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The Hospice Philosophy Scale (HPS) is the only scaled instrument that measures health professionals' attitudes about end-of-life care consistent with the hospice philosophy. This study tested the properties of a modified version of the HPS to provide preliminary validation data on internal consistency, convergent validity, and factorability in a broad population of adults. A cross-sectional telephone survey designed to assess the general population's attitudes regarding hospice use was administered. exploratory factor analysis elicited an eight-item instrument (HPS-8). The HPS-8 produced a Cronbach's alpha of.73 and demonstrated sufficient convergent validity, including positive associations with a scale measuring the importance of relevant end-of-life issues (r =.41, p <.001), a personal preference for hospice (ρ =.36, p <.001), and, among those who had experienced hospice care, satisfaction with hospice care (ρ =.28, p <.01). Our evidence suggests the HPS-8 is a reliable and valid instrument for use with a general adult population. [ABSTRACT FROM AUTHOR]

Numerous factors impede effective and timely end-of-life (EOL) care communication. These factors include delays in communication until patients are seriously ill and/or close to death. Gaps in patient–provider communication negatively affect advance care planning and limit referrals to palliative and hospice care. Confusion about the roles of various health care providers also limits communication, especially when providers do not coordinate care with other health care providers in various disciplines. Although providers receive education regarding EOL communication and care coordination, little is known about the roles of all health care providers, including nonphysician support staff working with physicians to discuss the possibility of dying and help patients prepare for death. This study explores the perspectives of physicians, nurses, social workers, and chaplains on engaging seriously ill patients and families in EOL care communication. Qualitative data were from 79 (medical and nonmedical) providers practicing at 2 medical centers in Central Los Angeles. Three themes that describe providers’ perceptions of their roles and responsibility in talking with seriously ill patients emerged: (1) providers’ roles for engaging in EOL discussions, (2) responsibility of physicians for initiating and leading discussions, and (3) need for team co-management patient care. Providers highlighted the importance of beginning discussions early by having physicians lead them, specifically due to their medical training and need to clarify medical information regarding patients’ prognosis. Although physicians are a vital part of leading EOL communication, and are at the center of communication of medical information, an interdisciplinary approach that involves nurses, social workers, and chaplains could significantly improve patient care. [ABSTRACT FROM AUTHOR]

Purpose: This study contributes to the sparse body of literature examining perceptions of coping among Latino men and women with a cancer diagnosis living in the United States. There are currently 50 million Latinos in the United States and, by 2050, projected to grow to 128 million. Although some research indicates that Latinos have unique sociocultural beliefs that influence their cancer care, very little is known about their perceptions of coping after being diagnosed with cancer. We examined Latino men and women’s perceptions of coping to understand the meaning of their experience with cancer Method: Using criterion sampling technique, 60 immigrant and migrant Latino men and women diagnosed with cancer within the past 5 years were recruited from community-based organizations, clinics, and churches. The study consisted of 60- to 90-minute semistructured interviews asking open-ended questions pertaining to coping. The qualitative design facilitated an understanding of coping within the participants’ social and cultural contexts. Results: Median age of the participants was 55 years. Among the women, 80% had breast cancer; 12% had ovarian cancer; and 8% had throat, thyroid, stomach, or skin cancers. Among the men, 94% had prostate cancer and 6% had brain, colorectal, or lung cancers. Emerging themes associated with the development of coping strategies involved positive reframing, family support, religion and spirituality, and support from health care providers. The term “positive reframing” relates to finding meaning and positive emotions that help sustain the coping process, despite having a cancer diagnosis. In addition, when medical and helping professionals provided tangible support, participants engaged in meaning-based coping. Conclusion: This study provides insights regarding the existing coping strategies which Latinos utilize and provides clinician-tangible information pertaining to participant’s engagement in meaning-based coping. Family support facilitated coping among the Latino men and women. The role of religion and spirituality in the lives of the participants enabled them to cope with the cancer diagnosis. Future research is necessary to examine coping strategies regarding specific cancers at end of life. [ABSTRACT FROM AUTHOR]

Objective. Despite the growth of the economic impact of pain and pain management, there remains a lack of knowledge about disparities, especially, evidence regarding individual attitudes and beliefs about accepting pain treatments. This study provides preliminary information on the prevalence of public concerns about pain management and a better understanding of factors that may ultimately lead to improved pain management and treatment adherence. Methods. Using a cross-sectional survey of community-dwelling adults 181 in the US, 123 randomly selected respondents were telephoneinterviewed in 2012. Principal components factor analysis (PCA) was used to detect statistical groupings of attitudes and beliefs about pain and pain management. The modified Protection Motivation Theory was applied to examine the willingness to use pain medicine. Results. The five most important components pertained to threat appraisal, coping appraisal, attitudes, subjective norms, and perceived control. Threat appraisal was the most common factor, and subjective norms was the least common factor. Lower income, more awareness of hospice, and less misconceptions about threat appraisal and attitudes toward pain and pain management were associated with more willingness to use pain medicine in hierarchical regression. Conclusions. These components are useful for future research on the willingness to use pain medicine and may have implications for assessing cognitive barriers toward pain and pain management among the general public. [ABSTRACT FROM AUTHOR]

This in-depth single-case-study explored the emergent trauma of psychosocial distress of an older male African-American veteran after being diagnosed with end-stage colon cancer. Using a qualitative case study methodology, three in-depth interviews were conducted which identified the following five themes: (1) the emotional impact of being diagnosed with cancer, (2) experiencing inescapable loss of control and independence, (3) adjusting to nursing home placement, (4) lacking social support, and (5) navigating complicated services. The findings expand our understanding of the need for identifying and managing psychosocial distress. Implications for behavioral health practitioners are discussed. [ABSTRACT FROM AUTHOR]

The issues of death and dying that have given impetus to the hospice movement include the effect on people with terminal illnesses and their families, impending death, renewed attention to long-term care centers and other alternatives to hospitalization, the scarcity of resources, the emphasis on holistic health, and recognition of the rights of people who are dying to die with dignity. Hospice offers patients compassionate care that is focused the pain relief and symptom management so that they can die a good death. In the US, hospice is considered the gold standard of care for terminally ill patients. Yet, racial and ethnic minorities are under-represented among those who receive this type of care. The present research takes a qualitative approach to exploring factors that influence hospice care among Hispanics in a hospice care setting. It discusses structural and cultural factors that influence the care among older adults. The research reveals organizational and professional that exist.