Internal and external consistency was tested. A pilot study showed that there was internal consistency. However, the results of the larger study indicate that more work on the KAESAD to improve the internal consistency of the scales used to measure the responses was needed. Data were statistically analyzed with an accepted value of statistical significance set at p < 0.05. Also, some data that was found to be statistically significant was determined by the authors to be clinically insignificant. How this was determined by the authors was not explained in the procedure.
The results were presented in several helpful tables and also interpreted by the authors. The authors discussed the results of each aspect of their research questions. None of the research questions were left out. The tables that were used were helpful, easy to read and agreed with the interpretations that the authors made about their results. The discussion was very well written. It was clear and concise and easy to read and understand. It is the strongest portion of this particular paper.
Since the authors did not make a hypothesis one cannot say whether the findings support or do not support their hypotheses. However, all of the research questions were answered. The authors did determine how much knowledge nurses have about AD, what their attitudes and experiences are regarding AD, and whether there is any correlation among these characteristics. The authors' discussion of the results is very clearly and logically written. They talk about the results and what they might mean. For example, many nurses disagreed with the...
The authors discuss how this is different from previous survey findings of other nurses and doctors and that it is also in conflict with recommendations from several medical associations. One aspect that lacks much discussion is why the authors find the statistically significant correlations to be clinically insignificant. The discussion mentions a statistical reason, but does not elaborate on how that relates to the clinical setting. Explaining why these findings would not also be applicable to the treatment of patients would be helpful in understanding why they came to this conclusion.
The authors indicate several areas for further research such as refining the scale of the KAESAD and following up on survey topics that produced interesting or conflicting results to other studies with more focused surveys. The implications of this research indicate a strong need for continuing education for emergency nurses on the topics of AD, advance care planning, and the ethics of withholding and withdrawing life support treatment.
References
Jezewski, M.A., & Feng, J.-Y. (2007). Emergency nurses' knowledge, attitudes, and experiential survey on advance directives. Applied Nursing Research, 20, 132-139. doi: 10.1016/j.apnr.2006.05.003
Jezewski, M.A., Brown, J.K., Wu, Y.-W., Meeker, M.A., Feng, J.-Y. & Bu, X. (2005). Oncology nurses' knowledge, attitudes and experiences regarding advance directives. Oncology Nursing Forum, 32(2), 1-9.
