Education about death, dying, and bereavement in nursing programs.

The authors report the results of a March 1992 survey of 650 baccalaureate nursing education programs concerning the education that they provide in the area of death, dying, and bereavement. The survey inquired about death education content in the curriculum, theoretic models, and whether organ/tissue donation is addressed. Results indicate that many schools are using outdated models. The authors suggest ways to address these issues more adequately.

Current models of death, dying, and bereavement.

This article reviews recent task-based models in the field of death, dying, and bereavement. An argument is made for the importance of theoretical models that emphasize individual tasks in coping with dying and bereavement. Such models seek to shift perspective from passive victimization to an opportunity for active processes, whereby one can regain some measure of control and meaning in living with loss. The appropriateness of task-based models for nurses in general and for critical care nurses in particular is suggested.

What is the rationale for or against contacts between donor families and transplant recipients?

This article examines the intellectual foundations for policies and practices concerning contacts between organ and tissue donor families and transplant recipients. Should there be contacts between donor families and transplant recipients? What might be an example of the form such contacts could or should take? These questions are explored, with the goal of stimulating open discussion and rationalizing the theoretical foundations behind policies and practices in this field.

Children's hospice care.

This article seeks to define the principles that are at the heart of the concept of children's hospice care and to indicate the wide range of activities to which that concept is relevant. The discussion is organized around five main points: 1) an analysis of that which is distinctive of the hospice philosophy or hospice-like approaches to care; 2) a sketch of situations involving children to which approaches guided by such a philosophy are or might be relevant; 3) a description of the principal contexts within which these approaches might be implemented; 4) some suggestions concerning the application of ideal models to practical realities; and 5) some concluding remarks concerning issues for practice and research. References to relevant literature indicate the present status of work in this field.

Adult hospice day care.

This article describes the concept of adult hospice day care, argues that programs of adult hospice day care can be an important adjunct to home care and inpatient care, and provides a concrete illustration of ways in which a typical program of adult hospice day care might be implemented.

Ac transposition from a T-DNA can generate linked and unlinked clusters of insertions in the tomato genome.

We have investigated the distribution of transposed Acs in the tomato genome. Our approach has been to clone the regions flanking the T-DNAs and transposed Acs from two transgenic lines of tomato and place these sequences on the tomato restriction fragment length polymorphism (RFLP) map. The distribution of transposed Acs around the T-DNA and at locations unlinked to the T-DNA indicates that Ac transposes to linked and unlinked sites in tomato as it does in maize. The structure and terminal sequence of these cloned elements shows that Ac remains intact after transposition. We discuss these results and their bearing on gene tagging strategies using Ac and Ds.

What is pediatric hospice care?

This article describes the application of hospice principles and values to situations involving children--here identified by the phrase "pediatric hospice care." The exposition is carried out in two ways. First, we explore the basic principles and values of hospice care to make them clear as a foundation for what follows and to dispel misunderstandings. Second, we indicate some of the many ways in which those principles and values can have relevance to situations involving children and to institutions in our society. Our underlying concern is to acknowledge the work of those caregivers who are already engaged in some aspect of this sort of care and to encourage expansion of that interest on behalf of those children and families who need this sort of supportive care.

Pediatric hospice care.

The concept of pediatric hospice care is in many ways a new one that is subject to misunderstanding, especially as to its character and scope. Nevertheless, with or without this particular title, implementation of pediatric hospice care may already be underway via existing caregivers and provider systems, and further development is dependent in large part upon the sensitivity, expertise, and cooperation of pediatricians and their colleagues. To encourage the collaborative effort that is required, this article reviews: the main principles of the hospice philosophy that are relevant to pediatric care, three types of situations involving children to which those principles might be applied, the wide range of needs and bewildering variety of factors that may complicate such care, three basic contexts within which this sort of care can be delivered, the multiplicity of skills that are relevant to this approach to care, and the many ways in which services can be provided.

Situations involving children: a challenge for the hospice movement.

Situations wherein children and their families become involved with problems of dying, death, and bereavement constitute an important challenge for the hospice movement. Such situations represent an opportunity for hospice programs and caregivers to add quality to the lives of vulnerable people, while also growing in their own self-understanding and appreciation. This article surveys three sorts of situations involving children which are appropriate for care in the hospice mode: (1) grieving or bereaved children; (2) adults who are grieving or bereaved in relation to the illness or death of a child; and (3) ill or dying children. Issues to be considered are identified and practical recommendations are offered for those who choose to enter into such care.

Exercises about death: facts, fiction, and values.

Our concern in this paper is to examine exercises about death of the sort that are commonly used at the outset of death education courses and hospice training programs. We describe a variety of these exercises and report data from a representative sample of those which we have used in our own courses and workshops. Three issues are singled out for discussion: 1) compliance in the doing of these exercises; 2) content in the responses (especially as concerns timing or manner of death and focus of concern); and 3) interpretation of results (e.g., limitations of such exercises, shifts between expectations and desires, "realism," and alterations when additional considerations are introduced). Our conclusion is that we must be cautious in giving two much weight to the ostensible results of such exercises, either as regards personal significance or as research projects. Nevertheless, as we show, there is value in the process itself when seen in the light of a proper understanding of the goals of a death-related educational or training program.