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Purpose: There is a lack of discussion regarding end-of-life care planning which results in low advanced directive execution (AD) rates. This can lead to decision making by family, friends, and the health care team on behalf of patients whose end-of-life care wishes are unknown. The purpose of this study was to determine the effectiveness of an educational intervention in the work setting to increase end-of-life discussions and the execution of advanced directives. Methods: A descriptive design was used in an occupational workplace setting at a local bottling company after appropriate IRB approval was obtained. An educational intervention based on the Five Wishes document was presented in an occupational health setting covering all shifts and employment categories. A pre-program questionnaire measured a lack of knowledge and understanding of end-of-life planning and advanced directives. A post-program questionnaire measured the increase in knowledge and understanding of end-of-life planning and advanced directives. A focus group was conducted with audio recording to describe personal experiences. The quantitative analysis used statistical procedures to describe and synthesize data and content analysis was conducted on the focus group data. Results: A sample of 78 participants was used to gather the quantitative data. Of the total participants, an overwhelming majority were male with ethnic backgrounds evenly represented. Most of the participants either were married and either were drivers, salespeople, or warehouse workers. More participants indicated no religious affiliation than any other affiliation, and the majority of participants indicated that they had a high school diploma. When questioned about their 1) knowledge of advanced directives, 2) whether or not they would consider executing an advanced directive, 3) whether or not they were likely to discuss end-of-life care with other, 4) whether they would be comfortable having someone make end-of-life decisions on their behalf, and 5) whether or not they believed that advanced directives were important, the majority of participants indicated that they strongly agreed or agreed. However, none of the participants had executed an advanced directive. Only 10.3% of participants had ever discussed AD's with a healthcare provider. When the same participants were asked the same questions after the education portion of the study, data analysis of the pre- and post-program questionnaire mean scores, revealed a significant increase in scores on questions 1,2 and 3 (p > .05), and no significant increase on question 4 and 5 (p > .05). The implication of these findings suggest that an education intervention program in a workplace setting significantly increases end-of-life discussions and advanced directive execution rates. The Jones model of end-of-life education intervention and interpretation of the study are presented. Limitations of the study, as well as implications for nursing professionals and health care providers that will improve patient outcomes are presented. Discussion/Implication: The study shows that workplace education regarding Advanced Directives can lead to increase end-of-life discussions and increase advanced directive execution rates. Therefore, this education program at a worksite merits further research and may serve as a model program for other worksite settings.

Thesis (Ph. D.)--Miami University, Dept. of Psychology, 2008. / Title from second page of PDF document. Includes bibliographical references (p. 31-37).

Made available in DSpace on 2016-08-10T10:47:44Z (GMT). No. of bitstreams: 1 IVAN GUSTAVO JUNIO SANTOS TRINDADE.pdf: 1386917 bytes, checksum: 8e7aff1b3c6e2338d01c7c463fdfebfb (MD5) Previous issue date: 2016-03-14 / After the ratification in 2009 by Brazil of the Convention on the Rights of Persons with Disabilities, published in 2007, the legal systematic regard to the theory of disability and its consequences suffered intense modifications. The Brazilian Civil Code, published in 2002, despite the ability to relate to the constitutional system of protection of human dignity, not encompassed in its content the admission of full autonomy of persons with disabilities. Nevertheless, the Federative Republic of Brazil became a signatory to the International Treaty on the Rights of Persons with Disabilities, which promoted a paradigm shift on the focus of the concept of disability, which, of course, sparked a significant impact on the study of theories of disabilities and its corollaries. Brazilian law inclusion of people with disabilities (Law no. 13,146 - 2015), called the Disabled status, in obedience to the fundamental principles of the Convention on the Rights of Persons with Disabilities, raised transformation in the parental system of disability and, consequently, the procedural issues relating to the protection of the disabled person. The changes brought about by People with Disabilities Statute generated sequels in the Civil Law inherent institutions such as marriage and interdiction, and Civil Procedure, like the reflections in prescription and decay and the institution of the new decision-making tool supported. / Após a ratificação em 2009 por parte do Brasil da Convenção sobre os Direitos da Pessoa com Deficiência, editada em 2007, a sistemática jurídica atinente à teoria das incapacidades e seus desdobramentos sofreu modificações intensas. O Código Civil brasileiro, editado em 2002, em que pese a aptidão para se relacionar com a sistemática constitucional de proteção da dignidade da pessoa humana, não abarcou em seu conteúdo a admissão da integral autonomia das pessoas com deficiência. A despeito disso, a República Federativa do Brasil se tornou signatária do Tratado Internacional sobre os Direitos das Pessoas com Deficiência, sendo promovida uma mudança paradigmática sobre o enfoque do conceito de deficiência, o que, naturalmente, deflagrou consequências significativas no estudo das teorias das incapacidades e seus corolários. A lei brasileira de inclusão da pessoa com deficiência (Lei nº. 13.146-2015), denominada de Estatuto da Pessoa com Deficiência, em obediência aos preceitos fundamentais da Convenção sobre os Direitos das Pessoas com Deficiência, suscitou transformação no sistema pátrio de incapacidade e, por consequência, nas questões processuais relativas à proteção da pessoa com deficiência. As mudanças trazidas pelo Estatuto da Pessoa com Deficiência geraram sequelas em institutos inerentes ao Direito Civil, como o casamento e interdição, e Processual Civil, a exemplo dos reflexos na prescrição e decadência e na instituição do novo instrumento de tomada de decisão apoiada.