Effects Of Reality Approach Counseling On Death Acceptance In Persons With Aids And Pulmonary Tuberculosis.

Abstract

          This action research aimed to investigate coping to death, Coping to reality, and the effects of reality approach counseling on death acceptance in persons with AIDS and pulmonary tuberculosis. Reality approach to counseling theory of Glasser (1965) was used as a framework of this study.

          A sample of 14 persons with AIDS and pulmonary tuberculosis in medical unit was purposively recruited for this study. The research instruments used included (1) Reaction to death form (2) Counseling guideline and record form (3) Interview questionnaires concerning on death acceptance and preparation to death. The internal consistency reliabilities of the interview questionnaires, death acceptance and preparation for death were 0.84 and 0.85 respectively. Quantitative data were analyzed by using descriptive statistics and Wilcoxon Signed - ranks test. Qualitative data were analyzed by using content analysis. The findings indicated that the majority of the sample could accept and cope with the reality even though there were some feelings of fear and guilty. The themes of coping process included (1) Building relationship; getting to know, and monitoring the symptoms, (2) Investigating of problems & needs; uncomfortable, fear (unacceptance, have no caregiver, unpleasant image, couldn’t work, and suffer before death), anxious and worried about family and spouse. (3) Coping with reality; mentally prepared and accepted by using Dharma and meditation, get ready to die, do the best for the time left (save more money, use time efficiently), support and gain from closed persons, (4) Making commitment and plan; take the best care of self (bio - psycho - social care), and (5) Following - up and ending the counseling; get ready to go on with clearer life goals. When the Wilcoxon signed - ranks test was used to test and compare the preparation to death scores before and after the counseling, it indicated that the scores after counseling were significantly higher than that of before (Z = -3.33, p = 0.000). Also, the scores on acceptance to death and preparation to death after the counseling were significantly higher than that of before (Z = -3.21, p = 0.000).

          The findings of this study would be of beneficial to nursing in that the guideline for counseling would be useful in caring of in - patients. It has been suggested that the guideline be further developed and tested in order to get a concise and specific guideline for nursing practice.