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Date of Award


Document Type


Degree Name

Master of Science in Nursing (MSN)



Thesis Committee Chairperson

Lisa Ball

Second Reader

Brian Clemency, DO, MBA, FACEP


Fire fighters are members of a dangerous career in which they could potentially pass away at any age. They put their lives at risk and have a higher mortality rate than the average person, therefore it is imperative that they have advance directives in place. The purpose of this project was to increase fire fighters’ understanding and completion of advance directives, specifically the health care proxy and medical orders for life sustaining treatment form. Dorothea Orem’s Self-care Deficit Theory of Nursing was used to guide this study. A health promotion-type project was utilized. The participants were obtained through convenience sampling from a pool of 73 active members from Hamburg Volunteer Fire Department. The project included a pretest, an educational intervention, and then a posttest. A paired-samples t test was calculated to compare the mean pretest score to the mean posttest score. The mean on the pretest was 74.49 (sd = 19.24), and the mean of the posttests was 85.76 (sd = 14.07). A statistically significant increase from pretest to posttest was found (t (37) = 0.001148, p