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Xu GR, Yu WY. Mediating effect of meaning in life on death anxiety and attitude toward palliative care among undergraduate nursing students. BMC Palliat Care 2024; 23:139. [PMID: 38840188 PMCID: PMC11151652 DOI: 10.1186/s12904-024-01472-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 05/28/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND This study investigates the mediating effect of meaning in life between death anxiety and attitude toward palliative care among nursing students. METHODS We enrolled 363 undergraduate nursing students using a convenience sampling method as the respondents and conducted a survey using general information about nursing students, the Chinese version of the FATCOD-B Scale, the Chinese version of the Death Anxiety Scale, and the Chinese version of the Meaning in Life Questionnaire. The SPSS25.0 statistical software was used to analyze the mediating effect. RESULTS The mean total attitude score toward palliative care was (104.72 ± 10.62). Death anxiety had a significant negative predictive effect on the attitude toward palliative care (β = -0.520, P < 0.01). When the mediating variable of the presence of meaning in life was included, the negative predictive effect of death anxiety on attitude toward palliative care remained significant (β = -0.379, P = 0.036); the mediating effect (-0.141) accounted for 27.12% of the total impact (-0.520). CONCLUSIONS The presence of meaning in life mediates the relationship between death anxiety and attitude toward palliative care. This implies that nursing educators, through their role in educating nursing students about the meaning of life, can significantly influence the development of a positive attitude toward palliative care.
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Affiliation(s)
- Gui-Ru Xu
- School of Nursing, Fujian Medical University, No. 1, Xuefu North Road, Minhou County, Fuzhou City, 350122, Fujian Province, China.
| | - Wen-Ying Yu
- School of Nursing, Fujian Medical University, No. 1, Xuefu North Road, Minhou County, Fuzhou City, 350122, Fujian Province, China
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Tian X, Zheng X, Peng Y, Zhou X, Huang B, Xie Y, Xiao W. The effects of hospice care education on first-year undergraduate nursing students in mainland China: A mixed-methods study. NURSE EDUCATION TODAY 2024; 134:106095. [PMID: 38266431 DOI: 10.1016/j.nedt.2024.106095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/18/2023] [Accepted: 01/14/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND With the rising number of people with end-stage chronic diseases, the demand for hospice care has increased dramatically. As the future health professionals for the implementation of hospice care, undergraduate nursing students in mainland China still lack knowledge and skills of hospice care, thus hospice care education plays a vital role in its development. OBJECTIVES To understand the effects of hospice care education on nursing students' death attitudes, end-of-life attitudes, humanistic care qualities, and their learning experiences. DESIGN This study used a mixed-methods design. SETTING A University of Chinese Medicine in mainland China. PARTICIPANTS The first-year undergraduate nursing students (n = 65). METHODS A mixed-methods study was conducted to evaluate the impact of a hospice care course from March to June 2021. The quantitative part included a quasi-experimental study designed with pre- and post-intervention measurements and the qualitative part included a descriptive qualitative study with semi-structured individual interviews. RESULTS The quantitative data revealed that after the course, nursing students experienced improvements in their death attitudes, end-of-life attitudes, and humanistic care qualities. Two categories were identified from the qualitative data. The category of "Gain from learning" included 4 themes (Confronting death and thinking about life; Understanding and agreeing with the idea of hospice care; Perceiving the humanistic spirit of medicine; Enhancing of the nursing discipline cognition and professional identity) and the category of "Course feedback" included 2 themes (Expressing recognition for the course arrangement; Making suggestions on the course optimization). CONCLUSIONS Hospice care education had a positive influence on nursing students. Students expressed satisfaction with the course arrangement. However, future hospice care courses should further optimize the curriculum designs by increasing the discussion of death-related topics, sharing more real clinical cases, recruiting students from different majors, and providing clinical practice, to provide high-quality nursing education for the development of hospice care.
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Affiliation(s)
- Xia Tian
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong, PR China
| | - Xiaoting Zheng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong, PR China
| | - Yunyi Peng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong, PR China
| | - Xiaojun Zhou
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong, PR China
| | - Baoxin Huang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong, PR China
| | - Yaqian Xie
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong, PR China
| | - Wenli Xiao
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou 510006, Guangdong, PR China.
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Chen L, Pan Q, Li X, Luo S, Pan X, Huang H. Factors Influencing the Knowledge and Attitudes of Hospice Care Practitioners in Guangxi, China: A Cross-Sectional Study. Risk Manag Healthc Policy 2024; 17:387-397. [PMID: 38476198 PMCID: PMC10928918 DOI: 10.2147/rmhp.s451588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/13/2024] [Indexed: 03/14/2024] Open
Abstract
Purpose Practitioners in China who implement hospice care services include doctors, nurses, and care workers. These individuals play an important role in the holistic care of patients at the end of life and their families. This study aimed to provide baseline data to develop hospice care services and improve relevant policies by investigating the knowledge and attitudes of hospice care practitioners (HCPs) and analyzing influencing factors. Methods This cross-sectional descriptive study used stratified sampling and quota sampling. The HCPs were from nursing homes, medical institutions, integrated medical and nursing institutions, and community health service centers in Guangxi Zhuang Autonomous Region. We examined HCPs' demographic characteristics and scores on a self-designed Chinese scale to measure their knowledge and attitudes(K&A scale). A total of 1821 HCPs completed surveys from May 2022 to July 2022. The data were analyzed using descriptive statistics, univariate analysis and multiple linear regression. Results The standard score of the K&A scale of 1821 HCPs was 61.62 (SD=9.78), and the individual mean scores of knowledge and attitudes were 76.42 (SD=28.13) and 58.69 (SD=11.31), respectively. The final multiple linear regression analysis indicated that the main factors that influenced the K&A score were monthly income, job satisfaction, and the hospice care-related system (HCS). Conclusion The HCPs in this study displayed moderate mean scores for knowledge and a less favorable attitude toward hospice care. Monthly income, job satisfaction and the HCS were the common factors that influenced HCPs' K&A. The results suggest the need to strengthen targeted and professional training for HCPs, increase their welfare and benefits, and improve indigenous policies of hospice care.
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Affiliation(s)
- Lin Chen
- Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, People’s Republic of China
| | - Qini Pan
- Department of nursing, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Xiaohong Li
- College of Life Sciences, Chongqing Normal University, Chongqing, People’s Republic of China
| | - Shuangli Luo
- Department of nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guxngxi, People’s Republic of China
| | - Xiao Pan
- Department of nursing, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Huiqiao Huang
- Department of nursing, The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
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Zhao J, Wang Y, Xiao B, Ye F, Chen J, Huang Y, Li T, Chen X, Ma H, Zhang Q, Zou Z. Behaviors and influencing factors of Chinese oncology nurses towards hospice care: a cross-sectional study based on social cognitive theory in 2022. BMC Palliat Care 2024; 23:53. [PMID: 38395799 PMCID: PMC10885468 DOI: 10.1186/s12904-024-01385-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Although there is growing demand for hospice care in China due to its aging population and increasing cancer rates, the sector remains slow to expand. Oncology nurses are the primary providers of hospice care, but little is known about their behaviors towards hospice care and related factors. METHODS This cross-sectional study conveniently sampled 933 oncology nurses from six grade A tertiary hospitals in Hubei Province between January to March 2022. The questionnaire was composed of seven parts: general information (including sociodemographic and work-related information), hospice care behaviors, hospice care knowledge, hospice care attitudes, hospice care self-efficacy, hospice care outcome expectancy, and hospice care environment. Data were analyzed using descriptive analysis, independent sample t-tests, one-way ANOVA, Pearson's correlation, multiple linear regression, random forest regression, and BP neural network model analysis. RESULTS A total of 852 questionnaires were valid. The mean score of hospice care behaviors was 50.47 ± 10.56, with a mean item score of 3.61 ± 0.75. The three highest scoring behaviors were "pain assessment of patients (4.21 ± 0.91)", "satisfying the physical and mental needs of dying patients (4.04 ± 0.92)", and "creating good relationships between the medical staff and family members (4.02 ± 0.87)". The two lowest-scoring behaviors were "proactively recommending medical institutions for hospice care to terminally ill patients and their families (2.55 ± 1.10)" and "proactively talking to patients and families about death-related topics for patients who are critically ill and cannot be reversed (2.87 ± 1.03)." Multiple linear regression, random forest regression, and BP neural network models all showed that the frequency of sharing hospice care experiences with colleagues, hospice care attitudes, hospice care self-efficacy, and hospice care environments were positively associated with hospice care behaviors. CONCLUSIONS The frequency of hospice care behaviors among Chinese oncology nurses is generally at a moderate to high level. The results provide a basis for promoting hospice care behaviors among oncology nurses in order to improve the quality of life for terminally ill cancer patients.
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Affiliation(s)
- Jing Zhao
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
| | - Yu Wang
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
| | - Binbin Xiao
- Renmin Hospital of Wuhan University, No.238 Jiefang Road, WuChang Distirct, Wuhan, Hubei Province, 430060, China
| | - Fucheng Ye
- Wuhan University of Technology, Wuhan, China
| | - Jianfei Chen
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
| | - Yingjuan Huang
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
| | - Ting Li
- Hubei Cancer Hospital, Wuhan, China
| | - Xiaoli Chen
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China
| | - Hongmei Ma
- Renmin Hospital of Wuhan University, No.238 Jiefang Road, WuChang Distirct, Wuhan, Hubei Province, 430060, China.
| | - Qing Zhang
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China.
| | - Zhijie Zou
- School of Nursing, Wuhan University, Located on No. 115 Donghu Road, Wuhan, Hubei province, 430071, China.
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Wang Y, Zhang X, Huang Y, Ma X. Palliative Care for Cancer Patients in Asia: Challenges and Countermeasures. Oncol Rev 2024; 17:11866. [PMID: 38293617 PMCID: PMC10824851 DOI: 10.3389/or.2023.11866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/29/2023] [Indexed: 02/01/2024] Open
Abstract
With the increasing incidence of cancer worldwide, palliative care has become an effective intervention to relieve cancer patients' pain and improve their quality of life, although the present development of palliative medicine and hospice care in many Asian countries remains insufficient. To this end, this review comprehensively discussed the main challenges that influence the promotion of palliative medicine, from the perspective of both healthcare professionals and cancer patients. We further proposed and summarized a series of potentially effective countermeasures and solutions, including the shared decision-making modal, multidisciplinary professional cooperation, application of modern science and technology, standardization training for medical workers, personalized palliative treatment regimens, and others, aiming to improve the clinical quality of palliative care practice for cancer patients and promote the development of palliative medicine in Asian regions.
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Affiliation(s)
- Yu Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xinqing Zhang
- School of Humanities and Social Sciences, Peking Union Medical College, Beijing, China
| | - Yilin Huang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangyu Ma
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Wang QL, Liu CR, Yue P, Han BR. Construction of Hospice Care Evaluation System for Terminally Ill Patients in ICU. Patient Prefer Adherence 2024; 18:29-37. [PMID: 38204758 PMCID: PMC10778909 DOI: 10.2147/ppa.s444290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
Background Terminally ill patients can benefit from hospice care, which specifically addresses the needs of patients and families affected by terminal illness. However, there is a lack of standardized evaluation criteria to assess the quality of hospice care for terminally ill patients in the ICU, and it is impossible to evaluate the service quality of hospice care. To use the Delphi method to construct a hospice care system for terminally ill patients in ICU that meets clinical needs, and to provide theoretical support for nursing decision-making of terminally ill patients in clinical ICU. Methods Obtain relevant literatures by entering specific key words into the database, the hospice care nursing system for terminally ill patients in ICU was preliminarily drawn up by literature analysis, and 24 experts in this field were consulted for 3 rounds by Delphi method to discuss the development status of hospice care and finally establish the hospice care nursing system. Results In the three rounds of letter inquiries, the positive coefficients of experts were all high, the expert authority coefficient (Cr) were 0.864, 0.849, 0.832, and the expert opinion coordination coefficient(W) were 0.186, 0.319, 0.224; The system includes 8 first-level indicators, 27 second-level indicators and 9 third-level indicators. Conclusion In this study, three rounds of Delphi consultation methods were used to construct an evaluation index system for the nursing quality of hospice care for ICU patients. The evaluation indicators formulated closely focus on the physiological and psychological characteristics of ICU patients, which can provide a better reference for ICU patients with advanced life in the future.
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Affiliation(s)
- Qing-Ling Wang
- Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, 100053, People’s Republic of China
| | - Cheng-Rui Liu
- School of Economics and Management, Beijing University of Technology, Beijing, 100124, People’s Republic of China
| | - Peng Yue
- Capital Medical University, School of Nursing, Beijing, 100069, People’s Republic of China
| | - Bin-Ru Han
- Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, 100053, People’s Republic of China
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Liu Q, Zhang M, Guo X, Zhang Y, Qin T, Wang Y, Gai Y. The Chinese Version of the Palliative Nursing Care Quality Scale: Translation, Cross-Cultural Adaptation, and Validity. J Palliat Care 2024; 39:47-57. [PMID: 37828752 DOI: 10.1177/08258597231204593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
BACKGROUND Nurses play an important role in palliative care, and high-quality assessment tools can help standardize palliative-related nursing behaviors, but there are no such tools in China. OBJECTIVE This study aimed to revise, cross-culturally adapt, and validate the Palliative Nursing Care Quality Scale (PNCQS) to provide an effective tool that can help nurses in mainland China assess the quality of palliative care. METHODS This study involved a 2-steps process. First, the PNCQS was translated, back-translated, and cross-cultural adapted using Brislin's translation model. Second, a cross-sectional study was used to evaluate the reliability and validity of the revised scale. From January to February 2023, 367 nurses engaged in palliative care-related nursing from 3 tertiary A general hospitals were surveyed with the revised scale. The evaluation methods used in this study included item analysis, test-retest reliability, internal consistency, criterion-related validity, content validity, and construct validity. RESULTS The PNCQS-Chinese included 20 items. In this study, the item-total correlation coefficients ranged from 0.67 to 0.83 (P < .01), and the critical ratio value of the items was 12.10 to 23.34 (P < .01). The scale-level content validity index was 0.98, and the item-level content validity ranged from 0.86 to 1.00. The total Cronbach's α and test-retest reliability of the scale were 0.96 and 0.79, respectively. Factor analysis of 20 items extracted 1 factor, and the contribution rate of cumulative variance was 60.03%. CONCLUSIONS PNCQS-Chinese shows acceptable validity and reliability for assessing the quality of palliative care-related nursing in mainland China.
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Affiliation(s)
- Qingwei Liu
- Department of Critical Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Meng Zhang
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaojing Guo
- Department of Critical Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuchen Zhang
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Tong Qin
- Department of Critical Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ying Wang
- Department of Oncology, Qingdao MUnicipal Hospital, Qingdao, China
| | - Yubiao Gai
- Department of Critical Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
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Liu J, Li X, Yu W, Liu B, Yu W, Zhang W, Hu C, Qin Z, Chen Y, Lü Y. Prediction of survival of persons with advanced dementia using the advanced dementia prognostic tool: A 2-year prospective study. Geriatr Nurs 2024; 55:64-70. [PMID: 37976557 DOI: 10.1016/j.gerinurse.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND In this prospective study, we evaluated the usefulness of the advanced dementia prognostic tool (ADEPT) for estimating the 2-year survival of persons with advanced dementia (AD) in China. METHODS The study predicted the 2-year mortality of 115 persons with AD using the ADEPT score. RESULTS In total, 115 persons with AD were included in the study. Of these persons, 48 died. The mean ADEPT score was 13.0. The AUROC for the prediction of the 2-year mortality rate using the ADEPT score was 0.62. The optimal threshold of the ADEPT score was 11.2, which had an AUROC of 0.63, specificity of 41.8, and sensitivity of 83.3. CONCLUSIONS The ADEPT score based on a threshold of 11.2 may serve as a prognostic tool to determine the 2-year survival rate of persons with AD in Chongqing, China. However, further studies are needed to explore the nature of this relationship.
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Affiliation(s)
- Junjin Liu
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Xuebing Li
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Weihua Yu
- Institutes of Neuroscience, Chongqing Medical University, Chongqing, 400016, China
| | - Bei Liu
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Wuhan Yu
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Wenbo Zhang
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China
| | - Cheng Hu
- Institutes of Neuroscience, Chongqing Medical University, Chongqing, 400016, China
| | - Zhangjin Qin
- Institutes of Neuroscience, Chongqing Medical University, Chongqing, 400016, China
| | - Yu Chen
- Institutes of Neuroscience, Chongqing Medical University, Chongqing, 400016, China
| | - Yang Lü
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
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Wang J, Qiu C, Zhou L, Huang X, Li X. The Death Café: Effectiveness of a hospice care educational program for nursing undergraduates based on LIFE experience-A qualitative study. NURSE EDUCATION TODAY 2023; 131:105981. [PMID: 37839140 DOI: 10.1016/j.nedt.2023.105981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/29/2023] [Accepted: 10/01/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Nursing students' knowledge of hospice care is limited to textbooks due to the inadequate education and training system in China and student's willingness to participate in hospice care. OBJECTIVES To deepen nursing students' understandings toward life and death, to improve their knowledge about hospice care, and to promote their willingness for hospice care practice. DESIGN This study used a qualitative descriptive study design. SETTINGS The study was conducted at a medical university in Sichuan province, China. PARTICIPANTS 71 nursing sophomores participated in this study. METHODS The Death Café teaching program was implemented which requires students to recall their memories about death and to imagine how they felt about dying, as if they were having a conversation in a death-themed café. During the implementation phase, a small-group interactive teaching approach was utilized. During the reflection phase, the students were asked to finish an essay answering four questions without standard right answers. The essays that students finished were used for evaluating the effectiveness of the Death Café program. The answers of the first two questions were presented as a word cloud. Graneheim and Lundman's qualitative content analysis method was used to analyze answers of the third and fourth questions. RESULTS Word cloud analysis indicated that at the beginning of the program participants showed more negative emotions (i.e., fearful). Students' attitudes toward death changed from negative to positive through imagining death when role-playing the different stages of life. The program enhanced students' understanding of life and taught the students effective ways to cope with death. Students clarified the objectives and necessary preparation for providing hospice care and gained new understandings for improving their hospice skills. CONCLUSIONS The Death Café program can address students' negative emotions and perceptions of death. Students gained personal benefits and professional benefits of coping with life and death from the program.
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Affiliation(s)
- Jingjun Wang
- West China School of Medicine/West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, China
| | - Chen Qiu
- West China School of Medicine/West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, China
| | - Lin Zhou
- West China School of Medicine/West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, China
| | - Xuehua Huang
- West China School of Medicine/West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, China
| | - Xiaolin Li
- West China School of Medicine/West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, China.
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Wu B, Zhu P, Wang T, Tan JYB, Cao Z, Wan J, Wu S, Zhang L, Xing Y. Experiences of Chinese advanced cancer patients after attending a "four-stage" death education programme: A qualitative study. Eur J Oncol Nurs 2023; 66:102361. [PMID: 37499403 DOI: 10.1016/j.ejon.2023.102361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 05/14/2023] [Accepted: 06/05/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE This study aimed to explore the experiences of cancer patients who participated in and completed a "four-stage" death education programme based on knowledge-attitude-practice theory. METHODS This study employed a qualitative descriptive design. Semistructured interviews with an interview guide were used to collect data. Fifteen cancer patients who participated in and completed the "four-stage" death education programme (from November 10, 2021, to December 29, 2021) were recruited via purposive sampling. The "four-stage" death education programme model was developed based on knowledge-attitude-practice theory and included eight death education modules. Each interview was audio-recorded and transcribed verbatim. Generic analysis was used to conduct data analysis by coding, classifying, and extracting themes. RESULTS Five themes were identified: the gradual shift of death cognition towards objective reality, a decrease in death anxiety, patients' early thoughts concerning issues related to death and preparation ahead of death, patients' improved ability to respond to death incidents, and patients' increased focus on cherishing the remainder of their lives and living in the moment. CONCLUSIONS Cancer patients accept and respond effectively to the implementation of a "four-stage" death education programme based on knowledge-attitude-practice theory. These findings can help cancer patients improve their reasonable perception of death and reduce their doubts and confusion concerning death.
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Affiliation(s)
- Bing Wu
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Ping Zhu
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Tao Wang
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Jing-Yu Benjamin Tan
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Zhenglan Cao
- Department of Oncology Surgery, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Wan
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Suya Wu
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China
| | - Liuliu Zhang
- Department of Nursing, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, 210009, China.
| | - Yihui Xing
- Department of Internal Medicine-Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China.
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Hou X, Li X, Guo R, Wang Y, He S, Yang H, Bai D, Lu Y. Knowledge and Practice Behaviors Toward the Care of the Dying Among Chinese Oncology Nurses: A Cross-Sectional Survey. J Hosp Palliat Nurs 2023; 25:E94-E101. [PMID: 37525347 DOI: 10.1097/njh.0000000000000967] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
The quality of care provided to patients with cancer at the end of their lives remains unsatisfactory, especially during their last days and hours of life. This study aimed to investigate knowledge and practice behaviors of oncology nurses in relation to the care of the dying and to analyze the influencing factors. A convenience sample of 222 oncology nurses was recruited from 14 hospitals in Beijing, China, in January 2022. These nurses completed an online survey that included a demographic and work characteristics questionnaire and knowledge and practice behavior questionnaires regarding the care needs of dying cancer patients. The self-perceived knowledge and practice behavior of oncology nurses toward the care of the dying were found to be moderate. However, their understanding of airway management, restlessness, and delirium management was insufficient. In addition, their ability to effectively communicate recommendations for discontinuing unnecessary procedures, medications, treatments, and monitoring was inadequate. Nurses' previous end-of-life care education and experience of caring for dying patients influenced their knowledge. Nurses' practice settings, experience of caring for dying patients, and their knowledge were key factors in shaping their behaviors. Providing targeted continuing education for nurses in hospital settings and exploring the nursing pathway may be important ways to bridge their knowledge gap and enhance their practice behaviors toward caring for dying patients.
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Liu J, Li JF, Li XX, Wu YP, Li SR, Li LY, Zhou HP. Awareness of Hospice Care Among Community-Dwelling Elderly Participants. Res Theory Nurs Pract 2023; 37:386-400. [PMID: 37591529 DOI: 10.1891/rtnp-2023-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Background and Purpose: The main goal of hospice care is to improve the quality of life for people who are at the end-of-life phase. However, investigations on the awareness of hospice care among community-dwelling elderly participants are limited. This work aimed to reveal the awareness status of hospice care and explore the factors influencing the awareness rate among elderly participants. Methods: A questionnaire survey was conducted among individuals aged 60 years and above. Results: A total of 4,969 individuals aged 60 years and above were randomly selected from 48 primary medical institutions in Handan. The awareness rate of hospice care in the baseline survey was 19.3% (n = 959). All included individuals were divided into two groups in accordance with their awareness of hospice care. The awareness of hospice care among participants with low educational level, living alone, and afraid of talking about death was low (p < .05). Implications for Practice: The level of awareness of hospice care among community-dwelling elderly participants is low. The influencing factors included educational level, living status, and fear of talking about death. The community-dwelling elderly participants' awareness of hospice care must be improved. It is recommended that public medical education and training should be enhanced to improve knowledge and awareness of hospice care among community-dwelling elderly residents with low educational level, living alone, and afraid of talking about death.
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Affiliation(s)
- Jun Liu
- Department of Geriatrics, Handan Central Hospital, Handan, China
| | - Jun-Fang Li
- Department of Geriatrics, Handan Central Hospital, Handan, China
| | - Xiao-Xiao Li
- Department of Geriatrics, Handan Central Hospital, Handan, China
| | - Yi-Ping Wu
- Department of Neurology, Handan Central Hospital, Handan, China
| | - Shu-Rui Li
- Department of Geriatrics, Handan Central Hospital, Handan, China
| | - Li-Yang Li
- Department of Geriatrics, Handan Central Hospital, Handan, China
| | - Hai-Ping Zhou
- Department of Ageing and Health, Medical Association of Handan, Handan, China
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Lee S, Kim B. A Photovoice Study on the Position and Role of Hospice Volunteers in Korea. Risk Manag Healthc Policy 2023; 16:931-943. [PMID: 37228846 PMCID: PMC10204757 DOI: 10.2147/rmhp.s403746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/13/2023] [Indexed: 05/27/2023] Open
Abstract
Purpose As the quality of life increases, so does the demand for a dignified life. Although there is an increasing interest in hospice care, which helps people experience a comfortable death, the level of change in perception and in its role remain insignificant. Methods This study investigated the position and role of hospice care using photovoice, a technique used in Participatory Action Research, to analyze the data collected from hospice volunteers who participated in a training program in Korea. Results The participants viewed hospice volunteering from the two perspectives: facing unexpected farewells and supporting like bicycle training wheels, highlighting the role of the "connection between death, life, and rest" as a mediator in conflicts between the patients and medical staff. Although the participants dreaded hospice volunteering, it prepared them to share their lives and provided an opportunity for inner growth by expanding knowledge through learning and establishing a "meaningful connection with the community" because they volunteered out of love, not obligation. Conclusion Because the demand for hospice and palliative care is increasing, this study is meaningful as it investigates the perception of hospice care and determines its influencing factors based on the perspective of hospice volunteers and the changes in their perception over time.
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Affiliation(s)
- Sowon Lee
- College of Nursing, Chonnam National University, Gwangju, South Korea
| | - Boyoung Kim
- College of Nursing, Chonnam National University, Gwangju, South Korea
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14
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Xu Y, Zhang S, Wang J, Shu Z, Jing L, He J, Liu M, Chu T, Teng X, Ma Y, Li S. Nurses' practices and their influencing factors in palliative care. Front Public Health 2023; 11:1117923. [PMID: 37275481 PMCID: PMC10234102 DOI: 10.3389/fpubh.2023.1117923] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 04/17/2023] [Indexed: 06/07/2023] Open
Abstract
Background In 2017, the Chinese government launched a pilot project in palliative care, in which Shanghai was a pioneer. Nurses play a key role in palliative care services as they are the main providers improving the quality of services for patients and their families. However, little is known about practices and influencing factors in the field of palliative care from a nursing perspective in China. This is an original empirical study that has meticulously analyzed the interrelationship and intensity between practices and other factors among nurses in the initial stage of palliative care in primary healthcare institutions in Shanghai, China. Methods A descriptive-correlational study design was used to sample 2,829 eligible palliative care nurses by purposive sampling survey in 225 healthcare institutions in Shanghai, China. Descriptive analyses were performed using IBM SPSS 24.0 software. Structural equation modeling was applied to analyze the data by AMOS 20.0. Data were collected using the well-designed Knowledge, Attitudes, and Practices of Hospice Care (KAPHC) scale. Results The final model showed a good model fit. Self-efficacy directly influenced practices (β = 0.506, P < 0.01) and indirectly influenced practices (β = 0.028, P < 0.01) through intention. Subjective norm directly influenced practices (β = 0.082, P < 0.01) and indirectly influenced practices (β = 0.030, P < 0.01) through intention. Intention (β = 0.152, P < 0.01) and knowledge (β = 0.068, P < 0.01) directly influenced practices. Perceived susceptibility (β = -0.027, P < 0.01), perceived benefits (β = -0.017, P < 0.01), and perceived barriers (β = -0.014, P < 0.01) indirectly influenced practices through intention. Conclusion This study provided evidence of the associations of knowledge, perceived susceptibility, benefits, barriers, subjective norm, self-efficacy, intention, and practices among nurses concerning palliative care and interventions improving their actual work practices. Our findings revealed that self-efficacy, intention, and subjective norms greatly influenced practices. It is imperative to take interventions that focus precisely on self-efficacy, intention, and subjective norms to improve nurses' practices.
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Affiliation(s)
- Yifan Xu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shiwen Zhang
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jingrong Wang
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhiqun Shu
- Disciplinary Planning Office, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Centre for Specialty Strategy Research of China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Limei Jing
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiangjiang He
- Department of Health Policy Research, Shanghai Health Development Research Center, Shanghai, China
| | - Mengtian Liu
- School of Foreign Language Education, Jilin University, Jilin, China
| | - Tianshu Chu
- School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaohan Teng
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Shuijing Li
- Department of Primary Health, Shanghai Municipal Health Commission, Shanghai, China
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15
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He S, Zhao H, Wang H, Chen F, Lv T, Li L, Zhang H. The mediating effects of attitude toward death and meaning of life on the relationship between perception of death and coping with death competence among Chinese nurses: a cross-sectional study. BMC Nurs 2023; 22:87. [PMID: 36997960 PMCID: PMC10060942 DOI: 10.1186/s12912-023-01245-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/11/2023] [Indexed: 03/31/2023] Open
Abstract
Abstract
Background
It is important to understand how the perception of death affects the competence to cope with death.
Objectives
To explore whether the perception of death has an indirect effect on competence to cope with death through the mediation of attitude toward death and meaning of life.
Methods
A total of 786 nurses from Hunan Province, China, selected by random sampling method and asked to complete an online electronic questionnaire between October and November 2021 were included in the study.
Results
The nurses’ scored 125.39 ± 23.88 on the competence to cope with death. There was a positive correlation among perception of death, competence to cope with death, the meaning of life, and attitude toward death. There were three mediating pathways: the separate mediating effect of natural acceptance and meaning of life, and the chain mediating effect of natural acceptance and meaning of life.
Conclusion
The nurses’ competence to cope with death was moderate. Perception of death could indirectly and positively predict nurses’ competence to cope with death by enhancing natural acceptance or sense of meaning in life. In addition, perception of death could improve natural acceptance and then enhance the sense of meaning in life to positively predict nurses’ competence to cope with death.
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16
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Ko E, Lowie S, Ni P. Confidence in carrying out palliative care among intensive care nurses. Nurs Crit Care 2023; 28:13-20. [PMID: 34889484 DOI: 10.1111/nicc.12735] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 11/11/2021] [Accepted: 11/12/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Nurses in intensive care units (ICUs) play a crucial role in providing palliative care. Effective provision of palliative care in the ICU requires nurses' active engagement, yet little is known about the confidence for palliative care that ICU nurses hold in China. AIM To explore confidence in performing palliative care among ICU nurses in China and factors related to nurses' level of confidence. STUDY DESIGN A cross-sectional design was implemented. METHODS This study utilized convenience sampling to recruit ICU nurses from nine hospitals in Wuhan, China. Data were collected via an online survey. Multiple regression was conducted to identify the predictors of the ICU nurses' confidence in performing palliative care. RESULTS A total of 231 ICU nurses participated in the study, resulting in a response rate of 78% (231/296). Participants reported a relatively low level of confidence for carrying out palliative care (mean score = 2.60 ± 0.53; range = 1-4). Nurses who had more positive attitudes toward palliative care communication (P < .001), higher levels of formal training on palliative care (P < .001), more years of working as an ICU nurse (P < .05) and those working in integrated ICU (P < .001) showed a higher level of confidence in carrying out palliative care. CONCLUSION Participants' lack of confidence in performing palliative care makes for increased challenges, particularly in uncertainty about family assessments, palliative care discussions and lack of palliative care training. Strengthening palliative care curricula in nursing education and professional training is imperative to enhance ICU nurses' confidence. RELEVANCE TO CLINICAL PRACTICE Strengthening palliative care education and training, particularly in relation to palliative care communication, is critical. Implementing and tailoring culturally relevant palliative care call for attention to practice and for policy changes in palliative care delivery in China.
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Affiliation(s)
- Eunjeong Ko
- School of Social Work, San Diego State University, San Diego, California, USA
| | - Samantha Lowie
- Outpatient Behavioral Health, Vista Hill Foundation, San Diego, California, USA
| | - Ping Ni
- Nursing School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Starr LT, Washington KT, McPhillips MV, Pitzer K, Demiris G, Oliver DP. "It was terrible, I didn't sleep for two years": A mixed methods exploration of sleep and its effects among family caregivers of in-home hospice patients at end-of-life. Palliat Med 2022; 36:1504-1521. [PMID: 36151698 PMCID: PMC10168118 DOI: 10.1177/02692163221122956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Due to overnight caregiving demands; exacerbation of high rates of anxiety, depression, and distress; and inadequate support, millions of family caregivers of patients receiving in-home hospice are at risk of poor sleep and negative health effects. AIM To describe sleep experiences of family caregivers of in-home hospice patients and perceptions of these experiences on caregivers' wellbeing in the context of caregiver health and live-in status. DESIGN Developed using the Symptom Management Model, this mixed methods study featured a concurrent nested design prioritizing qualitative reflexive thematic analysis. SETTING/PARTICIPANTS About 47 family caregivers of in-home hospice patients from two randomized clinical trials (NCT03712410, NCT02929108) were interviewed (United States, 2021). Anxiety (GAD-7), depression (PHQ-9), quality-of-life (QOL) (CQLI-R), and self-rated health and energy were reported prior to interviews. RESULTS Qualitative analysis revealed three themes: compromised sleep quality, factors influencing sleep, effects of sleep. 72.5% of hospice family caregivers described "fair" or "poor" sleep quality, with "interrupted" sleep and frequent night-waking due to "on-call" "vigilance" and anxiety. Negative effects included exhaustion, mental and physical health decline, and reduced caregiver function. Live-in caregivers reported higher mean depression scores (8.4 vs 4.3, p = 0.08), higher mean anxiety scores (7.7 vs 3.3, p = 0.06), and lower mean QOL scores (24.8 vs 33.6, p < 0.001) than live-out caregivers. Anxiety, depression, and QOL worsened as self-reported caregiver sleep quality decreased. Few caregivers had adequate support. CONCLUSION End-of-life family caregivers experience disrupted sleep with negative effects and inadequate support. Clinicians must assess sleep, offer sleep interventions, and provide more supports to hospice family caregivers.
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Affiliation(s)
- Lauren T Starr
- NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Karla T Washington
- Division of Palliative Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Miranda V McPhillips
- NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Kyle Pitzer
- Division of Palliative Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - George Demiris
- NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Debra Parker Oliver
- Division of Palliative Medicine, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
- Goldfarb School of Nursing, Barnes Jewish College, St. Louis, MO, USA
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18
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Li S, Zhang Z, Zhang X. A qualitative study exploring nursing students' perspectives on and attitudes towards hospice care in China. NURSE EDUCATION TODAY 2022; 119:105384. [PMID: 35750535 DOI: 10.1016/j.nedt.2022.105384] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 04/03/2022] [Accepted: 04/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND With the fast growth of the older population and the increasing rates of chronic illnesses, the demand for hospice care is increasing at a rapid pace. This is bringing great challenges to the healthcare system in China. Given that nursing students will be the main healthcare workforce in the future, and as such, have responsibilities to prepare for these challenges. Therefore, understanding nursing students' perspectives and attitudes towards hospice care in China is important to promote the development of hospice care services. OBJECTIVES To explore the perspectives and attitudes of Chinese nursing students towards hospice care. METHOD The descriptive phenomenology of a qualitative approach was used for the study. Data were collected through semi-structured individual interviews from 11 nursing students in China between April and June 2021. Data were analysed using Colaizzi's seven-step approach. FINDINGS Three main themes were identified: (1) Lack of knowledge and skills; (2) lack of clinical experience; and (3) needs for service improvement. These findings indicated the problems of hospice care education and hospice care services in China. CONCLUSION The nursing students in this study lacked theoretical knowledge and the practical skills of hospice care. This suggests that medical educational institutions and the government should take action to increase hospice care training for nursing students, in order to increase the capacity and availability of hospice care services. It also informs policy-makers, health professionals, and health educators about the further need for the development of hospice care services in China.
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Affiliation(s)
- Shouqin Li
- School of Nursing, Lanzhou University, Lanzhou 730000, China.
| | - Zhaoxin Zhang
- School of Nursing, Lanzhou University, Lanzhou 730000, China
| | - Xiubin Zhang
- School of Nursing, Lanzhou University, Lanzhou 730000, China.
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Wang Y, Huang Y, Ma X, Wusiman D, Zhang X, Bi N. The impact of the COVID-19 pandemic on palliative care practice: A survey of clinical oncologists. Front Public Health 2022; 10:1020937. [PMID: 36478730 PMCID: PMC9719914 DOI: 10.3389/fpubh.2022.1020937] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/31/2022] [Indexed: 11/22/2022] Open
Abstract
Background Palliative care is an essential intervention to improve the quality of life for patients with cancer, whereas the ongoing COVID-19 pandemic poses a challenge to supportive and palliative care providers. This survey aims to explore the current status of palliative care practice for cancer and the influence of COVID-19, from the perspective of oncologists. Methods The semi-structure electronic questionnaire was designed. Mixed-mode surveys including electronic questionnaires, face-to-face interactions, and telephone interviews were adopted according to the willingness of respondents. Face-to-face and telephone interviews were based on same questions in the online questionnaire. Participants working in cancer-related departments with frontline palliative care experience during the COVID-19 outbreak were included. Surveys covered experiences and perspectives regarding the impact of COVID-19 on clinical work, personal lives, and palliative care practice. Suggestions on coping strategies were further proposed and qualitatively analyzed. Results Thirty-seven oncologists participated in this study from September 2021 to January 2022. The majority of them believed COVID-19 significantly and negatively affected their clinical work routines (75.7%), personal daily lives (67.6%), and palliative care practice (64.9%). Most specialists considered that currently the palliative care system remained underdeveloped (73.0%), and other factors besides COVID-19 were associated with this situation (78.4%). Seventeen participants further made suggestions on how to promote palliative care during COVID-19, and three themes emerged through the qualitative analysis: (1) Remote or online service (88.2%); (2) Publicity, education, or shared decision-making for patients (29.4%); (3) Guidelines, training, or programs for care providers (23.6%). Conclusion Oncologists consider that COVID-19 has an adverse impact on their palliative care practice and daily routine. In addition to COVID-19, other factors affecting palliative care should not be neglected. Corresponding measures are warranted to encourage palliative care practice during COVID-19.
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Affiliation(s)
- Yu Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China
| | - Yilin Huang
- State Key Laboratory of Cardiovascular Disease, Division of Prevention and Community Health, National Center for Cardiovascular Disease, National Clinical Research Center of Cardiovascular Disease, Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xiangyu Ma
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China,Xiangyu Ma
| | - Dilinaer Wusiman
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xinqing Zhang
- School of Humanities and Social Sciences, Peking Union Medical College, Beijing, China
| | - Nan Bi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, China,*Correspondence: Nan Bi
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20
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Yan T, Chan CWH, Chow KM, Li M. Experiences and perception of character strengths among patients with breast cancer in China: a qualitative study. BMJ Open 2022; 12:e061994. [PMID: 36307158 PMCID: PMC9621164 DOI: 10.1136/bmjopen-2022-061994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To explore the patients' experiences on character strengths that Chinese patients experience after the diagnosis of breast cancer. DESIGN A qualitative, exploratory study using semistructured interviews based on the patients' lived experience after being diagnosed with breast cancer. Ethics approval was granted. Interviews were audiorecorded and transcribed verbatim. Values in Action Classification of Strengths provided conceptual framework for analysing strengths. Directed content analysis based on the classification of strengths and framework analysis were used to analyse transcribed data. The Standards for Reporting Qualitative Research guideline was followed. SETTING The Second Affiliated Hospital of Zhengzhou University and Henan Provincial Cancer Hospital in China. PARTICIPANTS Adult patients over 18 years, diagnosed with breast cancer between October 2019 and December 2020 were recruited. We used purposive sample method to collected data from 24 participants diagnosed with breast cancer. RESULTS Six themes (virtues) emerged from our analysis. In addition, two new subthemes (character strengths) emerged in this study, selflessness and pragmatism, respectively. Patients with breast cancer described a large repertoire of character strengths they used or wished for during survivorship, including gratitude, hope, humility, kindness, humour, honesty and forgiveness. Cultural values (eg, collectivism, familyism, Confucianism and Buddhist beliefs) helped structure the experiences of Chinese patients' character strengths. Patients wanted their character strengths to be more noticed, appreciated and encouraged by others and reported their psychological trajectory of using personal strengths. CONCLUSION The findings indicated that patients with breast cancer believing character strengths are important to them. Medical staff should pay more attention to motivating and cultivating character strengths of patients with breast cancer. Attention to make strength-based practices workable in clinical health promotion programmes is necessary. The healthcare system should develop tailored individualised psychological services that specifically address patients' needs for the application of personalised character strengths. TRIAL REGISTRATION NUMBER NCT04219267, Pre-results.
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Affiliation(s)
- Tingting Yan
- School of Nursing, Peking University, Beijing, Beijing, China
| | - Carmen Wing Han Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Mingzi Li
- School of Nursing, Peking University, Beijing, Beijing, China
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21
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When cultural values meets professional values: a qualitative study of chinese nurses' attitudes and experiences concerning death. BMC Palliat Care 2022; 21:181. [PMID: 36242029 PMCID: PMC9561326 DOI: 10.1186/s12904-022-01067-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/20/2022] Open
Abstract
Background In China, there is a culture of death-avoidance and death-denying. Influenced by this distinctive socio-cultural views surrounding death, nurses often find it challenging to handle death and care for dying patients. This study explores the nurses’ attitudes and coping strategies concerning death and caring for dying patients in a cultural context of death taboo. Methods This research is a qualitative study that employs in-depth, semi-structured interviews with nurses from two major hospitals in Guangzhou, China. Overall, 28 nurses from four departments with high patient death rate were recruited and interviewed. All of the interviews were analyzed thematically. Results The nurses who participated in this study expressed attitudes toward death and caring for dying patients from both a personal dimension and a professional dimension. The personal dimension is influenced by traditional culture and societal attitudes towards death and dying, while their professional dimension is congruent with the nursing and palliative care values concerning death and dying. With an obvious discrepancy between these two dimensions, Chinese nurses adopt three strategies in their practice to solve this tension: boundary-drawing to separate their personal and professional life, complying with the existing cultural values at work, and constructing positive meanings for end-of-life care. Conclusion In a society that traditionally avoids making any reference to death, it is useful to reduce cultural taboo and construct positive meanings in end-of-life care, death education and the development of palliative care. Meanwhile, nurses also need institutional support, education and training to transition smoothly from a novice to a mature professional when handling patient death. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-01067-3.
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22
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Lin X, Li X, Bai Y, Liu Q, Xiang W. Death-coping self-efficacy and its influencing factors among Chinese nurses: A cross-sectional study. PLoS One 2022; 17:e0274540. [PMID: 36094947 PMCID: PMC9467326 DOI: 10.1371/journal.pone.0274540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/28/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Nurses are the main caregivers of dying patients. Facing or dealing with death-related events is inevitable. Death-coping self-efficacy (DCS) is very important, as it can reduce the risk of nursing staff to adverse emotional distress, help them participate in end-of-life care and improve the quality of care of patients.
Methods
Using the convenient sampling method, this study included a total of 572 nurses from a tertiary hospital in Hangzhou, China. The status and influencing factors of the DCS of nurses were explored using a general information questionnaire and DCS scale.
Results
The scores of each parameter, ranging from low to high, were in the order of coping with grief, preparation for death and hospice care. Factors influencing nurses’ DCS included attendance in hospice care education courses within the previous year, experience of accompanying the family members of the deceased and attitude towards death.
Conclusions
The overall self-efficacy of nurses in palliative care was at a medium level. Moreover, their self-efficacy in coping with grief and preparation for death should be strengthened. Managers of medical institutions can assess the death-coping ability of nurses, which helps provide corresponding support and training for nurses at an early stage. Nurses should receive guidance in grief adjustment and emotion regulation. Medical units should provide nurses with a platform for continuous training and education, use of death-related theoretical models and frameworks to guide nurses in dealing with death-related events, reduce nurses’ negative mood and jointly promote their mental health.
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Affiliation(s)
- Xi Lin
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xiaoqin Li
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
| | - Yongqi Bai
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
- * E-mail: (YB); (QL)
| | - Qin Liu
- Department of Pediatrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Sichuan Clinical Research Center for Birth Defects, Luzhou, Sichuan, China
- Department of Nursing, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- * E-mail: (YB); (QL)
| | - Weilan Xiang
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China
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Yu H, Sun C, Xie L, Wang L, Song J, Zhu Y, Xiao R, Lowe S, Bentley R, Zhou D. Using a mediating model of death attitude and meaning in life to understand nursing students attitude about hospice care. NURSE EDUCATION TODAY 2022; 116:105448. [PMID: 35779526 DOI: 10.1016/j.nedt.2022.105448] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/03/2022] [Accepted: 06/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Nurse-led hospice teams are an emerging trend in contemporary health care practice in China. However, Chinese nursing students are often ill-prepared to work in hospice care. Study findings on the attitude of nursing students toward the care of people who are dying and death varied among different countries and regions. OBJECTIVES To propose and empirically test a mediating model that examines how death attitude and meaning in life interact to affect Chinese undergraduate nursing students and their attitude toward the care of people who are dying. DESIGN A cross-sectional study. PARTICIPANTS A convenience sample of 1410 Chinese undergraduate nursing students. METHODS Data were collected from July to December 2020 using Chinese versions of the Frommelt Attitude Toward Care of the Dying Scale, Form B (FATCOD-B-C), Death Attitude Profile-Revised (DAP-R-C), and Purpose in Life Test (CPLT-C). SPSS version 22.0 and AMOS version 24.0 were used for statistical analysis. RESULTS The average FATCOD-B-C score was 98.28 ± 8.02. Death attitude and meaning in life were positively correlated with attitude toward care of the dying (p < 0.001), but death attitude was negatively correlated with meaning in life (p < 0.001). Pathway analysis showed that fear of death was significantly and positively correlated with attitude toward care of people who are dying. A mediating role was found among neutral acceptance, escape acceptance, and meaning in life to some extent. Meaning in life suppressed effects among the model. CONCLUSION This study revealed that Chinese undergraduate nursing students' attitude toward care of the dying was a positive nurturing process. Future nurse education should first identity the fear of death, neutral acceptance, or escape acceptance of nursing students' death attitude, and then develop a hospice curriculum based on fear management.
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Affiliation(s)
- Huan Yu
- School of Nursing, Anhui Medical University, Hefei 230032, Anhui, China.
| | - Chenyu Sun
- AMITA Health Saint Joseph Hospital Chicago, Chicago 60657, IL, USA.
| | - Lunfang Xie
- School of Nursing, Anhui Medical University, Hefei 230032, Anhui, China
| | - Lu Wang
- School of Nursing, Anhui Medical University, Hefei 230032, Anhui, China
| | - Jiangyan Song
- Department of Nursing, Clinical Medical College, Anhui Medical University, Hefei 230032, China
| | - Yu Zhu
- School of Nursing, Anhui University of Chinese Medicine, Hefei 230012, Anhui, China
| | - Rui Xiao
- Intensive Care Unit, Yingshan County People's Hospital, Yingshan 637700, Sichuan, China
| | - Scott Lowe
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO 64106, USA
| | - Rachel Bentley
- College of Osteopathic Medicine, Kansas City University, Kansas City, MO 64106, USA
| | - Danye Zhou
- School of Nursing, Massachusetts College of Pharmacy and Health Sciences, Boston, MA 02115, USA
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Xu DD, Luo D, Chen J, Zeng JL, Cheng XL, Li J, Pei JJ, Hu F. Nurses' perceptions of barriers and supportive behaviors in end-of-life care in the intensive care unit: a cross-sectional study. Palliat Care 2022; 21:130. [PMID: 35854257 PMCID: PMC9294848 DOI: 10.1186/s12904-022-01020-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 07/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIM Patient deaths are common in the intensive care unit, and a nurse's perception of barriers to and supportive behaviors in end-of-life care varies widely depending upon their cultural background. The aim of this study was to describe the perceptions of intensive care nurses regarding barriers to and supportive behaviors in providing end-of-life care in a Chinese cultural context. METHODS A cross-sectional survey was conducted among intensive care nurses in 20 intensive care units in 11 general hospitals in central and eastern China. Instruments used in this study were general survey and Beckstrand's questionnaire. Data were collected via online survey platform. Descriptive analysis was used to describe general characteristics of participants and mean and standard deviations of the barriers and supportive behaviors. The mean and standard deviation were used to describe the intensity and frequency of each barrier or supportive behavior following Beckstrand's method to calculate the score of barriers and supportive behaviors. Content analysis was used to analyze the responses to open-ended questions. RESULTS The response rate was 53% (n = 368/700). Five of the top six barriers related to families and the other was the nurse's lack of time. Supportive behaviors included three related to families and three related to healthcare providers. Nurses in the intensive care unit felt that families should be present at the bedside of a dying patient, there is a need to provide a quiet, independent environment and psychological support should be provided to the patient and family. Nurses believe that if possible, families can be given flexibility to visit dying patients, such as increasing the number of visits, rather than limiting visiting hours altogether. Families need to be given enough time to perform the final rites on the dying patient. Moreover, it is remarkable that nurses' supportive behaviors almost all concern care after death. CONCLUSIONS According to ICU-nurses family-related factors, such as accompany of the dying patients and acceptence of patient's imminent death, were found the major factors affecting the quality of end-of-life care. These findings identify the most prominent current barriers and supportive behaviors, which may provide a basis for addressing these issues in the future to improve the quality of end-of-life care.
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Affiliation(s)
- Dan-Dan Xu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Critical Care and Anesthesia Nursing Research Center, School of Nursing, Wuhan University, PO Box 430071, No. 169 Donghu Road, Wuhan, Hubei Province, China
| | - Dan Luo
- Wuhan University School of Health Sciences, Wuhan, China
| | - Jie Chen
- University of Connecticut School of Nursing, Mansfield, USA
| | - Ji-Li Zeng
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
| | | | - Jin Li
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
| | - Juan-Juan Pei
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China
| | - Fen Hu
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Clinical Research Center of Hubei Critical Care Medicine, Critical Care and Anesthesia Nursing Research Center, School of Nursing, Wuhan University, PO Box 430071, No. 169 Donghu Road, Wuhan, Hubei Province, China.
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Li J, Wang Q, Guan C, Luo L, Hu X. Compassion fatigue and compassion satisfaction among Chinese palliative care nurses: A province-wide cross-sectional survey. J Nurs Manag 2022; 30:3060-3073. [PMID: 35689416 DOI: 10.1111/jonm.13708] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/02/2022] [Accepted: 06/09/2022] [Indexed: 02/05/2023]
Abstract
AIMS We aim to explore the prevalence and potential facilitators and inhibitors of compassion fatigue and compassion satisfaction among Chinese palliative care nurses. BACKGROUND Nurses with compassion fatigue may suffer from health-related problems, causing decreased work efficiency and quality of care. Palliative care nurses are especially at risk of compassion fatigue due to close contact with terminal patients. METHODS A province-wide cross-sectional survey using convenience sampling was conducted among 318 palliative care nurses at 25 hospitals and healthcare institutions in Sichuan Province, China. Data were collected using demographic questionnaire and five scales: Professional Quality of Life Scale, General Self-Efficacy Scale, Perceived Social Support Scale, Simplified Coping Style Questionnaire, and Connor-Davison Resilience Scale. Data analyses including descriptive statistics, t-test, one-way ANOVA, simple linear regression, and multiple linear regression. RESULTS Mean scores (SD) for burnout, secondary traumatic stress, and compassion satisfaction were 25.42 (4.75), 26.08 (5.72), and 35.67 (5.77), respectively. Related factors predicted 40.30%, 27.10%, and 35.4% of the variance in the model of burnout, secondary traumatic stress, and compassion satisfaction, respectively (all p < .001). CONCLUSIONS The levels of burnout and secondary traumatic stress among Chinese palliative care nurses were higher than those among other types of nurses. Social support, resilience, positive coping, family recognition of work, and income satisfaction are inhibitors of compassion fatigue among palliative care nurses. IMPLICATIONS FOR NURSING MANAGEMENT Nursing administrators and educators should consider providing effective and targeted strategies (e.g. ongoing training and psychological interventions) to decrease compassion fatigue among palliative care nurses based on the cultural and ethical settings.
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Affiliation(s)
- Juejin Li
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Qi Wang
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Chang Guan
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
| | - Lin Luo
- Human Resource Department, West China Hospital of Sichuan University, Chengdu, China
| | - Xiaolin Hu
- West China School of Nursing, Sichuan University/Department of Nursing, West China Hospital, Sichuan University, Chengdu, China
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Wang YL, Yang ZW, Tang YZ, Li HL, Zhou LS. A qualitative exploration of "empathic labor" in Chinese hospice nurses. Palliat Care 2022; 21:23. [PMID: 35172778 PMCID: PMC8851695 DOI: 10.1186/s12904-022-00911-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 02/08/2022] [Indexed: 11/15/2022] Open
Abstract
Background Hospice nurses may devote more emotional labor during the empathy process with patients, and this empathy can be used as a form of psychological behavior of emotional labor in the hospice care model. The aim of this study was to analyze hospice nurses’ empathy characteristics in the context of emotional labor theory, and explore the impact of empathy on patient care. Methods We conducted semi-participant observations from three hospitals and multicenter in-depth interviews with n = 26 hospice nurses from eight cities. Interviews were transcribed, and directed content analysis was applied. Results Two categories with four sub-categories were extracted from the data analysis. Category 1 described the “empathic labor” process which covers cognitive empathy (including empathic imagination, empathic consideration, and empathic perception) and affective empathy (including natural empathy, surface empathy, and deep empathy). The second category concerns the outcome of nurses’ “empathic labor” which incorporates both positive and negative effects. Conclusions The findings indicated that hospice nurses’ empathy process should be understood as emotional labor. Nursing managers should pay more attention to raising the ability of deep empathy with hospice nurses, and explore more sufficient active empowerment strategies to alleviate the negative impact of empathy on nurses and to strengthen nurses' deep empathy with terminal ill patients.
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Affiliation(s)
- Ya-Ling Wang
- School of Nursing, Soochow University, No.1, Shizi Street, Suzhou, 215000, China
| | - Zi-Wei Yang
- School of Nursing, Soochow University, No.1, Shizi Street, Suzhou, 215000, China
| | - Yue-Zhong Tang
- KangJian Community Health Service Center, 88 Jiangan Road, Shanghai, 200433, China
| | - Hui-Ling Li
- School of Nursing, Soochow University, No.1, Shizi Street, Suzhou, 215000, China.
| | - Lan-Shu Zhou
- School of Nursing, Naval Military Medical University, 800 Xiangyin Road, Shanghai, 200433, China.
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Zhong Y, Black BP, Kain VJ, Sun X, Song Y. Development of the Simplified Chinese version of neonatal palliative care attitude scale. Front Pediatr 2022; 10:962420. [PMID: 36238602 PMCID: PMC9551218 DOI: 10.3389/fped.2022.962420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/05/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The provision of palliative care for neonates who are not expected to survive has been slow in mainland China, and this model of care remains in its early stages. Evaluating nurses' attitudes toward neonatal palliative care (NPC) has the potential to provide valuable insight into barriers impeding NPC implementation. This study aimed to translate and adapt the traditional Chinese version of the Neonatal Palliative Care Attitude Scale (NiPCAS) into Simplified Chinese to assess its psychometric properties. METHODS The NiPCAS is a valid and reliable instrument to measure nurses' attitudes for evidence-based practice. To date, the scale has not been used largely in mainland China. With translation and cultural adaptation, the traditional Chinese version of the NiPCAS was developed into a Simplified Chinese version. Its reliability was tested using internal consistency and test-retest reliability, and its validity was measured using the content validity index and exploratory factor analysis. RESULTS A total of 595 neonatal nurses from mainland China were recruited. Twenty-six items in the scale were translated into Simplified Chinese. The scale demonstrated excellent reliability with a Cronbach's α coefficient of 0.87 and a test-retest reliability of 0.88. To support the Simplified Chinese version of NiPCAS, the scale content validity score was 0.98, and the exploratory factor analysis revealed five factors representing the conceptual dimensions of the scale. CONCLUSION This study demonstrated the psychometric properties of the Simplified Chinese version of NiPCAS, validated its use as a viable tool for measuring neonatal nurses' attitudes toward NPC, and identified facilitators and barriers to NPC adoption. Our findings suggested supported clinical application in the context of mainland China. A confirmatory factor-analysis approach with a different sample of neonatal nurses is required for further testing of the instrument in the future.
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Affiliation(s)
- Yajing Zhong
- Department of Public Health and Primary Care, Centre for Biomedical Ethics and Law, KU Leuven, Leuven, Belgium
| | - Beth Perry Black
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Victoria J Kain
- School of Nursing and Midwifery, Griffith University, Griffith, QLD, Australia
| | - Xiaoming Sun
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yang Song
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
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Zhu S, Zhu H, Zhang X, Liu K, Chen Z, Yang X, Sun C, Xie W, Xu Q, Li W, Pang D, Cui Y, Wang H. Care needs of dying patients and their family caregivers in hospice and palliative care in mainland China: a meta-synthesis of qualitative and quantitative studies. BMJ Open 2021; 11:e051717. [PMID: 34740931 PMCID: PMC8573656 DOI: 10.1136/bmjopen-2021-051717] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To investigate the care needs of dying patients and their family caregivers in hospice and palliative care in mainland China. METHODS A search for English and Chinese quantitative and qualitative studies was performed using the following English databases: PubMed (Medline), CINAHL and PsycINFO, as well as Chinese databases: SinoMed and CNKI. The records were independently screened by two reviewers and critiqued using Joanna Briggs Institute Critical Appraisal tools. All quantitative data were transformed into qualitative data, which were converted into textual descriptions. Due to the diversity of included studies, a three-step analysis was performed: narrative summary, thematic analysis and presentation of integrated results in a narrative form. The qualitative findings were pooled using the meta-aggregation approach. RESULTS The literature search identified 2964 papers after removing duplicates, from which 18 were included (9 quantitative and 9 qualitative studies). All studies were conducted in mainland China. Quantitative studies involved cross-sectional surveys, and qualitative studies involved interviews for data collection. Two synthesised results of patients' needs were identified, including needs to be comfortable and experience a good death. Another two synthesised results of family caregivers' needs included needs to care for and improve the quality of life of patients, and to care for themselves well. CONCLUSION This study identified that patients and family caregivers have an increasing demand for professional care at the end of life. Professionals, especially nurses, should enact a patients' demand-centred practice to overcome the challenges of organisation, education, emotion and communication to provide high-quality end-of-life care.
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Affiliation(s)
- Shuqin Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hanfei Zhu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xintong Zhang
- Emergency, Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Kouying Liu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zumei Chen
- China Jiliang University Hospital, Hangzhou, Zhejiang, China
| | - Xiaowen Yang
- Nanjing Medical University Library, Nanjing, Jiangsu, China
| | - Changxian Sun
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
- Jiangsu Vocational Institute of Commerce, Nanjing, Jiangsu, China
| | - Weiping Xie
- Department of Respiratory and Critical Care Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Qin Xu
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Weiying Li
- LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Dong Pang
- School of Nursing, Peking University, Beijing, China
- Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, Peking University Health Science Centre, Beijing, China
| | - Yan Cui
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hong Wang
- Department of Respiratory and Critical Care Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Zhang Q, Zheng R, Fu Y, Mu Q, Li J. Mental health consequences during alerting situations and recovering to a new normal of coronavirus epidemic in 2019: a cross-sectional study based on the affected population. BMC Public Health 2021; 21:1499. [PMID: 34344342 PMCID: PMC8330179 DOI: 10.1186/s12889-021-11550-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 07/26/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND As a major virus outbreak in the twenty-first century, the coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented hazards to mental health globally. METHODS We performed a cross-sectional study based on the results of an online survey. The survey was conducted 1 month after the outbreak (February 18-29, 2020) and repeated at the time of resuming activity (April 8-14, 2020). The 15-item Death Anxiety Scale (T-DAS) was used to assess the degree of death anxiety, and the Chinese version of PTSD checklist-civilian version (PCL-C), for PTSD symptom clusters. Through convenient sampling, a total of 7678 cases were collected. RESULTS Our findings showed that even after the lockdown was lifted, the prevalence of the symptoms of post-traumatic stress disorder (PTSD) and death anxiety remained significantly high in the general population affected by the outbreak. Regression model analysis showed that PTSD was significantly associated with age > 50 years, contact history/living community, poor health status of participants, past traumatic experience (PTE), and medical occupation. Moreover, death anxiety mediated the relationship between life-threatening PTE and PTSD, indicating that reducing death anxiety could buffer the negative effects of PTE on PTSD. CONCLUSIONS Despite the lifting of the lockdown, long-term adverse psychological effects remain in the affected general population. The management of mental health after major public health events is important, and high-risk groups such as the elderly and healthcare workers should receive targeted interventions. In addition, the study suggests that methods for alleviating death anxiety must be included in plans to manage the psychological impact of public health emergencies.
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Affiliation(s)
- Qian Zhang
- West China School of Medicine/West China School of Nursing, Sichuan University, Chengdu, 610041 China
| | - Rujun Zheng
- Department of Thoracic Oncology, West China Hospital, Sichuan University, No. 37, Chengdu, 610041 China
| | - Yan Fu
- Department of Thoracic Oncology, West China Hospital, Sichuan University, No. 37, Chengdu, 610041 China
| | - Qianqian Mu
- Department of Thoracic Oncology, West China Hospital, Sichuan University, No. 37, Chengdu, 610041 China
| | - Junying Li
- Department of Thoracic Oncology, West China Hospital, Sichuan University, No. 37, Chengdu, 610041 China
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Tong LK, Zhu MX, Wang SC, Cheong PL, Van IK. Nurses Who Are More Willing to Participate in the Fight against COVID-19: Evidence from China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147357. [PMID: 34299810 PMCID: PMC8305985 DOI: 10.3390/ijerph18147357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/02/2021] [Accepted: 07/06/2021] [Indexed: 12/24/2022]
Abstract
When facing an infectious disease disaster, nurses’ willingness to work is critical. Nurses’ lack of willingness to work during a pandemic may worsen the shortage of health care personnel. The purpose of this study is to assess the willingness of nurses to participate in the fight against COVID-19 in China and to identify factors associated therewith. This cross-sectional study examines nurses working in 11 Chinese cities including Macau, Hong Kong, Shenzhen, Dongguan, Huizhou, Guangzhou, Zhaoqing, Foshan, Jiangmen, Zhongshan, and Zhuhai. Questionnaires were collected from 19 May to 7 August 2020. A total of 8065 questionnaires were received, of which 8030 valid questionnaires were included for analysis. A total of 53.4% of participants reported that they had signed up to support the COVID-19 pandemic response. Multivariate logistic regression analysis revealed that being single (OR = 0.72, 95% CI: 0.60–0.87), having no children (OR = 0.81, 95% CI: 0.68–0.97), possessing higher professional qualifications (OR = 1.25, 95% CI: 1.14–1.37), having a more prestigious professional title (OR = 1.68, 95%CI: 1.50–1.90), being an administrative supervisor (OR = 0.53, 95% CI: 0.45–0.63), having a higher caring dimensions inventory score (OR = 1.01, 95% CI: 1.01–1.01), working in a hospital (OR = 0.53, 95% CI: 0.39–0.72), and receiving employer-provided care training (OR = 0.77, 95% CI: 0.68–0.87) were predictive of nurses’ willingness to participate in the fight against COVID-19. We suggest that unmarried nurses should be given priority when recruiting to fight an epidemic and, for married nurses with children who are recruited to fight an epidemic, supporting measures should be provided for childcare. We suggest strengthening workplace training of caring for nurses in order to better retain and recruit qualified support for an epidemic outbreak of infectious diseases.
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Affiliation(s)
- Lai-Kun Tong
- Research Management and Development Department, Kiang Wu Nursing College of Macau, Macau 999078, China;
| | - Ming-Xia Zhu
- Education Department, Kiang Wu Nursing College of Macau, Macau 999078, China; (M.-X.Z.); (S.-C.W.); (P.-L.C.)
| | - Si-Chen Wang
- Education Department, Kiang Wu Nursing College of Macau, Macau 999078, China; (M.-X.Z.); (S.-C.W.); (P.-L.C.)
| | - Pak-Leng Cheong
- Education Department, Kiang Wu Nursing College of Macau, Macau 999078, China; (M.-X.Z.); (S.-C.W.); (P.-L.C.)
| | - Iat-Kio Van
- Education Department, Kiang Wu Nursing College of Macau, Macau 999078, China; (M.-X.Z.); (S.-C.W.); (P.-L.C.)
- Correspondence: ; Tel.: +853-8295-6202
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Big Five Personality Model-based study of death coping self-efficacy in clinical nurses: A cross-sectional survey. PLoS One 2021; 16:e0252430. [PMID: 34043723 PMCID: PMC8158956 DOI: 10.1371/journal.pone.0252430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background Specific personality traits may affect the ability of nurses to deal with patient death. The relationship between personality and death coping self-efficacy (DCS) has rarely been investigated in the palliative care setting. In this study, we explored the associations between different personality profiles and DCS in clinical nurses from general wards and ICU. Methods A cross-sectional survey of 572 Chinese nurses was conducted between August and September 2020, by way of a self-administered questionnaire. Results Among the Big Five Personality Traits, in nurses the score was highest for conscientiousness and lowest for neuroticism. With regard to DCS, nurses scored highly on the intention of hospice care. The Big Five Personality Traits were found to explain 20.2% of the overall variation in DCS. Openness, agreeableness and conscientiousness were significantly associated with DCS in nurses. Conclusions Nursing managers should pay attention to differences in personality characteristics and provide personalized and targeted nursing education. This should improve nurses’ DCS, enrich their professional development and promote high quality palliative care for patients and their families.
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