Pediatric Nurses' Death Anxiety and Level of Comfort in Approaching Families of Dying Children

118 Pages·2013·2.31 MB·English

by  Elizabeth J. Cook

Grand Valley State University
ScholarWorks@GVSU
Masters Theses Graduate Research and Creative Practice
10-18-2011
Pediatric Nurses' Death Anxiety and Level of
Comfort in Approaching Families of Dying
Children
Elizabeth J. Cook
Grand Valley State University
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Recommended Citation
Cook, Elizabeth J., "Pediatric Nurses' Death Anxiety and Level of Comfort in Approaching Families of Dying Children" (2011).
Masters Theses.Paper 10.
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PEDIATRIC NURSES’ DEATH ANXIETY AND LEVEL OF COMFORT
IN APPROACHING FAMILIES OF DYING CHILDREN

By

Elizabeth June Cook

A THESIS

Submitted to
Grand Valley State University
In partial fulfillment of the requirements for the
Degree of

MASTER OF SCIENCE IN NURSING

2011

Kirkhof College of Nursing

Thesis Committee Members:
Linda Nicholson Grinstead, PhD, RN
Ruth Ann Brintnall, PhD, RN
Nancy Kingma, MA, BSN, RN, LLP, LPC
ABSTRACT

PEDIATRIC NURSES’ DEATH ANXIETY AND
LEVEL OF COMFORT IN APPROACHING FAMILIES OF DYING CHILDREN

By

Elizabeth June Cook

The purpose of this study is to examine how demographics; bereavement
education; personal death anxiety; and frequency of interaction with death and dying;
impact the level of comfort pediatric nurses have in approaching families of dying
children. Watson’s Theory of Human Caring (n.d.) and the Quality Caring Model (Duffy
& Hoskins, 2003) provide the theoretical framework for nursing actions and outcomes.
The convenience sample of 165 pediatric nurses comes from a metropolitan children’s
hospital population of 425 pediatric nurses. Nurses are recruited by a mass e-mail to their
work e-mails with a link to the online survey. Nurses’ comfort level in approaching
families of dying children is positively related to pediatric nursing experience;
bereavement and emotionally charged communication education; choosing to interact
with families of dying children; and frequency of interactions. Comfort level was not
associated with total DAS score.
Dedication
This thesis is dedicated to Niki, a baby who lived to 14 weeks gestation, whose
family tried for 10 years to have her, the families impacted by the death of a loved one,
and all the nurses who care for them.

i
Acknowledgements
Thanks to God, my father in heaven for placing within me the desire and capacity
to care for others. To Jason my husband for allowing me to work towards my masters
degree and providing loving support as well as the “voice of reason” to my heart. To
Nicki, my thesis chair, for being understanding and encouraging when the work felt
overwhelming. To Nancy Kingma for emphasizing the importance of caring for families
after they have lost a loved one. And to my mom for teaching me how to look into the
soul of others and love them no matter where they are at in life.

ii
Table of Contents
List of Tables .......................................................................................................................v
List of Figures .................................................................................................................... vi
List of Appendices ............................................................................................................ vii
CHAPTER
1 INTRODUCTION ...................................................................................................1
Problem Statement ...........................................................................................3
Purpose .............................................................................................................4
2 CONCEPTUAL FRAMEWORK AND LITERATURE REVIEW ........................5
Conceptual Framework ....................................................................................5
Summary ..........................................................................................................8
Literature Review .............................................................................................9
Research Questions ........................................................................................48
Definition of Terms ........................................................................................49
3 METHODS ....................................................................................................................51
Design .............................................................................................................51
Sample and Setting .........................................................................................52
Instruments .....................................................................................................52
Independent/Dependent Variables .................................................................54
Procedure ........................................................................................................54
4 RESULTS AND DATA ANALYSIS ...........................................................................56
Quantitative Findings .....................................................................................57
Qualitative Findings .......................................................................................67
5 DISCUSSION AND IMPLICATIONS .........................................................................70
Demographics .................................................................................................70
Comfort Level in Approaching Families of Dying Children .........................73
Choosing to Interact with Families of Dying Children ..................................74
Death Anxiety .................................................................................................75
Qualitative Results .........................................................................................77
iii
Alternative Explanations ................................................................................78
Impact of Study ..............................................................................................78
Strengths .........................................................................................................79
Weaknesses and Limitations ..........................................................................79
Professional Implications ...............................................................................80
Further Research .............................................................................................82
Results and Conceptual Framework ...............................................................83
Summary ........................................................................................................84
APPENDICES ...................................................................................................................85
REFERENCES ................................................................................................................100

iv
List of Tables
Table 1. Demographic: Age ...............................................................................................58
Table 2. Experience: Nursing Specialty.............................................................................60
Table 3. Experience: Pediatric Nursing Experience ..........................................................61
Table 4. Education: Bereavement and Emotionally Charged Communication .................62
Table 5. Comfort Level Correlation Matrix .......................................................................63
Table 6. Nursing Specialty DAS Score Means ..................................................................66

v
List of Figures

Figure 1. The Ten Caritas ....................................................................................................6
Figure 2. The Bereavement Caring Model ..........................................................................7

vi