Lorene Gray

Date of Award


Document Type

Independent Study

Degree Name

Master of Science in Nursing (MSN)


Palliative care has expanded beyond just caring for people at end-of-life to improving quality of life for all people living with serious, complex, and eventually terminal illnesses. Because of these changes, the need for palliative care services is increasing and nurses must be prepared to understand and provide care for this population. It has been difficult to develop quantifiable outcome measures to define the patients' perception of quality of life because of the difficulty conducting research at endof- life.

The purpose of this review of literature and subsequent independent study project is to better understand, identify and describe the quality of life issues that are of most importance to patients at this stage of life so that the following clinical question can be answered

"What measures of quality of life are most important to adult palliative care patients while receiving care from a home care agency in a rural setting?"

The results of the review of literature showed that the patient-derived description of quality of life is focused more on the outcomes of their care; and focus on the patients' desires for care was found to help patients achieve a sense of control, thereby improving their perception of quality end-of-life care. Education of staff to meet the needs of palliative care patients who are living at home is essential to assist in providing the quality of life that the palliative care patient deserves and desires

The project described is a multi-session educational program developed and implemented for the training of the nursing staff of a small rural home health and hospice agency. The series includes lecture/discussion sessions with visual aids, take home study guides and covers a variety of topics organized around the eight domains of palliative care as determined by the National Consensus Project in their recently updated Clinical Practice Guidelines for Quality Palliative Care (National Consensus Project for Quality Palliative Care, 2009). The method used to assess the effectiveness of the learning was a needs assessment quiz. After completion of the series, the results of the needs assessment quiz showed an overall improvement of 27% in the nurses' perception of their competence to perform the skills associated with each of the eight domains