Article Reivew

Attention

Here is the KVCC library site for Ebsco: http://kvcc.me.edu/Pages/Library/Library-Home

Learning Outcomes

Upon completion of this lesson's material, students will be able

  • Demonstrate oral and written skills in discussing and evaluating different arguments and approaches in the study of death and dying.
  • Develop research and analytical skills in writing scholarly essays and social analysis.
  • Assess the role that specific research has in developing a perception of death and dying.
  • Identify and describe key theories, concepts and debates in the sociology of death and dying.
  • Explore questions related to life, meaning, suffering, dying, death, and faith/religion/spirituality.
  • Identify, describe, and examine a social issue or situation from an academic perspective relevant to the issues or situations regarding death and dying.

Teaching

From: Peaceful Death: Recommended Competencies and Curricular Guidelines for End-of-Life Nursing Care

The United States is facing the realities of an aging population, a recognition of the limits and inappropriate use of technological resources, and concerns about the capabilities of health care providers. Additionally, the increase in demand for assisted suicide and apprehensions of the public about suffering and expenses associated with dying that may be prolonged unnecessarily by technology contribute to a renewed interest in humane end-of-life care. Increased awareness of the success of hospice as an alternative model of care has served as a catalyst for integrating palliative care into traditional models of care delivery.

Precepts underlying hospice care are essential principles for all end-of-life care. Such precepts include the assumptions that individuals live until the moment of death; that care until death may be offered by a variety of professionals; and that such care is coordinated, sensitive to diversity, offered around the clock, and gives attention to the physical, psychological, social, and spiritual concerns of the patient and the patient's family. These precepts provide guidance to the development of the educational preparation of nurses. However, educational preparation for end-of-life care has been inconsistent at best, and sometimes neglected within nursing curricula.

…Given the likelihood that care will be given by a variety of health care professionals, it is essential that such preparation be interdisciplinary in its approach to preparing students for the end-of-life practice in which they will engage.

The roundtable's group of health care ethicists and palliative care experts developed the End-of-Life Competency Statements presented here, which every undergraduate nursing student should attain….

1. Recognize dynamic changes in population demographics, health care economics, and service delivery that necessitate improved professional preparation for end-of-life care.

2. Promote the provision of comfort care to the dying as an active, desirable, and important skill, and an integral component of nursing care.

3. Communicate effectively and compassionately with the patient, family, and health care team members about end-of-life issues.

4. Recognize one's own attitudes, feelings, values, and expectations about death and the individual, cultural, and spiritual diversity existing in these beliefs and customs.

5. Demonstrate respect for the patient's views and wishes during end-of-life care.

6. Collaborate with interdisciplinary team members while implementing the nursing role in end-of-life care.
7. Use scientifically based standardized tools to assess symptoms (e.g., pain, dyspnea [breathlessness] constipation, anxiety, fatigue, nausea/vomiting, and altered cognition) experienced by patients at the end of life.

8. Use data from symptom assessment to plan and intervene in symptom management using state-of-the-art traditional and complementary approaches.

9. Evaluate the impact of traditional, complementary, and technological therapies on patient- centered outcomes.

10. Assess and treat multiple dimensions, including physical, psychological, social and spiritual needs, to improve quality at the end of life.

11. Assist the patient, family, colleagues, and one's self to cope with suffering, grief, loss, and bereavement in end-of-life care.

12. Apply legal and ethical principles in the analysis of complex issues in end-of-life care, recognizing the influence of personal values, professional codes, and patient preferences.

13. Identify barriers and facilitators to patients' and caregivers' effective use of resources.

14. Demonstrate skill at implementing a plan for improved end-of-life care within a dynamic and complex health care delivery system.

15. Apply knowledge gained from palliative care research to end-of-life education and care.

Content Areas Where Competencies Can Be Taught
… Below are content areas, or courses, where various aspects of end-of-life care can logically be included.

Health Assessment
In a course on health assessment, students should be taught to use standardized assessment tools for common problems experienced at the end of life. Such tools might include visual analogue or numeric rating scales to quantify pain or dyspnea. Since analysis of a symptom always includes assessment of intensity, this would be an appropriate opportunity to discuss the value of rating scales for initial and on-going assessment (competency #7).

For inclusion in the health assessment course, the roundtable participants also strongly advocate content on common symptoms experienced at the end of life, appropriateness of various physiological measures for evaluating comfort in the dying person, and the indicators of approaching death (competency #7)

Psychiatric-Mental Health
Coursework that addresses psych-mental health and communication issues provides multiple opportunities to discuss end of life issues, for example:

  • communication with the patient and family (competency #3);
  • eliciting patient's and family's wishes for end-of-life care (competency #4);
  • recognition of the student's own attitudes, feelings, and expectations about death (competency #5);
  • preparing the patient's family for decline in emotional and cognitive status (competency #10); and
  • assisting the patient, family, and colleagues to cope with suffering, grief and loss, and crisis in the family (competency # 11).

Ethical/Legal Content

Coursework that assists … students in identifying and assessing their own attitudes towards death, as well as teaching respect for others' attitudes and values, should be an integral part of the nursing curriculum (competency #4).

Faculty covering ethical-legal content might include content on:

  • relevant state and federal laws regarding informed consent, advance directives, portable (community based) do-not-resuscitate orders, etc. (competency #12);
  • common legal myths and professional misperceptions regarding end-of-life care (competency #12); and
  • differences between laws, institutional policies, personal values, family values, and professional values and ethics (competency #12)

Cultural Issues Content
Increasingly, … education includes content about culture. Faculty who teach this content should incorporate cultural influences on attitudes and beliefs about death and dying in the cultures represented in the surrounding community (competency #5).

Nursing Research
Courses that address nursing research should include examples of research done in palliative care settings and in settings where death is a frequent outcome. For example, a number of nursing studies have been published in the areas of symptom assessment and management, family member bereavement, and quality of life in palliative care settings (competency #15).

Professional Issues/Health Care Settings
A discussion of hospice as a type of health care model should be included in the curriculum. Professional issues surrounding providing care in the home, the role of the family caregiver, and the role of the nurse in supporting the family caregiver should also be addressed in addition to the professional issues surrounding provision of palliative care within traditional acute and clinic settings (competencies #1, #10, #11).

Assessment

ARTICLE REVIEW: There will be one article review due this semester.

Students will choose an article from the EBSCO database or from a preapproved scholarly (peer-reviewed) journal and select one scholarly article discussing aspects of death and dying and/or grieving from any cultural background.

From this selection, students will write a formal essay organizing the ideas and presenting the findings. Using the teaching section of this lesson to identify the competency you are hoping to improve in your analysis, and highlight key features of the study, providing synthesis to your course content and personal/professional experiences.

The purpose of this assignment is to better prepare you for further academic research and inquiry in formal writing skills.

Additionally, you will be creating a presentation to teach the class the concepts you researched within your article. A brief powerpoint/prezi/powtoons or iMovie will be completed and uploaded to the discussion board in order to share your findings.

Use the following format BUT use your own words. Cite when and where relevant.

Introduction: Background, rationale, and purpose of article.
Methods: Study design, measurement instruments, and rationale of their use.
Results: Describes the outcomes of the study without repeating the methodology.
Discussion: Presents the principles, relationships, and generalizations shown by the study; Explains how results support (or refute) previous research; Considers theoretical implications of the results; Provides conclusions of the study.
Further Research: present current and future trends in medical and psychological attitudes toward death in order to gain insight into the workings of today's medicalized and professionalized services.

Presentation: Describe the presentation software that you are going to be using, and describe the layout for your presentation.

These are helpful citation and APA reference websites:

https://owl.english.purdue.edu/owl/resource/560/01/
http://calstatela.libguides.com/content.php?pid=103564&sid=778792