Nurses' knowledge and attitudes towards palliative care and death: a learning intervention

The effect of mindfulness-based compassionate living training for informal caregivers of palliative inpatients on burnout and caregiving burden: a randomized controlled trial

This study was conducted to determine the effect of Mindfulness-Based Compassionate Living (MBCL) training given to the informal caregivers of palliative patients on burnout and caregiving burden. A single-blind, randomized, controlled, experimental study was conducted with 54 caregivers of patients admitted to a hospital palliative care unit. The participants were randomly allocated to the experimental group (n = 26) and control group (n = 28). The experimental group received MBCL training twice a week for 4 weeks. Data were collected before and after the intervention using the Maslach Burnout Inventory, Caregiver Burden Scale and Self-Compassion Scale-Short Form. The data were analyzed using kurtosis and skewness coefficients, number, percentage, mean, standard deviation, chi-square test, independent samples t test, Wilcoxon signed ranks test and Mann-Whitney U test in SPSS version 22.0. The informal caregivers in the experimental group demonstrated a significant decrease in emotional exhaustion and depersonalization scores and an increase in personal accomplishment and self-compassion scores in posttest assessments after the MBCL intervention (P < 0.05). All of these parameters differed significantly between the experimental and control groups after the intervention (P < 0.05). MBCL training seems to be effective in reducing emotional exhaustion and depersonalization and increasing personal accomplishment and self-compassion among informal caregivers of palliative inpatients. The results of this study can be generalized to the caretakers of patients receiving palliative care in university hospitals.

Mediating effect of meaning in life on death anxiety and attitude toward palliative care among undergraduate nursing students

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.

Simulation, Storytelling, and Pediatric End-of-Life Care: A Continuing Professional Development Approach for Nurse Residents

Background: Providing end-of-life (EOL) care to pediatric patients and their families is challenging. Newly licensed nurses, especially those working with the hematology/oncology population, have little to no experience providing the specialized care needed for the dying child. An evidence-based continuing professional development activity provided a novel approach to improve the knowledge, attitudes, and comfort levels of nurse residents related to pediatric EOL care. Method: A high-fidelity simulation module of a pediatric oncology patient at the EOL was embedded into a 12-month nurse residency program. The module employed several teaching strategies including a storytelling approach. Results: Thirteen pediatric nurse residents participated in the program. While the evidence-based intervention increased participants' EOL care knowledge, their overall attitudes, and comfort levels remained unchanged. Discussion: EOL simulation with a storytelling approach is a highly valuable method of teaching new nurses how to care for a dying patient. Additional studies are needed to explore how to increase the comfort levels of new nurses in the delicate population of pediatric hematology/oncology.

Palliative Care Knowledge Following an Interdisciplinary Palliative Care Seminar

BACKGROUND

The COVID-19 pandemic created a unique opportunity to evolve an interdisciplinary palliative care seminar (IPC) into a virtual platform. This seminar provides foundational palliative and hospice concepts, introductions into palliative care disciplines, integration of teamwork, and incorporates interdisciplinary student led patient encounters. Traditionally, this experience had been in person, however during the COVID-19 pandemic, healthcare restrictions transitioned the educational delivery to a virtual platform.

METHODS

To assess the knowledge gained from this novel experience, the Palliative Care Knowledge Test (PCKT) was administered before and after the IPC Seminar. A 1-year follow up survey was also administered to evaluate how the IPC Seminar was applicable to the students' clinical experiences and practice.

RESULTS

The virtual didactics and virtual student led patient encounters significantly improved learners understanding of palliative and hospice care. This gain of knowledge was noted across undergraduate and graduate programs, which highlights the need for and benefit from foundational concepts. Furthermore, a 1-year follow up survey noted the IPC seminar was applicable to their practices and suggests that this experience will impact future patients.

DISCUSSION

Many of the students practice in rural areas where access to palliative care services is limited or non-existent. This experience exponentially impacts the growth of palliative and hospice care understanding and access to care across the region.

CONCLUSION

Evolving our IPC Seminar has shown to significantly improve knowledge, foster collaboration of student led interdisciplinary teams, and increases capacity to meet the needs of more learners.

Nursing Students' Perceptions on a Pain Management E- Learning Module: An Exploratory Quantitative Study

BACKGROUND

Nursing students are graduating ill-prepared to assess and manage pain in older adults. To address this gap, we developed an e-learning module on the topic.

AIM

To examine nursing students' perceptions on a pain management e-learning module focused on older adults.

METHODS

Utilizing an exploratory quantitative design, we assessed nursing students' perceptions of the e-learning module. We used a feedback survey (four 5-point, Likert-type items) and one open-ended question to assess students' perceptions. Descriptive statistics were used to summarize students' perceptions and demographic characteristics. Responses to the open-ended question were content analyzed.

RESULTS

A total of 181 of 249 students completed the module, of whom two-thirds were female. Students perceived that the module enhanced their knowledge, confidence, and perception in working with older people. Students also found the method of instruction interactive and enjoyable.

CONCLUSIONS

The e-learning module on pain management was viewed by nursing students to be helpful and its interactive method of learning improved their knowledge, confidence, and perceptions of working with older adults in pain.

Core components of end-of-life care in nursing education programs: a scoping review

BACKGROUND

So far, there have been many studies on end-of-life nursing care education around the world, and in many cases, according to the cultural, social, and spiritual contexts of each country, the results have been different. The present study intends to gain general insight into the main components of end-of-life care in nursing education programs by reviewing scientific texts and the results of investigations.

METHODS

This study was a scoping review conducted with the Arksey and O'Malley methodology updated by Peters et al. First, a search was made in Wos, ProQuest, Scopus, PubMed, Science Direct, Research Gate, and Google Scholar databases to find studies about end-of-life care education programs. Then, the screening of the found studies was done in four stages, and the final articles were selected based on the inclusion and exclusion criteria of the studies. Due to the nature of the research, editorials, letters, and commentaries were excluded. The screening steps are shown in the PRISMA-ScR diagram.

RESULTS

23 articles related to end-of-life care education programs were reviewed. The studies included eleven descriptive and cross-sectional studies, two qualitative studies, eight interventional studies, one concept analysis article, and one longitudinal study. By summarizing the data from the studies, six themes were obtained as the main components of end-of-life care education: principles of end-of-life care, communication skills, physical considerations, psychosocial and spiritual considerations, ethical considerations, and after-death care.

CONCLUSION

End-of-life care is one of the most challenging nursing care in the world. Since many nurses are not prepared to provide such care, the information obtained from this review can help nursing education and treatment managers develop more comprehensive training programs to improve the quality of end-of-life care.

Attitude of nurses towards palliative care and its associated factors in Ethiopia, systematic review and meta-analysis

INTRODUCTION

Palliative care significantly improves the distressing symptoms of patients, especially those with cancer, heart disease, renal disease, and liver disease. The need for palliative care is increasing worldwide due to the growing burden of chronic disease. Nurses with an unfavorable attitude towards palliative care cannot skillfully assess the patient's needs, do not communicate effectively, and do not address the patient's problems adequately. Therefore, this study was aimed to assess the nurse's level of attitude towards palliative care in Ethiopia.

METHODS

Several databases were searched to find available articles. Microsoft Excel was used to extract and sort the data before it was exported to STATA/MP 17.0 for analysis. A weighted inverse variance random-effects model with a 95% confidence interval was employed to pool the data. Egger's test and Cochrane I2 statistics were used to assess heterogeneity and publication bias, respectively. Subgroup analysis was carried out to identify the source of heterogeneity. A log-odds ratio was employed to show the relationship between nurses' level of attitude towards palliative care and its related factors. P-value less than 0.05 was considered statistically significant.

RESULT

In Ethiopia, the pooled prevalence of favorable attitudes of nurses towards palliative care was 66.13% (95% CI: 54.00-78.27). The highest percentage of favorable attitudes towards palliative care among nurses was found in research studies done in Addis Ababa (80.31%; 95% CI: 72.00-88.63). Training on palliative care was significantly associated with the level of a nurse's attitude towards palliative care. Therefore, nurses who received palliative care training had a 2.5 times higher chance of having a favorable attitude towards palliative care than nurses who did not receive training on palliative care (AOR = 2.55; 95% CI: 2.28-2.82).

CONCLUSION

One-third of nurses had unfavorable attitude towards palliative care. Nurses who took palliative care training had a more favorable attitude than nurses who did not take palliative care training. Routine palliative care training is needed for nurses to improve their level of attitude towards palliative care.

Video training of nursing home healthcare workers in palliative care

OBJECTIVES

The provision of palliative care in nursing homes (NHs) is of paramount importance, a realism underscored by the frailty and medical complexity of the residents. However, palliative care (PC) education tends to be resource-intensive both for educators and healthcare workers (HCWs). The aim of this study was to investigate how PowerFacts, a video animation series that taught basic PC to NH HCWs in Singapore impacted their knowledge, attitudes and confidence.

METHODS

A cohort study design was adopted for the study. A total of 264 NH HCWs across 12 NHs in Singapore participated in the study from January 2021 to October 2022. Participants were assessed using a 20-summative multiple-choice question assessment, a 30-item Frommelt Attitude Toward Care of the Dying Scale (FATCOD) and four questions on their confidence level before and after the PowerFacts course.

RESULTS

Paired t-test was performed. Significant changes were noted in the knowledge and confidence score post-intervention. The knowledge score improved significantly from preintervention (12.2±3.5) to post-intervention (15.8±3.4; p<0.01). The confidence score increased significantly from 14.7±2.7 to 16.7±2.2 (p<0.01). However, the FATCOD score did not reveal any significant changes between preintervention and post-intervention results (p>0.05).

CONCLUSIONS

PowerFacts has demonstrated its potential as a valuable addition to the array of teaching methods available to NH HCWs. Future studies are required to evaluate the impact of animation on patient care and clinical practice.

The effects of hospice care education on first-year undergraduate nursing students in mainland China: A mixed-methods study

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.

Evaluation of Surgical Clinic Nurses' Knowledge Levels About Palliative Surgery

BACKGROUND

Currently, palliative care plays an important role in increasingly aging populations and their long-term care needs. Surgical palliative care is important for improving quality of life. This study aimed to determine the knowledge level of nurses working in surgical clinics about palliative surgery.

METHOD

This research was conducted as a descriptive study. We included 182 nurses working in surgical clinics who agreed to participate and met the inclusion criteria for participation in the study. The Personal Information and Palliative Surgery Information Forms were used to collect data. Data were collected between November 30, and December 15, 2022. The analysis of the data obtained was performed using the Statistical Program in Social Sciences (SPSS), Version 25. The level of significance was set at P < .05.

RESULTS

Nurses referred to palliative care as end-of-life care, 73.1% did not care for palliative care patients, and 84.6% did not receive training in palliative care. Surgical clinic nurses were found to have "moderate knowledge about palliative surgery. A statistically significant difference was found between the average palliative surgery knowledge of surgical clinic nurses and those trained in education and palliative care (P < .05).

CONCLUSIONS

The results of the study showed that surgical clinic nurses had moderate knowledge about palliative surgery. Moreover, the nurses who have received training in palliative care and had high level of education exhibited a higher level of knowledge.

Applying Adult Learning Theory in Improving Knowledge, Attitude, and Practice of Inadvertent Perioperative Hypothermia in Operating Room Nurses: Single-Group "Before and After Study"

The study aimed to explore the effect of the training scheme guided by Knowles' adult learning theory model on perioperative hypothermia prevention-related knowledge, practice, and behavior in operating room nurses. Operating room nurses of a teaching hospital were included from February to May 2023. Under the guideline of the adult learning theory, we accessed the score of the knowledge, attitude, and practice in operating room nurses about the prevention of the inadvertent perioperative hypothermia (IPH) before and after trainings through qualitative interviews and questionnaire surveys. There were statistically significant differences in scores of knowledge, attitude, and practice of IPH prevention in operating room nurses before and after training. The training program guided by adult learning theory could significantly increase the scores of IPH prevention-related knowledge of operating room nurses, improve the attitude of perioperative hypothermia prevention, and advance the compliance with IPH prevention interventions. Clinical Trial Registration number: 2023IIT109.

Exploring the variations in death anxiety among oncology nurses in China: a latent class analysis

BACKGROUND

Various factors have been found to be associated with high levels of death anxiety experienced by oncology nurses. The aim of this study was to use a person-oriented approach to examine the death anxiety patterns of Chinese oncology nurses and to analyze the differences in anxiety characteristics and their associated influencing factors.

METHODS

A cross-sectional survey regarding palliative care among registered oncology nurses was conducted in Jiangsu Province, China.Latent class analyses was applied to identify their patterns of death anxiety. The score of PCQN-C (The Chinese version of the Palliative Care Quiz for Nursing) and FATCOD-B-C (The Chinese version of the Frommelt Attitude Toward Care of the Dying scale), the demographic and working characteristics were further analyzed through covariance analysis (ANCOVA) and multivariate (or logistic) regression across the subgroups.

RESULTS

A two-potential-category model was selected based on the fit index. The results showed that 79% of oncology nurses belonged to the high pressure and pain group and 21% belonged to the low death anxiety group. The high pressure and pain group had significantly higher scores in the dimensions of emotion, stress and pain, time awareness, and cognition compared to the low death anxiety group. Factors influencing the high pressure and pain group included shorter working years, non-national or provincial oncology nursing specialists, non-national palliative care specialists, never discussing the topic of death with patients or family members, no palliative care related training, and PCQN and FATCOD scores.

CONCLUSIONS

Our study suggests that oncology nurses' death anxiety can be divided into two categories: low death anxiety and high stress pain, and certain factors, such as being female, having a short work experience, and lacking palliative care-related training, increase the likelihood of death anxiety.

Palliative care knowledge and attitudes toward end-of-life care among intensive care unit nurses in Jordan

BACKGROUND

There is a growing need for palliative care globally due to the rapid aging of the population and improvement in cancer survival rates. Adequate knowledge and a positive attitude are vital for palliative care nurses. The study's purpose was to examine nurses' knowledge and attitudes toward palliative care.

METHODS

A cross-sectional design with convenience sampling was used. The study included 182 intensive care unit (ICU) nurses from Jordanian hospitals in all sectors. Self-administered questionnaires were used to assess nurses' knowledge and attitudes toward palliative care. Descriptive statistics, analysis of variance, and the Kruskal-Wallis H test were used to analyze the data.

RESULTS

We measured nurses' knowledge using the Palliative Care Quiz for Nursing, and we measured nurses' attitudes using the Frommelt Attitude Toward Care of the Dying scale. The mean total knowledge and attitude scores were 8.88 (standard deviation [SD], 2.52) and 103.14 (SD, 12.31), respectively. The lowest level of knowledge was in psychosocial and spiritual care (mean, 0.51±0.70). The percentage of nurses with unfavorable attitudes was 53.3%. Significant differences in knowledge and attitude levels were observed according to educational level, experience, and hospital type.

CONCLUSIONS

ICU nurses have insufficient knowledge and inappropriate attitudes toward palliative care. Knowledge of psychological and spiritual aspects of palliative care was particularly lacking as were appropriate attitudes towards communication with dying patients. Improving knowledge and attitudes toward palliative care in nursing schools and hospitals would help overcome this problem.

Assessment of the Competence of Nurses in Taking Care of a Dying Patient in Poland

During nursing education, few practical hours are devoted to comprehensively preparing students to care for a dying patient. Contact with a dying patient is a key element of the job of every working nurse in the profession. Therefore, it is necessary to properly prepare nurses to care for a dying patient. This study aimed to assess the professional competence of nurses in caring for a dying patient and the factors that affect this preparation. This study involved 223 nurses during master's degree in nursing at the Medical University of Warsaw, receiving either full-time education (group I, N = 121) or hybrid education (group II, N = 102). The study used the FATCOD-BP ((Frommelt Attitudes Toward the Care Of the Dying scale Form B, Polish version)) questionnaire (Cronbach's alpha 0.75), an original questionnaire containing questions about feelings experienced during the SARS-CoV-2 virus pandemic and sociodemographic questions. FATCOD-BP for all groups was below average regarding caring for a dying patient (M = 109, SD = 11.68). Nurses pursuing full-time education were better prepared to care for a dying patient than were nurses pursuing hybrid education. Nurses who exhibited fear of their own deaths had a lower subjective level of preparation for caring for a dying patient. (1) Nurses are not sufficiently prepared to care for a dying patient. (2) The training of nurses should be provided in the form of in-patient education, and the methods of training should be modified by increasing the number of hours of practical and theoretical instruction in palliative care for a dying patient.

The Impact of End-of-Life Care Among Nurses Working in the Pediatric Intensive Care Unit

Health care providers caring for patients at the end of life (EOL) are faced with a multitude of emotions such as guilt, anger, sadness, and helplessness. Because of the negative impact of initiating EOL care (EOLC) to the pediatric population, organizations must be proactive in instituting education and resources on EOLC. They must also provide advanced skills to nurses who take care of patients at their EOL. Understanding the consequences of providing EOL care to patients in the pediatric intensive care unit allows for better allocation of resources and support services for nurses. This improves patient outcomes and nurse retention.

Examination of the relationship between thanatophobia and resilience levels of nurses working in intensive care and palliative care units

BACKGROUND

Nurses in critical care and palliative care units care for patients suffering from severe pain and suffering and at high mortality risk. For this reason, nurses working in these units should be psychologically resilient. However, nurses who are constantly exposed to the death process face the risk of thanatophobia. The aim of this study is to examine the relationship between thanatophobia levels and the psychological resilience of nurses working in intensive care and palliative care units.

METHODS

The sample of this descriptive and cross-sectional study included 158 nurses working in intensive care and palliative care units. Personal information form for nurses, Thanatophobia Scale and Psychological Resilience Scale for Adults were used. Data were collected through an online questionnaire in the study. Percentage calculations, mean measurements, Kruskal Wallis test and Mann Whitney U test were used in the statistical evaluation of the data.

RESULTS

The mean of thanatophobia scale and psychological resilience scale was found 31.74 ± 10.08 and 108.34 ± 7.12, respectively. There was a statistically significant difference between the tanatophobia total scale score and age, receiving training on psychological resilience (p < 0.05). A statistically significant difference was found between perseption of self, family cohesion and perception of future and the status of receiving training on psychological resilience (p < 0.05). A statistically negative significant correlation was determined between the thanatophobia scale and the psychological resilience scale total scores.

CONCLUSIONS

As a result, it was determined that as the thanatophobia of the nurses increased, their psychological resilience decreased. This situation may negatively affect nurses working in critical departments to provide quality health care to patients. Establishing and maintaining training programs to reduce thanatophobia and increase psychological resilience of nurses working in intensive care and palliative care units will ensure that nurses provide quality health care to the patient and reduce the physiological and psychological wear of nurses.

The effect of death education course utilizing constructivist learning theory on first grade undergraduate nursing student attitudes and coping abilities towards death: A mixed study design

Inadequate clinical preparation for palliative care is often reflected in inadequate education about death. Nursing students as nurses of the future, it is necessary to make them aware of death and overcome fear of it so that they can cope with their future careers and provide qualified and warmly care service.

OBJECTIVES

To determine the effect of death education course using constructivist learning theory on first grade undergraduate nursing student attitudes and coping abilities towards death.

DESIGN

This study was designed using a mixed-methods design.

SETTING

Two campuses of a university school of nursing in China.

PARTICIPANTS

First grade Bachelor of Nursing Science students (n = 191).

METHODS

Data collection includes questionnaires and reflective writing as after class task. Quantitative data were analyzed using descriptive statistics, the Wilcoxon Signed Rank test, and the Mann-Whitney U test. As for reflective writing, content analysis was hired to analysis.

RESULTS

The intervention group's attitude towards death tended to be neutral acceptance. The intervention group's ability to deal with death (Z = -5.354, p < 0.001) and expression of thoughts about death (Z = -3.89 b, p < 0.001) greater than that of the control group. Four themes (Awareness of death before class, Knowledge, The meaning of palliative care, New cognition) were identified from reflecting writing.

CONCLUSION

Compared with the conventional teaching, death education course utilizing constructivist learning theory was found to be a more effective method for developing students' death coping skills and reducing fear of death.

Assessment of Knowledge and Awareness Among Nurses of a Tertiary Care Hospital Regarding the Management of Acute Poisoning: A Cross-Sectional Study

BACKGROUND

Poisoning is a major health issue worldwide. Nurses are frequently the first healthcare professionals to come in contact with patients with acute poisoning. So, this study was conducted to assess the knowledge and awareness regarding the management of acute poisoning among nurses. In case of insufficient knowledge, they could be trained enough to manage any case of acute poisoning for life-saving purposes.

METHODOLOGY

This was a cross-sectional analytical study conducted among 212 nurses at Rajendra Institute of Medical Sciences, Ranchi, Jharkhand from July 2021 to December 2021. Data were collected using the structured questionnaire based on a previous study and regression analysis was used for determining the association between their overall knowledge score and independent variables like age, education, experience, and training status.

RESULTS

More than one-third (43.8%) of the study participants had an unsatisfactory level of knowledge, which might be because of a lack of proper training and experience, but still, 42.4% and 13.6% of the study participants had satisfactory and good knowledge, respectively. Moreover, more than one-third (45.2%) of the study participants had inefficient skills, while 48.1% and 6.6% of nurses had satisfactory and good skills, respectively, in the management of acute poisoning. The three independent variables (training, experience, and education) showed a 53.1% association with total scores in bivariate regression analysis while no significant association was seen between age and score in multivariate analysis.

CONCLUSIONS

About half of the nurses showed unsatisfactory knowledge, so they need improvement and they should be trained regarding this to reduce mortality among acute poisoning cases.

The relationship between eHealth literacy and palliative care knowledge, attitudes, and practice among nurses: a cross-sectional study

BACKGROUND

The crucial role that nurses play in offering palliative care to patients with life-threatening diseases is widely acknowledged, but the correlation between their eHealth literacy and their knowledge, attitudes, and practice in this domain has yet to be investigated. This study is conducted to investigate the status of eHealth literacy and knowledge, attitudes, and practice regarding palliative care among nurses, and to examine their relationship.

METHODS

A cross-sectional study design was conducted among 546 nurses selected from the first-class tertiary hospitals located both inside and outside of Zhejiang Province between May 12 and May 20, 2022. The online survey of eHealth literacy scale (eHEALS) and scale of knowledge, attitudes, and practice (KAP) regarding palliative care was performed using snowball sampling through the WeChat mini program "Questionnaire Star". The Spearman rank correlation and binary logistic regression model were used to analyze the independent association between eHealth literacy and KAP toward palliative care.

RESULTS

The median scores of eHEALS and KAP regarding palliative care were 32 (interquartile range[IQR] 29 to 38) and 82 (IQR 54 to 106) points. The results of correlation analysis showed that the KAP regarding palliative care was significantly correlated with eHEALS (rho = 0.189, P < 0.001). In addition, the results of binary logistic regression analysis demonstrated that the eHEALS score was independently associated with the KAP score regarding palliative care when controlling for sociodemographic factors (OR = 2.109; P < 0.001).

CONCLUSION

Nurses who worked in first-class tertiary hospitals have good levels of eHealth literacy, while the overall level of KAP regarding palliative care is moderate. Our findings highlight that the eHEALS score is independently associated with the KAP score regarding palliative care. Therefore, nursing managers should adopt multiple measures to comprehensively improve eHealth literacy among nurses, further enrich their knowledge of palliative care, promote a positive transformation of attitudes towards palliative care, and efficiently implement palliative care practice, in order to promote high-quality development of palliative care.

Relationship between Death Coping and Death Cognition and Meaning in Life among Nurses: A Cross-Sectional Study

To explore nurses' ability to cope with death and its relationship with death cognition and meaning in life in the context of Chinese traditional culture. 1146 nurses from six tertiary hospitals were recruited. Participants completed the Coping with Death Scale, the Meaning in Life Questionnaire, and the self-made Death Cognition Questionnaire. Multiple regression analysis revealed that the search for meaning, the understanding of "good death", receiving education related to life-and-death, cultural aspect, the presence of meaning, and the number of patient deaths experienced in career explained 20.3% of the variance in the ability to cope with death. Lacking a correct understanding of death, nurses are not sufficiently prepared to deal with death and their ability to cope with death is influenced by the unique cognition of death and the sense of the meaning in life in the context of Chinese traditional culture.

Self-reported practices, competence and difficulties towards palliative care among nurses: A cross-sectional study

OBJECTIVE

Nurses' palliative care practice ability is the key to evaluating the quality of palliative care. This study aimed to identify the current situation of palliative care practices, competence and difficulties among nurses and determine whether difficulties play a mediating role between practices and competence.

METHODS

A cross-sectional study was conducted. The online survey comprised demographics, the Palliative Care Self-Reported Practices Scale, the Palliative Care Nursing Self-competence Scale and the Palliative Care Difficulties Scale. Data were analysed by using descriptive statistics, univariate analysis, linear regression and mediation analysis.

RESULTS

A total of 284 questionnaires were included for statistical analysis. The mean scores for practices, competence and difficulties were 67.81 (SD = 13.60), 124.28 (41.21) and 44.32 (12.68), respectively. There was a correlation between practices, competence and difficulties (p < 0.01). Competence and difficulties were independent predictors of practices (R² _adj  = 0.384, p < 0.001). Furthermore, difficulties mediated the relationship between practices and competence (b = 0.052, 95% confidence interval: 0.008-0.155).

CONCLUSIONS

Continuous efforts should be made to enhance nurses' practices, competence and problem-solving abilities in palliative care. This study suggested further targeted education programmes, especially in special symptom management, interagency and multidisciplinary communication.

Impact of End-of-Life Nursing Education Consortium on Palliative Care Knowledge and Attitudes Towards Care of Dying of Nurses in India: A Quasi-Experimental Pre-post Study

Palliative care (PC) training is conspicuously absent in Indian nursing curricula which is an obstacle to deliver quality end of life care (EOLC). End of life care nursing education consortium (ELNEC) aims to improve nursing staff knowledge and attitudes in PC and EOLC, however its impact on knowledge and attitudes has not been investigated in India. We aimed to assess the impact of ELNEC on the knowledge and attitudes of nurses in India towards PC and care of the dying. This prospective study included 108 registered nurses. A pre- and post-training questionnaire containing Palliative Care Quiz of Nursing (PCQN) and Frommelt Attitude toward Care of the Dying Scale Form B (FATCOD-B) was used to evaluate the PC knowledge and attitudes towards EOLC respectively. Subgroup analysis to delineate association of baseline knowledge and attitudes with gender, educational qualification or professional experience of working with patients with cancer or chronic life limiting illnesses were done. Pre-test FATCOD-B and PCQN scores of 110.81 ± 9.37 and 8.45 ± 1.88 reflect favorable attitudes towards care of dying not backed by sufficient PC knowledge respectively. The mean PCQN and FATCOD-B scores improved from 8.45 ± 1.88 to 10.16 ± 1.89 (P = .0001) and from 110.81 ± 9.37 to 119.47 ± 10.14 (P = .0001) respectively; implying a statistically significant improvement in PC knowledge and a more positive attitudes towards care of the dying. End of life care nursing education consortium is effective in improving practicing nurses' knowledge and attitudes toward PC and care of the dying.

Analysis of factors influencing the attitudes towards the elderly of nursing students based on empathy and end-of-life care: A cross-sectional study

Aim

This study aimed to explore the factors associated with attitudes towards the older adults among nursing students, to clarify the impact of empathy and end‐of‐life care on the attitude of the older adults, and to provide a basis for the follow‐up of education courses related to older adults care and the training of older adults care talents.

Design

A cross‐sectional study.

Methods

A cross‐sectional survey on nursing students' knowledge and attitudes towards older adults was conducted from 24 December 2020–24 February 2021. The Chinese versions of the end‐of‐life Attitudes Scale, Jefferson Empathy Scale‐Nursing Version and Kogan Attitudes Scale for the Elderly were used for this cross‐sectional study. We used the purposive sampling method to conduct a questionnaire survey on nursing students at Heilongjiang Nursing College (n = 371, effective response rate: 64.52%).

Results

The average score of FATCOD‐B was 99.04 (7.71), and the score of C‐JSE‐HPS was 100.67 (12.90). The total average score of nursing students' attitudes towards older adults was 139.91 (15.79). The hierarchical regression analysis showed that education (β = −.125, p = .025) and personal experience (β = −.132, p = .008) correlated negatively with attitudes towards the older adults, while the end‐of‐life care (β = .140, p = .013) and empathy (β = .285, p < .001) correlated positively with attitudes towards the older adults.

Conclusions

Religion, end‐of‐life care and empathy were positively correlated with nursing students' attitudes towards older adults. It is necessary to set up end‐of‐life care, empathy and education related to the older adults, and combine a variety of training forms, increasing humanistic assessments and reducing the employment pressure on nursing students by relevant departments can improve their attitudes towards the older adults.

Factors Influencing Public Awareness of and Attitudes Toward Palliative Care: A Cross-Sectional Analysis of the 2018 HINTS Data

Background

The global burden of serious health-related suffering requiring palliative care has been projected to grow significantly by 2060, which indicates the imminent need for integrating palliative care into health systems globally. Moreover, research evidence has been accumulating in support of the earlier adoption of palliative care into the treatment course of serious life-threatening illnesses. However, barriers to earlier access to palliative care still remain, which might be attributable to the global lack of awareness of palliative care and the prevalence of negative perceptions and attitudes. To address this, further investigation of the influencing factors of public perceptions of palliative care is imperative to help inform and develop effective targeted public health campaigns and education messages aimed at improving views of palliative care and thereby early access.

Methods

We used data from the Health Information National Trends Survey (HINTS), a nationally representative cross-sectional survey routinely administrated by the National Cancer Institute from the United States. Specifically, we analyzed the latest palliative care data from HINTS 5 Cycle 2 data set. Sociodemographic characteristics, individual factors such as self-perceived health status, and interpersonal factors such as relationship quality were examined as predictors of public awareness of and attitudes toward palliative care. Survey data were analyzed using SPSS 26 with multiple hierarchical regression tests.

Results

Results showed that people's quality of interpersonal relationships was a significant influencing factor of their awareness of and attitudes toward palliative care. Moreover, cancer diagnosis history and perceived healthcare quality were found to jointly affect their awareness of palliative care; perceived health status and patient centeredness interacted to influence their awareness of and attitudes toward palliative care. Finally, female, non-white, and poorer people were more aware of palliative care, while female and more educated people had more favorable attitudes.

Conclusions

The quality of social relationships emerges as a significant predictor of people's awareness of and attitude toward palliative care, as treatment options and decisions of serious life-threatening illnesses often involve the patients' family. The results hold strong implications for public health campaigns and education messages aiming at changing people's views of palliative care, which ultimately improve end-of-life outcomes.

Knowledge of Critical Care Nurses about End-of-Life Care towards Terminal Illnesses: Levels and Correlating Factors

Introduction

The preparedness of nurses in relation to providing palliative care is not always adequate, indeed, it is sometimes unsatisfactory; this may be caused by lack of knowledge and limited experience in end-of-life care (EOLC). Thus, this study purposed to assess the levels of registered nurses' knowledge about EOLC, examine the relationships between EOLC knowledge and some demographic variables, and explore predictors of EOLC knowledge.

Methods

A cross-sectional design survey was conducted with Jordanian registered nurses in critical care units (N = 175) in different heath sectors in Jordan. The End-of Life Professional Caregiver Survey (EPCS) was used.

Results

Findings showed that nurses had moderate/quite a lot of knowledge (M (SD) = 2.58 (.48)) about EOLC. The cultural and ethical values was the highest subscale of knowledge about EOLC (M (SD) = 2.74 (.52)), while effective care delivery subscale was the lowest one ((M (SD) = 2.33 (.66). Knowledge about EOLC was correlated with age (r = .145, P < .05), work experience (r = .173, P < .05), and training course in palliative or EOLC (r = .217, P < .01). The main predictor of EPCS was training courses in palliative or EOLC (B = .190, P < .05).

Conclusion

The nurses need to enhance their knowledge about EOLC and correlating factors should be taken into consideration when developing any intervention program. Nurses need palliative care training courses; also more attention is required in palliative care education particularly in clinical skills in effective care delivery.

Spanish Nurses' Knowledge about Palliative Care. A National Online Survey

(1) Background: Nurses can find people with advanced diseases or in their last days of life during their professional careers and in many different care settings. For this reason, they need to have at least a basic level of palliative care education since they are the professional cohort treating these patients in a very close way. This research aims to determine the level of knowledge in palliative care of Spanish nurses and establish any possible difference based on their experience and training in palliative care. (2) Methods: A cross-sectional design using survey methods (distributed an online questionnaire) aimed at Spanish registered nurses. A validated questionnaire (PCQN-SV) was used to determine the level of knowledge in palliative care; information on some variables to characterize the population was also collected (experience and education in palliative care, years of professional experience, academic level, and others). Uni and bivariate descriptive analyses were performed. A binary logistic regression model was also developed to identify those variables that influenced obtaining results higher than the population’s average. (3) Results: Spanish nurses have a medium–low level of knowledge in palliative care, higher in those who have previous experience or education in this area. Statistically significant differences were also found according to the area in which their caring activity was developed. (4) Conclusions: It is necessary to implement strategies for the basic training of nursing professionals in palliative care to offer quality care to people in advanced stages of illnesses or at the end of their lives.

Comprehensive Hospitals Nurses' Cognition on Palliative Care in Shandong Province, China: A Cross-Sectional Study

Background:

Palliative care is an essential part of medical practice, however, it has developed slowly in China. We aimed to analyze the current situations of the cognition on palliative care among the nurses in Shandong Province, China.

Methods:

This was a cross sectional study. Investigation of 1050 nurses came from 5 third-class hospitals and 5 second-class hospitals in Shandong Province, China from Jul to Oct in 2018. The questionnaire included 4 parts: general information of the subject, the questionnaire of palliative nursing knowledge, attitude, and the behavior. Data were collected by the APP. Overall, after eliminating the invalid questionnaires, 1026 questionnaires were included in the final analyses. The software Stata 14.2 was used for all statistical analyses.

Results:

The score of knowledge and attitude was low, the practice was higher. Multivariate analysis results: the significant independent variables of univariate analysis were included in the multivariate non-conditional logistic regression model for analysis. Some departments had statistical significance in knowledge multivariate Logistic regression analysis. The multivariate logistic regression analysis of practice was significant for physical health and religious beliefs. The statistical variables of the total score of cognition were gender, age of care, health status and religious beliefs.

Conclusion:

Nursing knowledge is lacking and attitude remains to be improved as soon as possible. It is vital to improve the cognition of palliative care of nurses in Shandong general hospitals by developing relevant rules and regulations, strengthening the supervision of relevant ant departments, and enhancing training for nurses.