Prospective planning for end of life care: Research as praxis with community dwelling adults

2.50
Hdl Handle:
http://hdl.handle.net/10755/163635
Category:
Abstract
Type:
Presentation
Title:
Prospective planning for end of life care: Research as praxis with community dwelling adults
Author(s):
Havens, Gail Ann; Ashcroft, Bonnie L.
Author Details:
Gail Ann Havens, Associate Professor, University of Vermont, Department of Nursing, South Burlington, Vermont, USA, email: Gail.Havens@uvm.edu; Bonnie L. Ashcroft
Abstract:
Purpose: The goal of this research was to increase understanding of the prospective planning in which community dwelling adults (CDAs) engage in preparing for the phase of their lives in which they are dying. The results of prior pilot survey work suggested that a constellation of factors was related to the execution of advance directives (ADs) by community dwelling Pennsylvanians. The findings further suggested that most Pennsylvanians were unfamiliar with ADs, while the majority of those who were familiar with ADs had not completed one. Study aims: The study was designed to: identify and describe the process in which CDAs engage in executing an AD: examine and describe the perspectives and rationales of CDAs who have not executed ADs but who are familiar with them regarding prospective planning for end of life (EOL) care; explore and depict the viewpoints and beliefs of CDAs who are unfamiliar with AD documents about planning in advance for care and treatment during times when they are too ill or injured to speak for themselves; appraise the use of a purposive sampling design to obtain study participants; assess the efficacy of the procedures used in conducting focus group interviews Theoretical framework: A conceptual model of AD execution constituted by the concept of personal autonomy, the construct of moral communities, and the Stages of Change model provided theoretical direction for the study. Methods: A series of eight focus group interviews of purposively selected community dwelling Pennsylvanians (n=72) was conducted throughout the Commonwealth. A letter with contact information from the principal investigator (PI) confirming participation, an informed consent document, and a list of the topics to be discussed were mailed to participants two weeks prior to the interview. The PI moderated the interviews. An assistant moderator operated the audio recording equipment and noted participants' nonverbal communication. The same set of semi-structured questions was discussed in each interview; however the sequence varied to accommodate the natural flow of the discussion in the respective group. Each participant received a monetary incentive at the conclusion of the interview. Verbatim transcriptions were analyzed by interview question with categories formed for each group interview. Categories were organized across groups and themes derived. Results and conclusions: Twenty-one participants (30%) had planned for their EOL care by executing an AD. The sample was 44% female, ranged in age from 19 to 81 years, and was 79.4% White and 16.2% African-American. Most participants had little or inaccurate information about the options available to convey their EOL treatment choices. Of those who had previously pursued the topic, many were troubled that they were without a member of their moral community that is a spouse, family member, or friend willing to engage in conversation with them about their EOL treatment planning. The reasons for prospective planning for EOL care varied by age group, while the type and substance of EOL planning varied by race and type of community. The research context is a potent environment for educational interventions surrounding an anxiety-evoking topic. Community dwelling adults do not appear reluctant to talk about their deaths, nor about what constitutes an acceptable quality of life as they are dying. The nature of their EOL treatment plans and how CDAs envisioned these would be expressed and accomplished for them conveyed a broad range of designs that reflected the wide variety of personal values on which they are founded. As they engage in the process of prospective EOL care planning, CDAs need the support and mutual engagement of members of their moral communities. As well, they need access to culturally sensitive professionals well versed in the subject who can provide the information necessary for informed decision making. Implications for nursing practice and knowledge development in nursing: Participants came prepared to discuss a topic perceived to be unpleasant: their own deaths, but also had as a study objective to obtain information about a sensitive topic from a perceived expert. Thus, the research purpose was transformed concurrently from primarily a data-gathering endeavor to a dialogue characterized by information exchange that empowered both those who agreed to be researched and the researcher. Lather (1986) has termed this process of inquiry research as praxis. Using this process, nurse researchers can collaborate with colleagues engaged in clinical practice and transcend the traditional empirical paradigm to engage in scientific inquiry that is reciprocal and that empowers the researcher and the clinician, as well as those researched.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2002
Conference Name:
14th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
University Park, Pennsylvania, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleProspective planning for end of life care: Research as praxis with community dwelling adultsen_GB
dc.contributor.authorHavens, Gail Annen_US
dc.contributor.authorAshcroft, Bonnie L.en_US
dc.author.detailsGail Ann Havens, Associate Professor, University of Vermont, Department of Nursing, South Burlington, Vermont, USA, email: Gail.Havens@uvm.edu; Bonnie L. Ashcroften_US
dc.identifier.urihttp://hdl.handle.net/10755/163635-
dc.description.abstractPurpose: The goal of this research was to increase understanding of the prospective planning in which community dwelling adults (CDAs) engage in preparing for the phase of their lives in which they are dying. The results of prior pilot survey work suggested that a constellation of factors was related to the execution of advance directives (ADs) by community dwelling Pennsylvanians. The findings further suggested that most Pennsylvanians were unfamiliar with ADs, while the majority of those who were familiar with ADs had not completed one. Study aims: The study was designed to: identify and describe the process in which CDAs engage in executing an AD: examine and describe the perspectives and rationales of CDAs who have not executed ADs but who are familiar with them regarding prospective planning for end of life (EOL) care; explore and depict the viewpoints and beliefs of CDAs who are unfamiliar with AD documents about planning in advance for care and treatment during times when they are too ill or injured to speak for themselves; appraise the use of a purposive sampling design to obtain study participants; assess the efficacy of the procedures used in conducting focus group interviews Theoretical framework: A conceptual model of AD execution constituted by the concept of personal autonomy, the construct of moral communities, and the Stages of Change model provided theoretical direction for the study. Methods: A series of eight focus group interviews of purposively selected community dwelling Pennsylvanians (n=72) was conducted throughout the Commonwealth. A letter with contact information from the principal investigator (PI) confirming participation, an informed consent document, and a list of the topics to be discussed were mailed to participants two weeks prior to the interview. The PI moderated the interviews. An assistant moderator operated the audio recording equipment and noted participants' nonverbal communication. The same set of semi-structured questions was discussed in each interview; however the sequence varied to accommodate the natural flow of the discussion in the respective group. Each participant received a monetary incentive at the conclusion of the interview. Verbatim transcriptions were analyzed by interview question with categories formed for each group interview. Categories were organized across groups and themes derived. Results and conclusions: Twenty-one participants (30%) had planned for their EOL care by executing an AD. The sample was 44% female, ranged in age from 19 to 81 years, and was 79.4% White and 16.2% African-American. Most participants had little or inaccurate information about the options available to convey their EOL treatment choices. Of those who had previously pursued the topic, many were troubled that they were without a member of their moral community that is a spouse, family member, or friend willing to engage in conversation with them about their EOL treatment planning. The reasons for prospective planning for EOL care varied by age group, while the type and substance of EOL planning varied by race and type of community. The research context is a potent environment for educational interventions surrounding an anxiety-evoking topic. Community dwelling adults do not appear reluctant to talk about their deaths, nor about what constitutes an acceptable quality of life as they are dying. The nature of their EOL treatment plans and how CDAs envisioned these would be expressed and accomplished for them conveyed a broad range of designs that reflected the wide variety of personal values on which they are founded. As they engage in the process of prospective EOL care planning, CDAs need the support and mutual engagement of members of their moral communities. As well, they need access to culturally sensitive professionals well versed in the subject who can provide the information necessary for informed decision making. Implications for nursing practice and knowledge development in nursing: Participants came prepared to discuss a topic perceived to be unpleasant: their own deaths, but also had as a study objective to obtain information about a sensitive topic from a perceived expert. Thus, the research purpose was transformed concurrently from primarily a data-gathering endeavor to a dialogue characterized by information exchange that empowered both those who agreed to be researched and the researcher. Lather (1986) has termed this process of inquiry research as praxis. Using this process, nurse researchers can collaborate with colleagues engaged in clinical practice and transcend the traditional empirical paradigm to engage in scientific inquiry that is reciprocal and that empowers the researcher and the clinician, as well as those researched.en_GB
dc.date.available2011-10-27T11:11:04Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:11:04Z-
dc.conference.date2002en_US
dc.conference.name14th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationUniversity Park, Pennsylvania, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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