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Research Collaboration Focuses on Unfinished Business at the End of Life

Thursday, November 19, 2009 General News J E 4
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CLEVELAND, Nov. 18 Hospice workers have seen patients hang onto life to tell someone they love or forgive them. Researchers from the Frances Payne Bolton School of Nursing and the College of Arts and Sciences at Case Western Reserve University will study what drives the dying to resolve unfinished business.

The approach of Barbara Daly and Mary Jo Prince-Paul from nursing and Julie Exline from arts and sciences is to relieve psychological distress by marshaling the patient's inner strengths.

These qualities include hope, optimism and connectedness that they mustered before their terminal illnesses. While resiliency has shown to improve the psychological outlook of healthy people, researchers will find out the benefits in the severely ill.

Researchers have avoided including dying patients in research, but a goal is to give hospice patients options to participate in research.

With a National Institute of Nursing Research grant, researchers will establish the BEST Center (Building End-of-Life Science through Positive Human Strengths and Traits) to encourage research by recruiting and supporting faculty research.

Another function of the BEST Center, the Palliative Care Education and Research Leadership (PEARL) group of 20 faculty members, will meet regularly.

"Many people want the end-of-life experience to be meaningful," says Prince-Paul, CWRU assistant professor of nursing and hospice nurse at Hospice of the Western Reserve.

With funding from the American Cancer Society, 163 patients with advanced cancer will participate and test new communication tools to find out what life goals and key communication expressions, such as love, gratitude, and forgiveness.

Families sometimes have unresolved issues to settle, too. Exline, a psychologist and associate professor of psychology, will lead the Fetzer Foundation study of 200 family members who have someone near the end of life or have died.

Among those issues can be forgiveness. Exline, who has studied forgiving oneself, others and God over the past decade, will survey family members before and after the death of the loved one to see how hospice workers can help them as they undergo the emotional stress of caring for this seriously ill family member and then the challenges of bereavement.

The researchers will collaborate with healthcare workers from the Hospice of the Western Reserve, who will distribute questionnaires for those with a family member in hospice home care. Another group of family members will be interviewed during the bereavement period.

SOURCE Case Western Reserve University
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