Date of Award
Spring 2022
Degree Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
School
Leadership and Advanced Nursing Practice
Committee Chair
Dr. Bonnie Harbaugh
Committee Chair School
Leadership and Advanced Nursing Practice
Committee Member 2
Dr. Debra Copeland
Committee Member 2 School
Leadership and Advanced Nursing Practice
Committee Member 3
Dr. Kathleen Masters
Committee Member 3 School
Professional Nursing Practice
Committee Member 4
Dr. Lachel Story
Committee Member 4 School
Leadership and Advanced Nursing Practice
Committee Member 5
Dr. Elizabeth Tinnon
Committee Member 5 School
Professional Nursing Practice
Abstract
Advances in healthcare technology has changed how healthcare professionals care for patients, increasing the importance of Advance Directives (ADs). ADs are legal documents describing patient end-of-life care wishes. Despite the usefulness of ADs, particularly in oncology settings, most patients do not have one.
This qualitative content analysis study examined knowledge and attitudes of ADs among oncology nurses to obtain a better understanding of ADs. Literature on ADs and nurses is dominated by quantitative research. This study addresses knowledge gaps best filled by qualitative methods.
Ten experienced oncology nurses answered eleven open-ended questions using online video conference interviews. The eleven questions corresponded to five research questions. Content analysis met rigorous standards for trustworthiness, including data saturation.
Question 1 related to nurses’ firm understanding of ADs found the category Legality and themes Written Document, Wishes for EOL Care, and Unable to Speak for Self. Question 2, related to AD barriers found the category Barriers and themes Lack of Education on AD, Convenience, and Families. Question 3, related to nurses’ views of AD found the category Usefulness, with themes Prevention of Suffering and Unintended Consequences. Question 4, related to AD benefits found the category Benefits and themes Quality of Life and Peace. Question 5, related to AD discussions found the category Quality of Interactions with themes of Timing, Compassion, and Family Inclusion.
Oncology nurse participants understood the meaning, benefits, and barriers of ADs viewed ADs as useful and held AD discussions with families and patients. Results confirmed several findings from previous studies such as barriers to AD identified by Boddy et al. (2013). Results also confirmed aspects of Ruland and Moore’s (1998) theory for a Peaceful End of Life.
Oncology nurse participants valued increased knowledge along with AD-focused discussions. Nurses estimated under 40% of their oncology patients had an AD at admission. Additionally, AD education is needed for patients, healthcare providers, and families to ease AD-related confusion, conflict, stress, and uncertainty. Further, increased AD knowledge and awareness empowers patients, families, and fellow nurses to achieve peaceful end-of-life outcomes.
Copyright
Nettles, 2022
Recommended Citation
Nettles, Bailey, "The Knowledge and Attitudes Of Oncology Nurses On Advance Directives" (2022). Dissertations. 1982.
https://aquila.usm.edu/dissertations/1982
Included in
Other Nursing Commons, Palliative Nursing Commons, Public Health and Community Nursing Commons