There were 50 nurses (45 females and 5 males) with valid data on pretest and posttest surveys the Multidimensional Fear of Death Scale (MFDOS) the domains did not reveal a statistical significance however, there was an increase in six of the domains post educational program (shown in Figure 1). The Palliative Care Knowledge Test (PCKT) showed a statistical significance, pretest M = 12.4, SD = 1.97, posttest M = 15.8, SD = 2.61. As shown in Figure 1, the results were statistical significance for the nurses. Quality of Dying in Long Term Care (QOD-LTC) and Self-efficacy Palliative Care Scale (SEPC) revealed a statistical significance. As shown in Figure 2, the QOL-LTC and SEPC results had statistical significance.

q  The work of informed, educated, and knowledgeable nursing professionals is a prerequisite to high standards in end of life care.1

q  Fear of the individual dying in the nursing homes is a concern. Educating the nursing professionals on palliative care concepts can alleviate fear of death and promote quality of care.

q  Researchers have identified that inadequate care for dying residents in long-term care resulted from a lack of formal training for the long-term care nurses.2, 3, 4

q  Scholarly education could produce evidence based care for long-term care residents and families who face challenges and suffering associated with chronic illness and end of life issues.1, 5, 6

INTRODUCTION

REFERENCES

Palliative Care: Can Education Decrease Fear of Death with Long Term Nurses?

Sharon Bronner, DNP, MSN, GNP, BC School of Nursing and Health Professions, Brandman University

Purpose: Nursing professionals lack knowledge about palliative care and fear providing palliative care modalities in the long term care setting. Aim: The aim of the study was to determine if palliative care education can decrease fear in long term care nurses when the resident is approaching the end of life. Null hypothesis was rejected (Ho: M1 = M2, Ha: M1 ≠ M2). Design: Quantitative descriptive cross sectional study including pretest and posttest with intervention palliative care educational program Setting: Skilled Nursing Facilities Sample: Fifty nurses (LPN’s, RN’s and APRN’s) age ranging from 23-66 years old Measurement: Four tools were utilized. Multidimensional Fear of Death Scale, Palliative Care Knowledge Test, Quality of Dying in Long Term Care, and Self-efficacy Palliative Care Scale

METHODS

RESULTS

Furnished upon request: thebronners@aol.com/sbronner@optum.com

DISCUSSION

q  The competence and knowledge of nurses caring for the dying in long-term care facilities were improved by palliative care education.7, 8

q  Palliative care education increased the awareness of long-term care nurses regarding the death process and increased their utilization of palliative care modalities.

q  Nurses could change their behaviors to provide good

symptom management at the end of life. Knowledge and skills are important; however, sometimes they do not equal a change in behavior.9

q Providing resources for nurses could be a positive

achievement, and education for nurses could assure compliance with best practice standards in long-term care facilities and benefit the quality of care for patients/residents at the end of life.1, 2,3, 5,10

FIGURE 1

IMPLICATIONS

Improve the nurses self-confidence and palliative care knowledge. Enhancement of the clinician’s abilities to provide quality of care at the end of life. Best practices for end of life care in long-term care facilities is achievable.

ACKNOWLEDGEMENTS Thank you!

I would like to thank Dr. Jennifer Johnson and Dr. Edith Onua for the revisions of the manuscript, Dr. Mary Mays for her statistical expertise and Susan Mullaney GNP for her endless assistance and dedication. I would like to thank all the nurses who participated in the evidence-based project (Bethel Nursing and Rehabilitation, Wingate at Beacon, Wingate at Dutchess, and Wingate at Ulster). I would like to thank my husband and my young men (Lloyd, Brandon, and Lloyd III) for being part of my joyous endeavor.

Multidimensional Fear of Death Scale

Subscales Pre-intervention Mean (SD)

Post-intervention Mean (SD)

t df p-value

Fear of the Dying

Process

M = 2.37 (.948)

M = 2.64 (1.13)

-2.06

49

.044 Fear of the

Dead

M = 3.31(.608)

M = 3.36 (.637)

-723

49

.473 Fear of Being

Destroyed M = 3.20 (1.02)

M = 2.86 (.979)

2.60

49

.012 Fear for

Significant Others

M = 2.42 (.779)

M = 2.59 (.815)

-1.75

49

.085 Fear of the Unknown

M = 3.19 (.648)

M = 3.11 (.738)

0.76

49

.447 Fear of

Conscious Death

M = 3.54 (.845)

M = 3.75 (.889)

-1.84

49

.071 Fear for the Body after

Death

M = 3.62 (.859)

M = 3.77 (.809)

-1.38

49

.173 Fear of

Premature Death

M = 2.86 (1.15)

M = 3.13 (1.24)

-2.49

49

-.016 *Psychometric tool to evaluate fear of death in the nurses t = paired sample t test, df = degree of freedom (subjects), SD = Standard Deviation, p < 0.05 is statistically significant

Quality of Dying in Long-Term Care

Subscales t df p-value Mean Difference

95% Confidence Interval of the Difference

Lower Upper Closure 1.70 49 0.96 .188 -.034 .410 Control 1.45 49 .154 .240 -.092 .683 Social

Connection 6.05 49 .000 .824 .550 1.10

Preparatory Task

6.50 49 .000 .857 .583 1.10

Sense of Purpose

2.72 49 .009 .380 .099 .660

*Psychometric testing for monitoring, maintenance of quality of life and satisfaction with care in Long Term Care. t = One sample t test, df = degree of freedom (subjects), p < 0.05 is statistically significant

Self-efficacy Palliative Care Scale

Subscales t df p-value

Mean Difference

95% Confidence Interval of the Difference

Lower Upper Communication -17.5 45 .000 -1.22 -1.36 -1.08

Patient Management

-15.7 45 .000 -1.16 -1.31 -1.01

Teamwork -13.2 45 .000 -1.12 -1.30 -.952 *Psychometric testing of nurses’ ability to perform specific behaviors or skills. t = One sample t test, df = degree of freedom (subjects), p < 0.05 is statistically significant

Palliative Care Knowledge Test

Subscales Pre-intervention Mean (SD)

Post-intervention Mean (SD)

t df p-value

Total 12.4 (1.97) 15.8 (2.61) -.699 49 .000 Philosophy 1.58 (.609) 1.80 (.534) -1.87 49 0.67

Pain 3.50 (.974) 4.54 (1.05) -5.02 49 .000 Dyspnea 2.22 (.953) 3.14 (.783) -5.80 49 .000

Psychiatric Problems

2.50 (.995)

3.14 (.931)

-3.50

49

.001

Gastrointestinal Problems

2.64 (.827)

3.24 (.870)

-4.48

49

.000 *Psychometric tool to assess palliative care knowledge, t = paired sample t test, df = degree of freedom (subjects), SD = Standard Deviation, p < 0.05 is statistically significant