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The Process of Death Imminence Awareness by Family Members of Patients in Adult Critical Care

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The Process of Death Imminence Awareness by Family Members of Patients in Adult Critical Care The Process of Death Imminence Awareness by Family Members of Patients in Adult Critical Care Item Type text; Electronic Dissertation Authors Baumhover, Nancy Catherine Publisher The University of Arizona. Rights Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author. Download date 27/09/2021 13:12:18 Link to Item http://hdl.handle.net/10150/311478 THE PROCESS OF DEATH IMMINENCE AWARENESS BY FAMILY MEMBERS OF PATIENTS IN ADULT CRITICAL CARE by Nancy Catherine Baumhover ________________________ Copyright © Nancy Catherine Baumhover 2013 A Dissertation Submitted to the Faculty of the COLLEGE OF NURSING In Partial Fulfillment of the Requirements For the Degree of DOCTOR OF PHILOSOPHY In the Graduate College THE UNIVERSITY OF ARIZONA 2 0 1 3 2 THE UNIVERSITY OF ARIZONA GRADUATE COLLEGE As members of the Dissertation Committee, we certify that we have read the dissertation prepared by Nancy C. Baumhover entitled “The Process of Death Imminence Awareness by Family Members of Patients in Adult Critical Care” and recommend that it be accepted as fulfilling the dissertation requirement for the Degree of Doctor of Philosophy in Nursing. ____________________________________________________ Date: November 22, 2013 Pamela G. Reed, PhD, RN, FAAN Professor ____________________________________________________ Date: November 22, 2013 Janice D. Crist, PhD, RN, FNGNA, FAAN Associate Professor ____________________________________________________ Date: November 22, 2013 Cindy J. Rishel, PhD, RN, OCN Clinical Faculty Final approval and acceptance of this dissertation is contingent upon the candidate’s submission of the final copies of the dissertation to the Graduate College. I hereby certify that I have read this dissertation prepared under my direction and recommend that it be accepted as fulfilling the dissertation requirement. ____________________________________________________ Date: November 22, 2013 Dissertation Director: Pamela G. Reed, PhD, RN, FAAN Professor 3 STATEMENT BY AUTHOR This dissertation has been submitted in partial fulfillment of requirements for an advanced degree at The University of Arizona and is deposited in the University Library to be made available to borrowers under rules of the Library. Brief quotations from this dissertation are allowable without special permission, provided that accurate acknowledgment of source is made. Requests for permission for extended quotation from or reproduction of this manuscript in whole or in part may be granted by the copyright holder SIGNED: __Nancy Catherine Baumhover ___________ 4 ACKNOWLEDGEMENTS I wish to acknowledge and express my sincere appreciation to several individuals who supported me throughout my academic pursuits. My husband, Craig, significantly helped me to balance my roles as wife, mother, educator, and student. I could not have done this without his continual support as well as his belief and confidence in me. My children, Matthew and Katelyn Corning, were very understanding during my busy times. Follow your dreams and passions. Most importantly, take the FIRST step in the direction you want to go. Work hard and persevere. Eventually, you will reach your goal. As always, I love you “always and forever.” My parents, Jerry and Nettie Kreifels, are dearly missed. They would be so proud. My siblings, Gary, Carol, Ted, Mary, and Jane, provided their endless encouragement and well wishes. My committee, Dr. Pamela Reed, Dr. Janice Crist, Dr. Cindy Rishel, and Dr. Kathleen May, provided me with outstanding guidance and expertise. It was such a pleasure and honor to work with Dr. Pamela Reed as my committee chair. I am eternally grateful for her kindness, responsiveness, and grace. Dr. Janice Crist ignited and fueled a fire in me to conduct qualitative work. Dr. Cindy Rishel provided me with thoughtful and constructive feedback. Dr. May worked with me to publish a theoretical paper on the vulnerability of family members of patients in adult critical care. I am grateful for her writing and research skills. My colleagues and supervisors at Arizona State University were very helpful and supportive. Dean Pipe asked me to contact her if I ever needed anything. I am grateful that Dr. Nelma Shearer encouraged me to complete doctoral studies and introduced me to Dr. Pamela Reed. My supervisors, Dr. Brenda Morris and Dr. Judy Sayles, were always very conscientious of my workload. Many colleagues would stop me in the halls and ask how I was doing or offered a hug. Thank you for your support. Dr. Melanie Brewer, director of nursing research at Scottsdale Healthcare, provided me her time and expertise. My doctoral peers and I learned with and from each other. My study participants shared their personal and sometimes painful stories. Thank you for your openness and willingness to speak with me. A final thank you to anyone and everyone who ever said or did all the right things to keep me on the path to completion!! 5 DEDICATION I dedicate this dissertation to all of the adult critical care patients and their families that I have served and cared for throughout my career, especially, to those who have suffered the loss of a loved one in the adult critical care. May you find peace and continued healing. To Life! Live Knowing that Death is Imminent. 6 TABLE OF CONTENTS LIST OF FIGURES .......................................................................................................................10 LIST OF TABLES .........................................................................................................................11 ABSTRACT ...................................................................................................................................12 CHAPTER ONE: STATEMENT OF THE PROBLEM ..........................................................13 Purpose of the Study ....................................................................................................................14 Background and Significance .....................................................................................................15 Philosophical Perspective ............................................................................................................18 Conceptual Framework ...............................................................................................................18 Description of the Physical Environment ......................................................................20 Family Member Active Presence ....................................................................................21 Death Awareness ..............................................................................................................21 Knowing the Patient as a Family Member ....................................................................22 Interrelationships of Concepts ........................................................................................23 Aims and Research Questions .....................................................................................................25 Summary .......................................................................................................................................26 CHAPTER TWO: REVIEW OF THE LITERATURE ...........................................................27 Family Member Active Presence ................................................................................................27 Death Awareness ..........................................................................................................................29 Knowing the Patient as a Family Member ................................................................................36 Families of Patients in Adult Critical Care ...............................................................................40 End-of-Life Theories Across Disciplines ....................................................................................47 Synthesis Critique of Literature .................................................................................................49 CHAPTER THREE: METHODOLOGY .................................................................................52 Study Design .................................................................................................................................52 Sample and Setting ......................................................................................................................53 Setting ................................................................................................................................54 Participant Inclusion Criteria .....................................................................................................55 Secondary Data Sources ..............................................................................................................56 Recruitment Strategies ................................................................................................................56 Protection of Human Subjects ....................................................................................................57 Procedure ......................................................................................................................................58 Data Sources .................................................................................................................................59
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