13 In this study we extend the use of LSA to communication between cancer caregivers and hospice nurses during home hospice nursing visits. 12 LSA assigns values from 0 (signifying low similarity) to 1 (high similarity) and has been effectively used to assess communication similarity between patients and physicians. 10, 11 Latent Semantic Analysis (LSA) is a quantitative analytical approach that has proven useful when assessing communication similarity because it provides comparison of words that contain similar semantic information, that is, comparing different words that have similar meaning. Evaluating and assessing similarity is a measurement challenge given the inherent messiness of real life communication interactions. One indicator of successful communication interactions is communication similarity, defined in this study as hospice nurses and caregivers communicating about the same topic. 7, 8 However, effective communication is often hard to define, measure, and quantify. 4– 6 When communication and the development of a partnership between hospice nurses and caregivers is successful, caregiver burden and distress is reduced, patient symptom management is enhanced, and caregiver bereavement adjustment is improved. 3, 4 Effective communication skills facilitate nurses’ ability to engage in family and/or patient-centered communication, elicit and understand caregiver concerns in a culturally respectful manner, and to respond in an empathetic way that conveys accurate information and reassurance. 2 Caregivers look to the hospice nurse for information, validation, and support. Home Hospice settings are unique in that end-of-life cancer patient care is usually planned for by a hospice nurse but predominantly delivered by the caregiver due to the around the clock nature of patient needs. Optimally, hospice care delivery results in the creation of a mutual working/caring relationship between the hospice nurse, patient and caregiver. 1 During hospice care delivery, hospice nurses strive to understand each family’s unique experiences, meet emotional and physical needs, and develop a partnership with the family. 1, 2 The National Consensus Project for Hospice and Palliative Care has placed a renewed emphasis on communication during the delivery of end-of-life care across all 8 identified standards of quality hospice care delivery. In 2016 1.43 million Medicare beneficiaries received hospice care, with the majority of hospice patients receiving care at home, and having a cancer diagnosis. The number of families who receive hospice services is growing, and by extension so is the number of families who engage with hospice nurses. “You’ve made me understand so many things.Communication between cancer patients, family caregivers, and hospice nurses is an essential component of the provision of optimal end-of-life care. “Thank you for taking the fear out of this journey,” commented one person, while another one added: Julie has received a lot of heart-warming comments from her followers for breaking the taboo about talking about death. “They’re usually not afraid, it’s usually very comforting to them and they usually say they’re sending a message like ‘we’re coming to get you soon’ or ‘don’t worry, we’ll help you.’ Most people love this, they’re very comforted by it, it’s not scary to them.” Sometimes it’s through a dream, sometimes they physically see them, and they’ll actually ask us ‘Do you see what I’m seeing,'” Julie explained. “It usually happens a month or so before the patient dies, they start seeing dead relatives, dead friends, old pets that have passed on, spirits, angels, that are visiting them and only they can see them. In a second video, Julie opened up about another phenomenon which sees patients seeing dead family members, friends or pets before they die. View TikTok Nurse explains second phenomenon
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