1. Mayland et al. (2014) do not provide the degrees of freedom ( df ) in their s

Question

1. Mayland et al. (2014) do not provide the degrees of freedom ( df ) in their study. Use the degrees of freedom formulas provided at the beginning of this exercise to calculate the group df and the error df .

2. What is the F value and p value for spiritual need—patient? What do these results mean?

3. What is the post hoc result for facilities for the hospital with LCP vs. the hospital without LCP (see Table 2 )? Is this result statistically signi? cant? In your opinion, is this an expected ? nding?

4. What are the assumptions for use of ANOVA?

Introduction The Liverpool Care Pathway (LCP) for the Dying Patient was created to address the need for better end of life care for both patients and families, which had been identified as an issue in the United Kingdom at the national level. "LCP is an integrated care pathway used in the last days and hours of life that aims to transfer the hospice principles of best practice into the acute hospital and other settings" (Mayland et al., 2014, p. 688). "Evalu- ating Care and Health Outcomes-for the Dying (ECHO-D) is a post-bereavement ques tionnaire that assesses quality of care for the dying and is linked with the Liverpool Care Pathway for the Dying Patient (LCP)" (Mayland et al., 2014, p. 687) The purpose of this comparative descriptive study was to assess the internal consistency reliability, test-retest reliability, and construct validity of the key composite subscales of the ECHO-D scale. The study's convenience sample consisted of 255 next-of-kin or close family members of the patients with an anticipated death from cancer at either the selected hospice or hospital in Liverpool, United Kingdom. The sample consisted of three groups of family members based on where the patients received end of life care; the hospice, which used LCP; the hospital group that also used LCP; and another group from the same hospital that did not use LCP. The ECHO-D questionnaire was completed by all 255 study participants and a subset of self-selected participants completed a second ECHO-D 1 month after the completion of the first ECHO-D. Mayland and colleagues (2014) concluded their study provided additional evidence of reliability and validity for ECHO-D in the assessment of end of life care Relevant Study Results Overall, hospice participants had the highest scores for all composite scales, and hospital without LCP' participants had the lowest scores (Tables 2 and 3). The scores for the "hos pital with LCP' participants were between these two levels" (Mayland et al., 2014, p. 693) The level of significance was set at 0.05 for the study. One-way analysis of variance was calculated to assess differences among the hospice, hospital with LCP, and hospital without LCP groups. Post hoc testing was conducted with the Tukey HSD test. ANOVA and post hoc results are displayed in Tables 2 and 3

Explanation / Answer

There are total 255 number of observations with three groups (Hospice, Hospice with LCP, and Hospice without LCP)

Part 1:

Total Degree of Freedom = Total Number of Observations - 1 = 255 - 1

Total Degree of Freedom = 254

Group Degree of Freedom = Total Number of Groups - 1 = 3 - 1

Group Degree of Freedom = 2

Error Degree of Freedom = Total Degree of Freedom - Group Degree of Freedom = 254 - 2

Error Degree of Freedom = 252

Part 2:

The F value for spiritual need - patient is 38.1. and P value is <0.0001.

Hypothesis in this case is

Null Hypothesis: Patient's Spiritual and Religious Needs were met across all groups equally

Alternative Hypothesis: Patient's Spiritual and Religious Needs were NOT met equally atleast between two groups.

Since P value < 0.05 in this case, we reject the Null Hypothesis.

Conclusion: There is significant difference between Patient's Spiritual and Religious Needs that were met across the groups.

Part 3:

Since the P value is 0.85 < 0.05 (Significance Level), we can conclude that the result is not significant. It means that there is no difference of facilities' scores between the two groups. This is expected since the facilities do not vary much between Hospital with or without LCP. A minimum criteria has to be met in each condition.

Part 4:

Anova procedure has three main assumptions:

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