2.50
Hdl Handle:
http://hdl.handle.net/10755/163690
Category:
Abstract
Type:
Presentation
Title:
Shared decision-making near the end of life: Family members' perspective
Author(s):
Norton, Sally
Author Details:
Sally Norton, Assistant Professor, University of Rochester, School of Nursing, Rochester, New York, USA, email: Sally_Norton@urmc.rochester.edu
Abstract:
Background: A growing trend toward caring for the dying outside of hospitals, coupled with an aging population, will result in more deaths occurring in nursing home settings. Moreover, an aging population will result in an increased incidence of dementia, the strongest predictor for location of death in a nursing home. Persons with severe dementia typically lack the capacity to participate in their own end-of-life decisions. Thus, a growing number of proxies, usually family members, will be called on to participate in the end-of-life decision-making process. Specific Aims: Little is known about proxies and end-of-life decision-making in nursing homes. Increased proxy participation in decision-making may improve proxies' satisfaction with the process as well as outcomes of end-of-life decision-making and may improve care at the end of life. The aims of this study are to examine the relationship between proxies' preferences for and their involvement in shared decision-making near residents' end of life; to describe proxies' satisfaction with the care residents receive and the decision making process near residents' end of life; and to examine the relationship between preferences for and involvement in shared decision-making and proxy satisfaction. Framework: The Donabedian analytic model of structure, process, and outcome guided the methodological design of this study. Sample: The stratified sample consisted of 56 participants from five nursing homes who met the following criteria: adult, English speaking, and a designated proxy decision maker of a seriously-ill (hospice eligible) nursing home resident with moderate to severe dementia. Participants were predominantly family members (91%), white (87%), and female (70%), with a mean age of 62 years. Methods: A cross-sectional descriptive correlation design was used for this study. Data were collected from proxy decision-makers during a one-time face-to-face interview using a pre-tested 64-item questionnaire. A sample size of 56 participants was calculated as sufficient to achieve a power of .8 based on the mean and standard deviation of Kristjanson's FamCare satisfaction scale. Data analysis is in process. The majority of data are quantitative and they are being analyzed with descriptive and inferential techniques. Qualitative data are being analyzed with descriptive techniques. Results and Conclusions: Results will be highlighted in terms of the relationship between proxies desired and actual participation in decision-making, proxies' level of satisfaction of the care the seriously ill resident receives, and the relationship between proxies' level of participation in decision-making and their satisfaction with care. Implications for Nursing Practice and Knowledge Development: Implications will focus on nursing practices that can facilitate decision-making and proxies' satisfaction with the care their loved ones receive near the end of life.
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.titleShared decision-making near the end of life: Family members' perspectiveen_GB
dc.contributor.authorNorton, Sallyen_US
dc.author.detailsSally Norton, Assistant Professor, University of Rochester, School of Nursing, Rochester, New York, USA, email: Sally_Norton@urmc.rochester.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/163690-
dc.description.abstractBackground: A growing trend toward caring for the dying outside of hospitals, coupled with an aging population, will result in more deaths occurring in nursing home settings. Moreover, an aging population will result in an increased incidence of dementia, the strongest predictor for location of death in a nursing home. Persons with severe dementia typically lack the capacity to participate in their own end-of-life decisions. Thus, a growing number of proxies, usually family members, will be called on to participate in the end-of-life decision-making process. Specific Aims: Little is known about proxies and end-of-life decision-making in nursing homes. Increased proxy participation in decision-making may improve proxies' satisfaction with the process as well as outcomes of end-of-life decision-making and may improve care at the end of life. The aims of this study are to examine the relationship between proxies' preferences for and their involvement in shared decision-making near residents' end of life; to describe proxies' satisfaction with the care residents receive and the decision making process near residents' end of life; and to examine the relationship between preferences for and involvement in shared decision-making and proxy satisfaction. Framework: The Donabedian analytic model of structure, process, and outcome guided the methodological design of this study. Sample: The stratified sample consisted of 56 participants from five nursing homes who met the following criteria: adult, English speaking, and a designated proxy decision maker of a seriously-ill (hospice eligible) nursing home resident with moderate to severe dementia. Participants were predominantly family members (91%), white (87%), and female (70%), with a mean age of 62 years. Methods: A cross-sectional descriptive correlation design was used for this study. Data were collected from proxy decision-makers during a one-time face-to-face interview using a pre-tested 64-item questionnaire. A sample size of 56 participants was calculated as sufficient to achieve a power of .8 based on the mean and standard deviation of Kristjanson's FamCare satisfaction scale. Data analysis is in process. The majority of data are quantitative and they are being analyzed with descriptive and inferential techniques. Qualitative data are being analyzed with descriptive techniques. Results and Conclusions: Results will be highlighted in terms of the relationship between proxies desired and actual participation in decision-making, proxies' level of satisfaction of the care the seriously ill resident receives, and the relationship between proxies' level of participation in decision-making and their satisfaction with care. Implications for Nursing Practice and Knowledge Development: Implications will focus on nursing practices that can facilitate decision-making and proxies' satisfaction with the care their loved ones receive near the end of life.en_GB
dc.date.available2011-10-27T11:12:05Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:12:05Z-
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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