The final phase of the dying trajectory characterizes the point in which death is anticipated within hours to several days. Several indicators of functional and cognitive decline are often associated with this phase. A plethora of anecdotal accounts offered by nurses and other healthcare professionals suggested that some individuals in the final phase of the dying trajectory experience a sudden, unexpected surge of energy and enhanced mental clarity, varying in intensity and duration. This exploratory study, therefore, utilized the Delphi method to systematically collect from a panel of certified and advanced certified hospice and palliative nurses, observational experiences, opinions, and perceptions of the phenomenon labeled Premortem Surge (PS) in order to identify its distinguishing characteristics and validate PS manifests in the final phase of the dying trajectory. An online survey tool was used to disseminate three Delphi rounds of questionnaires. The first Delphi round (R1) questionnaire included demographic questions to create panelists' profile and eight semi-structured, open-ended questions in order to generate as much detail information possible regarding PS. Content analyses were conducted and emerged themes and concepts used to generate 58 summary statements for Delphi Round 2 (R2) questionnaire. Using a five-point scale, panelists rated their level of agreement or disagreement with each summary statement, resulting in 42 statements having met the predetermined criterion score. In Delphi Round 3 (R3) panelists' rerated the level of agreement or disagreement with the 42 statements and rank ordered statements, resulting in 40 retained statements. Thus, the Delphi study is the first study to generate a consensus of identified characteristic of PS and implications of PS for family and nurses by a panel of end of life care nurse experts; validating the phenomenon, Premortem Surge, manifests in the final phase of the dying trajectory.
|School:||Louisiana State University Health Sciences Center School of Nursing|
|School Location:||United States -- Louisiana|
|Source:||DAI-B 72/08, Dissertation Abstracts International|
|Subjects:||Nursing, Cognitive psychology|
|Keywords:||Dying trajectory, Premortem surge|
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