Perceived Personal Autonomy: An Advance Care Directives In A Cardiac Rehabilitation Population

2.50
Hdl Handle:
http://hdl.handle.net/10755/165921
Category:
Abstract
Type:
Presentation
Title:
Perceived Personal Autonomy: An Advance Care Directives In A Cardiac Rehabilitation Population
Author(s):
Artnak, Kathryn
Author Details:
Kathryn Artnak, MSN, University of Texas Health Science Center at San Antonio Department of Nursing, San Antonio, Texas, USA, email: kathryn.artnak@angelo.edu
Abstract:
The Patient Self-Determination Act (PSDA) of 1990 is designed to increase the role of patients and families in collaborative medical decision making with health care providers at the end of life. In effect for over 6 years, this federal law has had little impact on increasing the numbers of persons executing written documents for securing personal preferences for medical treatment at a time when they are unable to speak for themselves. In addition, the discouraging and disappointing results from the SUPPORT (Study to Understand the Prognoses and Preferences for Outcomes and Risks of Treatment ) project underscore the fundamental need for health care providers to better understand and subsequently communicate essential, meaningful information to patients and families at the end of life. These results are part of an overall study that is attempting to increase understanding of what it means to individuals to execute an advance care document. This phase is specifically looking at the presence and strength of autonomy as a personality characteristic in relationship to choice and behavior. It attempts to determine whether or not the presence of autonomy could provide a possible explanation for what motivates an individuals decision to choose whether or not to have a living will. Other factors such as age, religious preference, and gender are concurrently being investigated to see if any of these elements could also account for any variance observed relative to the presence or absence of any form of an advance care document, written or verbal. Seventy-three persons attending a cardiac rehabilitation class over a period of 18 months agreed to complete a personal information survey and a personality inventory, the General Causality Orientations Scale (GCOS). Developed by cognitive psychologists, the GCOS is based on the theory that people have an innate need to feel that their behavior is truly chosen by them. Persons who feel strongly this way are classified as being autonomous and consequently seek social situations that reinforce their autonomy. Participants were recruited during one of four classroom sessions conducted during Phase II cardiac rehabilitation at a hospital affiliated wellness center. All those agreeing to participate had experienced either open-heart surgery or a heart attack within the previous 6 months. Respondents were mostly male, retired, elderly, and European-American. The results to date indicate that persons enrolled in a cardiac rehabilitation program have a strong belief in their personal ability to choose behavior that affects outcomes in their lives. However, such a belief did not necessarily indicate a personal choice of living wills as a method to secure medical care and treatment preferences at the end of life. Persons with strong autonomy orientations tended to perceive their social world as more supportive of their own autonomy. The extent to which peoples' behavior is autonomous and intrinsically motivated is determined not only by their own personalities but also by the degree in which the social context is autonomy supportive. There appears to be emerging evidence for taking a closer look at the social experience of how health care providers and patients interact when attempting to communicate end of life treatment choices as well as the means and methods currently in place for documenting such vital decisions.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Host:
Southern Nursing Research Society
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.titlePerceived Personal Autonomy: An Advance Care Directives In A Cardiac Rehabilitation Populationen_GB
dc.contributor.authorArtnak, Kathrynen_US
dc.author.detailsKathryn Artnak, MSN, University of Texas Health Science Center at San Antonio Department of Nursing, San Antonio, Texas, USA, email: kathryn.artnak@angelo.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/165921-
dc.description.abstractThe Patient Self-Determination Act (PSDA) of 1990 is designed to increase the role of patients and families in collaborative medical decision making with health care providers at the end of life. In effect for over 6 years, this federal law has had little impact on increasing the numbers of persons executing written documents for securing personal preferences for medical treatment at a time when they are unable to speak for themselves. In addition, the discouraging and disappointing results from the SUPPORT (Study to Understand the Prognoses and Preferences for Outcomes and Risks of Treatment ) project underscore the fundamental need for health care providers to better understand and subsequently communicate essential, meaningful information to patients and families at the end of life. These results are part of an overall study that is attempting to increase understanding of what it means to individuals to execute an advance care document. This phase is specifically looking at the presence and strength of autonomy as a personality characteristic in relationship to choice and behavior. It attempts to determine whether or not the presence of autonomy could provide a possible explanation for what motivates an individuals decision to choose whether or not to have a living will. Other factors such as age, religious preference, and gender are concurrently being investigated to see if any of these elements could also account for any variance observed relative to the presence or absence of any form of an advance care document, written or verbal. Seventy-three persons attending a cardiac rehabilitation class over a period of 18 months agreed to complete a personal information survey and a personality inventory, the General Causality Orientations Scale (GCOS). Developed by cognitive psychologists, the GCOS is based on the theory that people have an innate need to feel that their behavior is truly chosen by them. Persons who feel strongly this way are classified as being autonomous and consequently seek social situations that reinforce their autonomy. Participants were recruited during one of four classroom sessions conducted during Phase II cardiac rehabilitation at a hospital affiliated wellness center. All those agreeing to participate had experienced either open-heart surgery or a heart attack within the previous 6 months. Respondents were mostly male, retired, elderly, and European-American. The results to date indicate that persons enrolled in a cardiac rehabilitation program have a strong belief in their personal ability to choose behavior that affects outcomes in their lives. However, such a belief did not necessarily indicate a personal choice of living wills as a method to secure medical care and treatment preferences at the end of life. Persons with strong autonomy orientations tended to perceive their social world as more supportive of their own autonomy. The extent to which peoples' behavior is autonomous and intrinsically motivated is determined not only by their own personalities but also by the degree in which the social context is autonomy supportive. There appears to be emerging evidence for taking a closer look at the social experience of how health care providers and patients interact when attempting to communicate end of life treatment choices as well as the means and methods currently in place for documenting such vital decisions.en_GB
dc.date.available2011-10-27T14:36:31Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T14:36:31Z-
dc.conference.hostSouthern Nursing Research Societyen_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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