purpose: Two patient education CD-ROMs were converted to a web-based environment. This article reports on users' evaluations of the programs' usability and content. description of evaluation: Subscribers to a center's web newsletter were asked to view one of two web programs and to complete a survey. The first 150 respondents were offered a free patient education CD-ROM of their choice, but users continued to respond to the survey even after a notice stated that 150 responses were received. A total of 301 surveys were completed (Colorectal Cancer Program 168; Chemotherapy Program 133). results: Sixty-eight percent of Colorectal Cancer Program respondents and 50% of Chemotherapy Program respondents considered the program to be more useful or much more useful than any other source of information on the topic. A majority of users for both programs preferred to view the information on the Internet rather than on CD-ROM. Many users reported trouble accessing certain segments of the media. Common complaints included the inability to open video or audio clips and the length of time needed for each page to load, despite a high-speed Internet connection. clinical implications: Internet use is high, with 60% of US households reporting having used the Internet to search for health information. However, little is known about user satisfaction with specific sites and what about them users like or do not like. It is hoped that these and other user evaluations will help web site authors and developers improve their sites.
purpose: The loss of patients to follow-up for abnormal findings from Pap screenings is an important public health concern, particularly among poor and minority women. This study explores factors affecting incomplete follow-up among a group of Hispanic women with low incomes. description of study: A qualitative descriptive study was conducted of 11 Hispanic patients with incomplete Pap smear follow-up at a public clinic in a major city in south Texas. Patients were interviewed using a semistructured, open-ended schedule of questions, and their medical records were abstracted. The clinic's five staff members also were interviewed. Comparative chronologies were constructed for each case, contrasting patient and staff accounts of the same set of events. All data were coded by at least two investigators. results: All study patients had mildly abnormal Pap smear results and had not met the follow-up criteria, but all understood and were committed to Pap screening. Although viewed by staff as noncompliant, none of the patients viewed her behavior this way. This staff-patient discrepancy was attributable to poor communication, mixed messages, clinic errors, and, perhaps most importantly, to a conflict between program policies and the specific circumstances of individual cases. Two case examples are presented to illustrate key points. clinical implications: Strategies that may help to reduce loss to follow-up among similar patients include the following: allowing clinic staff more flexibility in follow-up procedures for women who have consistently normal follow-up tests, including Spanish translations of written messages; enlisting patients' agreement in setting appointments; and updating patient records to reflect follow-up care that had been received in other clinics.
purpose: The purpose of this article is to describe the history of the State Cancer Pain Initiative (CPI) movement and current initiative activities that are directed at improving the management of cancer pain. overview: The undertreatment of pain is a major public health problem in the United States. State CPIs strive to remove the barriers to effective cancer pain management through the provision of innovative professional, patient, and public educational programs, through institutional change projects, and through public advocacy. Collaboration with organizations that share common goals is important in sustaining and maximizing the impact of the movement. clinical implications: Professionals, patients, and families benefit from the work of the State Initiatives. By enhancing the knowledge and skills of clinicians, supporting institutional change, and teaching patients and families the importance of effective pain control, the Initiatives help to improve the quality of life for all cancer survivors. Models of intervention that respond to local needs are discussed, and legislative and advocacy efforts that affect care also are noted.
purpose: In an effort to mitigate the negative psychological sequelae of a cancer diagnosis and cancer treatment, efforts have been made to explore a variety of psychosocial issues and interventions. This article describes the provision and preliminary evaluation of a novel psychosocial service delivery, a residential “retreat” program called Tapestry, which is run under the aegis of the established cancer care community in Alberta, Canada. overview: Retreat programs offer a novel way to provide psychosocial support for those persons who are living with cancer. The retreats are unique in the provision of a respite and the opportunity to address the isolation and other existential issues arising from a cancer diagnosis. The program described in this article has provided such a service six times per year since 1998. The intervention is described, and preliminary evaluation data are presented. clinical implications: Cancer care has begun to move beyond a solely biomedical paradigm toward a more holistic ethos in service delivery and research orientation. While the face value of and demand for such programming continues to grow, few residential psychosocial programs are offered under the auspices of conventional cancer care centers, and little work has been done to examine the nature and possible efficacy of retreat programs as a valid forum for psychosocial service delivery.
purpose: The purpose of this study was to examine the influence of heuristic reasoning on women's perceived risk for developing breast cancer, and to test for an expected bias in the direction of optimism that is predicted by recent research on human cognition. description of study: In total, 770 women recruited in community settings were surveyed regarding cancer screening behavior and their perceived risk of developing breast cancer. results: Most women perceived their risk of breast cancer to be lower than that of other women (3:1), confirming the expected bias toward optimism, and this finding was not attributable to the personality trait of optimism. Women following mammography guidelines showed greater optimism that their risk was low. Cancer knowledge and education diminished unwarranted optimism. Women with a history of benign breast disease, with a female relative with breast cancer, or both overestimated their risk. All findings suggest that heuristic thinking is being used to estimate personal cancer risk. clinical implications: Clinicians should expect women to be optimistic about their personal risk of developing breast cancer. As a result, women may put off breast cancer screening or delay the evaluation of breast symptoms that may signal breast cancer. Helping women to understand their relative risk is an essential part of a health promotion visit.
Cancer PracticeVolume 10, Issue 4 p. 174-178 Quality of Life through Rehabilitation at End of Life Sheri L. Wolfe RN, BSN, OCN, Sheri L. Wolfe RN, BSN, OCN Oncology Nurse Rehabilitation Liaison HealthSouth Mountain View, Regional Rehabilitation Hospital, Morgantown, West VirginiaSearch for more papers by this authorStephanie Elkins MD, Stephanie Elkins MD Associate Professor of Medicine University of Mississippi Medical Center, Jackson, MississippiSearch for more papers by this authorAndrew D. Shiller MD, Andrew D. Shiller MD Medical Director Outpatient Rehabilitation Kent Hospital, Warwick, Rhode IslandSearch for more papers by this authorJayne Fernsler Dsn, RN, AOCN, Jayne Fernsler Dsn, RN, AOCN Professor Emerita Department of Nursing, University of Delaware, Newark, DelawareSearch for more papers by this authorBarbara W. Hale MSW, LCSW, Barbara W. Hale MSW, LCSW Social Worker Graduate Social Work, Education Coordinator, The Cancer Institute of New Jersey, New Brunswick, New JerseySearch for more papers by this author Sheri L. Wolfe RN, BSN, OCN, Sheri L. Wolfe RN, BSN, OCN Oncology Nurse Rehabilitation Liaison HealthSouth Mountain View, Regional Rehabilitation Hospital, Morgantown, West VirginiaSearch for more papers by this authorStephanie Elkins MD, Stephanie Elkins MD Associate Professor of Medicine University of Mississippi Medical Center, Jackson, MississippiSearch for more papers by this authorAndrew D. Shiller MD, Andrew D. Shiller MD Medical Director Outpatient Rehabilitation Kent Hospital, Warwick, Rhode IslandSearch for more papers by this authorJayne Fernsler Dsn, RN, AOCN, Jayne Fernsler Dsn, RN, AOCN Professor Emerita Department of Nursing, University of Delaware, Newark, DelawareSearch for more papers by this authorBarbara W. Hale MSW, LCSW, Barbara W. Hale MSW, LCSW Social Worker Graduate Social Work, Education Coordinator, The Cancer Institute of New Jersey, New Brunswick, New JerseySearch for more papers by this author First published: 11 July 2002 https://doi.org/10.1046/j.1523-5394.2002.104007.xCitations: 4 The Department Editors encourage the submission of your challenging case studies to Cancer Practice. Your contributions continue to make Multidisciplinary Rounds a valuable resource for the entire oncology team. Send email to journals@cancer.org Department Editors: Laura J. Hilderley, RN, MS; Ryan R. Iwamoto, RN, CS, MN; and M. Tish Knobf, RN, PhD, FAAN. Queries and contributions for Multidisciplinary Rounds may be sent to the Department Editors at Cancer Practice, American Cancer Society, 1180 Avenue of the Americas, New York, NY 10036. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume10, Issue4July 2002Pages 174-178 RelatedInformation
purpose: The purpose of this study was to test an intervention (the Screening Adherence Follow-up Program [SAFe]) that was designed to reduce the number of known barriers to diagnostic follow-up adherence and initiation of treatment among women with low incomes who had abnormal mammogram findings. description of program: The investigators developed and implemented a highly structured, theory- and evidence-based intervention that combined health education, counseling, and systems navigation, which was delivered by a team consisting of a peer counselor and a social worker who held a masters degree. A scripted baseline telephone interview identified potential barriers to follow-up adherence and provided counseling interventions for each patient. Patients were assigned to different service intensities based on the level of risk for nonadherence. Patients with significant mental health symptoms, psychosocial stressors, or who had received a diagnosis of cancer were referred to the team social worker for further assessment and intervention. Patients also received reinforcing telephone follow-up calls at 6 and 12 months. results: An observational pilot study of SAFe (N = 605) in two large urban diagnostic centers showed that 71% of women receiving SAFe were Hispanic, 18% were Black, and 11% were from other ethnic backgrounds. Adherence rates through diagnostic resolution and the initiation of treatment for women who had received a diagnosis of cancer were 93% and 90%, respectively, at the two study sites. Rates of adherence among women who could not be located or who refused study consent were significantly lower (72% and 69%, respectively). The rate of timely adherence was also higher among the women served. Patient satisfaction with SAFe was generally high. clinical implications: Study results support the combining of interventions and the practical utility of a clinical decision-making algorithm to determine individualized nonadherence risk and to assign service intensity based on individual need. Problems in locating women for enrollment were experienced.
purpose: The purpose of this article is to present an overview of the epidemiology diagnosis, and management of bladder cancer, with a focus on the early stage of this disease. overview: English-language articles published between 1990 and 2000, as well as selected abstracts published in non-English languages before 1990, were reviewed. Epidemiologic data clearly indicate that bladder cancer is much more common in men, White persons, and the elderly. Cigarette smoking appears to be the most significant environmental risk factor. Screening for the disease is currently not standard in the United States or Canada. Potential tests include urine cytology, hematuria dipstick, and the urinary biomarkers. Diagnosis is made most often on the basis of the findings of cystoscopy, tumor biopsy, and urine cytology. Transurethral resection (TUR) of the tumor is generally the first-line treatment for superficial disease. Cystectomy is the “gold standard” treatment for invasive disease in many countries, although trimodality therapy (TUR, radiation, systemic chemotherapy) has shown promise as a bladder-preserving strategy. Intravesical therapy is effective for preventing disease recurrence, although its role in slowing disease progression is uncertain. Chemotherapy and radiation also can be used with cystectomy to treat or prevent pelvic recurrence of invasive disease or to prolong life in patients with metastatic disease. clinical implications: Bladder cancer is a commonly occurring disease. Prevention efforts must focus on the avoidance or cessation of cigarette smoking and on public education relating to known environmental risk factors. Patient and disease factors must be considered in making treatment decisions and determining prognosis. Careful follow-up after treatment is essential. It is hoped that ongoing research on potential tumor markers and tumor-specific therapies ultimately will result in improved clinical outcomes for patients with this malignancy.
purpose: This study was performed to assess the knowledge, attitudes, and experiences with viatical settlements among hospice staff who provide financial counseling to terminally ill patients and their families. description of study: A random sample of 300 hospices in the 50 states was selected from the National Hospice Directory. Staff members who provide financial counseling to patients and families were interviewed by phone using a 31-item structured questionnaire. results: The response rate was 80%. The results showed that only 4% of hospices provide information about viatical settlements to all patients, while 32% provide information only if asked. Only 9% of respondents rated themselves as very informed about viatical settlements, and 53% rated themselves as moderately informed. Of the 47 hospices where at least one patient had used a viatical settlement, 92% felt the patient had a positive experience using the resource. In response to a hypothetical case of a terminally ill patient considering a viatical settlement, 40% responded positively, while 51% were neutral. clinical implications: Among hospice financial counselors who have had experience with viatical settlements, most report positive experiences. When asked to respond to a hypothetical case, most respondents were either neutral or positive. However, lack of knowledge about viatical settlements may limit the availability of this resource for terminally ill patients and their families.
Cancer PracticeVolume 10, Issue 4 p. 216-218 Resources for Treatment of Chemotherapy-Related Cognitive Difficulty Susan E. Grober phd, Susan E. Grober phd Susan E. Grober, PhD, Director of Research, Cancer Care, Inc., New York, New York.Search for more papers by this author Susan E. Grober phd, Susan E. Grober phd Susan E. Grober, PhD, Director of Research, Cancer Care, Inc., New York, New York.Search for more papers by this author First published: 11 July 2002 https://doi.org/10.1046/j.1523-5394.2002.104005.xCitations: 8 Department Editors: Marie M. Lauria, MSW, CCSW; Victoria Mock, DNSc, RN, AOCN; and Marion E. Morra, MA, ScD. Queries and contributions for Patient Resources may be sent to the Department Editors at Cancer Practice, American Cancer Society, 1180 Avenue of the Americas, New York, NY 10036. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat References 1 Bender CM, Paraska KK, Sereika SM, Ryan CM, Berga SL. Cognitive function and reproductive hormones in adjuvant therapy for breast cancer: a critical review. J Pain Symptom Manage. 2001; 21: 407–424. 2 Brezden CB, Phillips K, Abdolell M, Bunston T, Tannock IF. Cognitive function in breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol. 2000; 18: 2695–2701. 3 Van Dam F, Schagen SB, Muller MJ, et al. Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. J Natl Cancer Inst. 1998; 90: 210–218. 4 Schagen SB, Van Dam F, Muller MJ, Boogerd W, Lindeboom J, Bruning PF. Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma. Cancer. 1999; 85: 640–650. 5 Carlson RH. “Chemo Brain” cognitive loss confirmed in adult cancer patients receiving systemic chemotherapy. Oncology Times. 2000; 6: 35–38. 6 Cimprich B, Ronis DL. Attention and symptom distress in women with and without breast cancer. Nurs Res. 2001; 50: 86–93. Citing Literature Volume10, Issue4July 2002Pages 216-218 ReferencesRelatedInformation
PURPOSE The purpose of this article is as follows: 1) to describe the characteristics and scope of mucosal tissue injury associated with cancer treatment; 2) to discuss recent advances in related basic and clinical science; and 3) to articulate research needs and opportunities to be addressed through collaborative interdisciplinary research. OVERVIEW Mucosal tissue injury is both a direct and indirect consequence of cancer therapy, with manifestations that include damage and a number of other potentially serious sequelae. Current research in mucosal tissue injury is focused on the biology, immunology, and genetics of mucosal injury; clinical problems; assessment and management; and processes and outcomes of care. CLINICAL IMPLICATIONS Results from these various areas of research enhance the understanding of the mechanisms of mucosal tissue injury, provide direction for the development of policy and for clinical practice, and help to define research needs and opportunities. Future research on the complex process of mucosal tissue injury will be interdisciplinary and will cross the boundaries among basic, translational, and clinical science.
Cancer PracticeVolume 10, Issue 3 p. 117-117 Improving Communication: A Constant Challenge Genevieve V Foley RN, MSN, OCN, CNAA, Genevieve V Foley RN, MSN, OCN, CNAASearch for more papers by this author Genevieve V Foley RN, MSN, OCN, CNAA, Genevieve V Foley RN, MSN, OCN, CNAASearch for more papers by this author First published: 30 April 2002 https://doi.org/10.1046/j.1523-5394.2002.103012.x Please send comments and suggestions for the Editor to: [email protected] Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume10, Issue3May 2002Pages 117-117 RelatedInformation
Cancer PracticeVolume 10, Issue 6 p. 266-268 Neuropsychological and Emotional Challenges in a 38-Year-Old Man with a Brain Tumor Mark Itzen , MD, Mark Itzen , MD Department of Social Work, Fox Chase Cancer Center, Philadelphia, PennsylvanniaDepartment of Radiation Oncology, Research Medical Center, Kansas City, MissouriProfessor of Neuropsychology, Department of Neuro-Oncology, M. D. Anderson Cancer Center, Houston, TexasRadiation Oncology Nursing Coordinator, Maine Medical Center, Portland, MaineClinical Social Workers, UCSF Comprehensive Cancer Center, San Francisco, CaliforniaSearch for more papers by this authorJohn Sheldon , MD, John Sheldon , MD Department of Social Work, Fox Chase Cancer Center, Philadelphia, PennsylvanniaDepartment of Radiation Oncology, Research Medical Center, Kansas City, MissouriProfessor of Neuropsychology, Department of Neuro-Oncology, M. D. Anderson Cancer Center, Houston, TexasRadiation Oncology Nursing Coordinator, Maine Medical Center, Portland, MaineClinical Social Workers, UCSF Comprehensive Cancer Center, San Francisco, CaliforniaSearch for more papers by this authorChristina A. Meyers , PhD, ABPP, Christina A. Meyers , PhD, ABPP Department of Social Work, Fox Chase Cancer Center, Philadelphia, PennsylvanniaDepartment of Radiation Oncology, Research Medical Center, Kansas City, MissouriProfessor of Neuropsychology, Department of Neuro-Oncology, M. D. Anderson Cancer Center, Houston, TexasRadiation Oncology Nursing Coordinator, Maine Medical Center, Portland, MaineClinical Social Workers, UCSF Comprehensive Cancer Center, San Francisco, CaliforniaSearch for more papers by this authorDonna Green , RN, BSN, BA, OCN, Donna Green , RN, BSN, BA, OCN Department of Social Work, Fox Chase Cancer Center, Philadelphia, PennsylvanniaDepartment of Radiation Oncology, Research Medical Center, Kansas City, MissouriProfessor of Neuropsychology, Department of Neuro-Oncology, M. D. Anderson Cancer Center, Houston, TexasRadiation Oncology Nursing Coordinator, Maine Medical Center, Portland, MaineClinical Social Workers, UCSF Comprehensive Cancer Center, San Francisco, CaliforniaSearch for more papers by this authorCarolyn Long , MSW, LCSW, Carolyn Long , MSW, LCSW Department of Social Work, Fox Chase Cancer Center, Philadelphia, PennsylvanniaDepartment of Radiation Oncology, Research Medical Center, Kansas City, MissouriProfessor of Neuropsychology, Department of Neuro-Oncology, M. D. Anderson Cancer Center, Houston, TexasRadiation Oncology Nursing Coordinator, Maine Medical Center, Portland, MaineClinical Social Workers, UCSF Comprehensive Cancer Center, San Francisco, CaliforniaSearch for more papers by this authorBarbara Buckley , MSW, LCSW, Barbara Buckley , MSW, LCSW Department of Social Work, Fox Chase Cancer Center, Philadelphia, PennsylvanniaDepartment of Radiation Oncology, Research Medical Center, Kansas City, MissouriProfessor of Neuropsychology, Department of Neuro-Oncology, M. D. Anderson Cancer Center, Houston, TexasRadiation Oncology Nursing Coordinator, Maine Medical Center, Portland, MaineClinical Social Workers, UCSF Comprehensive Cancer Center, San Francisco, CaliforniaSearch for more papers by this author Mark Itzen , MD, Mark Itzen , MD Department of Social Work, Fox Chase Cancer Center, Philadelphia, PennsylvanniaDepartment of Radiation Oncology, Research Medical Center, Kansas City, MissouriProfessor of Neuropsychology, Department of Neuro-Oncology, M. D. Anderson Cancer Center, Houston, TexasRadiation Oncology Nursing Coordinator, Maine Medical Center, Portland, MaineClinical Social Workers, UCSF Comprehensive Cancer Center, San Francisco, CaliforniaSearch for more papers by this authorJohn Sheldon , MD, John Sheldon , MD Department of Social Work, Fox Chase Cancer Center, Philadelphia, PennsylvanniaDepartment of Radiation Oncology, Research Medical Center, Kansas City, MissouriProfessor of Neuropsychology, Department of Neuro-Oncology, M. D. Anderson Cancer Center, Houston, TexasRadiation Oncology Nursing Coordinator, Maine Medical Center, Portland, MaineClinical Social Workers, UCSF Comprehensive Cancer Center, San Francisco, CaliforniaSearch for more papers by this authorChristina A. Meyers , PhD, ABPP, Christina A. Meyers , PhD, ABPP Department of Social Work, Fox Chase Cancer Center, Philadelphia, PennsylvanniaDepartment of Radiation Oncology, Research Medical Center, Kansas City, MissouriProfessor of Neuropsychology, Department of Neuro-Oncology, M. D. Anderson Cancer Center, Houston, TexasRadiation Oncology Nursing Coordinator, Maine Medical Center, Portland, MaineClinical Social Workers, UCSF Comprehensive Cancer Center, San Francisco, CaliforniaSearch for more papers by this authorDonna Green , RN, BSN, BA, OCN, Donna Green , RN, BSN, BA, OCN Department of Social Work, Fox Chase Cancer Center, Philadelphia, PennsylvanniaDepartment of Radiation Oncology, Research Medical Center, Kansas City, MissouriProfessor of Neuropsychology, Department of Neuro-Oncology, M. D. Anderson Cancer Center, Houston, TexasRadiation Oncology Nursing Coordinator, Maine Medical Center, Portland, MaineClinical Social Workers, UCSF Comprehensive Cancer Center, San Francisco, CaliforniaSearch for more papers by this authorCarolyn Long , MSW, LCSW, Carolyn Long , MSW, LCSW Department of Social Work, Fox Chase Cancer Center, Philadelphia, PennsylvanniaDepartment of Radiation Oncology, Research Medical Center, Kansas City, MissouriProfessor of Neuropsychology, Department of Neuro-Oncology, M. D. Anderson Cancer Center, Houston, TexasRadiation Oncology Nursing Coordinator, Maine Medical Center, Portland, MaineClinical Social Workers, UCSF Comprehensive Cancer Center, San Francisco, CaliforniaSearch for more papers by this authorBarbara Buckley , MSW, LCSW, Barbara Buckley , MSW, LCSW Department of Social Work, Fox Chase Cancer Center, Philadelphia, PennsylvanniaDepartment of Radiation Oncology, Research Medical Center, Kansas City, MissouriProfessor of Neuropsychology, Department of Neuro-Oncology, M. D. Anderson Cancer Center, Houston, TexasRadiation Oncology Nursing Coordinator, Maine Medical Center, Portland, MaineClinical Social Workers, UCSF Comprehensive Cancer Center, San Francisco, CaliforniaSearch for more papers by this author First published: 29 October 2002 https://doi.org/10.1046/j.1523-5394.2002.106003.x Department Editors: Laura J. Hilderley, RN, MS; Ryan R. Iwamoto, RN, CS, MN; and M. Tish Knobf, RN, PhD, FAAN. The Department Editors encourage the submission of your challenging case studies to Cancer Practice. Your contributions continue to make Multidisciplinary Rounds a valuable resource for the entire oncology team. Send email to [email protected] Queries and contributions for Multidisciplinary Rounds may be sent to the Department Editors at Cancer Practice, American Cancer Society, 1180 Avenue of the Americas, New York, NY 10036. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Volume10, Issue6November 2002Pages 266-268 RelatedInformation
PURPOSE The purpose of this National Cancer Institute-funded training project was to improve end-of-life care agencies through implementation of a palliative care curriculum. The Home Care Outreach for Palliative Care Education (HOPE) program was designed to improve the knowledge and skills of home healthcare professionals who provide care to the terminally ill and their families at home. DESCRIPTION OF PROGRAM A five-module palliative care education curriculum was designed and implemented in five home care agencies in the Los Angeles area. One hundred twenty-five nurses and 28 home health aides participated. The methods of data collection included two written surveys conducted before and after intervention, chart audit tool and a case study analysis form. RESULTS The precourse data revealed deficiencies in home-care agency staff knowledge in and clinical aspects of end-of-life care. Regarding agency nurses' knowledge on end-of-life issues, the overall percentage scores from preeducation to posteducation rose from 84.6% to 89.0% (P =.0001). Participants rated the education program as extremely valuable for the home care agency staff. CLINICAL IMPLICATIONS As home care will likely continue to be a primary setting for end-of-life healthcare, improvement of palliative care education in home health agencies is needed. The HOPE project provided insight and experience in the education of nonhospice home care staff in end-of-life care. Participant responses and evaluations indicated that end-of-life care education can improve the quality of care provided by home health agencies. Finally, this education program may result in a heightened awareness of hospice care and, although not objectively quantified, perhaps an increase in referrals to hospice.
