IU Indianapolis ScholarWorks :: Browsing by Author "Rosa, William E."

Browsing by Author "Rosa, William E."

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Author Response to Reader's Comments to Fitzgerald Jones et al., Top Ten Tips Palliative Care Clinicians Should Know About Delivering Antiracist Care to Black Americans (DOI: 10.1089/jpm.2021.0502)
(Mary Ann Liebert, 2022) Jones, Katie Fitzgerald; Laury, Esther; Sanders, Justin; Starr, Lauren T.; Rosa, William E.; Booker, Staja Q.; Wachterman, Melissa; Jones, Christopher A.; Hickman, Susan; Merlin, Jessica S.; Meghani, Salimah H.; School of Nursing
Global Assessment of Palliative Care Need: Serious Health-Related Suffering Measurement Methodology
(Elsevier, 2024) Kwete, Xiaoxiao J.; Bhadelia, Afsan; Arreola-Ornelas, Héctor; Mendez, Oscar; Rosa, William E.; Connor, Stephen; Downing, Julia; Jamison, Dean; Watkins, David; Calderon, Renzo; Cleary, Jim; Friedman, Joseph R.; De Lima, Liliana; Ntizimira, Christian; Pastrana, Tania; Pérez-Cruz, Pedro E.; Spence, Dingle; Rajagopal, M. R.; Vargas Enciso, Valentina; Krakauer, Eric L.; Radbruch, Lukas; Knaul, Felicia Marie; Medicine, School of Medicine
Context: Inequities and gaps in palliative care access are a serious impediment to health systems especially in low- and middle-income countries and the accurate measurement of need across health conditions is a critical step to understanding and addressing the issue. Serious Health-related Suffering (SHS) is a novel methodology to measure the palliative care need and was originally developed by The Lancet Commission on Global Access to Palliative Care and Pain Relief. In 2015, the first iteration - SHS 1.0 - was estimated at over 61 million people worldwide experiencing at least 6 billion days of SHS annually as a result of life-limiting and life-threatening conditions. Objectives: In this paper, an updated methodology - SHS 2.0 - is presented building on the work of the Lancet Commission and detailing calculations, data requirements, limitations, and assumptions. Methods and results: The updates to the original methodology focus on measuring the number of people who die with (decedents) or live with (non-decedents) SHS in a given year to assess the number of people in need of palliative care across health conditions and populations. Detail on the methodology for measuring the number of days of SHS that was pioneered by the Lancet Commission, is also shared, as this second measure is essential for determining the health system responses that are necessary to address palliative care need and must be a priority for future methodological work on SHS. Conclusions: The methodology encompasses opportunities for applying SHS to future policy making assessment of future research priorities particularly in light of the dearth of data from low- and middle-income countries, and sharing of directions for future work to develop SHS 3.0.
Integrating Palliative Care into Nursing Care
(Wolters Kluwer, 2022) Parekh de Campos, Amisha; Levoy, Kristen; Pandey, Shila; Wisniewski, Renee; DiMauro, Pierce; Ferrell, Betty R.; Rosa, William E.; School of Nursing
The need for palliative care in our health care system has exponentially increased in the past few years as a result of the COVID-19 pandemic, the aging population, and the increasing number of people living with serious illnesses. While nurses play a critical role in delivering palliative care, many lack confidence and knowledge, causing practice gaps in the clinical and psychological management of seriously ill patients. The collective burden of the pandemic has demonstrated the importance of palliative care education and training, specifically in communication, symptom management, and continuing education. All nurses, including nursing students, transitioning nurses, and practicing nurses, should be trained to offer generalist (or primary) palliative care, in accordance with the American Association of Colleges of Nursing Essentials: Core Competencies for Professional Nursing Education. Provision of holistic, relationship-based, and integrated palliative care for patients and their families is an ethical obligation for all nurses.
"It's Rougher on Me Than It Is on Him": Family Caregiver-Generated and Prioritized Illness Concerns While Patients Undergo Cancer Treatments
(American Society of Clinical Oncology, 2022) Levoy, Kristin; Wool, Jesse; Ashare, Rebecca L.; Rosa, William E.; Barg, Frances K.; Meghani, Salimah H.; School of Nursing
Purpose: Research eliciting patients' illness concerns has typically focused later in the cancer continuum, rather than during cancer treatments. Family caregiver concerns are overlooked during this time. Less is known about how patients and caregivers prioritize concerns during cancer treatments, which holds potential for improving supportive oncology care (ie, primary palliative care). The purpose of this study was to elicit and compare which domains of supportive oncology are of highest importance to patients and caregivers during cancer treatments. Methods: Freelisting, a cognitive anthropology method, was used to elicit concerns in order of importance. Freelist data were analyzed using Smith's salience index. Qualitative interviews were conducted with a caregiver subsample to add explanatory insights. Results: In descending order, pain, death, fear, family, and awful were salient Freelist items for patients (n = 65), whereas sadness, time-consuming, support, anger, tired, death, and frustration were salient for caregivers (n = 24). When integrated with supportive oncology domains, patients' concerns reflected a prioritization of the physical (pain) and emotional (death, fear, and awful) domains, with less emphasis on social (family) aspects. Caregivers' prioritized the emotional (sadness, anger, death, and frustration) and social (time-consuming and support) domains, with less emphasis on the physical (tired) aspects. Conclusion: Our findings suggest that enhancing primary palliative care delivery by oncology teams requires systems thinking to support both the patient and caregiver as the primary unit of care. Primary palliative care may be improved by prioritizing interventions that address physical concerns among patients as well as key social concerns among caregivers to support the complex caregiving role while patients undergo cancer treatments.
Palliative care delivery changes during COVID-19 and enduring implications in oncology nursing: a rapid review
(Wolters Kluwer, 2022) Levoy, Kristin; Foxwell, Anessa; Rosa, William E.; School of Nursing
Purpose of review: A rapid review was conducted to synthesize evidence of palliative care delivery changes during the COVID-19 pandemic. Changes were synthesized according to the eight domains of high-quality palliative care and enduring implications for oncology nurses beyond the pandemic discussed. Recent findings: The most significant changes occurred in the structure and processes of palliative care (Domain 1), where increased utilization of telehealth was critical in circumventing barriers imposed by COVID-19 mitigation. The suboptimal availability of community-based psychosocial supports for patients and caregivers and inadequate health system-based psychosocial supports for healthcare providers were highlighted (Domains 3-5). The pandemic also ushered in an increased emphasis on the need for advance care planning (ACP), where integrating its delivery earlier in the outpatient setting and shifting policy to promote subsequent virtual documentation (Domain 8) were essential to ensure care preferences were clarified and accessible before health crises occurred. Summary: Continuing to embrace and sustain systems-level changes with respect to telehealth, psychosocial supports, and ACP are critical to bridging gaps in palliative care delivery underscored by the pandemic. Oncology nurses are well positioned to fill these gaps in care beyond the pandemic by providing evidence-based, palliative care throughout the cancer continuum.
The evolution of serious health-related suffering from 1990 to 2021: an update to The Lancet Commission on global access to palliative care and pain relief
(Elsevier, 2025) Knaul, Felicia M.; Arreola-Ornelas, Héctor; Kwete, Xiaoxiao J.; Bhadelia, Afsan; Rosa, William E.; Touchton, Michael; Méndez-Carniado, Oscar; Vargas Enciso, Valentina; Pastrana, Tania; Friedman, Joseph R.; Connor, Stephen R.; Downing, Julia; Jamison, Dean T.; Krakauer, Eric L.; Watkins, David; Calderon-Anyosa, Renzo; Garcia-Santisteban, Rodrigo; Nargund, Renu S.; Cleary, Jim; De Lima, Liliana; Gafer, Nahla; Grant, Liz; Ntizimira, Christian; Pérez-Cruz, Pedro E.; Rajagopal, M. R.; Spence, Dingle; Vila, Paul; Radbruch, Lukas; Medicine, School of Medicine
Background: The Lancet Commission on global access to palliative care and pain relief introduced the concept of serious health-related suffering (SHS) to measure the worldwide dearth of palliative care. This Article provides an extended analysis of SHS from 1990 to 2021 and the corresponding global palliative care need. Methods: This Article is the first to apply the SHS 2·0 method published in 2024, incorporating prevalence data from the Global Burden of Diseases, Injuries, and Risk Factors Study to improve non-decedent estimates that account for country-level epidemiological variation; adjusting for non-decedent double counting of HIV/AIDS, cancer, cerebrovascular disease, and dementia; improving the non-decedent estimates for cancer using survivorship data from the Global Cancer Observatory and for HIV/AIDS incorporating access to antiretroviral therapy; differentiating by sex; considering more specific age groups allowing for better estimates, especially in children; and adding endocrine, metabolic, blood, and immune disorders to the health conditions causing SHS. We describe SHS trends globally and within country income groups, differentiating among decedents and non-decedents, by health conditions, sex, and across child and adult age groups. Findings: The SHS global burden increased by 74% between 1990 and 2021 to almost 73·5 million individuals, with population growth accounting for only half of that increase. Low-income and middle-income countries (LMICs) accounted for 80% of SHS, with an increase of 83% from 1990 to 2021 compared with a 46% increase in high-income countries (HICs). Between 1990 and 2021, the decedent burden increased by 35%, whereas SHS in non-decedents more than doubled, accounting for 63% of SHS by 2021. The proportion of SHS from communicable diseases declined, especially in LMICs; however, the absolute number stayed relatively stable and even increased from 2019 to 2021 with the start of the COVID-19 pandemic. SHS from non-communicable diseases drastically increased, led by cancer (excluding leukaemia), cardiovascular diseases, and dementia in HICs. HIV/AIDS continued to be a major contributor, accounting for a substantial share of SHS in sub-Saharan Africa. The share of SHS in children decreased from 25% of SHS in 1990 to 14% in 2021 and accounted for 33% of SHS in low-income countries, compared with 2% in HICs. In 2021, SHS in low-income countries was concentrated in female individuals aged 20-49 years (affecting 59% of this population); in HICs, SHS was concentrated in female individuals aged 70 years and older (affecting 54% of this population and probably related to dementia). Interpretation: SHS and the associated need for palliative care is a major and persistent but not insurmountable challenge for health systems worldwide. Our findings highlight the urgency to both reduce the avoidable SHS burden through prevention and treatment, and guarantee comprehensive, universal access to palliative care as an equity and health system imperative, especially in LMICs.
Three-Year Nursing PhD Model Recommendations from the RWJF Future of Nursing Scholars
(Slack, 2022) Rosa, William E.; Hartley, Kim; Hassmiller, Susan B.; Frisch, Stephanie O.; Bennett, Stephanie G.; Breen, Katherine; Goldberg, Jessica I.; Koschmann, Kara S.; Missel, Amanda L.; Parekh de Campos, Amisha; Pho, Anthony T.; Rausch, Jamie; Schlak, Amelia E.; Shook, Alic; Tierney, Meghan K.; Umberfield, Elizabeth; Fairman, Julie A.; School of Nursing
Background: In response to the 2011 Future of Nursing report, the Robert Wood Johnson Foundation created the Future of Nursing Scholars (FNS) Program in partnership with select schools of nursing to increase the number of PhD-prepared nurses using a 3-year curriculum. Method: A group of scholars and FNS administrative leaders reflect on lessons learned for stakeholders planning to pursue a 3-year PhD model using personal experiences and extant literature. Results: Several factors should be considered prior to engaging in a 3-year PhD timeline, including mentorship, data collection approaches, methodological choices, and the need to balance multiple personal and professional loyalties. Considerations, strategies, and recommendations are provided for schools of nursing, faculty, mentors, and students. Conclusion: The recommendations provided add to a growing body of knowledge that will create a foundation for understanding what factors constitute "success" for both PhD programs and students.
Top Ten Tips Palliative Care Clinicians Should Know About Delivering Antiracist Care to Black Americans
(Mary Ann Liebert, 2022) Jones, Katie Fitzgerald; Laury, Esther; Sanders, Justin J.; Starr, Lauren T.; Rosa, William E.; Booker, Staja Q.; Wachterman, Melissa; Jones, Christopher A.; Hickman, Susan; Merlin, Jessica S.; Meghani, Salimah H.; School of Nursing
Racial disparities, including decreased hospice utilization, lower quality symptom management, and poor-quality end-of-life care have been well documented in Black Americans. Improving health equity and access to high-quality serious illness care is a national palliative care (PC) priority. Accomplishing these goals requires clinician reflection, engagement, and large-scale change in clinical practice and health-related policies. In this article, we provide an overview of key concepts that underpin racism in health care, discuss common serious illness disparities in Black Americans, and propose steps to promote the delivery of antiracist PC.
Using the Nurse Coaching Process to Support Bereaved Staff During the COVID-19 Crisis
(Wolters Kluwer, 2021) Rosa, William E.; Levoy, Kristin; Battista, Vanessa; Dahlin, Constance; Thaxton, Cheryl; Greer, Kelly; School of Nursing
Nurses are confronting a number of negative mental health consequences owing to high burdens of grief during COVID-19. Despite increased vaccination efforts and lower hospitalization and mortality rates, the long-term effects of mass bereavement are certain to impact nurses for years to come. The nurse coaching process is an evidence-based strategy that nurse leaders can use to assist staff in mitigating negative mental health outcomes associated with bereavement. The End-of-Life Nursing Education Consortium brought together a team of palliative nursing experts early in the pandemic to create resources to support nurses across settings and promote nurse well-being. This article shares a timely resource for health systems and nursing administration that leverages the nurse coaching process to support bereaved staff in a safe and therapeutic environment.

Browsing by Author "Rosa, William E."

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