Tennessee Nurse - May 2022

May, June, July 2022 Tennessee Nurse Page 21
symptom control for patients with a terminal illness.
Hospice does not focus efforts on curative treatment;
rather, energy is diverted to nursing, psychosocial, and
spiritual support to facilitate a collaborative approach.
While many areas of healthcare strive for a multidisciplinary
team approach hospice accomplishes this
via a system built upon collaboration. Incorporating
spiritual care, medical social workers, massage, pet
therapy, trained volunteer support, and bereavement
services provide a rich support network for patients
and families. Further, hospice regards patients and
their families as a unit; and focuses care efforts on
both entities. The ANA highlights the importance of
inter-disciplinary collaboration and establishing patient
trust via nurse advocacy. Hospice care serves as a
viable model for this assignment.
Concept Development Process
The CINAHL database was queried for “hospice
care”; the search was further refined by literature
that is written in the English language, published from
2012 to 2021, and the results had to have full-text
availability. Finally, in keeping with the purpose of this
analysis, the first author of each publication must be a
nurse. A total of 215 articles were retrieved utilizing this
search criterion. Ten articles were selected at random
representing a variety of contexts, including hospice
education and practice, pediatric hospice and palliative
care, nurse practitioner documentation, hospice patient
education, end-of-life care in the inpatient setting, and
cultural constructs of death. Each selected manuscript
has the word “hospice” within the text.
Attributes of Hospice Care
Clarification of the concept of hospice care
revealed a common thread of comfort, palliative care,
collaboration, and patient education within care. These
themes divulge the special and meaningful nature of
hospice interactions. The term palliative was recognized
as a recurring attribute of hospice care; this theme is
somewhat confusing, as the two terms sometimes are
used interchangeably, but they aren’t identical in nature.
This provides an opportunity for further research to
distinguish between the two concepts. Comfort was
identified as an attribute of hospice care. The attribute
of comfort aligns with NIH guidance regarding endof-life
care. Comfort is a cornerstone of hospice care
and is at the forefront of hospice nursing. Another
recurring characteristic is the collaborative approach
to care. Again this is a foundational concept of the
hospice movement, and it utilizes multidisciplinary
professionals to provide a team approach to hospice
care. The final attribute noted was the importance
of patient and family education. This illuminates the
complex nature of hospice care; especially within the
home setting. Hospice nurses have complex roles that
include extensive patient and family education during
high-stress situations. The occurrence of this theme
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within the literature reinforces this essential attribute
and highlights the importance of effective patient and
family education.
Through literature review and reflection on
the concept of hospice care, this paper has added
additional depth to the concept of hospice care.
The NINR lists “relieving symptoms and suffering”
and “understanding decision-making by patients,
caregivers, and health care providers” as prominent
research goals, and this concept analysis of hospice
care aligns with said goals. This additional information
can benefit current and future hospice patients and
nursing professionals caring for hospice patients. By
embracing the fluid nature of hospice care one can
have a better understanding of the concept. Utilizing
this new information will assist with progression and
reveal relevant research paths.
Antecedents of Hospice Care
The most common antecedents were end-oflife
and 6 months or less life expectancy. These are
unsurprising as hospice care is end-of-life care. One
can argue that these are different words to describe
the same thing, however, there are small variations
within each, and both shed light on the concept of
hospice care. Acknowledgment of these similar terms
can facilitate improved nursing communication with
hospice patients and families. Healthcare professionals
often use technical and possibly confusing language
when interacting with their patients and families. The
realization of these antecedents can be employed
with the help of therapeutic communication to
clearly articulate common goals and expected patient
prognosis.
Conclusion
This concept analysis has revealed the
multidimensional nature of hospice care. Further,
through the systematic process of redefinition, the
importance of the educational component of hospice
has been realized and expanded upon. Birth and death
are certainties for all persons; dying with support
enables a good death and a meaningful experience for
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FOR YOURSELF.
the patient and family. Building upon the information
learned from this concept analysis of hospice care
adds additional information to the pre-analysis
definition. Initiating hospice care early facilitates
therapeutic communication and builds trust within
the nurse-patient relationship. Hospice represents the
humanization of healthcare; it seeks to alleviate the
unpleasant aspects of death and highlight the intimate
nature of the process.
Appendix B
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