Term Paper on "Perceptions of Palliative Nursing Care by Patients and Nurses"

/>Studies suggest despite the importance of patient and familial input in treatment decisions, relatively little research has been conducted investigating the role families and patients have in healthcare decision-making (Coulton, 1990). Still other studies confirm that nurses views on palliative care often differ significantly from views offered and preferences stated by doctors or other primary care providers (Carmel, Werner & Ziedenberg, 2004).

Significance of the Study

Carmel, Werner & Ziedenberg (2004) are among a growing body of researchers that note often decisions about palliative care rest in the hands of doctors or other primary healthcare providers, rather than on the perceptions of patients or other care providers including social workers and nurses. This suggests a need for further exploration into palliative care (Carmel, Werner & Ziedenberg, 2004) including the need to ascertain whether assessment should also include patient and family preferences as a more significant component.

The introduction of interdisciplinary healthcare teams into medicine has introduced the potential for such inclusion (Schoefield & Amodeo, 1999; Solomon et. al, 1993).

Literature Review

Overview of Palliative Care Studies

Many studies have explored nurses and patients perceptions of palliative and life-sustaining treatment decisions (Schoefield & Amodeo, 1999; Werner & Carmel, 2001; Carmel, Werner & Ziedenberg, 2004). Many decisions about palliative and life-sustaining care are made with regard to a patient's health status, age and desires (Carmel, Werner & Ziedenberg, 2004). Helpful in assessing appropriate care is the use of palliative care teams or support care teams that work together to help decide the best course of action when treating patients; these teams may include the patient's physician, nurse, social worker and family members (Schofield & Amodeo, 1999; Carmel, Werner & Ziedenberg, 2004).

Carmel, Werner & Ziedenberg (2004) note that often decisions about palliative care are deferred to doctor's and nurses, and relate to their preferences more so than that of the patient, especially in cases of elderly patients or patients with poor health prognosis. Solomon et. al (1993) conducted a study involving over 600 physicians and 700 nurses working in five hospitals, finding that significant differences existed between the needs for palliative care and preferences between doctors, nurses and even patients (Carmel, Werner & Ziedenberg, 2004). Most notably, there is evidence suggesting more attention need be paid on "prognoses or patients' preferences" instead of the attitudes and beliefs of the healthcare providers involved in care (Carmel, Werner & Ziedenberg, 2004, p. 27).

Still other studies suggest that to involve patients more in palliative care decisions, social workers must become more involved, encouraging patients to work closer with teams of nurses and their families so proper decisions can be made about palliative treatment taking into consideration patients' needs, wishes and desires (Csikai, 1999; Coulton, 1990).

Method

Theoretical Framework

Carmel, Werner & Ziedenberg (2004) provide the framework for conducting this study, suggesting a model developed by Carmel & Multran (1997) ideal for assessing the conceptual wishes for palliative care treatment among nurses', patients and doctors. This model involves direct exploration of attitudes among health professionals and patients, suggesting attitudes are affected by many factors including: "professional self-esteem, socio-demographic characteristics, experience,… READ MORE