8. State the null hypothesis for care for the three study groups (see Table 2 ).

Question

8. State the null hypothesis for care for the three study groups (see Table 2 ). Should the null hypothesis be accepted or rejected? Provide a rationale for your answer.

9. What are the post hoc results for care? Which results are statistically signi? cant? What do the results mean?

10. In your opinion, do the study ? ndings presented in Tables 2 and 3 have implications for end of life care? Provide a rationale for your answer.

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

8 ) The hypothesis formulation is

H0 : The mean values of the 3 study groups are not different

H1 : The mean values of the 3 study groups are different , atleast for 2 groups

as the anova test is signifcant at 0.05 , we can reject the null hypothesis in favor of alternate hypothesis .kindly note that the p values of all the anova tests are less than 0.05

9 ) Refer to table 3 , spiritiual need patient and spiritual need to kin are statistically significant as the p values are both less than 0.05 , one is 0.0001 and the pther one is 0.006. This means that the group means of these 2 groups are different and are statistically significant .

so basically all the group means on the right side of table3 , whose p value is less than 0.05 are statistically signifcant. 7 out of 9 values turn out to be significant , which is in accordance with the omnibus anova results.

10 ) yes , as most of the test related to the difference in the group means turns out to be significant from both table 2 and table 3 . Had there been no difference in the group means then we could have concluded that there were no implications for the end of the life care.

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