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Bachelor of Nursing Studies
RESEARCH PROPOSAL

Title: A quantitative study of the attitude, knowledge and experience of staff nurses on prioritizing comfort measures in care of the dying patient in an acute hospital setting.

Research Proposal submitted to the University of Dublin Trinity College, in partial fulfilment of the requirements for the Bachelor in Nursing Studies

9th March 2011

I hereby declare that this research proposal is entirely my own work and has not been submitted as an exercise for assessment at this or any other University.

Signed:……………………………………………………… Print Name: Date:

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Acknowledgements The author would like to thank and gratefully acknowledges the following people, who helped make this project possible: my mother for her continued support, my husband and daughter for keeping me going and my uncle who proof read my work. A special thank you goes my tutor and my facilitator for being so understanding and supportive during the development of this research proposal. Their practical guidance motivated me to keep going.

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Contents

Title Page…………………………………………………………………………...i Declaration ………………………………………………………………………...ii Acknowledgements……………………………………………………………….iii Contents Page…………………………………………………………………….iv Abstract …………………………………………………………………………....vi

CHAPTER 1
1.1 Introduction …………………………………………………………………....1 1.2 Literature Review..................................................................................... 1 1.3 Identification of the dying phase……………………………………………..2 1.4 Comfort Care .………………………………………………………………….4 1.5 Symptom Control………………………………………………………………6 1.6 Conclusion……………………………………………………………………...8 1.6 Research Problem……………………………………………………………..8 1.7 Research Question………………………………………………………….....8 1.8 Objectives…………………………………………………………………….....9

CHAPTER 2 – METHODOLOGY
2.1 Introduction to Research Method …………………………………………...10 2.2 Research Design………………………………………………………………10 2.3 Population/Sample…………………………………………………………….10 2.4 Data Collection………………………………………………………………....12 2.5 Validity & Reliability…………………………………………………………....13 iv

2.6 Data Analysis…………………………………………………………………..14 2.7 Pilot Study………………………………………………………………………16 2.8 Ethical Considerations………………………………………………………...16

CHAPTER 3 – PROPOSED OUTCOME
3.1 Proposed outcome…………………………………………………………......18 3.2 Time scale……………………………………………………………………….19 3.3 Resources……………………………………………………………………….19

Reference List……………………………………………………………………….20 Bibliography………………………………………………………………………….23 Appendices…………………………………………………………………………..25

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Abstract
Background: When the prognosis for a patient is imminent death, hospice care concentrates on the quality of life of the patient, reducing the severity of the disease symptoms rather than vainly trying to treat the disease itself. To assist in delivery of this type of quality end-of-life care to patients in acute hospitals the Irish Hospital Foundation (IHF) developed a Hospice Friendly Hospital programme (HFH). This HFH developed the Quality Standards for End-of-Life Care in Hospitals to set out a shared vision for the type of end-of life care that each hospital should aim to provide. This development is significant as almost 50% of those who die in Ireland die in hospital and care of the dying in Irish hospitals, while regarded as good, is described as ‘care at the end of life’ rather than ‘end-of-life care’ because the care seems to lack an effective palliative care component” (McKeown et al. 2010, p.158). Literature Review To investigate international perspectives on end-of-life care, the current international literature was reviewed using the key themes of identifying the dying phase, comfort care and symptom control for the dying patient. It was concluded from the literature review that nurses and medical staff often differed in their approach to care of the dying patient and this hindered effective delivery of end-oflife care. Education on end-of-life care was recommended in...
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