Date of Conferral

2021

Degree

Ph.D.

School

Psychology

Advisor

Rhonda Bohs

Abstract

This study was conducted to test how social exclusion, experienced through a culture of healthcare hierarchy, influenced the feelings/attitudes of respiratory therapists (RTs) who are excluded from discussions of end-of-life (EOL) care. Data analysis was conducted using a multivariate analysis of variance to address the research questions. A quantitative nonexperimental survey research design incorporating four evidence-based surveys was used. There was no significance found between professional exclusion from EOL care discussions and the abilities of RTs to collaborate with intensive care unit (ICU) team members within the shared decision-making model as it relates to providing care in the ICU. There was significance in the differences measured by the variable “planned together” on abilities to perform EOL care procedures. In survey responses, RTs expressed a strong desire for inclusion. The study concluded that RTs are rarely involved in EOL care discussions and/or planning. Despite their exclusion, RTs are responsible for performing the majority of EOL care procedures in the ICU, which generated discomfort. This topic of inquiry has social change implications, in that the ethical and emotional burdens of caring for dying patients can impact all ICU team members. All team members are stakeholders in the EOL care process, and the findings of this study can offer insight into the unique goals and essential roles each has within the EOL care decision-making process. This study may give stakeholders such as RTs new insight into the critical roles that they play. Additional knowledge of methods to reduce the burden posed by exclusion may make it easier for RTs to perform their duties in a more fulfilling way leading to positive social change.

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