title: Diffusion effects of an inpatient hospice unit on improving the parent hospital's pain management of terminally ill cancer patients not receiving hospice care in Taiwan.
abstract: BACKGROUND
  The impact of hospice care on cancer-pain management at the institutional level of an acute-care hospital setting has not been addressed in prior research.
  
  
  OBJECTIVE
  The aim of the study was to investigate the diffusion effects of an inpatient hospice unit on improving the parent hospital's quality of pain management.
  
  
  METHODS
  A convenience sample of 1370 terminally ill cancer patients not receiving hospice care in Taiwan measured pain relief experiences and perceived pain-management practices of healthcare professionals.
  
  
  RESULTS
  Taiwanese terminally ill cancer patients in the with-hospice group were 2.40 times (95% confidence interval [CI], 1.53-3.76]) more likely than those in the without-hospice group to report their pain as not controlled before hospital admission. However, after patients with uncontrolled pain were hospitalized, they were equally as likely as those in the without-hospice group to report pain as not yet been relieved when interviewed (adjusted odds ratio, 1.42; 95% CI, 0.77-2.64). Patients in the with-hospice group were (1) less likely to complain about waiting too long for pain medication (adjusted odds ratio, 0.41; 95% CI, 0.18-0.93) and (2) more or as likely to rate the amount of pain medication received as adequate (depending on the status of adequate pain control before admission) than/as those from hospitals without an inpatient hospice unit.
  
  
  CONCLUSIONS
  Hospice care may add value at the institutional level by effectively and appropriately managing cancer pain of Taiwanese terminally ill patients not receiving hospice care.
  
  
  CONCLUSIONS
  Translation of evidence-based strategies to manage cancer pain could be facilitated by expanding collaboration between hospice-care professionals and other healthcare professionals both within and among institutions.
authors.affiliation: Chang Gung University, Graduate School of Nursing, Tao-Yuan, and Nursing Department, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China. sttang@mail.cgu.edu.tw
authors.forename: Siew Tzuh
authors.initials: ST
authors.lastname: Tang
mesh_terms: D001294:Attitude to Health; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004059:Diffusion of Innovation; D005260:Female; D017051:Hospice Care / Q000458:organization & administration* / Q000523:psychology; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000150:complications*; D015403:Nursing Evaluation Research; D010146:Pain / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D010147:Pain Measurement; D015397:Program Evaluation; D013624:Taiwan; D019452:Terminally Ill / Q000523:psychology; D017749:Total Quality Management / Q000458:organization & administration