A mixed-methods exploration of death exposure in certified nursing assistants: moderating factors and implications

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dc.contributor Hart, William P.
dc.contributor Oliver, JoAnn S.
dc.contributor Parmelee, Patricia A.
dc.contributor Kim, Giyeon
dc.contributor.advisor Allen, Rebecca S.
dc.contributor.author Eichorst, Morgan Kay
dc.date.accessioned 2018-01-19T19:37:47Z
dc.date.available 2018-01-19T19:37:47Z
dc.date.issued 2017
dc.identifier.other u0015_0000001_0002734
dc.identifier.other Eichorst_alatus_0004D_12792
dc.identifier.uri http://ir.ua.edu/handle/123456789/3372
dc.description Electronic Thesis or Dissertation
dc.description.abstract Certified Nursing Assistants (CNAs) are responsible for 80-90% of direct-to-resident care in skilled nursing home facilities (SNFs), and often develop close, family-like relationships with their residents. With SNFs becoming an increasingly common place of death for older adults, CNAs now find themselves engaging in end-of-life caregiving without proper training, or institutional support for the emotional outcomes. Moreover, little is known about the impact of frequent death exposure on CNAs. The present project examined these issues in a set of three interrelated studies, employing mixed-methods analyses. The first study found support for a new measure of attitudes toward advance care planning (ACP) in two samples, while finding that personal exposure to death is significantly related to more developed ACP attitudes. The second, qualitative study revealed CNAs’ varying attitudes toward death, the importance of their relationships with residents, and the ways in which exposure to the dying process has influenced their ACP attitudes. Finally, while study 3 failed to find support for behavioral inhibition and experiential avoidance as moderators of the impact of death exposure on negative death attitudes, results supported the relationship between these variables and their impact on compassion fatigue. Moreover, positive death attitudes, and death exposure, were found to be more influential to ACP attitudes than negative death attitudes. Implications highlight researcher’s imperative to develop interventions focusing on education and support of CNAs in their role as end-of-life caregivers to decrease high job turnover, and increase quality-of-care outcomes for residents.
dc.format.extent 156 p.
dc.format.medium electronic
dc.format.mimetype application/pdf
dc.language English
dc.language.iso en_US
dc.publisher University of Alabama Libraries
dc.relation.ispartof The University of Alabama Electronic Theses and Dissertations
dc.relation.ispartof The University of Alabama Libraries Digital Collections
dc.relation.hasversion born digital
dc.rights All rights reserved by the author unless otherwise indicated.
dc.subject.other Psychology
dc.title A mixed-methods exploration of death exposure in certified nursing assistants: moderating factors and implications
dc.type thesis
dc.type text
etdms.degree.department University of Alabama. Dept. of Psychology
etdms.degree.discipline Psychology
etdms.degree.grantor The University of Alabama
etdms.degree.level doctoral
etdms.degree.name Ph.D.


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