Lessons learned from a secret Facebook support group.

The National Association of Social Workers developed practice standards for social workers using technology in their practice. These standards were derived from the foundation of the social work code of ethics and are helpful as social workers explore the use of new tools for the benefit of their clients. Hospice caregivers, both active and bereaved, are in great need of support but are often unable to attend traditional support groups.

Rethinking family caregiving: tailoring cognitive-behavioral therapies to the hospice experience.

Hospice family caregivers experience significantly higher rates of psychological distress than demographically similar noncaregivers. Interventions based on cognitive-behavioral therapy have been shown to reduce psychological distress in the general population by providing tools to modify thinking patterns that directly affect emotions and behavior. Such interventions might reasonably be incorporated into hospice social work; however, numerous contextual factors must be taken into account to ensure that any interventions are appropriate to the unique needs of clients.

Palliative care communication.

Objectives: To summarize the challenges of teaching, practicing, and learning palliative care communication and offer resources for improving skills and educating others.

Data Sources: A theoretically grounded, evidence-based communication curriculum called COMFORT (Communication, Orientation and opportunity, Mindful presence, Family, Openings, Relating, and Team).

Conclusion: The COMFORT curriculum is available for free through a Web site, a smartphone/iPad application, and online for continuing education units.

The entry-level physical therapist: a case for COMFORT communication training.

Entry-level physical therapists provide clinical care for patients with functional mobility limitations. Their care spans the continuum of settings, disease processes, and diagnoses. Although effective communication skills are required to conduct physical therapy work, there is limited instruction provided in physical therapy education and students receive little exposure to seriously or chronically ill patients.

Perceived benefits and challenges of an oncology nurse support group.

This study explores the perceived benefits and barriers of participating in a monthly oncology nurse support group. Ten oncology nurses participated in an average of seven support group meetings over a one-year period. Interviews were conducted, transcribed, analyzed, and thematized using qualitative descriptive methods.

Exploring aging-related stress among older spousal caregivers.

The goal of this study was to explore aging-related stress among older spousal caregivers providing hospice care for an older adult with cancer. Cases were selected from an ongoing randomized controlled trial that involved audiorecorded visits with caregivers over four different time points. Recordings consisted of caregivers discussing caregiving problems and ways they attempted to cope.

YouTube as a tool for pain management with informal caregivers of cancer patients: a systematic review.

Context: Cancer caregivers have information and support needs, especially about cancer pain management. With high Internet use reported among caregivers, YouTube may be an accessible option when looking for information on cancer pain management.

Objectives: The purpose of this study was to explore the availability and characteristics of instructional cancer pain management videos on YouTube and determine to what extent these videos addressed the role of informal caregivers in cancer pain management.

"It is the 'starting over' part that is so hard": Using an online group to support hospice bereavement.

Objective: Although hospice agencies are required to provide informal caregivers (family or friends of the patient) with formal bereavement support when their loved one passes, most bereavement interventions lack standardization and remain untested. We employed the Dual Processing Model of Bereavement as a theoretical framework for assessing the potential of a secret Facebook group for bereaved hospice caregivers.

Method: A mixed-methods approach was utilized to analyze online communication (posts and comments) in the secret Facebook group, and self-reported outcome measures on depression and anxiety were compared pre- and post-intervention.

Assessment of an interprofessional online curriculum for palliative care communication training.

Background: Curricular changes to palliative care communication training are needed in order to accommodate a variety of learners, especially in lieu of the projected national shortage of hospice and palliative medicine physicians and nurses.

Objective: This study assessed the utility of a palliative care communication curriculum offered through an online platform and also examined health care professionals' clinical communication experiences related to palliative care topics.

Design: Four of the seven modules of the COMFORT communication curriculum were made available online, and participant assessments and knowledge skills were measured.

Exploring the collective hospice caregiving experience.

Background: Collective caregiving, performed by caregivers working in pairs (informal primary and secondary caregivers working together), is common in the hospice setting. Research suggests that caregiving pairs may experience different caregiver outcomes. However, little is known about how caregiving pairs differ from solo caregivers (informal primary caregivers) on outcome measures.

Understanding social support burden among family caregivers.

Despite the abundance of research on social support, both as a variable in larger studies and as a central focus of examination, there is little consensus about the relationship between social support and health outcomes. Current social support measures typically account only for frequency and size of network, and a paucity of research exists that has explained social support burden, defined as the burden associated with accessing and receiving support from others. We analyzed audio-recorded discussions by hospice family caregivers about their caregiving problems and potential solutions to examine social relationships within networks and identify the processes that influence social support seeking and receiving.

Hospice caregiver depression: the evidence surrounding the greatest pain of all.

Terminal illness affects the entire family, both the one with the illness and their loved ones. These loved ones must deal not only with the loss but with the challenges of managing daily care. The purpose of the systematic review of the peer-reviewed literature was to identify and explore depression and related interventions for caregivers of hospice patients.

COMFORT: evaluating a new communication curriculum with nurse leaders.

Nursing faculty face increasing instructional demands to keep pace with mounting knowledge and competency requirements for student nurses. In the context of nursing practice, tasks and time pressures detract from the high skill and aptitude expectation of communication. The communication, orientation and opportunity, mindful presence, family, openings, relating, and team (COMFORT) curriculum, an acronym that represents 7 basic nursing communication principles, has been introduced into the communication module of the End-of-Life Nursing Education Consortium, which currently provides the only standardized undergraduate and graduate nurse training in hospice and palliative care.

Patient safety incidents in hospice care: observations from interdisciplinary case conferences.

Background: In the home hospice environment, issues arise every day presenting challenges to the safety, care, and quality of the dying experience. The literature pertaining to the safety challenges in this environment is limited.

Aim: The study explored two research questions; 1) What types of patient safety incidents occur in the home hospice setting? 2) How many of these incidents are recognized by the hospice staff and/or the patient or caregiver as a patient safety incident?

Design And Methods: Video-recordings of hospice interdisciplinary team case conferences were reviewed and coded for patient safety incidents.

Using medical words with family caregivers.

Background: Although there is poor communication about pain management between informal caregivers and hospice providers, little research has examined these interactions.

Objective: This study explored communication between informal caregivers and hospice team members by investigating the use of medical words in care planning discussions.

Design: Transcripts of clinical communication between caregivers and hospice team members were reviewed for use of medical words, word placement (statement or question), whether or not the word was explained, and the caregiver's response to the word.

Hospice caregivers' experiences with pain management: "I'm not a doctor, and I don't know if I helped her go faster or slower".

Context: Those caring for their loved ones in hospice experience tremendous stress, being faced with numerous decisions as they work to manage the pain experienced by their loved one. Although hospice care teams create pain management strategies, it is the role of the caregiver to implement these plans.

Objectives: The purpose of this study was to further understand the hospice caregiver experience relating to pain management.

Caregiver evaluation of the ACTIVE intervention: "it was like we were sitting at the table with everyone".

Central to the hospice philosophy is the belief that the patient/family owns the plan of care. However, barriers prevent the majority of hospice patients/families from participating in the meetings where plans are created and revised. This study evaluates the participant experience of the ACTIVE (assessing caregivers for team intervention via video encounters) intervention, designed to use web conferencing technology to overcome the barriers of participation in development and review of individual care plans.

Informal hospice caregiver pain management concerns: a qualitative study.

Background: Informal, unpaid, family caregivers provide much hospice care in the United States. These caregivers suffer physically, psychologically, emotionally, and socially from the burden of caring. The most often identified area of caregiver burden is the management of end-of-life pain.

Implementation science: implications for intervention research in hospice and palliative care.

This article provides a general introduction to implementation science-the discipline that studies the implementation process of research evidence-in the context of hospice and palliative care. By discussing how implementation science principles and frameworks can inform the design and implementation of intervention research, we aim to highlight how this approach can maximize the likelihood for translation and long-term adoption in clinical practice settings. We present 2 ongoing clinical trials in hospice that incorporate considerations for translation in their design and implementation as case studies for the implications of implementation science.

Palliative care communication in oncology nursing.

Oncology nurses consistently exhibit distress when communicating about end-of-life topics with patients and families. Poor communication experiences and processes correlate with emotional distress, moral distress, and work-related stress. The National Consensus Project (NCP) for Quality Palliative Care developed clinical practice guidelines to establish quality standards for the practice of palliative care.

Oncology nurse communication barriers to patient-centered care.

Although quality communication has been identified as a necessary component to cancer care, communication skills training programs have yet to focus on the unique role of nurses. This study explored communication barriers as reported by seven nurse managers to better identify communication skills needed for oncology nurses to practice patient-centered care. Thematic analysis of transcripts was used to identify barriers to patient and family communication and desirable patient-centered nursing communication skills.

Exploring oral literacy in communication with hospice caregivers.

Context: Low oral literacy has been identified as a barrier to pain management for informal caregivers who receive verbal instructions on pain medication and pain protocols.

Objectives: To examine recorded communication between hospice staff and informal caregivers and explore caregiver experiences.

Methods: Using transcripts of interactions (n = 47), oral literacy features were analyzed by examining the generalized language complexity using the Flesch-Kincaid grading scale and the dialogue interactivity defined by talking turns and interaction time.

Telehealth group interactions in the hospice setting: assessing technical quality across platforms.

Objective: This study aims to examine the technical quality of videoconferencing used in hospice to engage caregivers as "virtual" members of interdisciplinary team meetings and their impressions of telehealth. Furthermore, it aims to compare the quality of plain old telephone service (POTS) and Web-based videoconferencing and provide recommendations for assessing video quality for telehealth group interactions.

Materials And Methods: Data were obtained from an ongoing randomized clinical trial exploring Web-based videoconferencing and a completed prospective study of POTS-based videoconferencing in hospice.

Medical oncologists' perception of palliative care programs and the impact of name change to supportive care on communication with patients during the referral process. A qualitative study.

Objective: In a simultaneous care model, patients have concurrent access to both cancer-directed therapies and palliative care. As oncologists play a critical role in determining the need/timing of referral to palliative care programs, their understanding of the service and ability to communicate this with patients is of paramount importance. Our study aimed to examine oncologists' perceptions of the supportive care program at M.