2.50
Hdl Handle:
http://hdl.handle.net/10755/154871
Type:
Presentation
Title:
The Culture of Care: End-of-Life Care Delivery in Specialty Clinics
Abstract:
The Culture of Care: End-of-Life Care Delivery in Specialty Clinics
Conference Sponsor:Sigma Theta Tau International
Conference Year:2011
Author:Penrod, Janice, PhD, RN
P.I. Institution Name:The Pennsylvania State University
Title:Associate Professor of Nursing
Co-Authors:Brenda L. Baney BS, Research Coordinator
Peggy Z. Shipley RN, Graduate Assistant
Judith Hupcey EdD, Assistant Professor
Susan J. Loeb PhD, RN, Associate Professor of Nursing
[22nd International Nursing Research Congress - Research Presentation] Purpose: To highlight variations in five inter-related spheres of cultural influence that  influence end-of-life care in three distinct care delivery models.
Methods:  Ethnographic methods were used to examine cultural influences on the delivery of end-of-life care in three specialty clinics serving patients with life-limiting or terminal conditions (including amyotrophic lateral sclerosis, advanced lung cancer, and heart failure). Data consisted of over 450 observations of  patient visits, supplemented by interviews with key informants and observations of general clinic milieu. Prolonged immersion in the filed (>12 months) promoted the rigor of the study. Item level analysis and pattern analysis were applied in an iterative analytic process to reveal the shared values and beliefs that influenced care delivery in each distinct setting.
Results: Shared values, based in expectations of the illness trajectory and related care, were evident in each clinic--that is, a distinct culture of care was evident in each setting. Five interdependent, co-occurring spheres of influence were identified as shaping the care delivery system: Role of  formal providers, Perception of patient system, Continuum of care across the illness trajectory, Context of the illness experience, Focus of the visit across the illness trajectory. Different constellations of the spheres of influence created distinct models of the dominant care delivery system in each clinic, including: Interdisciplinary; Network Cooperative; and Provider Dominant. The models of care delivery varied significantly in addressing end-of-life issues with the patient and informal family caregiver.
Conclusion: The culture of care manifest in a care delivery system is shaped by shared values and beliefs. Varied configurations of five co-occurring components of the culture of care shape distinct models of care delivery. These models influence how end-of-life care is conceived and delivered. Nurses are instrumental in shaping the culture of care and are positioned to change the care delivery system.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleThe Culture of Care: End-of-Life Care Delivery in Specialty Clinicsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/154871-
dc.description.abstract<table><tr><td colspan="2" class="item-title">The Culture of Care: End-of-Life Care Delivery in Specialty Clinics</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2011</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Penrod, Janice, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The Pennsylvania State University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor of Nursing</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jlp198@psu.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Brenda L. Baney BS, Research Coordinator<br/>Peggy Z. Shipley RN, Graduate Assistant<br/>Judith Hupcey EdD, Assistant Professor<br/>Susan J. Loeb PhD, RN, Associate Professor of Nursing</td></tr><tr><td colspan="2" class="item-abstract">[22nd International Nursing Research Congress - Research Presentation] Purpose:&nbsp;To highlight variations in five inter-related spheres of cultural influence that&nbsp; influence end-of-life care in three distinct care delivery models. <br/>Methods:&nbsp;&nbsp;Ethnographic methods were used to examine cultural influences on the delivery of end-of-life care in three specialty clinics serving patients with life-limiting or terminal conditions (including amyotrophic lateral sclerosis, advanced lung cancer, and heart failure). Data consisted of over 450 observations of&nbsp; patient visits, supplemented by interviews with key informants and observations of general clinic milieu. Prolonged immersion in the filed (&gt;12 months) promoted the rigor of the study. Item level analysis and pattern analysis were applied in an iterative analytic process to reveal the shared values and beliefs that influenced care delivery in each distinct setting. <br/>Results: Shared values, based in expectations of the illness trajectory and related care, were evident in each clinic--that is, a distinct culture of care was evident in each setting. Five interdependent, co-occurring spheres of influence were identified as shaping the care delivery system: Role of&nbsp; formal providers, Perception of patient system, Continuum of care across the illness trajectory, Context of the illness experience, Focus of the visit across the illness trajectory. Different constellations of the spheres of influence created distinct models of the dominant care delivery system in each clinic, including: Interdisciplinary; Network Cooperative; and Provider Dominant. The models of care delivery varied significantly in addressing end-of-life issues with the patient and informal family caregiver. <br/>Conclusion: The culture of care manifest in a care delivery system is shaped by shared values and beliefs. Varied configurations of five co-occurring components of the culture of care shape distinct models of care delivery. These models influence how end-of-life care is conceived and delivered. Nurses are instrumental in shaping the culture of care and are positioned to change the care delivery system.</td></tr></table>en_GB
dc.date.available2011-10-26T13:20:48Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T13:20:48Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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