":"Javier","last_name":"medina","domain_name":"independent","page_name":"Javiermedina253","display_name":"Javier medina","profile_url":"https://independent.academia.edu/Javiermedina253?f_ri=882903","photo":"https://0.academia-photos.com/146127261/40027772/32924438/s65_javier.medina.jpg"}</script></span></span></li><li class="js-paper-rank-work_74129111 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="74129111"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 74129111, container: ".js-paper-rank-work_74129111", }); 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$(".js-view-count[data-work-id=74129111]").text(description); $(".js-view-count-work_74129111").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_74129111").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="74129111"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">18</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="606" rel="nofollow" href="https://www.academia.edu/Documents/in/Cardiology">Cardiology</a>, <script data-card-contents-for-ri="606" type="text/json">{"id":606,"name":"Cardiology","url":"https://www.academia.edu/Documents/in/Cardiology?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="2898" rel="nofollow" href="https://www.academia.edu/Documents/in/Pain">Pain</a>, <script data-card-contents-for-ri="2898" type="text/json">{"id":2898,"name":"Pain","url":"https://www.academia.edu/Documents/in/Pain?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="4482" rel="nofollow" href="https://www.academia.edu/Documents/in/Palliative_Care">Palliative Care</a>, <script data-card-contents-for-ri="4482" type="text/json">{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="7125" rel="nofollow" href="https://www.academia.edu/Documents/in/Culture">Culture</a><script data-card-contents-for-ri="7125" type="text/json">{"id":7125,"name":"Culture","url":"https://www.academia.edu/Documents/in/Culture?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=74129111]'), work: {"id":74129111,"title":"Pain management within the palliative and end-of-life care experience in the ICU","created_at":"2022-03-20T05:46:39.539-07:00","url":"https://www.academia.edu/74129111/Pain_management_within_the_palliative_and_end_of_life_care_experience_in_the_ICU?f_ri=882903","dom_id":"work_74129111","summary":"In the ICU where critically ill patients receive aggressive life-sustaining interventions, suffering is common and death can be expected in up to 20% of patients. High-quality pain management is a part of optimal therapy and requires knowledge and skill in pharmacologic, behavioral, social, and communication strategies grounded in the holistic palliative care approach. This contemporary review article focuses on pain management within comprehensive palliative and end-of-life care. These key points emerge from the transdisciplinary review: (1) all ICU patients experience opportunities for discomfort and suffering regardless of prognosis or goals, thus palliative therapy is a requisite approach for every patient, of which pain management is a principal component; (2) for those dying in the ICU, an explicit shift in management to comfort-oriented care is often warranted and may be the most beneficial treatment the health-care team can offer; (3) communication and cultural sensitivity with the patient-family unit is a principal approach for optimizing palliative and pain management as part of comprehensive ICU care; (4) ethical and legal misconceptions about the escalation of opiates and other palliative therapies should not be barriers to appropriate care, provided the intention of treatment is alleviation of pain and suffering; (5) standardized instruments, performance measurement, and care delivery aids are effective strategies for decreasing variability and improving palliative care in the complex ICU setting; and (6) comprehensive palliative care should addresses family and caregiver stress associated with caring for critically ill patients and anticipated suffering and loss.","downloadable_attachments":[{"id":82392209,"asset_id":74129111,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":146127261,"first_name":"Javier","last_name":"medina","domain_name":"independent","page_name":"Javiermedina253","display_name":"Javier medina","profile_url":"https://independent.academia.edu/Javiermedina253?f_ri=882903","photo":"https://0.academia-photos.com/146127261/40027772/32924438/s65_javier.medina.jpg"}],"research_interests":[{"id":606,"name":"Cardiology","url":"https://www.academia.edu/Documents/in/Cardiology?f_ri=882903","nofollow":true},{"id":2898,"name":"Pain","url":"https://www.academia.edu/Documents/in/Pain?f_ri=882903","nofollow":true},{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true},{"id":7125,"name":"Culture","url":"https://www.academia.edu/Documents/in/Culture?f_ri=882903","nofollow":true},{"id":7470,"name":"Quality of life","url":"https://www.academia.edu/Documents/in/Quality_of_life?f_ri=882903"},{"id":9435,"name":"Medical Ethics","url":"https://www.academia.edu/Documents/in/Medical_Ethics?f_ri=882903"},{"id":16635,"name":"Health Services Research","url":"https://www.academia.edu/Documents/in/Health_Services_Research?f_ri=882903"},{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine?f_ri=882903"},{"id":40165,"name":"Pain Management","url":"https://www.academia.edu/Documents/in/Pain_Management?f_ri=882903"},{"id":70497,"name":"End of life care","url":"https://www.academia.edu/Documents/in/End_of_life_care?f_ri=882903"},{"id":94234,"name":"INTENSIVE CARE","url":"https://www.academia.edu/Documents/in/INTENSIVE_CARE?f_ri=882903"},{"id":129739,"name":"Anesthesia","url":"https://www.academia.edu/Documents/in/Anesthesia?f_ri=882903"},{"id":201441,"name":"Caregivers","url":"https://www.academia.edu/Documents/in/Caregivers?f_ri=882903"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903"},{"id":532928,"name":"Chest","url":"https://www.academia.edu/Documents/in/Chest?f_ri=882903"},{"id":793339,"name":"Intensive Care Units","url":"https://www.academia.edu/Documents/in/Intensive_Care_Units?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":2723721,"name":"professional patient relations","url":"https://www.academia.edu/Documents/in/professional_patient_relations?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_71795335" data-work_id="71795335" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/71795335/Slippery_slopes_in_flat_countries_a_response">Slippery slopes in flat countries--a response</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">In response to the paper by Keown andJochemsen in which the latest empirical data concerning euthanasia and other end-of-life decisions in the Netherlands is discussed, this paper discusses three points. The use of euthanasia in cases in... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_71795335" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">In response to the paper by Keown andJochemsen in which the latest empirical data concerning euthanasia and other end-of-life decisions in the Netherlands is discussed, this paper discusses three points. The use of euthanasia in cases in which palliative care was a viable alternative may be taken as proof of a slippery slope. However, it could also be interpreted as an indication of a shift towards more autonomy-based end-of-life decisions. The cases of non-voluntary euthanasia are a serious problem in the Netherlands and they are only rarely justifiable. However, they do not prove the existence of a slippery slope. Persuading the physician to bring euthanasia cases to the knowledge of the authorities is a problem of any euthanasia policy. The Dutch notification procedure has recendy been changed to reduce the underreporting ofcases. However, many questions remain.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/71795335" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="c9e8391d0e2be36b055cb95a5fe7e4f0" rel="nofollow" data-download="{"attachment_id":80993762,"asset_id":71795335,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/80993762/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="34110570" href="https://independent.academia.edu/JohannesVanDelden">Johannes Van Delden</a><script data-card-contents-for-user="34110570" type="text/json">{"id":34110570,"first_name":"Johannes Van","last_name":"Delden","domain_name":"independent","page_name":"JohannesVanDelden","display_name":"Johannes Van Delden","profile_url":"https://independent.academia.edu/JohannesVanDelden?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_71795335 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="71795335"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 71795335, container: ".js-paper-rank-work_71795335", }); 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$(".js-view-count[data-work-id=71795335]").text(description); $(".js-view-count-work_71795335").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_71795335").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="71795335"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">14</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="206" rel="nofollow" href="https://www.academia.edu/Documents/in/Social_Change">Social Change</a>, <script data-card-contents-for-ri="206" type="text/json">{"id":206,"name":"Social Change","url":"https://www.academia.edu/Documents/in/Social_Change?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="906" rel="nofollow" href="https://www.academia.edu/Documents/in/Applied_Ethics">Applied Ethics</a>, <script data-card-contents-for-ri="906" type="text/json">{"id":906,"name":"Applied Ethics","url":"https://www.academia.edu/Documents/in/Applied_Ethics?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="1681" rel="nofollow" href="https://www.academia.edu/Documents/in/Decision_Making">Decision Making</a>, <script data-card-contents-for-ri="1681" type="text/json">{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="9435" rel="nofollow" href="https://www.academia.edu/Documents/in/Medical_Ethics">Medical Ethics</a><script data-card-contents-for-ri="9435" type="text/json">{"id":9435,"name":"Medical Ethics","url":"https://www.academia.edu/Documents/in/Medical_Ethics?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=71795335]'), work: {"id":71795335,"title":"Slippery slopes in flat countries--a response","created_at":"2022-02-18T02:50:48.274-08:00","url":"https://www.academia.edu/71795335/Slippery_slopes_in_flat_countries_a_response?f_ri=882903","dom_id":"work_71795335","summary":"In response to the paper by Keown andJochemsen in which the latest empirical data concerning euthanasia and other end-of-life decisions in the Netherlands is discussed, this paper discusses three points. The use of euthanasia in cases in which palliative care was a viable alternative may be taken as proof of a slippery slope. However, it could also be interpreted as an indication of a shift towards more autonomy-based end-of-life decisions. The cases of non-voluntary euthanasia are a serious problem in the Netherlands and they are only rarely justifiable. However, they do not prove the existence of a slippery slope. Persuading the physician to bring euthanasia cases to the knowledge of the authorities is a problem of any euthanasia policy. The Dutch notification procedure has recendy been changed to reduce the underreporting ofcases. However, many questions remain.","downloadable_attachments":[{"id":80993762,"asset_id":71795335,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":34110570,"first_name":"Johannes Van","last_name":"Delden","domain_name":"independent","page_name":"JohannesVanDelden","display_name":"Johannes Van Delden","profile_url":"https://independent.academia.edu/JohannesVanDelden?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":206,"name":"Social Change","url":"https://www.academia.edu/Documents/in/Social_Change?f_ri=882903","nofollow":true},{"id":906,"name":"Applied Ethics","url":"https://www.academia.edu/Documents/in/Applied_Ethics?f_ri=882903","nofollow":true},{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true},{"id":9435,"name":"Medical Ethics","url":"https://www.academia.edu/Documents/in/Medical_Ethics?f_ri=882903","nofollow":true},{"id":13513,"name":"Euthanasia","url":"https://www.academia.edu/Documents/in/Euthanasia?f_ri=882903"},{"id":37778,"name":"Law Enforcement","url":"https://www.academia.edu/Documents/in/Law_Enforcement?f_ri=882903"},{"id":157892,"name":"Netherlands","url":"https://www.academia.edu/Documents/in/Netherlands?f_ri=882903"},{"id":186492,"name":"Empirical Research","url":"https://www.academia.edu/Documents/in/Empirical_Research?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":991655,"name":"Formal Social Control","url":"https://www.academia.edu/Documents/in/Formal_Social_Control?f_ri=882903"},{"id":1201074,"name":"Psychological Stress","url":"https://www.academia.edu/Documents/in/Psychological_Stress?f_ri=882903"},{"id":1821487,"name":"Personal autonomy","url":"https://www.academia.edu/Documents/in/Personal_autonomy?f_ri=882903"},{"id":2463786,"name":"Truth Disclosure","url":"https://www.academia.edu/Documents/in/Truth_Disclosure?f_ri=882903"},{"id":2491318,"name":"Guideline Adherence","url":"https://www.academia.edu/Documents/in/Guideline_Adherence?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_48540781" data-work_id="48540781" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/48540781/The_Right_to_Die_with_Dignity">The Right to Die with Dignity</a></div></div><div class="u-pb4x u-mt3x"></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share 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href="https://www.academia.edu/Documents/in/Psychology">Psychology</a>, <script data-card-contents-for-ri="221" type="text/json">{"id":221,"name":"Psychology","url":"https://www.academia.edu/Documents/in/Psychology?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="534" rel="nofollow" href="https://www.academia.edu/Documents/in/Law">Law</a>, <script data-card-contents-for-ri="534" type="text/json">{"id":534,"name":"Law","url":"https://www.academia.edu/Documents/in/Law?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="859" rel="nofollow" href="https://www.academia.edu/Documents/in/Communication">Communication</a>, <script data-card-contents-for-ri="859" type="text/json">{"id":859,"name":"Communication","url":"https://www.academia.edu/Documents/in/Communication?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="1414" rel="nofollow" href="https://www.academia.edu/Documents/in/Bioethics">Bioethics</a><script data-card-contents-for-ri="1414" type="text/json">{"id":1414,"name":"Bioethics","url":"https://www.academia.edu/Documents/in/Bioethics?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=48540781]'), work: {"id":48540781,"title":"The Right to Die with Dignity","created_at":"2021-05-04T22:44:23.913-07:00","url":"https://www.academia.edu/48540781/The_Right_to_Die_with_Dignity?f_ri=882903","dom_id":"work_48540781","summary":null,"downloadable_attachments":[{"id":67099326,"asset_id":48540781,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":373292,"first_name":"Raphael","last_name":"Cohen-Almagor","domain_name":"hull","page_name":"RaphaelCohenAlmagor","display_name":"Raphael Cohen-Almagor","profile_url":"https://hull.academia.edu/RaphaelCohenAlmagor?f_ri=882903","photo":"https://0.academia-photos.com/373292/96730/159257724/s65_maya.chernichenko.jpg"}],"research_interests":[{"id":221,"name":"Psychology","url":"https://www.academia.edu/Documents/in/Psychology?f_ri=882903","nofollow":true},{"id":534,"name":"Law","url":"https://www.academia.edu/Documents/in/Law?f_ri=882903","nofollow":true},{"id":859,"name":"Communication","url":"https://www.academia.edu/Documents/in/Communication?f_ri=882903","nofollow":true},{"id":1414,"name":"Bioethics","url":"https://www.academia.edu/Documents/in/Bioethics?f_ri=882903","nofollow":true},{"id":2122,"name":"Death","url":"https://www.academia.edu/Documents/in/Death?f_ri=882903"},{"id":3931,"name":"Fear","url":"https://www.academia.edu/Documents/in/Fear?f_ri=882903"},{"id":9435,"name":"Medical Ethics","url":"https://www.academia.edu/Documents/in/Medical_Ethics?f_ri=882903"},{"id":13513,"name":"Euthanasia","url":"https://www.academia.edu/Documents/in/Euthanasia?f_ri=882903"},{"id":45951,"name":"Brain Death","url":"https://www.academia.edu/Documents/in/Brain_Death?f_ri=882903"},{"id":50238,"name":"Affect","url":"https://www.academia.edu/Documents/in/Affect?f_ri=882903"},{"id":99773,"name":"Disease","url":"https://www.academia.edu/Documents/in/Disease?f_ri=882903"},{"id":587281,"name":"Right to Die","url":"https://www.academia.edu/Documents/in/Right_to_Die?f_ri=882903"},{"id":621387,"name":"Biomedica","url":"https://www.academia.edu/Documents/in/Biomedica?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":2529977,"name":"attitude to health","url":"https://www.academia.edu/Documents/in/attitude_to_health?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_32899902" data-work_id="32899902" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/32899902/The_right_to_die_and_the_duty_to_die_perceptions_of_nurses_in_the_West_and_in_Japan">The right-to-die and the duty-to-die: perceptions of nurses in the West and in Japan</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">The right-to-die means that the terminally ill person has the right to refuse further treatment. The duty-to-die means that terminally ill persons feel that they have no choice and must refuse treatment because of social factors such as... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_32899902" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">The right-to-die means that the terminally ill person has the right to refuse further treatment. The duty-to-die means that terminally ill persons feel that they have no choice and must refuse treatment because of social factors such as family burden or financial cost to society. This article describes the perceptions of a sample of 72 Japanese nurses and 71 counterparts from the West. The right-to-die received support from all of the western and from a majority of the Japanese sample. However, the duty-to-die received weaker support from the West and rather strong disagreement from Japan. Themes emerged in the two groups from a content analysis of their reactions to the major concepts of right-to-die and duty-to-die, and these included autonomy, values surrounding life, justice, family as a possible coercive agent and family as a partner in decision making. Differences and similarities across the cultures in the meaning of these themes were explored.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/32899902" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="520a7a6f6db6f46e4cad9a0724ab5d2d" rel="nofollow" data-download="{"attachment_id":53038808,"asset_id":32899902,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/53038808/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="64002878" href="https://independent.academia.edu/EmikoKonishi">Emiko Konishi</a><script data-card-contents-for-user="64002878" type="text/json">{"id":64002878,"first_name":"Emiko","last_name":"Konishi","domain_name":"independent","page_name":"EmikoKonishi","display_name":"Emiko Konishi","profile_url":"https://independent.academia.edu/EmikoKonishi?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_32899902 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="32899902"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 32899902, container: ".js-paper-rank-work_32899902", }); 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$(".js-view-count[data-work-id=32899902]").text(description); $(".js-view-count-work_32899902").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_32899902").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="32899902"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">14</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="588" rel="nofollow" href="https://www.academia.edu/Documents/in/Nursing">Nursing</a>, <script data-card-contents-for-ri="588" type="text/json">{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="1681" rel="nofollow" href="https://www.academia.edu/Documents/in/Decision_Making">Decision Making</a>, <script data-card-contents-for-ri="1681" type="text/json">{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="6574" rel="nofollow" href="https://www.academia.edu/Documents/in/Family">Family</a>, <script data-card-contents-for-ri="6574" type="text/json">{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="6697" rel="nofollow" href="https://www.academia.edu/Documents/in/Australia">Australia</a><script data-card-contents-for-ri="6697" type="text/json">{"id":6697,"name":"Australia","url":"https://www.academia.edu/Documents/in/Australia?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=32899902]'), work: {"id":32899902,"title":"The right-to-die and the duty-to-die: perceptions of nurses in the West and in Japan","created_at":"2017-05-07T23:38:18.459-07:00","url":"https://www.academia.edu/32899902/The_right_to_die_and_the_duty_to_die_perceptions_of_nurses_in_the_West_and_in_Japan?f_ri=882903","dom_id":"work_32899902","summary":"The right-to-die means that the terminally ill person has the right to refuse further treatment. The duty-to-die means that terminally ill persons feel that they have no choice and must refuse treatment because of social factors such as family burden or financial cost to society. This article describes the perceptions of a sample of 72 Japanese nurses and 71 counterparts from the West. The right-to-die received support from all of the western and from a majority of the Japanese sample. However, the duty-to-die received weaker support from the West and rather strong disagreement from Japan. Themes emerged in the two groups from a content analysis of their reactions to the major concepts of right-to-die and duty-to-die, and these included autonomy, values surrounding life, justice, family as a possible coercive agent and family as a partner in decision making. 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However, no empirical studies have focused specifically on the impact of CNA communication on end-of-life (EOL) care processes. This study... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_14306702" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Objective-Staff communication has been shown to influence overall nursing home (NH) performance. However, no empirical studies have focused specifically on the impact of CNA communication on end-of-life (EOL) care processes. This study examines the relationship between CNA communication and nursing home performance in EOL care processes.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/14306702" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="f9a2d943e7e34d58c01b93088ac2f04a" rel="nofollow" data-download="{"attachment_id":44338685,"asset_id":14306702,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/44338685/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="33262539" href="https://independent.academia.edu/HelenaTemkingreener">Helena Temkin-greener</a><script data-card-contents-for-user="33262539" type="text/json">{"id":33262539,"first_name":"Helena","last_name":"Temkin-greener","domain_name":"independent","page_name":"HelenaTemkingreener","display_name":"Helena Temkin-greener","profile_url":"https://independent.academia.edu/HelenaTemkingreener?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_14306702 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="14306702"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 14306702, container: ".js-paper-rank-work_14306702", }); 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$(".js-view-count[data-work-id=14306702]").text(description); $(".js-view-count-work_14306702").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_14306702").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="14306702"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">12</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="859" rel="nofollow" href="https://www.academia.edu/Documents/in/Communication">Communication</a>, <script data-card-contents-for-ri="859" type="text/json">{"id":859,"name":"Communication","url":"https://www.academia.edu/Documents/in/Communication?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="8974" rel="nofollow" href="https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care">Quality of Mental Health Care</a>, <script data-card-contents-for-ri="8974" type="text/json">{"id":8974,"name":"Quality of Mental Health Care","url":"https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="28850" rel="nofollow" href="https://www.academia.edu/Documents/in/Linear_models">Linear models</a>, <script data-card-contents-for-ri="28850" type="text/json">{"id":28850,"name":"Linear models","url":"https://www.academia.edu/Documents/in/Linear_models?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="45038" rel="nofollow" href="https://www.academia.edu/Documents/in/Quality_of_Care">Quality of Care</a><script data-card-contents-for-ri="45038" type="text/json">{"id":45038,"name":"Quality of Care","url":"https://www.academia.edu/Documents/in/Quality_of_Care?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=14306702]'), work: {"id":14306702,"title":"End-of-Life Care in Nursing Homes: The Importance of CNA Staff Communication","created_at":"2015-07-22T12:54:03.355-07:00","url":"https://www.academia.edu/14306702/End_of_Life_Care_in_Nursing_Homes_The_Importance_of_CNA_Staff_Communication?f_ri=882903","dom_id":"work_14306702","summary":"Objective-Staff communication has been shown to influence overall nursing home (NH) performance. However, no empirical studies have focused specifically on the impact of CNA communication on end-of-life (EOL) care processes. This study examines the relationship between CNA communication and nursing home performance in EOL care processes.","downloadable_attachments":[{"id":44338685,"asset_id":14306702,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":33262539,"first_name":"Helena","last_name":"Temkin-greener","domain_name":"independent","page_name":"HelenaTemkingreener","display_name":"Helena Temkin-greener","profile_url":"https://independent.academia.edu/HelenaTemkingreener?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":859,"name":"Communication","url":"https://www.academia.edu/Documents/in/Communication?f_ri=882903","nofollow":true},{"id":8974,"name":"Quality of Mental Health Care","url":"https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care?f_ri=882903","nofollow":true},{"id":28850,"name":"Linear models","url":"https://www.academia.edu/Documents/in/Linear_models?f_ri=882903","nofollow":true},{"id":45038,"name":"Quality of Care","url":"https://www.academia.edu/Documents/in/Quality_of_Care?f_ri=882903","nofollow":true},{"id":70497,"name":"End of life care","url":"https://www.academia.edu/Documents/in/End_of_life_care?f_ri=882903"},{"id":90380,"name":"Nursing Homes","url":"https://www.academia.edu/Documents/in/Nursing_Homes?f_ri=882903"},{"id":243490,"name":"Nursing Home","url":"https://www.academia.edu/Documents/in/Nursing_Home?f_ri=882903"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903"},{"id":248366,"name":"New York","url":"https://www.academia.edu/Documents/in/New_York?f_ri=882903"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":2063674,"name":"Nursing staff","url":"https://www.academia.edu/Documents/in/Nursing_staff?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_22380989" data-work_id="22380989" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/22380989/End_of_life_issues_for_aboriginal_patients_a_literature_review">End-of-life issues for aboriginal patients: a literature review</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">To understand some of the cross-cultural issues in providing palliative care to aboriginal patients. MEDLINE (1966 to 2005), CINAHL, PsycINFO, Google Scholar, and the Aboriginal Health Collection at the University of Manitoba were... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_22380989" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">To understand some of the cross-cultural issues in providing palliative care to aboriginal patients. MEDLINE (1966 to 2005), CINAHL, PsycINFO, Google Scholar, and the Aboriginal Health Collection at the University of Manitoba were searched. Studies were selected based on their focus on both general cross-cultural caregiving and, in particular, end-of-life decision making and treatment. Only 39 relevant articles were found, half of which were opinion pieces by experienced nonaboriginal professionals; 14 were qualitative research projects from nursing and anthropologic perspectives. All patients are unique. Some cultural differences might arise when providing palliative care to aboriginal patients, who value individual respect along with family and community. Involvement of family and community members in decision making around end-of-life issues is common. Aboriginal cultures often have different approaches to telling bad news and maintaining hope for patients. Use of interpreters an...</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/22380989" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="702600bd2c0338aa3d0cc611fa9e4f1a" rel="nofollow" data-download="{"attachment_id":43009658,"asset_id":22380989,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/43009658/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="43839886" href="https://independent.academia.edu/AlanaMinty">Alana Minty</a><script data-card-contents-for-user="43839886" type="text/json">{"id":43839886,"first_name":"Alana","last_name":"Minty","domain_name":"independent","page_name":"AlanaMinty","display_name":"Alana Minty","profile_url":"https://independent.academia.edu/AlanaMinty?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_22380989 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="22380989"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 22380989, container: ".js-paper-rank-work_22380989", }); 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$(".js-view-count[data-work-id=22380989]").text(description); $(".js-view-count-work_22380989").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_22380989").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="22380989"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">13</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="1681" rel="nofollow" href="https://www.academia.edu/Documents/in/Decision_Making">Decision Making</a>, <script data-card-contents-for-ri="1681" type="text/json">{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="4086" rel="nofollow" href="https://www.academia.edu/Documents/in/Traditional_Medicine">Traditional Medicine</a>, <script data-card-contents-for-ri="4086" type="text/json">{"id":4086,"name":"Traditional Medicine","url":"https://www.academia.edu/Documents/in/Traditional_Medicine?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="6697" rel="nofollow" href="https://www.academia.edu/Documents/in/Australia">Australia</a>, <script data-card-contents-for-ri="6697" type="text/json">{"id":6697,"name":"Australia","url":"https://www.academia.edu/Documents/in/Australia?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="7125" rel="nofollow" href="https://www.academia.edu/Documents/in/Culture">Culture</a><script data-card-contents-for-ri="7125" type="text/json">{"id":7125,"name":"Culture","url":"https://www.academia.edu/Documents/in/Culture?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=22380989]'), work: {"id":22380989,"title":"End-of-life issues for aboriginal patients: a literature review","created_at":"2016-02-24T05:13:26.596-08:00","url":"https://www.academia.edu/22380989/End_of_life_issues_for_aboriginal_patients_a_literature_review?f_ri=882903","dom_id":"work_22380989","summary":"To understand some of the cross-cultural issues in providing palliative care to aboriginal patients. MEDLINE (1966 to 2005), CINAHL, PsycINFO, Google Scholar, and the Aboriginal Health Collection at the University of Manitoba were searched. Studies were selected based on their focus on both general cross-cultural caregiving and, in particular, end-of-life decision making and treatment. Only 39 relevant articles were found, half of which were opinion pieces by experienced nonaboriginal professionals; 14 were qualitative research projects from nursing and anthropologic perspectives. All patients are unique. Some cultural differences might arise when providing palliative care to aboriginal patients, who value individual respect along with family and community. Involvement of family and community members in decision making around end-of-life issues is common. Aboriginal cultures often have different approaches to telling bad news and maintaining hope for patients. Use of interpreters an...","downloadable_attachments":[{"id":43009658,"asset_id":22380989,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":43839886,"first_name":"Alana","last_name":"Minty","domain_name":"independent","page_name":"AlanaMinty","display_name":"Alana Minty","profile_url":"https://independent.academia.edu/AlanaMinty?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true},{"id":4086,"name":"Traditional Medicine","url":"https://www.academia.edu/Documents/in/Traditional_Medicine?f_ri=882903","nofollow":true},{"id":6697,"name":"Australia","url":"https://www.academia.edu/Documents/in/Australia?f_ri=882903","nofollow":true},{"id":7125,"name":"Culture","url":"https://www.academia.edu/Documents/in/Culture?f_ri=882903","nofollow":true},{"id":12135,"name":"Qualitative Research","url":"https://www.academia.edu/Documents/in/Qualitative_Research?f_ri=882903"},{"id":18174,"name":"Language","url":"https://www.academia.edu/Documents/in/Language?f_ri=882903"},{"id":57511,"name":"Cross-Cultural Comparison","url":"https://www.academia.edu/Documents/in/Cross-Cultural_Comparison?f_ri=882903"},{"id":172809,"name":"Interpersonal Relations","url":"https://www.academia.edu/Documents/in/Interpersonal_Relations?f_ri=882903"},{"id":178369,"name":"Grief","url":"https://www.academia.edu/Documents/in/Grief?f_ri=882903"},{"id":281901,"name":"Family Relations","url":"https://www.academia.edu/Documents/in/Family_Relations?f_ri=882903"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1?f_ri=882903"},{"id":589991,"name":"Patient Participation","url":"https://www.academia.edu/Documents/in/Patient_Participation?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_71273603" data-work_id="71273603" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/71273603/Patients_beliefs_about_cancer_management">Patients' beliefs about cancer management</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">The results of a questionnaire answered by 205 medical patients are reported (100 patients with cancer and 105 with other medical conditions). The questionnaire examined beliefs and preferences regarding various aspects of cancer,... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_71273603" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">The results of a questionnaire answered by 205 medical patients are reported (100 patients with cancer and 105 with other medical conditions). The questionnaire examined beliefs and preferences regarding various aspects of cancer, including expectations of medical management and treatment. The issues examined relate to beliefs and preferences about information giving, trust of doctors' control of decision making, expectations of help, expectations of treatment, the treatment of cancer pain including morphine use, and issues of terminal care. Some patients appear to hold the inconsistent beliefs that doctors should tell them all they want to know, but that doctors do not know a lot of what they would like to be told. They were also ambivalent about who should make decisions, patient or doctor, suggesting a preference for collaborative consensus decision making. It may be important to inform patients more clearly about what doctors can and cannot reasonably be expected to know and do. Some incorrect beliefs about management were related to fear about having cancer. The results suggest the need for better communication between patients and their professional carers and the need for accessible health information about cancer management to be available to the general public.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/71273603" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="179a9eab1f59e0d951705784bd2bda21" rel="nofollow" data-download="{"attachment_id":80689189,"asset_id":71273603,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/80689189/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="127518115" href="https://monash.academia.edu/IanHaines">Ian Haines</a><script data-card-contents-for-user="127518115" type="text/json">{"id":127518115,"first_name":"Ian","last_name":"Haines","domain_name":"monash","page_name":"IanHaines","display_name":"Ian Haines","profile_url":"https://monash.academia.edu/IanHaines?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_71273603 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="71273603"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 71273603, container: ".js-paper-rank-work_71273603", }); });</script></li><li class="js-percentile-work_71273603 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71273603; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_71273603"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_71273603 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="71273603"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71273603; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71273603]").text(description); $(".js-view-count-work_71273603").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_71273603").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="71273603"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">8</a>  </div><span class="InlineList-item-text u-textTruncate u-pl9x"><a class="InlineList-item-text" data-has-card-for-ri="1681" rel="nofollow" href="https://www.academia.edu/Documents/in/Decision_Making">Decision Making</a>, <script data-card-contents-for-ri="1681" type="text/json">{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="26327" rel="nofollow" href="https://www.academia.edu/Documents/in/Medicine">Medicine</a>, <script data-card-contents-for-ri="26327" type="text/json">{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="72845" rel="nofollow" href="https://www.academia.edu/Documents/in/Cancer_pain">Cancer pain</a>, <script data-card-contents-for-ri="72845" type="text/json">{"id":72845,"name":"Cancer pain","url":"https://www.academia.edu/Documents/in/Cancer_pain?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="130808" rel="nofollow" href="https://www.academia.edu/Documents/in/Health_information">Health information</a><script data-card-contents-for-ri="130808" type="text/json">{"id":130808,"name":"Health information","url":"https://www.academia.edu/Documents/in/Health_information?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=71273603]'), work: {"id":71273603,"title":"Patients' beliefs about cancer management","created_at":"2022-02-12T19:38:45.818-08:00","url":"https://www.academia.edu/71273603/Patients_beliefs_about_cancer_management?f_ri=882903","dom_id":"work_71273603","summary":"The results of a questionnaire answered by 205 medical patients are reported (100 patients with cancer and 105 with other medical conditions). The questionnaire examined beliefs and preferences regarding various aspects of cancer, including expectations of medical management and treatment. The issues examined relate to beliefs and preferences about information giving, trust of doctors' control of decision making, expectations of help, expectations of treatment, the treatment of cancer pain including morphine use, and issues of terminal care. Some patients appear to hold the inconsistent beliefs that doctors should tell them all they want to know, but that doctors do not know a lot of what they would like to be told. They were also ambivalent about who should make decisions, patient or doctor, suggesting a preference for collaborative consensus decision making. It may be important to inform patients more clearly about what doctors can and cannot reasonably be expected to know and do. Some incorrect beliefs about management were related to fear about having cancer. The results suggest the need for better communication between patients and their professional carers and the need for accessible health information about cancer management to be available to the general public.","downloadable_attachments":[{"id":80689189,"asset_id":71273603,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":127518115,"first_name":"Ian","last_name":"Haines","domain_name":"monash","page_name":"IanHaines","display_name":"Ian Haines","profile_url":"https://monash.academia.edu/IanHaines?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true},{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine?f_ri=882903","nofollow":true},{"id":72845,"name":"Cancer pain","url":"https://www.academia.edu/Documents/in/Cancer_pain?f_ri=882903","nofollow":true},{"id":130808,"name":"Health information","url":"https://www.academia.edu/Documents/in/Health_information?f_ri=882903","nofollow":true},{"id":144361,"name":"Supportive Care","url":"https://www.academia.edu/Documents/in/Supportive_Care?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":2922956,"name":"Psychology and Cognitive Sciences","url":"https://www.academia.edu/Documents/in/Psychology_and_Cognitive_Sciences?f_ri=882903"},{"id":3763225,"name":"Medical and Health Sciences","url":"https://www.academia.edu/Documents/in/Medical_and_Health_Sciences?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_58836835" data-work_id="58836835" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/58836835/Ensuring_A_Good_Death_Pain_and_Palliative_Care_in_a_Cancer_Center">Ensuring A Good Death. Pain and Palliative Care in a Cancer Center</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">The purpose of this article is to describe how the commitment of the Dana-Farber Cancer Institute to pain management, quality of life, and optimal end-of-life care is operationalized through a comprehensive pain and palliative-care... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_58836835" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">The purpose of this article is to describe how the commitment of the Dana-Farber Cancer Institute to pain management, quality of life, and optimal end-of-life care is operationalized through a comprehensive pain and palliative-care program. OVERVIEW: Institutional standards for pain management often address only the physical aspects of pain. Effective pain management requires assessment and interventions that address the multidimensional nature of pain, suffering, and quality of life throughout the cancer continuum. This approach seeks to lay the foundation of comfort and peace associated with a good death. CLINICAL IMPLICATIONS: Institutional pain management standards need to reflect the complexity of pain, especially cancer-related pain, by emphasizing comprehensive, holistic assessment and multimodality approaches to pain control and quality-of-life issues.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/58836835" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="a5fcef7e393a7ecd0c0dfc2d6a36560a" rel="nofollow" data-download="{"attachment_id":73055266,"asset_id":58836835,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/73055266/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="34348443" href="https://hms-harvard.academia.edu/JanetAbrahm">Janet Abrahm</a><script data-card-contents-for-user="34348443" type="text/json">{"id":34348443,"first_name":"Janet","last_name":"Abrahm","domain_name":"hms-harvard","page_name":"JanetAbrahm","display_name":"Janet Abrahm","profile_url":"https://hms-harvard.academia.edu/JanetAbrahm?f_ri=882903","photo":"https://0.academia-photos.com/34348443/78631108/90866783/s65_janet.abrahm.jpg"}</script></span></span></li><li class="js-paper-rank-work_58836835 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="58836835"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 58836835, container: ".js-paper-rank-work_58836835", }); });</script></li><li class="js-percentile-work_58836835 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 58836835; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_58836835"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_58836835 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="58836835"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 58836835; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=58836835]").text(description); $(".js-view-count-work_58836835").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_58836835").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="58836835"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">7</a>  </div><span class="InlineList-item-text u-textTruncate u-pl9x"><a class="InlineList-item-text" data-has-card-for-ri="2898" rel="nofollow" href="https://www.academia.edu/Documents/in/Pain">Pain</a>, <script data-card-contents-for-ri="2898" type="text/json">{"id":2898,"name":"Pain","url":"https://www.academia.edu/Documents/in/Pain?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="4482" rel="nofollow" href="https://www.academia.edu/Documents/in/Palliative_Care">Palliative Care</a>, <script data-card-contents-for-ri="4482" type="text/json">{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="7470" rel="nofollow" href="https://www.academia.edu/Documents/in/Quality_of_life">Quality of life</a>, <script data-card-contents-for-ri="7470" type="text/json">{"id":7470,"name":"Quality of life","url":"https://www.academia.edu/Documents/in/Quality_of_life?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="40165" rel="nofollow" href="https://www.academia.edu/Documents/in/Pain_Management">Pain Management</a><script data-card-contents-for-ri="40165" type="text/json">{"id":40165,"name":"Pain Management","url":"https://www.academia.edu/Documents/in/Pain_Management?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=58836835]'), work: {"id":58836835,"title":"Ensuring A Good Death. Pain and Palliative Care in a Cancer Center","created_at":"2021-10-18T07:57:55.063-07:00","url":"https://www.academia.edu/58836835/Ensuring_A_Good_Death_Pain_and_Palliative_Care_in_a_Cancer_Center?f_ri=882903","dom_id":"work_58836835","summary":"The purpose of this article is to describe how the commitment of the Dana-Farber Cancer Institute to pain management, quality of life, and optimal end-of-life care is operationalized through a comprehensive pain and palliative-care program. OVERVIEW: Institutional standards for pain management often address only the physical aspects of pain. Effective pain management requires assessment and interventions that address the multidimensional nature of pain, suffering, and quality of life throughout the cancer continuum. This approach seeks to lay the foundation of comfort and peace associated with a good death. CLINICAL IMPLICATIONS: Institutional pain management standards need to reflect the complexity of pain, especially cancer-related pain, by emphasizing comprehensive, holistic assessment and multimodality approaches to pain control and quality-of-life issues.","downloadable_attachments":[{"id":73055266,"asset_id":58836835,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":34348443,"first_name":"Janet","last_name":"Abrahm","domain_name":"hms-harvard","page_name":"JanetAbrahm","display_name":"Janet Abrahm","profile_url":"https://hms-harvard.academia.edu/JanetAbrahm?f_ri=882903","photo":"https://0.academia-photos.com/34348443/78631108/90866783/s65_janet.abrahm.jpg"}],"research_interests":[{"id":2898,"name":"Pain","url":"https://www.academia.edu/Documents/in/Pain?f_ri=882903","nofollow":true},{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true},{"id":7470,"name":"Quality of life","url":"https://www.academia.edu/Documents/in/Quality_of_life?f_ri=882903","nofollow":true},{"id":40165,"name":"Pain Management","url":"https://www.academia.edu/Documents/in/Pain_Management?f_ri=882903","nofollow":true},{"id":230729,"name":"Cancer Care Facilities","url":"https://www.academia.edu/Documents/in/Cancer_Care_Facilities?f_ri=882903"},{"id":469018,"name":"Neoplasms","url":"https://www.academia.edu/Documents/in/Neoplasms?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_57131665" data-work_id="57131665" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/57131665/The_medical_oncologists_role_in_palliative_care_AIOMs_position">The medical oncologist's role in palliative care: AIOM's position</a></div></div><div class="u-pb4x u-mt3x"></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/57131665" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="80f8fea0bf5df2291f31e919d4f7ab6d" rel="nofollow" data-download="{"attachment_id":72178057,"asset_id":57131665,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/72178057/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="36459910" href="https://independent.academia.edu/GianluigiCetto">Gianluigi Cetto</a><script data-card-contents-for-user="36459910" type="text/json">{"id":36459910,"first_name":"Gianluigi","last_name":"Cetto","domain_name":"independent","page_name":"GianluigiCetto","display_name":"Gianluigi Cetto","profile_url":"https://independent.academia.edu/GianluigiCetto?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_57131665 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="57131665"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 57131665, container: ".js-paper-rank-work_57131665", }); 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$(".js-view-count[data-work-id=57131665]").text(description); $(".js-view-count-work_57131665").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_57131665").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="57131665"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">6</a>  </div><span class="InlineList-item-text u-textTruncate u-pl9x"><a class="InlineList-item-text" data-has-card-for-ri="4482" rel="nofollow" href="https://www.academia.edu/Documents/in/Palliative_Care">Palliative Care</a>, <script data-card-contents-for-ri="4482" type="text/json">{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="45213" rel="nofollow" href="https://www.academia.edu/Documents/in/Italy">Italy</a>, <script data-card-contents-for-ri="45213" type="text/json">{"id":45213,"name":"Italy","url":"https://www.academia.edu/Documents/in/Italy?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="64900" rel="nofollow" href="https://www.academia.edu/Documents/in/Medical_Oncology">Medical Oncology</a>, <script data-card-contents-for-ri="64900" type="text/json">{"id":64900,"name":"Medical Oncology","url":"https://www.academia.edu/Documents/in/Medical_Oncology?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="244814" rel="nofollow" href="https://www.academia.edu/Documents/in/Clinical_Sciences">Clinical Sciences</a><script data-card-contents-for-ri="244814" type="text/json">{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=57131665]'), work: {"id":57131665,"title":"The medical oncologist's role in palliative care: AIOM's position","created_at":"2021-10-11T02:00:05.571-07:00","url":"https://www.academia.edu/57131665/The_medical_oncologists_role_in_palliative_care_AIOMs_position?f_ri=882903","dom_id":"work_57131665","summary":null,"downloadable_attachments":[{"id":72178057,"asset_id":57131665,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":36459910,"first_name":"Gianluigi","last_name":"Cetto","domain_name":"independent","page_name":"GianluigiCetto","display_name":"Gianluigi Cetto","profile_url":"https://independent.academia.edu/GianluigiCetto?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true},{"id":45213,"name":"Italy","url":"https://www.academia.edu/Documents/in/Italy?f_ri=882903","nofollow":true},{"id":64900,"name":"Medical Oncology","url":"https://www.academia.edu/Documents/in/Medical_Oncology?f_ri=882903","nofollow":true},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903","nofollow":true},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":2603607,"name":"Tumori","url":"https://www.academia.edu/Documents/in/Tumori?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_48717464" data-work_id="48717464" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/48717464/Barriers_to_Goals_of_Care_Discussions_With_Seriously_Ill_Hospitalized_Patients_and_Their_Families_A_Multicenter_Survey_of_Clinicians">Barriers to Goals of Care Discussions With Seriously Ill Hospitalized Patients and Their Families: A Multicenter Survey of Clinicians</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Seriously ill hospitalized patients have identified communication and decision making about goals of care as high priorities for quality improvement in end-of-life care. Interventions to improve care are more likely to succeed if tailored... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_48717464" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Seriously ill hospitalized patients have identified communication and decision making about goals of care as high priorities for quality improvement in end-of-life care. Interventions to improve care are more likely to succeed if tailored to existing barriers. To determine, from the perspective of hospital-based clinicians, (1) barriers impeding communication and decision making about goals of care with seriously ill hospitalized patients and their families and (2) their own willingness and the acceptability for other clinicians to engage in this process. Multicenter survey of medical teaching units of nurses, internal medicine residents, and staff physicians from participating units at 13 university-based hospitals from 5 Canadian provinces. Importance of 21 barriers to goals of care discussions rated on a 7-point scale (1 = extremely unimportant; 7 = extremely important). Between September 2012 and March 2013, questionnaires were returned by 1256 of 1617 eligible clinicians, for a...</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/48717464" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="dcb7b57cfa2276aa5521d7a15e917e61" rel="nofollow" data-download="{"attachment_id":67186496,"asset_id":48717464,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/67186496/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="58271253" href="https://independent.academia.edu/PatriciaStrachan">Patricia Strachan</a><script data-card-contents-for-user="58271253" type="text/json">{"id":58271253,"first_name":"Patricia","last_name":"Strachan","domain_name":"independent","page_name":"PatriciaStrachan","display_name":"Patricia Strachan","profile_url":"https://independent.academia.edu/PatriciaStrachan?f_ri=882903","photo":"https://0.academia-photos.com/58271253/22551561/21744259/s65_patricia.strachan.jpg"}</script></span></span></li><li class="js-paper-rank-work_48717464 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="48717464"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 48717464, container: ".js-paper-rank-work_48717464", }); });</script></li><li class="js-percentile-work_48717464 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 48717464; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_48717464"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_48717464 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="48717464"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 48717464; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=48717464]").text(description); $(".js-view-count-work_48717464").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_48717464").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="48717464"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">15</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="1681" rel="nofollow" href="https://www.academia.edu/Documents/in/Decision_Making">Decision Making</a>, <script data-card-contents-for-ri="1681" type="text/json">{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="4482" rel="nofollow" href="https://www.academia.edu/Documents/in/Palliative_Care">Palliative Care</a>, <script data-card-contents-for-ri="4482" type="text/json">{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="6574" rel="nofollow" href="https://www.academia.edu/Documents/in/Family">Family</a>, <script data-card-contents-for-ri="6574" type="text/json">{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="26945" rel="nofollow" href="https://www.academia.edu/Documents/in/Communication_Skills">Communication Skills</a><script data-card-contents-for-ri="26945" type="text/json">{"id":26945,"name":"Communication Skills","url":"https://www.academia.edu/Documents/in/Communication_Skills?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=48717464]'), work: {"id":48717464,"title":"Barriers to Goals of Care Discussions With Seriously Ill Hospitalized Patients and Their Families: A Multicenter Survey of Clinicians","created_at":"2021-05-05T06:56:55.920-07:00","url":"https://www.academia.edu/48717464/Barriers_to_Goals_of_Care_Discussions_With_Seriously_Ill_Hospitalized_Patients_and_Their_Families_A_Multicenter_Survey_of_Clinicians?f_ri=882903","dom_id":"work_48717464","summary":"Seriously ill hospitalized patients have identified communication and decision making about goals of care as high priorities for quality improvement in end-of-life care. Interventions to improve care are more likely to succeed if tailored to existing barriers. To determine, from the perspective of hospital-based clinicians, (1) barriers impeding communication and decision making about goals of care with seriously ill hospitalized patients and their families and (2) their own willingness and the acceptability for other clinicians to engage in this process. Multicenter survey of medical teaching units of nurses, internal medicine residents, and staff physicians from participating units at 13 university-based hospitals from 5 Canadian provinces. Importance of 21 barriers to goals of care discussions rated on a 7-point scale (1 = extremely unimportant; 7 = extremely important). Between September 2012 and March 2013, questionnaires were returned by 1256 of 1617 eligible clinicians, for a...","downloadable_attachments":[{"id":67186496,"asset_id":48717464,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":58271253,"first_name":"Patricia","last_name":"Strachan","domain_name":"independent","page_name":"PatriciaStrachan","display_name":"Patricia Strachan","profile_url":"https://independent.academia.edu/PatriciaStrachan?f_ri=882903","photo":"https://0.academia-photos.com/58271253/22551561/21744259/s65_patricia.strachan.jpg"}],"research_interests":[{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true},{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true},{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true},{"id":26945,"name":"Communication Skills","url":"https://www.academia.edu/Documents/in/Communication_Skills?f_ri=882903","nofollow":true},{"id":54114,"name":"Canada","url":"https://www.academia.edu/Documents/in/Canada?f_ri=882903"},{"id":65390,"name":"Internal Medicine","url":"https://www.academia.edu/Documents/in/Internal_Medicine?f_ri=882903"},{"id":97252,"name":"Comprehension","url":"https://www.academia.edu/Documents/in/Comprehension?f_ri=882903"},{"id":153039,"name":"Nurses","url":"https://www.academia.edu/Documents/in/Nurses?f_ri=882903"},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged?f_ri=882903"},{"id":599219,"name":"Interdisciplinary Communication","url":"https://www.academia.edu/Documents/in/Interdisciplinary_Communication?f_ri=882903"},{"id":693934,"name":"Communication barriers","url":"https://www.academia.edu/Documents/in/Communication_barriers?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":1030142,"name":"Self report","url":"https://www.academia.edu/Documents/in/Self_report?f_ri=882903"},{"id":1798559,"name":"Mental Competency","url":"https://www.academia.edu/Documents/in/Mental_Competency?f_ri=882903"},{"id":3128906,"name":"internship and residency","url":"https://www.academia.edu/Documents/in/internship_and_residency?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_48076071" data-work_id="48076071" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/48076071/Continuous_Sedation_Until_Death_With_or_Without_the_Intention_to_Hasten_Death_A_Nationwide_Study_in_Nursing_Homes_in_Flanders_Belgium">Continuous Sedation Until Death With or Without the Intention to Hasten Death—A Nationwide Study in Nursing Homes in Flanders, Belgium</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Objectives: Continuous sedation until death (CSD), the removal of consciousness of an incurably ill patient until death, has become a controversial practice. Some consider CSD a palliative treatment, whereas others claim that CSD is... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_48076071" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Objectives: Continuous sedation until death (CSD), the removal of consciousness of an incurably ill patient until death, has become a controversial practice. Some consider CSD a palliative treatment, whereas others claim that CSD is frequently used with the intention to hasten death. In nursing homes in Flanders, the rate of CSD has tripled over the past decade, whereas legal euthanasia remains a rare practice. This study wants to investigate to what extent CSD is used to hasten death (CSDþ) and to identify possible associated factors. Design: Nationwide cross-sectional retrospective survey, conducted in 2012. Setting: Nursing homes in Flanders, Belgium. Participants: Coordinating and advisory physicians of all nursing homes in Flanders (n ¼ 660). Measurements: Physician reports of their most recent patient treated with CSD. Results: The response rate was 57.3%, and 159 of the 378 responding physicians reported a case of CSD (42.1%). According to the reported intentions involved, 62.2% of these cases were considered CSDÀ cases (no life-shortening pursued), whereas 37.8% were labeled CSDþ (life-shortening pursued). Physician factors such as experience in end-of-life care, palliative care training, training in sedation, or knowledge of sedation guidelines did not affect the outcome distribution (CSDÀ or CSDþ). In CSDþ, the patient has a longer life expectancy, is more competent, is clearly longing for death, and requests for euthanasia more frequently. Conclusions: In nursing homes in Flanders, CSD is frequently used to hasten the patient's death. In some cases, CSD can even be considered a substitute for legal euthanasia.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/48076071" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="37f05916f2a61b35d62115e1be58234c" rel="nofollow" data-download="{"attachment_id":66875820,"asset_id":48076071,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/66875820/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="17124920" href="https://vub-be.academia.edu/ReginaldDeschepper">Reginald Deschepper</a><script data-card-contents-for-user="17124920" type="text/json">{"id":17124920,"first_name":"Reginald","last_name":"Deschepper","domain_name":"vub-be","page_name":"ReginaldDeschepper","display_name":"Reginald Deschepper","profile_url":"https://vub-be.academia.edu/ReginaldDeschepper?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_48076071 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="48076071"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 48076071, container: ".js-paper-rank-work_48076071", }); 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$(".js-view-count[data-work-id=48076071]").text(description); $(".js-view-count-work_48076071").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_48076071").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="48076071"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">10</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="588" rel="nofollow" href="https://www.academia.edu/Documents/in/Nursing">Nursing</a>, <script data-card-contents-for-ri="588" type="text/json">{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="2122" rel="nofollow" href="https://www.academia.edu/Documents/in/Death">Death</a>, <script data-card-contents-for-ri="2122" type="text/json">{"id":2122,"name":"Death","url":"https://www.academia.edu/Documents/in/Death?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="13513" rel="nofollow" href="https://www.academia.edu/Documents/in/Euthanasia">Euthanasia</a>, <script data-card-contents-for-ri="13513" type="text/json">{"id":13513,"name":"Euthanasia","url":"https://www.academia.edu/Documents/in/Euthanasia?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="40862" rel="nofollow" href="https://www.academia.edu/Documents/in/Belgium">Belgium</a><script data-card-contents-for-ri="40862" type="text/json">{"id":40862,"name":"Belgium","url":"https://www.academia.edu/Documents/in/Belgium?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=48076071]'), work: {"id":48076071,"title":"Continuous Sedation Until Death With or Without the Intention to Hasten Death—A Nationwide Study in Nursing Homes in Flanders, Belgium","created_at":"2021-05-04T00:30:59.205-07:00","url":"https://www.academia.edu/48076071/Continuous_Sedation_Until_Death_With_or_Without_the_Intention_to_Hasten_Death_A_Nationwide_Study_in_Nursing_Homes_in_Flanders_Belgium?f_ri=882903","dom_id":"work_48076071","summary":"Objectives: Continuous sedation until death (CSD), the removal of consciousness of an incurably ill patient until death, has become a controversial practice. Some consider CSD a palliative treatment, whereas others claim that CSD is frequently used with the intention to hasten death. In nursing homes in Flanders, the rate of CSD has tripled over the past decade, whereas legal euthanasia remains a rare practice. This study wants to investigate to what extent CSD is used to hasten death (CSDþ) and to identify possible associated factors. Design: Nationwide cross-sectional retrospective survey, conducted in 2012. Setting: Nursing homes in Flanders, Belgium. Participants: Coordinating and advisory physicians of all nursing homes in Flanders (n ¼ 660). Measurements: Physician reports of their most recent patient treated with CSD. Results: The response rate was 57.3%, and 159 of the 378 responding physicians reported a case of CSD (42.1%). According to the reported intentions involved, 62.2% of these cases were considered CSDÀ cases (no life-shortening pursued), whereas 37.8% were labeled CSDþ (life-shortening pursued). Physician factors such as experience in end-of-life care, palliative care training, training in sedation, or knowledge of sedation guidelines did not affect the outcome distribution (CSDÀ or CSDþ). In CSDþ, the patient has a longer life expectancy, is more competent, is clearly longing for death, and requests for euthanasia more frequently. Conclusions: In nursing homes in Flanders, CSD is frequently used to hasten the patient's death. In some cases, CSD can even be considered a substitute for legal euthanasia.","downloadable_attachments":[{"id":66875820,"asset_id":48076071,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":17124920,"first_name":"Reginald","last_name":"Deschepper","domain_name":"vub-be","page_name":"ReginaldDeschepper","display_name":"Reginald Deschepper","profile_url":"https://vub-be.academia.edu/ReginaldDeschepper?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true},{"id":2122,"name":"Death","url":"https://www.academia.edu/Documents/in/Death?f_ri=882903","nofollow":true},{"id":13513,"name":"Euthanasia","url":"https://www.academia.edu/Documents/in/Euthanasia?f_ri=882903","nofollow":true},{"id":40862,"name":"Belgium","url":"https://www.academia.edu/Documents/in/Belgium?f_ri=882903","nofollow":true},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903"},{"id":327850,"name":"Questionnaires","url":"https://www.academia.edu/Documents/in/Questionnaires?f_ri=882903"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1?f_ri=882903"},{"id":469105,"name":"Retrospective Studies","url":"https://www.academia.edu/Documents/in/Retrospective_Studies?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":1034181,"name":"Cross Sectional Studies","url":"https://www.academia.edu/Documents/in/Cross_Sectional_Studies?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_27451141" data-work_id="27451141" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/27451141/Hydration_and_nutrition_at_the_end_of_life_a_systematic_review_of_emotional_impact_perceptions_and_decision_making_among_patients_family_and_health_care_staff">Hydration and nutrition at the end of life: a systematic review of emotional impact, perceptions, and decision-making among patients, family, and health care staff</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Background: Decrease in oral intake, weight loss, and muscular weakness in the last phases of a terminal illness, particularly in the context of the cachexia-anorexia syndrome, can be an important source of anxiety for the triad of... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_27451141" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Background: Decrease in oral intake, weight loss, and muscular weakness in the last phases of a terminal illness, particularly in the context of the cachexia-anorexia syndrome, can be an important source of anxiety for the triad of patient, family, and health staff.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/27451141" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="2cb1dd177be09e88e2c7746890291c03" rel="nofollow" data-download="{"attachment_id":47710235,"asset_id":27451141,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/47710235/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="32636292" href="https://uc-cl.academia.edu/BeatrizShand">Beatriz Shand</a><script data-card-contents-for-user="32636292" type="text/json">{"id":32636292,"first_name":"Beatriz","last_name":"Shand","domain_name":"uc-cl","page_name":"BeatrizShand","display_name":"Beatriz Shand","profile_url":"https://uc-cl.academia.edu/BeatrizShand?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_27451141 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="27451141"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 27451141, container: ".js-paper-rank-work_27451141", }); });</script></li><li class="js-percentile-work_27451141 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 27451141; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_27451141"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_27451141 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="27451141"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 27451141; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=27451141]").text(description); $(".js-view-count-work_27451141").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_27451141").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="27451141"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">13</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="221" rel="nofollow" href="https://www.academia.edu/Documents/in/Psychology">Psychology</a>, <script data-card-contents-for-ri="221" type="text/json">{"id":221,"name":"Psychology","url":"https://www.academia.edu/Documents/in/Psychology?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="867" rel="nofollow" href="https://www.academia.edu/Documents/in/Perception">Perception</a>, <script data-card-contents-for-ri="867" type="text/json">{"id":867,"name":"Perception","url":"https://www.academia.edu/Documents/in/Perception?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="1681" rel="nofollow" href="https://www.academia.edu/Documents/in/Decision_Making">Decision Making</a>, <script data-card-contents-for-ri="1681" type="text/json">{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="4482" rel="nofollow" href="https://www.academia.edu/Documents/in/Palliative_Care">Palliative Care</a><script data-card-contents-for-ri="4482" type="text/json">{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=27451141]'), work: {"id":27451141,"title":"Hydration and nutrition at the end of life: a systematic review of emotional impact, perceptions, and decision-making among patients, family, and health care staff","created_at":"2016-08-01T19:02:24.040-07:00","url":"https://www.academia.edu/27451141/Hydration_and_nutrition_at_the_end_of_life_a_systematic_review_of_emotional_impact_perceptions_and_decision_making_among_patients_family_and_health_care_staff?f_ri=882903","dom_id":"work_27451141","summary":"Background: Decrease in oral intake, weight loss, and muscular weakness in the last phases of a terminal illness, particularly in the context of the cachexia-anorexia syndrome, can be an important source of anxiety for the triad of patient, family, and health staff.","downloadable_attachments":[{"id":47710235,"asset_id":27451141,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":32636292,"first_name":"Beatriz","last_name":"Shand","domain_name":"uc-cl","page_name":"BeatrizShand","display_name":"Beatriz Shand","profile_url":"https://uc-cl.academia.edu/BeatrizShand?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":221,"name":"Psychology","url":"https://www.academia.edu/Documents/in/Psychology?f_ri=882903","nofollow":true},{"id":867,"name":"Perception","url":"https://www.academia.edu/Documents/in/Perception?f_ri=882903","nofollow":true},{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true},{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true},{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903"},{"id":42162,"name":"Emotions","url":"https://www.academia.edu/Documents/in/Emotions?f_ri=882903"},{"id":135265,"name":"Psycho Oncology","url":"https://www.academia.edu/Documents/in/Psycho_Oncology?f_ri=882903"},{"id":192551,"name":"Nutritional Status","url":"https://www.academia.edu/Documents/in/Nutritional_Status?f_ri=882903"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903"},{"id":469018,"name":"Neoplasms","url":"https://www.academia.edu/Documents/in/Neoplasms?f_ri=882903"},{"id":589991,"name":"Patient Participation","url":"https://www.academia.edu/Documents/in/Patient_Participation?f_ri=882903"},{"id":647820,"name":"Fluid Therapy","url":"https://www.academia.edu/Documents/in/Fluid_Therapy?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_26233778 coauthored" data-work_id="26233778" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/26233778/Assessing_a_patients_spiritual_needs_a_comprehensive_instrument">Assessing a patient's spiritual needs: a comprehensive instrument</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Seven major constructs-belonging, meaning, hope, the sacred, morality, beauty, and acceptance of dying-were revealed in an analysis of the literature pertaining to patient spiritual needs. The authors embedded these constructs within a... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_26233778" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Seven major constructs-belonging, meaning, hope, the sacred, morality, beauty, and acceptance of dying-were revealed in an analysis of the literature pertaining to patient spiritual needs. The authors embedded these constructs within a 29-item survey designed to be inclusive of traditional religion, as well as non-institutional-based spirituality. This article describes the development of a multidimensional instrument designed to assess a patient&#39;s spiritual needs. This framework for understanding a patient&#39;s spiritual needs hopefully contributes to the growing body of literature, providing direction to healthcare professionals interested in a more holistic approach to patient well-being.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/26233778" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="91dc635d1334aaac1ee92f8f6db0a27f" rel="nofollow" data-download="{"attachment_id":46550136,"asset_id":26233778,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/46550136/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="50142953" href="https://independent.academia.edu/KathleenGalek">Kathleen Galek</a><script data-card-contents-for-user="50142953" type="text/json">{"id":50142953,"first_name":"Kathleen","last_name":"Galek","domain_name":"independent","page_name":"KathleenGalek","display_name":"Kathleen Galek","profile_url":"https://independent.academia.edu/KathleenGalek?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span><span class="u-displayInlineBlock InlineList-item-text"> and <span class="u-textDecorationUnderline u-clickable InlineList-item-text js-work-more-authors-26233778">+1</span><div class="hidden js-additional-users-26233778"><div><span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a href="https://independent.academia.edu/AdamVane">Adam Vane</a></span></div></div></span><script>(function(){ var popoverSettings = { el: $('.js-work-more-authors-26233778'), placement: 'bottom', hide_delay: 200, html: true, content: function(){ return $('.js-additional-users-26233778').html(); 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The authors embedded these constructs within a 29-item survey designed to be inclusive of traditional religion, as well as non-institutional-based spirituality. This article describes the development of a multidimensional instrument designed to assess a patient\u0026#39;s spiritual needs. This framework for understanding a patient\u0026#39;s spiritual needs hopefully contributes to the growing body of literature, providing direction to healthcare professionals interested in a more holistic approach to patient well-being.","downloadable_attachments":[{"id":46550136,"asset_id":26233778,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":50142953,"first_name":"Kathleen","last_name":"Galek","domain_name":"independent","page_name":"KathleenGalek","display_name":"Kathleen Galek","profile_url":"https://independent.academia.edu/KathleenGalek?f_ri=882903","photo":"/images/s65_no_pic.png"},{"id":50161444,"first_name":"Adam","last_name":"Vane","domain_name":"independent","page_name":"AdamVane","display_name":"Adam Vane","profile_url":"https://independent.academia.edu/AdamVane?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true},{"id":3815,"name":"Spirituality","url":"https://www.academia.edu/Documents/in/Spirituality?f_ri=882903","nofollow":true},{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true},{"id":15772,"name":"Holistic Nursing","url":"https://www.academia.edu/Documents/in/Holistic_Nursing?f_ri=882903","nofollow":true},{"id":44886,"name":"Empathy","url":"https://www.academia.edu/Documents/in/Empathy?f_ri=882903"},{"id":131343,"name":"Survey design","url":"https://www.academia.edu/Documents/in/Survey_design?f_ri=882903"},{"id":446717,"name":"Patient Care","url":"https://www.academia.edu/Documents/in/Patient_Care?f_ri=882903"},{"id":784431,"name":"Nursing Assessment","url":"https://www.academia.edu/Documents/in/Nursing_Assessment?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":983634,"name":"Instrument Design","url":"https://www.academia.edu/Documents/in/Instrument_Design?f_ri=882903"},{"id":998798,"name":"Holistic Approach","url":"https://www.academia.edu/Documents/in/Holistic_Approach?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_17535862" data-work_id="17535862" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/17535862/Supporting_Hope_and_Prognostic_Information_Nurses_Perspectives_on_Their_Role_When_Patients_Have_Life_Limiting_Prognoses">Supporting Hope and Prognostic Information: Nurses' Perspectives on Their Role When Patients Have Life-Limiting Prognoses</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Context-Clinicians often feel challenged by the need to deliver difficult prognostic information to patients with a life-limiting illness while, at the same time, supporting their hopes. Few studies have examined nurses' perspectives on... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_17535862" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Context-Clinicians often feel challenged by the need to deliver difficult prognostic information to patients with a life-limiting illness while, at the same time, supporting their hopes. Few studies have examined nurses' perspectives on their roles in meeting these patient and family needs.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/17535862" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="8a024834a4382c178e5580ae17b0e098" rel="nofollow" data-download="{"attachment_id":39565032,"asset_id":17535862,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/39565032/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="37312189" href="https://washington.academia.edu/SarahShannon">Sarah Shannon</a><script data-card-contents-for-user="37312189" type="text/json">{"id":37312189,"first_name":"Sarah","last_name":"Shannon","domain_name":"washington","page_name":"SarahShannon","display_name":"Sarah Shannon","profile_url":"https://washington.academia.edu/SarahShannon?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_17535862 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="17535862"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 17535862, container: ".js-paper-rank-work_17535862", }); 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$(".js-view-count[data-work-id=17535862]").text(description); $(".js-view-count-work_17535862").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_17535862").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="17535862"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">11</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="588" rel="nofollow" href="https://www.academia.edu/Documents/in/Nursing">Nursing</a>, <script data-card-contents-for-ri="588" type="text/json">{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="859" rel="nofollow" href="https://www.academia.edu/Documents/in/Communication">Communication</a>, <script data-card-contents-for-ri="859" type="text/json">{"id":859,"name":"Communication","url":"https://www.academia.edu/Documents/in/Communication?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="2898" rel="nofollow" href="https://www.academia.edu/Documents/in/Pain">Pain</a>, <script data-card-contents-for-ri="2898" type="text/json">{"id":2898,"name":"Pain","url":"https://www.academia.edu/Documents/in/Pain?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="4482" rel="nofollow" href="https://www.academia.edu/Documents/in/Palliative_Care">Palliative Care</a><script data-card-contents-for-ri="4482" type="text/json">{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=17535862]'), work: {"id":17535862,"title":"Supporting Hope and Prognostic Information: Nurses' Perspectives on Their Role When Patients Have Life-Limiting Prognoses","created_at":"2015-10-30T19:25:02.284-07:00","url":"https://www.academia.edu/17535862/Supporting_Hope_and_Prognostic_Information_Nurses_Perspectives_on_Their_Role_When_Patients_Have_Life_Limiting_Prognoses?f_ri=882903","dom_id":"work_17535862","summary":"Context-Clinicians often feel challenged by the need to deliver difficult prognostic information to patients with a life-limiting illness while, at the same time, supporting their hopes. Few studies have examined nurses' perspectives on their roles in meeting these patient and family needs.","downloadable_attachments":[{"id":39565032,"asset_id":17535862,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":37312189,"first_name":"Sarah","last_name":"Shannon","domain_name":"washington","page_name":"SarahShannon","display_name":"Sarah Shannon","profile_url":"https://washington.academia.edu/SarahShannon?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true},{"id":859,"name":"Communication","url":"https://www.academia.edu/Documents/in/Communication?f_ri=882903","nofollow":true},{"id":2898,"name":"Pain","url":"https://www.academia.edu/Documents/in/Pain?f_ri=882903","nofollow":true},{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true},{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903"},{"id":70497,"name":"End of life care","url":"https://www.academia.edu/Documents/in/End_of_life_care?f_ri=882903"},{"id":112822,"name":"Physicians","url":"https://www.academia.edu/Documents/in/Physicians?f_ri=882903"},{"id":153039,"name":"Nurses","url":"https://www.academia.edu/Documents/in/Nurses?f_ri=882903"},{"id":153168,"name":"Data Collection","url":"https://www.academia.edu/Documents/in/Data_Collection?f_ri=882903"},{"id":489727,"name":"Prognosis","url":"https://www.academia.edu/Documents/in/Prognosis?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_10963499" data-work_id="10963499" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/10963499/Comparative_Efficacy_of_Oral_Extended_Release_Hydromorphone_and_Immediate_Release_Hydromorphone_in_Patients_with_Persistent_Moderate_to_Severe_Pain_Two_Randomized_Controlled_Trials">Comparative Efficacy of Oral Extended-Release Hydromorphone and Immediate-Release Hydromorphone in Patients with Persistent Moderate to Severe Pain: Two Randomized Controlled Trials</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Two multicenter, randomized, double-blind, crossover studies with identical designs evaluated the efficacy of oral extended-release hydromorphone (HHER) administered q24h compared with immediate-release hydromorphone (HHIR) dosed four... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_10963499" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Two multicenter, randomized, double-blind, crossover studies with identical designs evaluated the efficacy of oral extended-release hydromorphone (HHER) administered q24h compared with immediate-release hydromorphone (HHIR) dosed four times daily in patients with persistent moderate to severe pain. Patients titrated to a stable HHER dose were randomized to individualized doses of HHER or HHIR for 3 to 7 days before crossover to the second treatment. Primary efficacy end point was the mean of average pain intensity (API) scores, rated on a 0-to 10-point numeric scale, over the last 2 days before the pharmacokinetics/pharmacodynamics day of each double-blind period. Difference between treatments (HHER Ϫ HHIR) in study 1 was 0.17 with a 90% confidence interval (CI) (Ϫ0.01, 0.34); in study 2, difference was 0.07 with a 90% CI (Ϫ0.12, 0.26). There were no significant differences between treatments in API scores or amount of rescue medication used at any time interval within the 24-hour dosing period. No reduction in pain control occurred in patients administered HHER at the end of the 24-hour dosing period. Most treatment-emergent adverse events were opioid-related. In these studies, HHER administered q24h and HHIR dosed four times daily provided comparable analgesia at an equivalent total daily dose. J Pain Symptom Manage 2005;29:584-594. Ć 2005 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/10963499" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="ae763aa0571bcb6660d977f5b878e49c" rel="nofollow" data-download="{"attachment_id":46994697,"asset_id":10963499,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/46994697/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="26556848" href="https://independent.academia.edu/AlanGrosset">Alan Grosset</a><script data-card-contents-for-user="26556848" type="text/json">{"id":26556848,"first_name":"Alan","last_name":"Grosset","domain_name":"independent","page_name":"AlanGrosset","display_name":"Alan Grosset","profile_url":"https://independent.academia.edu/AlanGrosset?f_ri=882903","photo":"https://0.academia-photos.com/26556848/125873830/115243841/s65_alan.grosset.png"}</script></span></span></li><li class="js-paper-rank-work_10963499 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="10963499"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 10963499, container: ".js-paper-rank-work_10963499", }); 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Patients titrated to a stable HHER dose were randomized to individualized doses of HHER or HHIR for 3 to 7 days before crossover to the second treatment. Primary efficacy end point was the mean of average pain intensity (API) scores, rated on a 0-to 10-point numeric scale, over the last 2 days before the pharmacokinetics/pharmacodynamics day of each double-blind period. Difference between treatments (HHER Ϫ HHIR) in study 1 was 0.17 with a 90% confidence interval (CI) (Ϫ0.01, 0.34); in study 2, difference was 0.07 with a 90% CI (Ϫ0.12, 0.26). There were no significant differences between treatments in API scores or amount of rescue medication used at any time interval within the 24-hour dosing period. No reduction in pain control occurred in patients administered HHER at the end of the 24-hour dosing period. Most treatment-emergent adverse events were opioid-related. In these studies, HHER administered q24h and HHIR dosed four times daily provided comparable analgesia at an equivalent total daily dose. J Pain Symptom Manage 2005;29:584-594. Ć 2005 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.","downloadable_attachments":[{"id":46994697,"asset_id":10963499,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":26556848,"first_name":"Alan","last_name":"Grosset","domain_name":"independent","page_name":"AlanGrosset","display_name":"Alan Grosset","profile_url":"https://independent.academia.edu/AlanGrosset?f_ri=882903","photo":"https://0.academia-photos.com/26556848/125873830/115243841/s65_alan.grosset.png"}],"research_interests":[{"id":2898,"name":"Pain","url":"https://www.academia.edu/Documents/in/Pain?f_ri=882903","nofollow":true},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged?f_ri=882903","nofollow":true},{"id":413196,"name":"Randomized Controlled Trial","url":"https://www.academia.edu/Documents/in/Randomized_Controlled_Trial?f_ri=882903","nofollow":true},{"id":425873,"name":"Adverse Event","url":"https://www.academia.edu/Documents/in/Adverse_Event?f_ri=882903","nofollow":true},{"id":469018,"name":"Neoplasms","url":"https://www.academia.edu/Documents/in/Neoplasms?f_ri=882903"},{"id":613398,"name":"Design Evaluation","url":"https://www.academia.edu/Documents/in/Design_Evaluation?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":1137107,"name":"Delayed-Action Preparations","url":"https://www.academia.edu/Documents/in/Delayed-Action_Preparations?f_ri=882903"},{"id":1587858,"name":"Confidence Interval","url":"https://www.academia.edu/Documents/in/Confidence_Interval?f_ri=882903"},{"id":1619706,"name":"Hydromorphone","url":"https://www.academia.edu/Documents/in/Hydromorphone?f_ri=882903"},{"id":1666580,"name":"Extended release","url":"https://www.academia.edu/Documents/in/Extended_release?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_3880651" data-work_id="3880651" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/3880651/Euthanasia_A_Buddhist_perspective">Euthanasia: A Buddhist perspective</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">This paper introduces basic Buddhist cosmology and ethical teachings, emphasizing the concepts of rebirth and Karma. There follows a discussion of the Buddhist view of illness and its causes. Using these introductory concepts, the... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_3880651" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">This paper introduces basic Buddhist cosmology and ethical teachings, emphasizing the concepts of rebirth and Karma. There follows a discussion of the Buddhist view of illness and its causes. Using these introductory concepts, the Buddhist view on euthanasia is explored and contrasted with the views of Marvin Kohl, a leading proponent of euthanasia. It is shown that Buddhism prohibits euthanasia as an option for the terminally ill but instead advocates hospice care. The paper is offered to expand the current dialogue on bioethical issues beyond the Judeo-Christian perspective.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/3880651" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="f05406f19344c5f231ef3f1289179d7e" rel="nofollow" data-download="{"attachment_id":33558447,"asset_id":3880651,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/33558447/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="4760638" href="https://independent.academia.edu/PhillipLecso">Phillip Lecso</a><script data-card-contents-for-user="4760638" type="text/json">{"id":4760638,"first_name":"Phillip","last_name":"Lecso","domain_name":"independent","page_name":"PhillipLecso","display_name":"Phillip Lecso","profile_url":"https://independent.academia.edu/PhillipLecso?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_3880651 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="3880651"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 3880651, container: ".js-paper-rank-work_3880651", }); 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There follows a discussion of the Buddhist view of illness and its causes. Using these introductory concepts, the Buddhist view on euthanasia is explored and contrasted with the views of Marvin Kohl, a leading proponent of euthanasia. It is shown that Buddhism prohibits euthanasia as an option for the terminally ill but instead advocates hospice care. The paper is offered to expand the current dialogue on bioethical issues beyond the Judeo-Christian perspective.","downloadable_attachments":[{"id":33558447,"asset_id":3880651,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":4760638,"first_name":"Phillip","last_name":"Lecso","domain_name":"independent","page_name":"PhillipLecso","display_name":"Phillip Lecso","profile_url":"https://independent.academia.edu/PhillipLecso?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":106,"name":"Religion","url":"https://www.academia.edu/Documents/in/Religion?f_ri=882903","nofollow":true},{"id":113,"name":"Buddhism","url":"https://www.academia.edu/Documents/in/Buddhism?f_ri=882903","nofollow":true},{"id":13513,"name":"Euthanasia","url":"https://www.academia.edu/Documents/in/Euthanasia?f_ri=882903","nofollow":true},{"id":110578,"name":"Asia","url":"https://www.academia.edu/Documents/in/Asia?f_ri=882903","nofollow":true},{"id":112822,"name":"Physicians","url":"https://www.academia.edu/Documents/in/Physicians?f_ri=882903"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1?f_ri=882903"},{"id":606036,"name":"Psychotropic 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href="https://www.academia.edu/Documents/in/Medicine">Medicine</a>, <script data-card-contents-for-ri="26327" type="text/json">{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="99698" rel="nofollow" href="https://www.academia.edu/Documents/in/Resuscitation">Resuscitation</a>, <script data-card-contents-for-ri="99698" type="text/json">{"id":99698,"name":"Resuscitation","url":"https://www.academia.edu/Documents/in/Resuscitation?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="153168" rel="nofollow" href="https://www.academia.edu/Documents/in/Data_Collection">Data Collection</a>, <script data-card-contents-for-ri="153168" type="text/json">{"id":153168,"name":"Data Collection","url":"https://www.academia.edu/Documents/in/Data_Collection?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="244814" rel="nofollow" href="https://www.academia.edu/Documents/in/Clinical_Sciences">Clinical Sciences</a><script data-card-contents-for-ri="244814" type="text/json">{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=67672358]'), work: {"id":67672358,"title":"Trauma Death","created_at":"2022-01-09T03:55:32.787-08:00","url":"https://www.academia.edu/67672358/Trauma_Death?f_ri=882903","dom_id":"work_67672358","summary":null,"downloadable_attachments":[{"id":78407842,"asset_id":67672358,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":71117960,"first_name":"Lenworth","last_name":"Jacobs","domain_name":"independent","page_name":"LenworthJacobs","display_name":"Lenworth Jacobs","profile_url":"https://independent.academia.edu/LenworthJacobs?f_ri=882903","photo":"https://0.academia-photos.com/71117960/89560640/78276822/s65_lenworth.jacobs.png"}],"research_interests":[{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine?f_ri=882903","nofollow":true},{"id":99698,"name":"Resuscitation","url":"https://www.academia.edu/Documents/in/Resuscitation?f_ri=882903","nofollow":true},{"id":153168,"name":"Data Collection","url":"https://www.academia.edu/Documents/in/Data_Collection?f_ri=882903","nofollow":true},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences?f_ri=882903","nofollow":true},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":1031658,"name":"Wounds and Injuries","url":"https://www.academia.edu/Documents/in/Wounds_and_Injuries?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_52432750" data-work_id="52432750" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/52432750/Mother_Teresas_care_for_the_dying">Mother Teresa's care for the dying</a></div></div><div class="u-pb4x u-mt3x"></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/52432750" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="5c2ca1130876985a30799c61c61ba486" rel="nofollow" data-download="{"attachment_id":69698124,"asset_id":52432750,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/69698124/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="50394632" href="https://independent.academia.edu/GillyBurn">Gilly Burn</a><script 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var workId = 52432750; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_52432750"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_52432750 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="52432750"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 52432750; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=52432750]").text(description); $(".js-view-count-work_52432750").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_52432750").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="52432750"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">7</a>  </div><span class="InlineList-item-text u-textTruncate u-pl9x"><a class="InlineList-item-text" data-has-card-for-ri="43838" rel="nofollow" href="https://www.academia.edu/Documents/in/India">India</a>, <script data-card-contents-for-ri="43838" type="text/json">{"id":43838,"name":"India","url":"https://www.academia.edu/Documents/in/India?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="218374" rel="nofollow" href="https://www.academia.edu/Documents/in/Morphine">Morphine</a>, <script data-card-contents-for-ri="218374" type="text/json">{"id":218374,"name":"Morphine","url":"https://www.academia.edu/Documents/in/Morphine?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="243629" rel="nofollow" href="https://www.academia.edu/Documents/in/Lancet">Lancet</a>, <script data-card-contents-for-ri="243629" type="text/json">{"id":243629,"name":"Lancet","url":"https://www.academia.edu/Documents/in/Lancet?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="256112" rel="nofollow" href="https://www.academia.edu/Documents/in/Hospice_Care">Hospice Care</a><script data-card-contents-for-ri="256112" type="text/json">{"id":256112,"name":"Hospice Care","url":"https://www.academia.edu/Documents/in/Hospice_Care?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=52432750]'), work: {"id":52432750,"title":"Mother Teresa's care for the dying","created_at":"2021-09-15T05:46:58.527-07:00","url":"https://www.academia.edu/52432750/Mother_Teresas_care_for_the_dying?f_ri=882903","dom_id":"work_52432750","summary":null,"downloadable_attachments":[{"id":69698124,"asset_id":52432750,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":50394632,"first_name":"Gilly","last_name":"Burn","domain_name":"independent","page_name":"GillyBurn","display_name":"Gilly Burn","profile_url":"https://independent.academia.edu/GillyBurn?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":43838,"name":"India","url":"https://www.academia.edu/Documents/in/India?f_ri=882903","nofollow":true},{"id":218374,"name":"Morphine","url":"https://www.academia.edu/Documents/in/Morphine?f_ri=882903","nofollow":true},{"id":243629,"name":"Lancet","url":"https://www.academia.edu/Documents/in/Lancet?f_ri=882903","nofollow":true},{"id":256112,"name":"Hospice Care","url":"https://www.academia.edu/Documents/in/Hospice_Care?f_ri=882903","nofollow":true},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":3094070,"name":"The Lancet","url":"https://www.academia.edu/Documents/in/The_Lancet?f_ri=882903"},{"id":3763225,"name":"Medical and Health Sciences","url":"https://www.academia.edu/Documents/in/Medical_and_Health_Sciences?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_26730756" data-work_id="26730756" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/26730756/Palliative_Care_An_Historical_Perspective">Palliative Care: An Historical Perspective</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Palliative care began with a focus on the care of the dying. Dr. Cicely Saunders first articulated her ideas about modern hospice care in the late 1950s based on the careful observation of dying patients. She advocated that only an... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_26730756" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Palliative care began with a focus on the care of the dying. Dr. Cicely Saunders first articulated her ideas about modern hospice care in the late 1950s based on the careful observation of dying patients. She advocated that only an interdisciplinary team could relieve the "total pain" of a dying person in the context of his or her family, and the team concept is still at the core of palliative care.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/26730756" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="db2a7cb2d2f26ba6ce95f44400d23871" rel="nofollow" data-download="{"attachment_id":47010356,"asset_id":26730756,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/47010356/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="33983339" href="https://independent.academia.edu/MatthewLoscalzo">Matthew Loscalzo</a><script data-card-contents-for-user="33983339" type="text/json">{"id":33983339,"first_name":"Matthew","last_name":"Loscalzo","domain_name":"independent","page_name":"MatthewLoscalzo","display_name":"Matthew Loscalzo","profile_url":"https://independent.academia.edu/MatthewLoscalzo?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_26730756 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="26730756"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 26730756, container: ".js-paper-rank-work_26730756", }); });</script></li><li class="js-percentile-work_26730756 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 26730756; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_26730756"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_26730756 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="26730756"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 26730756; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=26730756]").text(description); $(".js-view-count-work_26730756").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_26730756").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="26730756"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">5</a>  </div><span class="InlineList-item-text u-textTruncate u-pl9x"><a class="InlineList-item-text" data-has-card-for-ri="619" rel="nofollow" href="https://www.academia.edu/Documents/in/Hematology">Hematology</a>, <script data-card-contents-for-ri="619" type="text/json">{"id":619,"name":"Hematology","url":"https://www.academia.edu/Documents/in/Hematology?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="4482" rel="nofollow" href="https://www.academia.edu/Documents/in/Palliative_Care">Palliative Care</a>, <script data-card-contents-for-ri="4482" type="text/json">{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="256112" rel="nofollow" href="https://www.academia.edu/Documents/in/Hospice_Care">Hospice Care</a>, <script data-card-contents-for-ri="256112" type="text/json">{"id":256112,"name":"Hospice Care","url":"https://www.academia.edu/Documents/in/Hospice_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="469018" rel="nofollow" href="https://www.academia.edu/Documents/in/Neoplasms">Neoplasms</a><script data-card-contents-for-ri="469018" type="text/json">{"id":469018,"name":"Neoplasms","url":"https://www.academia.edu/Documents/in/Neoplasms?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=26730756]'), work: {"id":26730756,"title":"Palliative Care: An Historical Perspective","created_at":"2016-07-04T14:23:42.340-07:00","url":"https://www.academia.edu/26730756/Palliative_Care_An_Historical_Perspective?f_ri=882903","dom_id":"work_26730756","summary":"Palliative care began with a focus on the care of the dying. Dr. Cicely Saunders first articulated her ideas about modern hospice care in the late 1950s based on the careful observation of dying patients. She advocated that only an interdisciplinary team could relieve the \"total pain\" of a dying person in the context of his or her family, and the team concept is still at the core of palliative care.","downloadable_attachments":[{"id":47010356,"asset_id":26730756,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":33983339,"first_name":"Matthew","last_name":"Loscalzo","domain_name":"independent","page_name":"MatthewLoscalzo","display_name":"Matthew Loscalzo","profile_url":"https://independent.academia.edu/MatthewLoscalzo?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":619,"name":"Hematology","url":"https://www.academia.edu/Documents/in/Hematology?f_ri=882903","nofollow":true},{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true},{"id":256112,"name":"Hospice Care","url":"https://www.academia.edu/Documents/in/Hospice_Care?f_ri=882903","nofollow":true},{"id":469018,"name":"Neoplasms","url":"https://www.academia.edu/Documents/in/Neoplasms?f_ri=882903","nofollow":true},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_13519473" data-work_id="13519473" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/13519473/End_of_life_management_of_adult_patients_in_an_Australian_metropolitan_intensive_care_unit_A_retrospective_observational_study">End of life management of adult patients in an Australian metropolitan intensive care unit: A retrospective observational study</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Background: Death in the intensive care unit is often predictable. End of life management is often discussed and initiated when futility of care appears evident. Respect for patients wishes, dignity in death, and family involvement in the... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_13519473" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Background: Death in the intensive care unit is often predictable. End of life management is often discussed and initiated when futility of care appears evident. Respect for patients wishes, dignity in death, and family involvement in the decision-making process is optimal. This goal may often be elusive. Purpose: Our purpose was to review the end of life processes and family involvement within our Unit. Methods: We conducted a chart audit of all deaths in our 10 bed Unit over a 12-month period, reviewing patient demographics, diagnosis on admission, patient acuity, expectation of death and not-for-resuscitation status. Discussions with the family, treatments withheld and withdrawn and extubation practices were documented. The presence of family or next-of-kin at the time of death, the time to death after withdrawal of therapy and family concerns were recorded. Results: There were 70 patients with a mean age of 69 years. Death was expected in 60 patients (86%) and not-for-resuscitation was documented in 58 cases (85%). Family discussions were held in 63 cases (90%) and treatment was withdrawn in 34 deaths (49%). After withdrawal of therapies, 31 patients (44%) died within 6 h. Ventilatory support was withdrawn in 24 cases (36%). Family members were present at the time of death in 46 cases (66%). Family concerns were documented about the end of life care in only 1 case (1.4%).</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/13519473" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="be5ad17de26433fd0e985b77164039ee" rel="nofollow" data-download="{"attachment_id":45245407,"asset_id":13519473,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/45245407/download_file?st=MTc0MDM0ODIwOSw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="32716527" href="https://monash.academia.edu/RavindranathTiruvoipati">Ravindranath Tiruvoipati</a><script data-card-contents-for-user="32716527" type="text/json">{"id":32716527,"first_name":"Ravindranath","last_name":"Tiruvoipati","domain_name":"monash","page_name":"RavindranathTiruvoipati","display_name":"Ravindranath Tiruvoipati","profile_url":"https://monash.academia.edu/RavindranathTiruvoipati?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_13519473 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="13519473"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 13519473, container: ".js-paper-rank-work_13519473", }); 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$(".js-view-count[data-work-id=13519473]").text(description); $(".js-view-count-work_13519473").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_13519473").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="13519473"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">18</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="588" rel="nofollow" href="https://www.academia.edu/Documents/in/Nursing">Nursing</a>, <script data-card-contents-for-ri="588" type="text/json">{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="1681" rel="nofollow" href="https://www.academia.edu/Documents/in/Decision_Making">Decision Making</a>, <script data-card-contents-for-ri="1681" type="text/json">{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="4482" rel="nofollow" href="https://www.academia.edu/Documents/in/Palliative_Care">Palliative Care</a>, <script data-card-contents-for-ri="4482" type="text/json">{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="6574" rel="nofollow" href="https://www.academia.edu/Documents/in/Family">Family</a><script data-card-contents-for-ri="6574" type="text/json">{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=13519473]'), work: {"id":13519473,"title":"End of life management of adult patients in an Australian metropolitan intensive care unit: A retrospective observational study","created_at":"2015-07-01T17:28:20.447-07:00","url":"https://www.academia.edu/13519473/End_of_life_management_of_adult_patients_in_an_Australian_metropolitan_intensive_care_unit_A_retrospective_observational_study?f_ri=882903","dom_id":"work_13519473","summary":"Background: Death in the intensive care unit is often predictable. End of life management is often discussed and initiated when futility of care appears evident. Respect for patients wishes, dignity in death, and family involvement in the decision-making process is optimal. This goal may often be elusive. Purpose: Our purpose was to review the end of life processes and family involvement within our Unit. Methods: We conducted a chart audit of all deaths in our 10 bed Unit over a 12-month period, reviewing patient demographics, diagnosis on admission, patient acuity, expectation of death and not-for-resuscitation status. Discussions with the family, treatments withheld and withdrawn and extubation practices were documented. The presence of family or next-of-kin at the time of death, the time to death after withdrawal of therapy and family concerns were recorded. Results: There were 70 patients with a mean age of 69 years. Death was expected in 60 patients (86%) and not-for-resuscitation was documented in 58 cases (85%). Family discussions were held in 63 cases (90%) and treatment was withdrawn in 34 deaths (49%). After withdrawal of therapies, 31 patients (44%) died within 6 h. Ventilatory support was withdrawn in 24 cases (36%). Family members were present at the time of death in 46 cases (66%). Family concerns were documented about the end of life care in only 1 case (1.4%).","downloadable_attachments":[{"id":45245407,"asset_id":13519473,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":32716527,"first_name":"Ravindranath","last_name":"Tiruvoipati","domain_name":"monash","page_name":"RavindranathTiruvoipati","display_name":"Ravindranath Tiruvoipati","profile_url":"https://monash.academia.edu/RavindranathTiruvoipati?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":588,"name":"Nursing","url":"https://www.academia.edu/Documents/in/Nursing?f_ri=882903","nofollow":true},{"id":1681,"name":"Decision Making","url":"https://www.academia.edu/Documents/in/Decision_Making?f_ri=882903","nofollow":true},{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true},{"id":6574,"name":"Family","url":"https://www.academia.edu/Documents/in/Family?f_ri=882903","nofollow":true},{"id":32538,"name":"Critical Care","url":"https://www.academia.edu/Documents/in/Critical_Care?f_ri=882903"},{"id":94234,"name":"INTENSIVE CARE","url":"https://www.academia.edu/Documents/in/INTENSIVE_CARE?f_ri=882903"},{"id":97487,"name":"End of life","url":"https://www.academia.edu/Documents/in/End_of_life?f_ri=882903"},{"id":211917,"name":"Length of Stay","url":"https://www.academia.edu/Documents/in/Length_of_Stay?f_ri=882903"},{"id":218815,"name":"Victoria","url":"https://www.academia.edu/Documents/in/Victoria?f_ri=882903"},{"id":263029,"name":"Intensive Care Unit","url":"https://www.academia.edu/Documents/in/Intensive_Care_Unit?f_ri=882903"},{"id":285047,"name":"Apache","url":"https://www.academia.edu/Documents/in/Apache?f_ri=882903"},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged?f_ri=882903"},{"id":413195,"name":"Time Factors","url":"https://www.academia.edu/Documents/in/Time_Factors?f_ri=882903"},{"id":469105,"name":"Retrospective Studies","url":"https://www.academia.edu/Documents/in/Retrospective_Studies?f_ri=882903"},{"id":793339,"name":"Intensive Care Units","url":"https://www.academia.edu/Documents/in/Intensive_Care_Units?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":910024,"name":"Observational Study","url":"https://www.academia.edu/Documents/in/Observational_Study?f_ri=882903"},{"id":1273584,"name":"Medical Audit","url":"https://www.academia.edu/Documents/in/Medical_Audit?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_24565248" data-work_id="24565248" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/24565248/Palliative_sedation_therapy_does_not_hasten_death_results_from_a_prospective_multicenter_study">Palliative sedation therapy does not hasten death: results from a prospective multicenter study</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">Background: Palliative sedation therapy (PST) is indicated for and used to control refractory symptoms in cancer patients undergoing palliative care. We aimed to evaluate whether PST has a detrimental effect on survival in terminally ill... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_24565248" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">Background: Palliative sedation therapy (PST) is indicated for and used to control refractory symptoms in cancer patients undergoing palliative care. We aimed to evaluate whether PST has a detrimental effect on survival in terminally ill patients.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/24565248" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="f735c4ad9fba2e5bda9ce1ac935f96d3" rel="nofollow" data-download="{"attachment_id":44895088,"asset_id":24565248,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/44895088/download_file?st=MTc0MDM0ODIxMCw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="32563911" href="https://independent.academia.edu/OrianaNanni">Oriana Nanni</a><script data-card-contents-for-user="32563911" type="text/json">{"id":32563911,"first_name":"Oriana","last_name":"Nanni","domain_name":"independent","page_name":"OrianaNanni","display_name":"Oriana Nanni","profile_url":"https://independent.academia.edu/OrianaNanni?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span></li><li class="js-paper-rank-work_24565248 InlineList-item InlineList-item--bordered hidden"><span class="js-paper-rank-view hidden u-tcGrayDark" data-paper-rank-work-id="24565248"><i class="u-m1x fa fa-bar-chart"></i><strong class="js-paper-rank"></strong></span><script>$(function() { new Works.PaperRankView({ workId: 24565248, container: ".js-paper-rank-work_24565248", }); });</script></li><li class="js-percentile-work_24565248 InlineList-item InlineList-item--bordered hidden u-tcGrayDark"><span class="percentile-widget hidden"><span class="u-mr2x percentile-widget" style="display: none">•</span><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 24565248; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-percentile-work_24565248"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></li><li class="js-view-count-work_24565248 InlineList-item InlineList-item--bordered hidden"><div><span><span class="js-view-count view-count u-mr2x" data-work-id="24565248"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 24565248; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=24565248]").text(description); $(".js-view-count-work_24565248").attr('title', description).tooltip(); }); });</script></span><script>$(function() { $(".js-view-count-work_24565248").removeClass('hidden') })</script></div></li><li class="InlineList-item u-positionRelative" style="max-width: 250px"><div class="u-positionAbsolute" data-has-card-for-ri-list="24565248"><i class="fa fa-tag InlineList-item-icon u-positionRelative"></i>  <a class="InlineList-item-text u-positionRelative">20</a>  </div><span class="InlineList-item-text u-textTruncate u-pl10x"><a class="InlineList-item-text" data-has-card-for-ri="2122" rel="nofollow" href="https://www.academia.edu/Documents/in/Death">Death</a>, <script data-card-contents-for-ri="2122" type="text/json">{"id":2122,"name":"Death","url":"https://www.academia.edu/Documents/in/Death?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="4482" rel="nofollow" href="https://www.academia.edu/Documents/in/Palliative_Care">Palliative Care</a>, <script data-card-contents-for-ri="4482" type="text/json">{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="12426" rel="nofollow" href="https://www.academia.edu/Documents/in/Treatment_Outcome">Treatment Outcome</a>, <script data-card-contents-for-ri="12426" type="text/json">{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome?f_ri=882903","nofollow":true}</script><a class="InlineList-item-text" data-has-card-for-ri="41482" rel="nofollow" href="https://www.academia.edu/Documents/in/Multivariate_Analysis">Multivariate Analysis</a><script data-card-contents-for-ri="41482" type="text/json">{"id":41482,"name":"Multivariate Analysis","url":"https://www.academia.edu/Documents/in/Multivariate_Analysis?f_ri=882903","nofollow":true}</script></span></li><script>(function(){ if (true) { new Aedu.ResearchInterestListCard({ el: $('*[data-has-card-for-ri-list=24565248]'), work: {"id":24565248,"title":"Palliative sedation therapy does not hasten death: results from a prospective multicenter study","created_at":"2016-04-19T12:53:36.991-07:00","url":"https://www.academia.edu/24565248/Palliative_sedation_therapy_does_not_hasten_death_results_from_a_prospective_multicenter_study?f_ri=882903","dom_id":"work_24565248","summary":"Background: Palliative sedation therapy (PST) is indicated for and used to control refractory symptoms in cancer patients undergoing palliative care. We aimed to evaluate whether PST has a detrimental effect on survival in terminally ill patients.","downloadable_attachments":[{"id":44895088,"asset_id":24565248,"asset_type":"Work","always_allow_download":false}],"ordered_authors":[{"id":32563911,"first_name":"Oriana","last_name":"Nanni","domain_name":"independent","page_name":"OrianaNanni","display_name":"Oriana Nanni","profile_url":"https://independent.academia.edu/OrianaNanni?f_ri=882903","photo":"/images/s65_no_pic.png"}],"research_interests":[{"id":2122,"name":"Death","url":"https://www.academia.edu/Documents/in/Death?f_ri=882903","nofollow":true},{"id":4482,"name":"Palliative Care","url":"https://www.academia.edu/Documents/in/Palliative_Care?f_ri=882903","nofollow":true},{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome?f_ri=882903","nofollow":true},{"id":41482,"name":"Multivariate Analysis","url":"https://www.academia.edu/Documents/in/Multivariate_Analysis?f_ri=882903","nofollow":true},{"id":62112,"name":"Prospective studies","url":"https://www.academia.edu/Documents/in/Prospective_studies?f_ri=882903"},{"id":69841,"name":"Standard Deviation","url":"https://www.academia.edu/Documents/in/Standard_Deviation?f_ri=882903"},{"id":70497,"name":"End of life care","url":"https://www.academia.edu/Documents/in/End_of_life_care?f_ri=882903"},{"id":121179,"name":"Population based study","url":"https://www.academia.edu/Documents/in/Population_based_study?f_ri=882903"},{"id":123230,"name":"Regression Analysis","url":"https://www.academia.edu/Documents/in/Regression_Analysis?f_ri=882903"},{"id":133057,"name":"Young Adult","url":"https://www.academia.edu/Documents/in/Young_Adult?f_ri=882903"},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged?f_ri=882903"},{"id":469018,"name":"Neoplasms","url":"https://www.academia.edu/Documents/in/Neoplasms?f_ri=882903"},{"id":532278,"name":"Cancer Patient","url":"https://www.academia.edu/Documents/in/Cancer_Patient?f_ri=882903"},{"id":675316,"name":"Hospices","url":"https://www.academia.edu/Documents/in/Hospices?f_ri=882903"},{"id":710565,"name":"Annals","url":"https://www.academia.edu/Documents/in/Annals?f_ri=882903"},{"id":882903,"name":"Terminal care","url":"https://www.academia.edu/Documents/in/Terminal_care?f_ri=882903"},{"id":892890,"name":"Point of View","url":"https://www.academia.edu/Documents/in/Point_of_View?f_ri=882903"},{"id":1225372,"name":"Overall Survival","url":"https://www.academia.edu/Documents/in/Overall_Survival?f_ri=882903"},{"id":1491248,"name":"Life tables","url":"https://www.academia.edu/Documents/in/Life_tables?f_ri=882903"},{"id":1587858,"name":"Confidence Interval","url":"https://www.academia.edu/Documents/in/Confidence_Interval?f_ri=882903"}]}, }) } })();</script></ul></li></ul></div></div><div class="u-borderBottom1 u-borderColorGrayLighter"><div class="clearfix u-pv7x u-mb0x js-work-card work_22820660 coauthored" data-work_id="22820660" itemscope="itemscope" itemtype="https://schema.org/ScholarlyArticle"><div class="header"><div class="title u-fontSerif u-fs22 u-lineHeight1_3"><a class="u-tcGrayDarkest js-work-link" href="https://www.academia.edu/22820660/Key_Factors_Affecting_Dying_Children_and_Their_Families">Key Factors Affecting Dying Children and Their Families</a></div></div><div class="u-pb4x u-mt3x"><div class="summary u-fs14 u-fw300 u-lineHeight1_5 u-tcGrayDarkest"><div class="summarized">The death of a child alters the life and health of others immediately and for the rest of their lives. How a child dies influences parents' abilities to continue their role functions as well as siblings' abilities to make and maintain... <a class="more_link u-tcGrayDark u-linkUnstyled" data-container=".work_22820660" data-show=".complete" data-hide=".summarized" data-more-link-behavior="true" href="#">more</a></div><div class="complete hidden">The death of a child alters the life and health of others immediately and for the rest of their lives. How a child dies influences parents' abilities to continue their role functions as well as siblings' abilities to make and maintain friendships, and may be the basis for health care providers' decisions to exit direct care roles. Thus, facilitating a "good death"-an obvious care priority for all involved with the dying child-ought also to be a priority for the health of bereaved families and affected health care providers. Making this a care priority is complicated by a serious lack of data, as details of the last hours or weeks of a dying child or adolescent's life are largely unknown. The purpose of this paper is to identify key factors that affect the course of dying children and adolescents and that of their bereaved survivors, and to link those key factors to needed research that could produce clinically relevant findings to improve the care of these patients. Key factors described here include suffering (physical, psychological, and spiritual), communication, decision making, prognostic ambiguities, ability of the seriously ill child to give assent to research participation, and educational preparation of health care providers to give competent end-of-life care.</div></div></div><ul class="InlineList u-ph0x u-fs13"><li class="InlineList-item logged_in_only"><div class="share_on_academia_work_button"><a class="academia_share Button Button--inverseBlue Button--sm js-bookmark-button" data-academia-share="Work/22820660" data-share-source="work_strip" data-spinner="small_white_hide_contents"><i class="fa fa-plus"></i><span class="work-strip-link-text u-ml1x" data-content="button_text">Bookmark</span></a></div></li><li class="InlineList-item"><div class="download"><a id="e40ca1cb2f573403b39e763ecbe02be6" rel="nofollow" data-download="{"attachment_id":43367328,"asset_id":22820660,"asset_type":"Work","always_allow_download":false,"track":null,"button_location":"work_strip","source":null,"hide_modal":null}" class="Button Button--sm Button--inverseGreen js-download-button prompt_button doc_download" href="https://www.academia.edu/attachments/43367328/download_file?st=MTc0MDM0ODIxMCw4LjIyMi4yMDguMTQ2&s=work_strip"><i class="fa fa-arrow-circle-o-down fa-lg"></i><span class="u-textUppercase u-ml1x" data-content="button_text">Download</span></a></div></li><li class="InlineList-item"><ul class="InlineList InlineList--bordered u-ph0x"><li class="InlineList-item InlineList-item--bordered"><span class="InlineList-item-text">by <span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a class="u-tcGrayDark u-fw700" data-has-card-for-user="44568454" href="https://independent.academia.edu/JoanneWolfe">Joanne Wolfe</a><script data-card-contents-for-user="44568454" type="text/json">{"id":44568454,"first_name":"Joanne","last_name":"Wolfe","domain_name":"independent","page_name":"JoanneWolfe","display_name":"Joanne Wolfe","profile_url":"https://independent.academia.edu/JoanneWolfe?f_ri=882903","photo":"/images/s65_no_pic.png"}</script></span></span><span class="u-displayInlineBlock InlineList-item-text"> and <span class="u-textDecorationUnderline u-clickable InlineList-item-text js-work-more-authors-22820660">+1</span><div class="hidden js-additional-users-22820660"><div><span itemscope="itemscope" itemprop="author" itemtype="https://schema.org/Person"><a href="https://independent.academia.edu/PamelaHinds1">Pamela Hinds</a></span></div></div></span><script>(function(){ var popoverSettings = { el: $('.js-work-more-authors-22820660'), placement: 'bottom', hide_delay: 200, html: true, content: function(){ return $('.js-additional-users-22820660').html(); 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How a child dies influences parents' abilities to continue their role functions as well as siblings' abilities to make and maintain friendships, and may be the basis for health care providers' decisions to exit direct care roles. Thus, facilitating a \"good death\"-an obvious care priority for all involved with the dying child-ought also to be a priority for the health of bereaved families and affected health care providers. Making this a care priority is complicated by a serious lack of data, as details of the last hours or weeks of a dying child or adolescent's life are largely unknown. The purpose of this paper is to identify key factors that affect the course of dying children and adolescents and that of their bereaved survivors, and to link those key factors to needed research that could produce clinically relevant findings to improve the care of these patients. 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