scholarly journals Divergent patterns of confrontation with death using the Anticipated Farewell to Existence Questionnaire (AFEQT): a cross-sectional comparative study of four samples with increasing proximity to death

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Juan Valdés-Stauber ◽  
Ursula Stabenow ◽  
Jakob Böttinger ◽  
Sarah Kramer ◽  
Reinhold Kilian

Abstract Background Based on the concept of “Daseinsverabschiedung”, an anthropological theory of “Anticipated Farewell to Existence” (AFE) was suggested on the basis of six grounding dimensions: selfhood, interpersonality, temporality, corporeality, worldliness, and transcendence, which are activated in a genuine manner facing death. The purpose of the study is to quantitatively compare the extent of confrontation with death between dying people in palliative care and those in other stages of life by means of the Anticipated Farewell to Existence Questionnaire” (AFEQT), based on these dimensions. Methods The sample (N = 485) consists of dying individuals in palliative wards and hospices (n = 121); old people living in nursing homes not suffering from a mortal disease (n = 62); young adults (n = 152), and middle-aged adults (n = 150). The design is cross-sectional and analytical. The relevance of anticipated farewell to existence was measured by means of the AFEQT. The internal consistency of the AFEQT was assessed using Cronbach’s alpha and convergent validity by means of dimensions of the Life Attitude Profile-Revised (LAP-R). Differences between groups and associations with control variables were estimated by means of multiple regression models, including propensity scores. Results Cronbach’s alpha for AFEQT was > 0.80 for the whole test and all subsamples, but < 0.70 for most dimensions in dying people. Correlations between each dimension and corresponding two factors was almost overall r > 0.80, p < 0.001. Good convergent validity between dimensions of AFEQT and of Life Attitude Profile-Revised in young and middle-aged participants showed correlations for superordinate indices between -0.23 and 0.72, and an overall p < 0.001. Dying people scored significantly higher for all dimensions, especially “altruistic preoccupation” and “reconciliation with existence” than people in other life stages (p < 0.01- < 0.001). Personality traits of “openness” and “agreeableness” are positively associated with higher scoring of AFEQT dimensions. About 77% of dying participants reported a personal benefit through the interview questions. Conclusions With proximity to death, the anthropological dimensions proposed scored significant higher than in other stages of life, reflecting a stronger awareness, confrontation and reconciliation with the end of their own life. These dimensions, especially preoccupation for related persons and coexistence of acceptance and struggle with death have to be taken into account in a sensitive way by supporting dialogues with dying people and their relatives. Trial registration Observational cross-sectional study.

2021 ◽  
Author(s):  
Juan Valdés-Stauber ◽  
Ursula Stabenow ◽  
Jakob Böttinger ◽  
Sarah Kramer ◽  
Reinhold Kilian

Abstract Background: Based on the concept of “Daseinsverabschiedung”, an anthropological theory of “Anticipated Farewell to Existence” (AFE) was suggested on the basis of six grounding dimensions (“derived in AFE”): selfhood (“expiration of the time of existence”), interpersonality (“altruistic preoccupation”), temporality (“struggle for acceptance”), corporeality (“wounded physical integrity”), worldliness (“reconciliation with own existence”), and transcendence (“self-transcendence”). The purpose of the study is to investigate the extent to which the relevance of these anthropological dimensions differs between people in different stages of life, especially those facing their own death.Methods: The sample (N=485) consists of dying individuals in palliative wards and hospices (n=121); old people living in nursing homes not suffering from a mortal disease (n=62); young adults (n=152), and middle-aged adults (n=150). The relevance of anticipated farewell to existence was measured by means of the “Anticipated Farewell to Existence Questionnaire” (AFEQT). Further assessment tools: Big Five Inventory (BFI-10), Life Attitude Profile (LAP-R), Eastern Cooperative Oncology Group (ECOG), and Basic Documentation for Psycho-Oncology (PO-Bado). The internal consistency of the AFEQT was assessed using Cronbach’s alpha and convergent validity by means of dimensions of LAP-R. Differences in the relevance of the AFEQT dimensions among stages of life were estimated by means of multiple regression models.Results: According to Cronbach’s alpha, the internal consistency of the AFEQT subscales was sufficient for the whole sample. Convergent validity with dimensions of LAP-R was found for young and middle-aged participants. Dying people scored significantly higher for most of the dimensions than young and middle-aged as well as elderly people. Personality traits of “oenness” and “agreeableness” are positively associated with the extent of assessed dimensions of AFEQT.Conclusions: Anthropological reflections on the structure of human beings, which is activated or actualized in a special way in the face of death, can provide a framework for practice facing a humanization of medicine at the end of life, considering real experiences, possible needs, and underlying human conditions when facing end of life. The dimensions proposed can be taken into account in a sensitive way by supporting dialogues with dying people and their relatives.Trial registration: observational study.


2021 ◽  
pp. 003022282110368
Author(s):  
Feni Betriana ◽  
Tetsuya Tanioka ◽  
Tomoya Yokotani ◽  
Youko Nakano ◽  
Hirokazu Ito ◽  
...  

Frequent exposure to patient deaths prompts nurses to experience grief. Unresolved grief leads to harmful consequences of nurses’ mental health and quality of nursing care. A cross-sectional study using an online survey was conducted to determine the psychometric properties of the Grief traits and State Scale for Nurses. Exploratory factor analysis revealed two factors measuring the level of nurses’ grief traits (Cronbach’s alpha: 0.84) and two factors in grief state (Cronbach’s alpha: 0.86). Nurses’ feelings of unable to provide good care were associated with a higher risk of grief (odds ratio (OR): 4.30, 95% confidence interval (CI): 1.45–12.75), uncomfortable feeling toward deaths (OR: 11.29, 95%CI: 1.48–85.91), and emotional exhaustion (OR: 7.12, 95%CI: 1.63–30.99). Results indicated that the scale was reliable in determining the levels of their grief. Nurse managers can use the scale to identify their nurses’ levels of grief, creating opportunities to influence the resolution of the grief experiences.


2021 ◽  
Vol 1 (1) ◽  
pp. 1-6
Author(s):  
Kusuma Wijaya Ridi Putra ◽  
Riesmiyatiningdyah Riesmiyatiningdyah ◽  
Agus Sulistyowati

Introduction: The problem that is often experienced by young women is anemia. This anemia condition causes them to feel lethargic, dizzy, and a pale face. This situation causes them to be less eager to carry out activities and interfere with their learning concentration. Objective: This study aimed to determine the reliability test results of the questionnaire on the level of knowledge about anemia in adolescents. Methods: This study used a cross-sectional study method. This research was conducted on February 28, 2021. The study population was all adolescents in the Islamic Boarding School of Tahfizh Putri Alfirdaus Hidayatullah, Sekardangan, Sidoarjo. The sampling technique used was total sampling. The sample size of the study was 24 adolescents. This study used a modified questionnaire for adolescent knowledge about anemia (Zulaekah, 2007). The questionnaire used in this study only used 8 items from the original questionnaire. The data analysis carried out was Mean, Standard Deviation, and Cronbach's Alpha. Results: Based on the results of the reliability test on the adolescent knowledge level questionnaire, it was found that Cronbach's Alpha was .594. This illustrates that the questionnaire is good enough to be used as an instrument in research. Conclusion: A modified questionnaire about the level of adolescent knowledge about anemia can be used in a study.


2019 ◽  
Author(s):  
Ευφροσύνη Κλεάνθους

Η μέτρηση της έκβασης του ασθενούς έχει λάβει εξέχουσα θέση στην αξιολόγηση των συστημάτων υγείας τα τελευταία 30 χρόνια ενώ παράλληλα άρχισε να φαίνεται ότι η φροντίδα της ψυχικής υγείας πρέπει να παρέχεται βάσει των αναγκών των ασθενών, με απώτερο στόχο να βελτιωθεί η ποιότητα ζωής τους. Κύριος σκοπός της παρούσας έρευνας ήταν η αξιολόγηση των αναγκών, της ποιότητας ζωής και της λειτουργικότητας των ψυχικά πασχόντων που λαμβάνουν φροντίδα σε δομές ψυχικής υγείας στην Κύπρο. Επιπλέον, η έρευνα αποσκοπούσε στην διερεύνηση της σχέσης μεταξύ των μεταβλητών που μελετήθηκαν. Μέθοδος: Πραγματοποιήθηκε μια συγχρονική μελέτη (cross-sectional study). Η συλλογή των δεδομένων πραγματοποιήθηκε σε δομές ψυχικής υγείας στην Κύπρο,κοινοτικές αλλά και νοσοκομειακές, με την χρήση ενός ερωτηματολογίου το οποίο περιλάμβανε την ελληνική μετάφραση του εργαλείου Camberwell Assessment ofNeed Short Appraisal Schedule (CANSAS), την Κλίμακα Αξιολόγησης τηςΠοιότητας Ζωής του Παγκόσμιου Οργανισμού Υγείας (WHOQOL-BREF), και τηνΚλίμακα Ολικής Εκτίμησης της Λειτουργικότητας (GAS). Αποτελέσματα: Το δείγμα αποτελείτο από 202 ασθενείς οι οποίοι λαμβάνουν φροντίδα σε εξωτερικές και νοσοκομειακές δομές των Υπηρεσιών Ψυχικής Υγείαςτης Κύπρου. Η μέση ηλικία των ασθενών ήταν 46,4 έτη. Το 53,5% των ασθενών ήταν άνδρες Το 58,4% των ασθενών έπασχαν από ψυχωσικές διαταραχές, το 34,7%έπασχαν από διαταραχές διάθεσης και το 6,9% έπασχαν από αγχώδεις διαταραχές. Ομέσος αριθμός ετών με τη νόσο ήταν 17,1 χρόνια. Ο συντελεστής εσωτερικήςαξιοπιστίας Cronbach’s alpha του ερωτηματολογίου αναγκών του Camberwell στην παρούσα μελέτη ήταν 0,75 γεγονός που δηλώνει αποδεκτή αξιοπιστία. Σε ότι αφορά στις ανάγκες σύμφωνα με το CANSAS, η μέση τιμή των εκλαμβανόμενων συνολικών αναγκών από τους ψυχικά πάσχοντες στην Κύπρο ήταν 9,56, η μέση τιμή των καλυμμένων αναγκών ήταν 4,08 και η μέση τιμή των ακάλυπτων αναγκών 5,51. Στηνπαρούσα έρευνα οι πέντε πιο συχνά αναφερόμενες ακάλυπτες ανάγκες ήταν 1)σεξουαλική έκφραση, 2) ψυχολογική ανησυχία ή ψυχική αναστάτωση, 3) οικείες σχέσεις, 4) συντροφικότητα και 5) καθημερινές δραστηριότητες σε φθίνουσα σειρά.Οι πέντε λιγότερο αναφερόμενες ακάλυπτες ανάγκες ήταν οι ανάγκες για 1)αυτοφροντίδα, 2) στέγαση, 3) χρήση τηλεφώνου, 4) φροντίδα παιδιών, 5) χρήση 7αλκοόλ. Το 18,2% δήλωσαν ότι δεν είναι καθόλου ικανοποιημένοι την ποιότητα ζωής τους γενικά, το 22,7% ότι είναι λίγο ικανοποιημένοι, το 29,3% ότι είναι μέτρια ικανοποιημένοι, το 21,2% δήλωσαν ότι είναι πολύ ικανοποιημένοι και το 8,6% ότι είναι υπερβολικά ικανοποιημένοι. Το 19,9% δήλωσαν ότι δεν είναι καθόλου ικανοποιημένοι με την υγεία τους, το 17,3% ότι είναι λίγο ικανοποιημένοι, το 34,2%ότι είναι μέτρια ικανοποιημένοι, το 18,9% δήλωσαν ότι είναι πολύ ικανοποιημένοι και το 9,7% ότι είναι υπερβολικά ικανοποιημένοι. Οι περισσότεροι ασθενείς είχαν σοβαρή διαταραχή της λειτουργικότητας (42,6%), το 28,7% είχαν μέτρια διαταραχή της λειτουργικότητας, το 19,8% είχαν ήπια διαταραχή της λειτουργικότητας, το 6,9%είχαν βαριά διαταραχή της λειτουργικότητας και το 2% είχαν καλή λειτουργικότητα.Η μείωση της βαθμολογίας των ακάλυπτων αναγκών σχετίζονταν με αύξηση της βαθμολογίας αυτοεκτίμησης της ποιότητας ζωής. Η μείωση της βαθμολογίας των ακάλυπτων αναγκών σχετίζονταν με αύξηση της βαθμολογίας λειτουργικότητας. Η αύξηση της βαθμολογίας των καλυμμένων αναγκών σχετίζονταν με αύξηση της βαθμολογίας ικανοποίησης για την υγεία.Συμπεράσματα: Τα εργαλεία εκτίμησης των αναγκών, της ποιότητας ζωής και της λειτουργικότητας μπορούν να χρησιμοποιηθούν για εκτίμηση της κλινικής αποτελεσματικότητας και του κόστους των παρεμβάσεων, την παρακολούθηση της υγείας του πληθυσμού των ψυχικά πασχόντων, στον σχεδιασμό υπηρεσιών για κάλυψη των αναγκών τους, στην βελτίωση της ποιότητας της παρεχόμενης φροντίδας καθώς και ως ενίσχυση στην διαδικασία λήψης αποφάσεων στην καθημερινή κλινική πρακτική. Η ικανοποίηση των κοινωνικών αναγκών, πέρα από τη μείωση των συμπτωμάτων, φαίνεται να έχει ιδιαίτερη σημασία για την εξασφάλιση καλύτερης ποιότητας ζωής και καλύτερης ψυχοκοινωνικής λειτουργικότητας για τα άτομα με ψυχικές διαταραχές. Τα αποτελέσματα από την χρήση των εργαλείων στον πληθυσμό των ψυχικά πασχόντων στην Κύπρο φαίνεται να συμβαδίζουν με δεδομένα από άλλες διεθνείς έρευνες.


Author(s):  
Leila Bernarda Donato Gottems ◽  
Elisabete Mesquita Peres De Carvalho ◽  
Dirce Guilhem ◽  
Maria Raquel Gomes Maia Pires

ABSTRACT Objectives: to analyze the internal consistency of the evaluation instrument of the adherence to the good practices of childbirth and birth care in the professionals, through Cronbach’s Alpha Coefficient for each of the dimensions and for the total instrument. Method: this is a descriptive and cross-sectional study performed in obstetric centers of eleven public hospitals in the Federal District, with a questionnaire applied to 261 professionals who worked in the delivery care. Results: The study was attended by 261 professionals, 42.5% (111) nurses and 57.5% (150) physicians. The reliability evaluation of the instrument by the Cronbach Alfa resulted in 0.53, 0.78 and 0.76 for dimensions 1, 2 and 3, after debugging that resulted in the exclusion of 11 items. Conclusions: the instrument obtained Cronbach’s alpha of 0.80. There is a need for improvement in the items of dimension 1 that refer to attitudes, knowledge, and practices of the organization of the network of care to gestation, childbirth, and birth. However, it can be applied in the way it is used to evaluate practices based on scientific evidence of childbirth care.


2017 ◽  
Vol 2 (1) ◽  
pp. 23
Author(s):  
Nia Kurniasih ◽  
Dwi Hastuti

<p>This research aimed to analyze the effect of maternal discipline on discipline of children at two kindergarten in Bogor City. The research design used was<em> a </em>cross sectional study involving 46 mothers and children, selected by accidental sampling, and the data were collected using a questionnaire. Parenting discipline was measured using a questionnaire of The Dimensions of Discipline Inventory (DDI), which was adapted and modified from Straus and Fauchier (2011) with a Cronbach's alpha value of 0.864, and Character Development Questionnaire Preschooler adapted and modified from Hastuti (2014) with a Cronbach's alpha value of 0649. The results showed that there was a significantly positive correlation between the lenght of education and mother’s implementation of discipline, and there is a significantly positive correlation between marital status with cognitive appraisal of discipline. Cognitive appraisal of discipline is an opinion or judgment against parent parenting discipline either approved or not. Discipline of children was influenced by mother’s  length of education, mother’s age, and  situation in the application of discipline by mother (R<sup>2 </sup>Adjusted= 0.492). The situation in the application of discipline is a state or condition of the mother when applying disciplinary behavior to children.</p><p> </p>


2019 ◽  
Author(s):  
Naoki Sakakibara ◽  
Hiroko Komatsu ◽  
Mikako Takahashi ◽  
Hideko Yamauchi ◽  
Teruo Yamauchi ◽  
...  

Abstract Background: The Barriers Questionnaire II (BQ-II) was developed to assess barriers to effective pain management. In this study, we aimed to assess the reliability and validity of the newly developed Japanese version of the BQ-II (JBQ-II).Methods: This study used a cross-sectional design. The study was conducted an ambulatory infusion center for cancer in a general hospital in Tokyo, Japan. Participants were 120 Japanese patients with cancer and 21 Japanese health professionals with experience in pain management. Cronbach’s alpha coefficient was used to calculate reliability. Test–retest reliability was assessed with Spearman’s intra-class correlation coefficient (ICC). Construct, criterion-related, and discriminant validity were assessed using information about pain management, daily life, mental health, and subjective health.Results: The Cronbach’s alpha was 0.90 for the JBQ-II, and all ICCs exceeded 0.70 (P < 0.01). Factor analysis showed the JBQ-II had a virtually identical structure to the BQ-II, and path analysis supported the JBQ-II constructs. The JBQ-II was weakly correlated with poor mental state (r = 0.36, P < 0.01). Patients’ JBQ-II scores were significantly higher than health professionals’ scores.Conclusion: The JBQ-II is a valid and reliable measure of patient-related barriers to pain management among Japanese people with cancer.


2020 ◽  
Vol 19 (3) ◽  
pp. 241-250
Author(s):  
Fatemeh Sadat Mirzadeh ◽  
Mahtab Alizadeh-Khoei ◽  
Farshad Sharifi ◽  
Reyhaneh Aminaloroaya ◽  
Sakar Hormozi ◽  
...  

Purpose Normal aging changes, acute and chronic illness, and the long stay in the hospital made the decline in elderly physical and mental abilities in non-instrumental and Instrumental Activities Daily Livings (IADL). This paper aims to determine the validity and reliability of Lawton IADL in the Iranian elderly community relevancy to physical, mental and cognitive measurements. Design/methodology/approach A cross-sectional study with 422 participants, age 60 years old and over selected by face-to-face interviewing from the geriatric clinic, Tehran medical university from January to June 2019. Findings Of 422 participants referring to outpatient clinics the majority were male (62.8%); with an average of 66.9 ± 5.95 years old. Reliability was significantly high (Cronbach’s alpha = 0.96, p < 0.001). There was a significant relationship between IADL with Short-Form Health Survey36-Mental Component Score (SF36-MCS), with p < 0.01. Reliability was significantly high (Cronbach’s alpha = 0.96, p < 0.001). In the factor analysis with eigenvalues more than one, two components were found; that the first factor named as observational daily activities, whereas the second factor named “advanced daily activities”. Research limitations/implications The limitation of this study was the low number of similar studies to compare the results and the stronger discussion. Originality/value Determining IADL's dependency in the community elderly is important to maintain their self-care manages. More studies are needed to manifest the relationship between mental health and IADL's independence. Therefore, validation in different settings is important in planning for the geriatrics team.


PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254317
Author(s):  
Raziyeh Ghafouri ◽  
Malihe Nasiri ◽  
Foroozan Atashzadeh-Shoorideh ◽  
Faraz Tayyar-Iravanlou ◽  
Zahra Rahmaty

Background and objectives Nurses’ caring behaviors, professional activities, and behaviors for the benefit of patients, influence patients’ perception of care and satisfaction with the quality of care provided. Caring behaviors of nurses are contextual and various factors such as patients’ social structure, lifestyle, culture, and interests, as well as their biographical, social, and physiological characteristics, can influence perceptions of caring behaviors of nurses, as caring behaviors are an interactive and mental process between patients and nurses. This study was conducted to provide a transcultural translation and psychometric analysis of Caring Behaviors Inventory (CBI) among nurses in Iran. Methodology Transcultural translation of the 16-item CBI was performed. Then, face validity (qualitative), content validity (quantitative and qualitative), and construct validity were examined in a cross-sectional study of 509 patients. A demographic questionnaire and the 16-item CBI were sent to enrolled patients via online questionnaires. The reliability of the instrument was assessed by internal consistency using Cronbach’s alpha. Then, construct validity of the single factor CBI was assessed using Confirmatory Factor Analysis (CFA). Since one factor CBI was not confirmed, construct validity was examined using Exploratory Factor Analysis (EFA). The final number of factors was confirmed using CFA. Results The internal consistency of the instrument was good with Cronbach’s alpha 0.89. Based on EFA, the CBI were loaded on two factors, eigenvalues >1, no item was removed. The emergent factors were named "Communicating respectfully" and "Professional knowledge and skill". These two factors explained 50.197% of the total variance. Then, CFA showed an acceptable fit for the two factors CBI. Conclusion The results showed that the Persian version of the 16-item CBI had adequate validity and reliability. Accordingly, this instrument can be used to study nurses’ caring behaviors.


2019 ◽  
Vol 5 (1) ◽  
pp. 26-30
Author(s):  
Mahin Nomali ◽  
◽  
Akram Sanagoo ◽  
Farzaneh Sarayloo ◽  
Leila Mahasti Jouybari ◽  
...  

Background: Classroom is an important place for university students. Students do not choose their seat at random and many factors may influence their seat selection. On the other hand, where they choose to seat may have a relationship with their self-esteem. Aims and objectives: Determination of classroom seat selection from the perspective of Iranian medical sciences` students and its relationship with self-esteem was the aim of this study. Study Design: We conducted a cross- sectional study. Setting: Different faculties of Golestan University of Medical Sciences (GoUMS, Gorgan, North of Iran) were our study setting. Materials and Methods: 350 students of both sexes and with different fields of study at GoUMS were included in the study by convenience sampling from September to December in 2016. In order to measure university students` perspective, seat selection questionnaire (Cronbach’s alpha =0.82 ) with 9 multiple choice questions (MCQs) was used which answer to each question has been reported with a frequency and percent. Ten- item Rosenberg Self- Esteem (RSE) scale (Cronbach’s alpha=0.74) consisting 5 negative and 5 positive items with 4- point Likert (score of 0 to 3 from completely agree to completely disagree) were used. Range of score was between 0 to 30. Score lower than 15, between 15-25, and more than 25 indicated low, intermediate, and high self- esteem, respectively. Statistics: We analyzed data by SPSS software version 16. Descriptive statistics such as mean, standard deviation (SD), frequency, and partial frequency percentage were used. In order to test the relationship between place and direction of the seat, and self-esteem, the chi-squared test was used with significance level of less than 0.05. Results: 300 out of 350 medical sciences` students with a mean age of 21.5 (2.4) year completed the study (participation rate = 85.7%). 50.3 % of participants were male, and with nursing field of study (28.7%). Proximity to instructor or board, or projector (48.7%) and personal factors such as eyeglasses/hearing aids (19.3%) were the most and the least important factors influencing students` seat selection. And “inability to see/hear properly” was the most important factor that made students change their seats. The majority of students mentioned that they choose the middle of the classroom (43.3%). Low, intermediate and high self- steam were seen among 5 (1.7%), 290 (96.6%), and 5 (1.7%) of students, respectively, and there was no relationship between classroom seat selection and self-esteem of students. Conclusion: From the perspective of Iranian medical sciences` students, classroom seat selection is affected by many factors. And they usually preferred to sit in the middle of the classroom. However, there was no relationship between students seating preferences and self-esteem. Thus, considering to these factors may help instructors and educational policy makers improving the quality of courses, students` performance, and classroom attractiveness.


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