Betty R. Ferrell's research while affiliated with City of Hope National Medical Center and other places

Publications (222)

Article
Importance: Despite growing evidence, the role of spirituality in serious illness and health has not been systematically assessed. Objective: To review evidence concerning spirituality in serious illness and health and to identify implications for patient care and health outcomes. Evidence review: Searches of PubMed, PsycINFO, and Web of Scien...
Article
Background: Family caregivers provide complex care for patients with cancer, including management of multiple symptoms associated with the disease and its treatment. Objectives: The objective of this pilot project was to develop and conduct feasibility testing of a family caregiver educational intervention for symptom management. Methods: The...
Article
Background: Pancreatic cancer patients often present with complications, which can impact treatment tolerance. Thus, symptom management is a vital component of treatment in addition to traditional chemotherapeutics. Concurrent palliative care with an emphasis on aggressive symptom management may sustain both clinical and patient-centered outcomes d...
Article
Background Mutually respectful and long-term global partnerships are critical to increasing hospice and palliative care access as a key component of universal health coverage. The importance of sustained, transnational palliative care collaboration has become more urgent since the COVID-19 pandemic. Aim To provide an overview of characteristics fo...
Article
The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. Part I of this consensus paper herein provides the rationale and background to support the policy...
Article
The purpose of this consensus paper was to convene leaders and scholars from eight Expert Panels of the American Academy of Nursing and provide recommendations to advance nursing's roles and responsibility to ensure universal access to palliative care. On behalf of the Academy, these evidence-based recommendations will guide nurses, policy makers,...
Chapter
This chapter reviews advances in nursing education as well as future needs to prepare clinical nurses for palliative care. Nurses are an essential component of the palliative care workforce across all patient populations and settings. The delivery of quality palliative care requires nursing care which includes competency in physical, psychosocial,...
Article
The Interprofessional Spiritual Care Curriculum (ISPEC) was created to train interdisciplinary health care teams to recognize and address the spiritual needs of seriously or chronically ill patients. The curriculum, in a train-the-trainer format, employs didactic presentations, discussions, lab sessions, skill demonstrations, and video clips. In co...
Article
Context: Palliative care access is fundamental to the highest attainable standard of health and a core component of universal health coverage. Forging universal palliative care access is insurmountable without strategically optimizing the nursing workforce and integrating palliative nursing into health systems at all levels. The COVID-19 pandemic...
Article
Objective The objective of this training project is to develop and host Interprofessional Communication courses to improve interdisciplinary communication in oncology care. The initial national course was held in a virtual format and included pre- and post-course participant data. The curriculum was developed with support from the National Cancer I...
Article
The COVID-19 pandemic continues to affect the health and well-being of individuals and communities worldwide. Patients with cancer are particularly vulnerable to experiencing serious health-related suffering from COVID-19. This requires oncology nurses in inpatient and clinic settings to ensure the delivery of primary palliative care while consider...
Article
Background: COVID-19 has highlighted the need for universal palliative care access. Nurses require palliative care education throughout the trajectory of professional training to effectively achieve this vision. Method: Review of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care and use of educational exempl...
Chapter
This chapter describes prevalence estimates of cancer caregivers in the United States and provides a comprehensive review of the effect of cancer on caregivers’ psychological, physical, and financial well-being. The unique burden faced by spouse caregivers versus adult child caregivers is clearly delineated. Four evidence-based interventions to ass...
Article
Background The coronavirus disease 2019 pandemic has led to escalating infection rates and associated deaths worldwide. Amid this public health emergency, the urgent need for palliative care integration throughout critical care settings has never been more crucial. Objective To promote palliative care engagement in critical care; share palliative...
Article
The COVID-19 crisis has amplified the importance of palliative care to countless patients suffering with and dying from this disease, as well as to their families, communities, and the worldwide cadre of overburdened healthcare workers. Particularly urgent is the need for spiritual care specialists and generalists to address spiritual suffering giv...
Article
The alleviation of suffering during the COVID-19 pandemic - William E. Rosa, Betty R. Ferrell, Allison J. Applebaum
Article
12107 Background: Symptoms are common among patients enrolled in phase I trials. To integrate the patient perspective, the National Cancer Institute developed a patient-reported outcomes version of the CTCAE (PRO-CTCAE) to capture symptomatic adverse events (AEs) directly from patients; however, the tool has not been used often in early phase trial...
Article
12001 Background: The purpose of this study was to test a Palliative Care Intervention for patients with solid tumors enrolled in phase I therapeutic trials. Methods: This randomized trial compared patients accrued to phase I Clinical Trials in groups of Usual Care compared to a Palliative Care Intervention (PCI) in two comprehensive cancer centers...
Article
Palliative care began in academic centers with specialty consultation services, and its value to patients, families, and health systems has been evident. The demand for palliative care to be integrated throughout the cancer trajectory, combined with a limited palliative care workforce, means that new models of care are needed. This review discusses...
Article
48 Background: Patients with solid tumors in Phase 1 clinical trials are at an important phase in the cancer trajectory. Understanding patients’ experiences can guide healthcare providers to provide optimum care. The main objectives of this study were to describe patient perspectives on participating in a Phase 1 trial, understand their disease sta...
Article
Purpose: To explore palliative care and oncology clinicians' perspectives on current challenges and facilitating factors in meeting the spiritual needs of patients with lung cancer and family caregivers. This study was conducted in preparation for a community-based lung cancer palliative care intervention. Participants & setting: 19 oncology and...
Chapter
The term psychoeducation , first employed by Anderson et al., was used to describe an approach to psychotherapy that included helping individuals better understand their illness and acquire basic skills in problem-solving, communication, and coping. This chapter first provides an overview of the components of psychoeducation in the context of cance...
Article
84 Background: A major public health concern is the recognition of the growing demand for PC in oncology practice. Despite proven benefits, there is often no system in place to provide concurrent palliative and oncology care. Oncology patients and families often report psychological and social stress from cancer care impacted by unmet information a...
Article
83 Background: Expert communication skills are essential for the delivery of effective palliative care across the domains of care. However, few healthcare providers receive formal communication training. The purpose of this presentation is to describe a train-the-trainer course for interprofessional hospital-based palliative care teams to prepare t...
Article
77 Background: A notable gap in the evidence-base for outpatient palliative care (PC) for cancer is that most trials were conducted in specialized centers with limited translation and further evaluation in “real-world” settings. Health systems are desperate for guidance on effective, scalable models. The purpose of this study was to determine the e...
Article
80 Background: Cancer patients participating in phase 1 clinical trials often represent a population with advanced disease, symptoms and QOL impact from disease and treatment. This analysis was conducted using data from a randomized trial in progress testing a palliative care intervention for solid tumor patients on phase 1 trials to evaluate goals...
Article
Family caregivers are centrally involved in cancer pain management, especially for patients with advanced disease. This issue is becoming ever more important as care shifts to the outpatient setting and home care and as the aging population creates more patients who have multiple illnesses and family caregivers who often live with serious illnesses...
Article
Background: The goal of the 4th edition of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care (NCP Guidelines) is to improve access to quality palliative care for all people with serious illness regardless of setting, diagnosis, prognosis, or age. Objective: The NCP Guidelines are intended to encourage and gu...
Article
Spiritual issues play a prominent role for patients with cancer. Studies have demonstrated a positive connection between a patient's spirituality and health outcomes, including quality of life, depression and anxiety, hopefulness, and the ability to cope with illness. Spiritual or existential distress is prominent in patients with cancer. Models ar...
Article
Background: While providing physical, psychological, and spiritual care to their loved ones with cancer, family caregivers (FCGs) are physically and emotionally vulnerable to the tolls of caregiving. Patients and FCGs experience the uncertainty that comes with illness and treatment, its side effects, the lack of control, the emotional upheaval, th...
Article
Palliative care (PC) concurrent with usual oncology care is now the standard of care that is recommended for any patient with advanced cancer to begin within 8 weeks of diagnosis on the basis of evidence-driven national clinical practice guidelines; however, there are not enough interdisciplinary palliative care teams to provide such care. How and...
Article
Background: Patients in phase 1 clinical trials often have significant symptom burdens and quality-of-life concerns that increase as they progress along the cancer trajectory and experience drug toxicities from the clinical trial. . Objectives: The interdisciplinary intervention described is aimed at providing optimum palliative care to suppor...
Article
After AACN endorsed the Palliative CARES document, outlining 17 key competencies for palliative and end-of-life nursing care, ELNEC developed 6 one-hour online modules: 1) Introduction to Palliative Nursing; 2) Communication in Serious Illness; 3) Pain Assessment and Management; 4) Symptom Assessment and Management; 5) Loss, Grief, and Bereavement;...
Article
Family caregivers who provide care for a loved one with advanced cancer suffer physically and psychologically from the care demands of a family member with high symptom burden and a poor prognosis. Often, family members are also faced with financial burden and suffer financial strain from their loved one's care demands. This article describes an on...
Article
In 2015, AACN and ELNEC convened a national panel of experts in nursing education, gerontology, and palliative care to revise the 1997 AACN Peaceful Death document and establish palliative and end-of-life nursing care competencies. The ELNEC train-the-trainer project to date has over 21,100 trainers training over 550,000 professionals in all 50 sta...
Article
Introduction: Advanced cancer patients participating in phase 1 clinical trials experience considerable symptom burden. Palliative care (PC) may benefit these individuals by providing supportive care during clinical research participation. This study investigates integration of a PC intervention among phase 1 trial participants with advanced cance...
Article
Background: A notable gap in the evidence base for outpatient palliative care (PC) for cancer is that most trials were conducted in specialized oncology or academic centers with limited translation and further evaluation in "real-world" settings. Health systems are desperate for guidance regarding the most effective and sustainable PC service mode...
Article
e18070 Background: Psychological distress has been linked to poor outcomes among cancer patients. In 2007, the Institute of Medicine reported that distress is often unrecognized. While much is known about distress screening in English speaking populations, little is known about the provision of screening in Spanish. Methods: From 2009-2016, over 90...
Article
In 2016, the Hospice and Palliative Nurses Association created the Nessa Coyle Leadership Fund to recognize the career achievements of Nessa Coyle, PhD, RN, as a pioneer in the field of palliative nursing and an exemplar of leadership. The first lectureship recognizing this award was presented at the annual assembly of the American Academy of Hospi...
Article
Purpose To provide evidence-based recommendations to oncology clinicians, patients, family and friend caregivers, and palliative care specialists to update the 2012 American Society of Clinical Oncology (ASCO) provisional clinical opinion (PCO) on the integration of palliative care into standard oncology care for all patients diagnosed with cancer....
Article
26 Background: Oncology nurses working across the cancer continuum need communication tools in order to navigate between oncology and palliative care for the benefit of patients and their families. An evidence-based communication training course funded by the National Cancer Institute and identified by the acronym COMFORT was provided to 187 oncolo...
Article
Full-text available
138 Background: Cancer patients receiving Phase I clinical trials are a population with advanced disease, high symptom burden, and with multiple QOL concerns including use of advance directives. Methods: An NCI funded R01 is currently in progress (2014-2019) as a randomized clinical trial to test a palliative care intervention (PCI) in this populat...
Article
Methods: This interdisciplinary team of authors wrote and published a communication curriculum known by the acronym COMFORT. The curriculum, emphasizing team communication, teaches nurses how to provide life-altering news, assess patient/family health literacy needs, practice mindful communication, acknowledge family caregivers, and address commun...
Chapter
The goal of nursing research is to improve care for patients and caregivers. Palliative nursing research includes many sensitive topics such as suffering, quality of life, and life meaning. Nurse researchers face many obstacles in conducting research, such as obtaining informed consent, dealing with high subject attrition, and openly discussing end...
Chapter
Although newer in the traditional setting, palliative care and surgeries are emerging at a very rapid pace. As the path of the surgeon, the patient‘s disease trajectory, and the path of palliative intervention overlap, it is possible for professional and personal conflicts to arise, with negotiations needing to take place. Surgeons and palliative c...
Article
Background and objective: In September 2013 the Institute of Medicine (IOM) released a report on the quality of cancer care in the United States. We report here on the recommendations of the IOM report and the implications for the palliative care community. Methods: The IOM report is based on a consensus of literature and expert opinion. The rec...
Article
To review assessment of spiritual needs of family caregivers and four core interventions by nurses in addressing spirituality: presence, deep listening, bearing witness and compassion in action. Literature review. Spirituality is increasingly recognized as a key domain of quality of life and essential to quality cancer care. In addition to the need...
Article
9068 Background: Palliative cancer care is the integration into cancer care of therapies that address multiple issues that cause suffering for patients and their families and impact their life quality. Challenges and barriers continue to hinder the integration of palliative care into comprehensive, ambulatory oncology care. This paper aims to descr...
Article
e16563 Background: HDCT is a viable and potentially curative approach for patients with relapsed or refractory GCTs. However, no comparative data exist to define the optimal chemotherapeutic strategy. Herein, long-term follow-up data and QOL assessments are provided for an expanded cohort of patients treated with high-dose paclitaxel, etoposide, ca...
Article
325 Background: HDCT is a viable and potentially curative approach for patients with relapsed or refractory GCTs. However, no comparative data exist to define the optimal chemotherapeutic strategy. Herein, long-term follow-up data and QOL assessments are provided for an expanded cohort of patients treated with high-dose paclitaxel, etoposide, carbo...
Article
Full-text available
Purpose: An American Society of Clinical Oncology (ASCO) provisional clinical opinion (PCO) offers timely clinical direction to ASCO's membership following publication or presentation of potentially practice-changing data from major studies. This PCO addresses the integration of palliative care services into standard oncology practice at the time...
Article
Full-text available
The purpose of this study was to describe patients' perceptions of the causes, relief, related symptoms, meaning, and suffering secondary to cancer-related fatigue (CRF). In total, 252 patients with breast, lung, colon, and prostate cancers were enrolled in a quasiexperimental study to test the effects of a clinical intervention on reducing barrier...
Article
Full-text available
The Institute of Medicine's National Cancer Policy Forum recently convened a workshop on patient-centered cancer treatment planning, with the aim of raising awareness about this important but often overlooked aspect of cancer treatment. A primary goal of patient-centered treatment planning is to engage patients and their families in meaningful, tho...
Article
The prevalence and survival rates of critically ill patients with cancer in the intensive care unit have increased considerably in the past 2 decades; yet, the meaning of caring for cancer patients in this setting may fall along a continuum. This article addresses the nurse's experience in caring for the critically ill patient with cancer by presen...
Article
The prevalence and survival rates of critically ill patients with cancer in the intensive care unit have increased considerably in the past 2 decades; yet, the meaning of caring for cancer patients in this setting may fall along a continuum. This article addresses the nurse’s experience in caring for the critically ill patient with cancer by presen...
Article
The objective of this study was to develop a patient-reported outcome (PRO) to assess reduced muscle strength in sarcopenia. Qualitative research study. University of Arkansas for Medical Sciences. Subjects with sarcopenia. Adults aged 55 years and older with sarcopenia (n = 12) attended open-ended, concept elicitation interviews to characterize th...
Article
Full-text available
Oncology nurses play an important role in the provision of survivorship care. Using report recommendations from the Institute of Medicine, nurses provide quality cancer care based on the specific characteristics of individual healthcare settings and the populations they serve. As part of the planning process, the evaluation of a setting's resources...
Article
Life-threatening illnesses such as HIV/AIDS, malaria, tuberculosis, and other disorders are prevalent in the developing world, including Kenya. The aim of this project was to assist in the development of palliative care throughout Kenya by enhancing the knowledge and skill of faculty members in palliative care so they could integrate this content i...
Article
Full-text available
To summarize the current research pertaining to the concepts initially examined by the Oncology Nursing Society Life Cycle of the Oncology Nurse Task Force and related projects completed in 1994. Published articles on the 21 concepts from the Oncology Nursing Society Life Cycle of the Oncology Nurse Task Force work. Research published in English fr...