Publications by authors named "Marian S Grant"

Article Synopsis
  • * A qualitative study utilized interviews and imagery from 20 healthcare providers to uncover their underlying beliefs and emotional views regarding palliative care using the Zaltman Metaphor Elicitation Technique.
  • * Key themes revealed include concerns about delivering the "right" information, risk aversion in decision-making, reliance on clinical algorithms, and the subjective nature of palliative care, which can inform better outreach and messaging strategies.
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When speaking to public audiences, palliative care advocates often reach for personal experiences of great meaning and significance in their own lives, and often distill those experiences to a key message. However, this approach may not be the most effective way to engage a public audience whose closest experience with palliative care is based on social media or third-hand stories. Research demonstrates that the lay public often starts with inaccurate assumptions about palliative care, including that it is only for people at end of life.

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Article Synopsis
  • * Qualitative research using deep metaphors reveals that patients experience significant emotional disruptions due to serious illness, including feelings of shame, a lack of agency, and loss of identity.
  • * Participants expressed a need for validation, autonomy in their care, guidance to resources, and a chance to rebuild their identity, which can inform future campaigns to enhance public understanding of Palliative Care.
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A year ago, we began a project designed to align public messages from 10 organizations involved in advance care planning (ACP), palliative care (PC), and hospice to increase public engagement. By public messaging, we are referring to a well-established evidence-driven method of disseminating information at scale that enables the public to take action to protect their health. Our project plan was upended by the coronavirus disease 2019 (COVID-19) pandemic-but we used the opportunity to conduct focus groups during the pandemic that, compared with focus groups conducted before the pandemic, provide an important portrait of public perceptions of serious illness care that can be used to design for greater public engagement.

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Article Synopsis
  • Despite increased access to advance care planning (ACP), palliative care, and hospice, public attitudes still pose challenges to their effective use, requiring better public messaging.
  • A review of 12 studies, with over 9,800 participants, showed that while awareness of ACP is high (80-90%), actual engagement is low (10-41% have named a proxy or completed documentation).
  • For palliative care, 66-71% of participants were unaware of it, but 95% reacted favorably when given a clear definition, while hospice awareness was high at 86%, but misconceptions remained in 37% of respondents.
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Objectives: Effective communication skills are fundamental to good nursing care and required by certification bodies for nursing education. The purpose of this literature review was to update one done in 2002 of communication education to pre-licensure registered nursing students. That review concluded that it was unclear which interventions were most effective due to methodological and other quality issues.

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Objective: Increasing evidence demonstrates the benefits of online cancer interventions but very little about the needs of those with pancreatic cancer or interaction with online providers. Our study was done to (1) see how many people would visit a webpage where they could interact with a palliative care nurse practitioner (PCNP), (2) see how many would ask the PCNP questions, (3) determine the type of questions, and (4) obtain feedback regarding the usefulness of the webpage.

Method: Mixed-methods descriptive design.

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Families of older adults are intricately involved in the end-of-life decision-making process for a family member with a serious illness in the intensive care unit (ICU) setting. However, families are not always as involved and as informed as they would like to be. Creating a culture that assesses family needs and supports families is an important component of family-centered care.

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Despite advances in pain management, little formal teaching is given to practitioners and nurses in its use for postoperative orthopedic patients. The goal of our study was to determine the educational needs for orthopedic pain management of our residents, nurses, and physical therapists using a quantitative and qualitative assessment. The needs analysis was conducted in a 10-bed orthopedic unit at a teaching hospital and included a survey given to 20 orthopedic residents, 9 nurses, and 6 physical therapists, followed by focus groups addressing barriers to pain control and knowledge of pain management.

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Context: Patients with pancreatic cancer and their families are candidates for palliative care given the physical, emotional, and existential aspects of this serious illness. However, they may not have access to it while pursuing aggressive treatment, or due to physical location or lack of awareness of these services. The Internet may offer a way to overcome these barriers as it is quickly becoming an important health resource and link between patients, families, and health care providers.

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Objective: The objective of this study was to identify venipuncture and blood draw factors associated with hemolysis (red blood cell damage) of ED blood samples.

Methods: A convenience sample of ED blood samples was studied for degree of hemolysis and phlebotomy technique using data obtained from surveys completed by ED nurses and/or ED clinical technicians. The questionnaires were submitted with each blood sample sent to the laboratory for diagnostic testing.

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