Quantitative_Study

Running head: QUANTITATIVE REVIEW June 18, 2010 Quantitative Review Problem Statement The relationship between a nurse’s personal anxiety level about death and the comfort level of that nurse when communicating with patients about death is important to explore. We, as nurses perceive that we should automatically know how to handle these concerns and anxieties (Bell & Deffner, 2005, p. 19). Death is common in the nursing field and every nurse has different anxiety levels when dealing with and communicating about death. It is also important to realize that communication with patients is a crucial component of nursing. Study Purpose The purpose of this study is significant to nursing because how these relate to each other is important to know to help educate nurses on this topic. It is also important for nurses to be aware of their personal anxiety levels and their ability to communicate with patients. Research Question 1) The main research question is: Is there a relationship between a nurse’s death anxiety and the comfort level of the nurse when communicating with patients about death (Bell & Deffner, 2005, p. 19-20)' 2) Other question is: Have nurses had any exposure to communication education for dealing with difficult subjects such as death, and does this exposure have any relationship to the comfort level of the nurse when communicating with patients about death (Bell & Deffner, 2005, p. 20)' Hypothesis I would say the hypothesis is that there is a direct relationship between nurse’s anxiety level about death and their comfort level when communicating about death. Study Variables The independent variable in this study is the nurse’s anxiety level. The dependent variable is the comfort level when communicating about death. Conceptual Model There is no specific conceptual model used to guide this study. The Health Belief Model (HBM) would be the closest to what was used. The HBM states, “health-related behavior is influenced by a person’s perception of a threat” (Beck & Polit, 2010, p. 204). This would relate to the theory that the nurse’s anxiety level, or threat, is related to their communication skills, or behavior. Review of Related Literature The literature review supports the need for this study, because death anxiety has been studied, but not on healthcare providers (Bell & Deffner, 2005, p. 20). One study found that nurses can communicate well with patients when they use a patient-centered approach. However, health care organizations do not appear to value or recognize the importance of using a patient-centered approach when communicating with patients (McCabe, 2003, p. 48). Study Design 1) This was a correlation study (Bell & Deffner, 2005, p. 20). It used a prospective design to determine the effect that the anxiety that the nurses had about death had on the communication skills. 2) The design was an appropriate one because correlational studies are used to determine an association between two variables, or a tendency for variation in one variable to be related to a variation in another variable (Beck & Polit, 2010, p. 235). This study wanted to determine an association between anxiety and communication. 3) Two threats to the internal validity of the study are: a) Temporal ambiguity- It is unclear whether the anxiety level precedes the communication skills or if the communication skills may have an effect on the anxiety level. b) Maturation threat- 108 respondents had over 15 years of nursing experience (Bell & Deffner, 2005, p. 21). 4) Two threats to the external validity of this study are: a) This study was done in the state of Arizona. Can this sample be generalized with the rest of the United States' b) Only 5% of respondents were male (Bell & Deffner, 2005, p. 21). This may not give a very diverse sample of men and women in this study. Sample and Setting The sample is large enough because 190 people responded. There was a diverse age range from 25-68 (Bell & Deffner, 2005, p. 21). 1) The sample is representative of the target population because it uses a variety of different types of nurses. Areas in which the respondents were employed varied between hospitals, schools, home health, hospice, nursing schools, and “other” areas (Bell & Deffner, p. 21). 2) The setting in which data was collected was appropriate because it was a questionnaire mailed to registered nurses (Bell & Deffner 2005, p. 20). It was a random sample of nurses in Arizona. Identification and Control of Extraneous Variables 1) The extraneous variables are the respondents. 2) These variables were controlled by randomization. Study Instruments/Tools 1) The reliability of the scale used was tested during the construction of the scale, and reliability coefficients were significant at the .10 level in two of three analyses. A 3-week test/retest reliability was .83, with an internal consistency of .76. The validity of the scale was significant with a p value of .01 (Bell & Deffner, 2005, p. 20). 2) The instruments used were significant for this study because the study showed a correlation between the two variables. Data Collection Methods 1) The data collection was appropriate for this study because it was a random, convenience study with questionnaires mailed, and then returned. 2) The rights of the subjects were protected because it was an anonymous study, and the questionnaires were not coded in any way to reveal the identity (Bell & Deffner, 2005, p. 20). Data Analysis Procedures 1) Data analysis procedures were appropriate. The results were coded using values ranging from -2 to +2, with a positive value corresponding to a higher level of anxiety (Bell & Deffner, 2005, p. 21). 2) The data analysis procedures are appropriate because it does show which variables had the strongest relationships to comfort levels (Bell & Deffner, p. 21), using two different statistical techniques. Strengths/ Limitations 1) Two major strengths of this study were: a. It did show that discomfort decreases as age, experience, education, and experiences of communication increase (Bell & Deffner, 2005, p. 21-22). b. It also did prove that respondents who were more anxious talking about death events typically found it less comfortable to talk with patients about death (Bell & Deffner, 2005, p. 23). 1) Two limitations of this study were: a. The results were generalized because of a convenience sample (Bell & Deffner, 2005, p. 23). b. Some of the items on the Death Anxiety Scale are not statistically significant with the comfort level variable (Bell & Deffner, 2005, p. 23). 2) The study findings are greatly valid because the results of the questionnaires showed a relationship between the two variables studied. 3) The study findings are practical for use in nursing because it shows there needs to be more communication education among nurses to aid the nurse in feeling more comfortable talking with patients and families. It is also important for nurses to identify their own level of death anxiety (Bell & Deffner, 2005, p. 23). Implications 1) The implications for practice are for the nurse to be aware of their own level of death anxiety. 2) The implication for education is that this is an important area to focus on for the future of nursing education. 3) The implications for more research would be to determine what nurses have experience with when it comes to communication with patients about difficult topics, such as death. References Beck, C. T. & Polit, D. F. (2010). Essentials of nursing research (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Bell, S. K., & Deffner, J. M. (2005). Nurses’ death anxiety, comfort level during communication with patients and families regarding death, and exposure to communication education. Journal for Nurses in Staff Development, 21(1), 19-23. Retrieved from http://journals.lww.com/jnsdonline/pages/default.aspx McCabe, C. (2003). Nurse–patient communication: an exploration of patients’ experiences. Journal of Clinical Nursing, 13(1), 41-49. 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