Abstract

Background: Twenty percent of Americans live in rural areas where most of their healthcare is provided in Critical Access Hospitals (CAHs). It is unknown how frequently obstacle and helpful behavior items occur in End-of-Life (EOL) care in CAHs. Objectives: To determine the frequency of occurrence scores of obstacle and helpful behavior items in providing EOL care in CAHs. To also determine which obstacles and helpful behaviors have the greatest or least impact on EOL care based on the magnitude scores. Methods: A questionnaire was sent to nurses working in 39 CAHs in the United States. Nurse participants were asked to rate obstacle and helpful behavior items by size and frequency of occurrence. Data were analyzed to quantify the impact of obstacle and helpful behavior items on EOL care in CAHs by multiplying the mean size by the mean frequency of items to determine mean magnitude scores. Results: Items with the highest and lowest frequency were determined. Additionally, obstacle and helpful behavior item magnitude scores were calculated. Seven of the top ten obstacles were related to patients' families. Seven of the top ten helpful behaviors involved nurses ensuring families had positive experiences. Discussion: CAH nurses perceived issues around patient family members as significant obstacles to EOL care. Nurses work to ensure that families have positive experiences. Visiting hour issues seemed to be irrelevant. The use of technology, such as telehealth, seemed to provide little benefit in EOL care in CAHs.

Degree

MS

College and Department

Nursing; Nursing

Rights

https://lib.byu.edu/about/copyright/

Date Submitted

2022-04-25

Document Type

Thesis

Handle

http://hdl.lib.byu.edu/1877/etd12735

Keywords

Critical Access Hospital, nurses, end-of-life care, obstacles, helpful behaviors, magnitude, rural nursing

Language

english

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