EVALUATING OF SELF-ADMINISTERED ADVANCE CARE PLANNING AMONG NURSES:A QUASI-EXPERIMENTAL DESIGN

Abstract

Background: The benefits of Advance Care Planning (ACP) are well established in improving quality of end-of-life patient-centered care. Although nurses play a critical role and are ideally situated in advocating ACP, their participation rate in ACP engagement are low. The nurses’ perception of life meaning and anxiety towards death and dying could be the important factors, but there are limited studies conducted. Objective: This study aimed to evaluate effectiveness of self-administered ACP education on life meaning, death anxiety and attitudes toward dying among nurses. Methods: A quasi-experimental study using a single-group pretest-posttest design. A census sample of 101 nurses from a tertiary hospital in Singapore. All participants completed the self-administered ACP education and the three instruments, which included: Meaning in Life Questionnaire, Death Anxiety Questionnaire and Frommelt Attitudes Toward Care of the Dying Scale. Results: The paired t-test showed significant increase (p <0.001) in mean scores for meaning in life when comparing the pretest (mean=23.6; SD=4.89) with post-test (mean= 52.08, SD=7.56). Similar statistically significant (p <0.001) effects were found for death anxiety. Levels of death anxiety pretest (mean=13.05; SD=3.91) were reduced when compared post-test (mean= 11.47; SD=4.48). However, there was no difference in attitudes toward care of the dying, p=0.398. Conclusion: The introduction of self-administered ACP education had a positive influence on life meaning and reduction of death anxiety among nurses. Implications: The study findings showed promising results, suggesting that such educational interventions have positive impact. They potentially influence the nurses’ likelihood to advocate ACP and improve on its current low uptake. Healthcare organizations should allocate resources to strategizing of ACP policies among the nursing population. The results can serve as baseline information for future research in educational programmes on this topic of interest