NUR 440 MS 3 Annotated Bibliography.docx - 4-3 Milestone...

4-3 Milestone Three: Annotated Bibliography
Milestone Three: Annotated Bibliography
Southern New Hampshire University
NUR-440
March 31, 2019
PICO(T) Question : Comfort based care including pain management and symptom management
is key to improving and maintaining quality of life of hospice patients, whether they are actively
1

4-3 Milestone Three: Annotated Bibliography
dying or in early stages of the end of life. In patients with terminal illness on hospice/palliative
care service, does education of comfort medications, compared to education at the time of
transition to actively dying improve pain, symptom management, quality of life and
apprehension during the end of life.
Annotated Bibliography
Oliver, D. P., Wittenberg-Lyles, E., Washington, K., Kruse, R. L., Albright, D. L., Baldwin, P. K.,
. . . Demiris, G. (2013). Hospice caregivers' experiences with pain management: "I'm not
a doctor, and I don't know if I helped her go faster or slower". Journal of Pain and
Symptom Management, 46 (6), 846-858. doi: 10.1016/j.jpainsymman.2013.02.011
In this study researchers aimed to understand the hospice patients’ caregivers experience
with pain management at the end of life. This was a randomized clinic trial including
qualitative and descriptive data obtained from interviews with 146 hospice caregivers.
These caregivers were asked to answer 7 questions related to their experience of caring
for a loved one during the end of life. These interviews resulted in 5 themes related to
pain medication: administration, side effect concerns, ability to assess pain,
communication and ongoing suffering. The study determined that education and
communication related to administration of pain medication at the end of life should
begin at the time of admission to hospice. It was also found that values and beliefs of
patients and caregivers need to be taken into consideration.
This research article has been peer reviewed and is reliable in the outcome of the
research. However, there were limitations mentioned in the article related to participants
2

4-3 Milestone Three: Annotated Bibliography
not being available for follow-up interviews after their loved one’s death. Other
limitations included not all the survey questions being answered by participants. This
study found that >37% of caregivers were concerned about side effects of pain
medications (Oliver et al., 2013).
This article is consistent with the purposed PICO(T) question in that it reflects on the
importance of early education and communication regarding caregiver and patient
feelings on administration early on in hospice care leading to an improved end of life
experience for the patient and caregivers.
Howes, J. (2015). Nurses’ Perceptions of Medication Use at the End of Life in an Acute Care
Setting. Journal of Hospice & Palliative Nursing, 17(6), 508-516. doi:
10.1097/NJH.000000000000192.