DiscussionParticipants in the EOL s

Discussion
Participants in the EOL survey were members of ONS
and had an average of 18 years of nursing experience.
Participants were highly educated in oncology nursing,
with 65% having had oncology nursing certification at
some time in their practice. The sample was randomly
selected, geographically dispersed, and of a statistically
significant size, so results can be generalized to ONS
members who work in a hospital-based setting.
Similarities were found between the current study
and the previous study of oncology nurses’ perceptions
of obstacles and supportive behaviors to EOL care
(Beckstrand et al., 2009). Eight of the top 10 obstacles
and 8 of the top 10 supportive behavior items identified
by POIS and PSBIS in this study also were found to
be in the top 10 items of the previous study. However,
significant discrepancies also were found between the
two studies.
Four obstacle items and four supportive behavior
items ranked significantly different with the addition of
frequency of occurrence data. For example, the highestranked
obstacle by size in the 2009 study (having to
deal with angry family members) decreased to eighth
place by POIS. In addition, the 5th ranked obstacle in
the 2009 study (doctors insisting on aggressive care)
dropped to 11th. Two other obstacle items ranked
higher with the addition of frequency of occurrence
data, moving from 13th to 6th (nurse having to deal
with distraught family while still providing care) and
from 23rd to 14th (nurse knowing patient’s poor prognosis
before family) (Beckstrand et al., 2009).