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Results of the screening indicated that family caregiver concerns included side effects, fatalism and overdose. At the two-week interval, the intervention group scored better than the control group with increased knowledge, decreased patient pain and decreased barriers. The three-month follow up continued the improved outcome within the intervention group. The results of this study found that the EMPOWER program can assist in managing symptoms and improve comfort for hospice patients. The authors feel that the EMPOWER program can be a positive intervention to address barriers to pain management in hospice. However, they feel that further research is needed to expand the demographics, patient illness, and populations.
Morphine and Hospice4This article is consistent with this authors PICO(T) question in that it proposes an intervention to relieve family concerns regarding pain management beginning with hospice admission which can lead to better quality of life of the hospice patient.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 The purpose of this study was to understand the experience of caregivers to hospice patient’s pain management. The study consisted of interviews of 146 caregivers which resulted in five themes: administration, side effects, insecurity with assessment, communication and unrelieved pain. The study concluded that effective planning for pain control needs to include values and beliefs of patients and families. This study is important to this writers’ research because it finds many caregivers (37%) are concerned about side effects of medications (Oliver et al., 2013). Further results indicate thatfamily caregivers can feel guilt, thinking they overmedicated the patient. The authors of this study feel that a formal assessment of caregiver beliefs and values can assist staff in planning care. They conclude that “Early in the admission while the patient is more likely to be able to communicate coherently, hospice staff would be well served to facilitate family discussions between caregivers and patients as part of the pain control plan(Oliver et al., 2013).”
Morphine and Hospice5Kehl, K. A. (2014). How hospice staff members prepare family caregivers for the patient’s final days of life: An exploratory study. Palliative Medicine,29(2), 128-137. doi:10.1177/0269216314551320The goal of this study was to understand the content, strategies and timing of preparing family caregivers of end of life as well as if information is tailored and who prepares it. The study interviewed nineteen hospice clinicians to gather the information. Results included symptoms, implications of symptoms, what to expect next and what to do.Timing of family preparation was a key component. Many nurses timed the preparation according to factors such as medication and symptom changes. Many nurses believed that preparation should begin at admission. With early preparation, families won’t be panicked as thepatient becomes active (Kehl, 2014). It also allows for continual reinforcement of knowledge shared and time to process the information. This would also apply to pain management options,