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Document Type

Thesis - University Access Only

Award Date


Degree Name

Master of Science (MS)


Graduate Nursing

First Advisor

Barbara Heater


patient attitudes, home care services, right to die


The Patient Self-Determination Act of 1990 sought to respond to a public demand for increased autonomy for patients in the making of medical treatment decisions at the end of life. It sought to increase the use of advance directives (ADs) by requiring institutions to document their existence in patient records. In spite of generalized enthusiasm for ADs, their use has remained consistently low. A related issue is the role of resuscitation preferences. A population in which little study of end of life planning has been conducted is the rapidly growing population of home healthcare patients.
The purpose of this study was to describe the knowledge, attitudes, and behaviors of home healthcare patients and to determine if a recent hospitalization makes a difference in their knowledge, attitudes or behaviors. The questions this study sought to answer were; (I) What are the knowledge, attitudes and behaviors' regarding advance directives and resuscitation orders; and, (2) Does a recent hospitalization make a difference in the end of life treatment decisions of home healthcare patients?
A descriptive comparative design was used to study the variables under investigation. A convenience sample of 70 home healthcare patients completed a self-report questionnaire. No significant differences were found between those patients who had experienced and recent hospitalization and those who had not. The data shows an elderly, vulnerable sample who are interested in planning for the end of their lives with both their families and healthcare providers. While they have a general understanding and positive attitudes toward planning, they lack the knowledge and ability to do so.

Library of Congress Subject Headings

Patients -- Attitudes
Home care services
Right to die



Number of Pages



South Dakota State University


Copyright © 1998 Gregg Waylander. All rights reserved