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Pan Y, Qi Q, Qiu H, Yang C, Su W, Zhang S, Li L. Factors Influencing the Willingness of Clinical Nurses to Participate in Narrative Nursing: A Cross-Sectional Study. J Adv Nurs 2024. [PMID: 39227304 DOI: 10.1111/jan.16434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 07/16/2024] [Accepted: 08/14/2024] [Indexed: 09/05/2024]
Abstract
AIMS Narrative nursing (NN) is a crucial component of modern medical humanistic care. It involves utilising storytelling as a means to guide nurses in devising future interventions for patients, and help patients in reconstructing positive psychological defences. The willingness of clinical nurses to engage in narrative nursing holds significant implications for both effective communication and the overall quality of care. However, there is limited knowledge regarding clinical nurses' willingness to engage in narrative nursing. This study aims to investigate the participation willingness of Chinese nurses, identify its predictors and explore its corresponding reasons. DESIGN A cross-sectional study. METHODS Clinical nurses were enrolled in Hunan province, Central South, China, and a convenience sampling strategy was used. A structured questionnaire was distributed to clinical nurses by an online survey platform. Information on sociodemographic characteristics, willingness and possible influencing factors (experience, ability, perceptions on narrative nursing) was collected. Binary logistic regression was conducted to identify the predictors of willingness to participate in narrative nursing. RESULTS A total of 2310 nurses were recruited, of which 2092 nurses completed the questionnaire (response rate: 90.6%). One thousand seven hundred and thirty-four nurses (82.9%) were willing to participate in NN, and 358 (17.1%) were not. Binary logistic regression analysis identified nine predictors of participants' willingness to participate, including working departments, professional title, working position, experience of received mobilisation and training of NN, understanding of related knowledge, NCS level, affirmation of NN and positive attitude towards clinical application (all p values < 0.05). These indicators explained 17.1% of the variances in the dependent variable (p < 0.001). CONCLUSION A high proportion of nurses in Hunan province were willing to practice in clinic using NN. Willingness to participate may be increased by a focus on nurses with low professional titles, no administrative position and working in specialised departments, such as emergency departments, infectious departments, critical care units and operating theatres. IMPACT The study identified a high proportion of nurses in Hunan Province who were willing to use NN. However, the figure was slightly lower than expected. Influencing factors were analysed to give insights for managers to develop more effective NN outreach programs. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Yingyan Pan
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Qiong Qi
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Hailiing Qiu
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Chao Yang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Wanying Su
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Siqi Zhang
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, China
| | - Lin Li
- Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha, 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 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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Tu W, Fan H, Liu W, Zhao X, Li M, Gao X. Status and influencing factors of knowledge, attitude and self-reported practice regarding hospice care among nurses in Hainan, China: A cross-sectional study. Nurs Open 2024; 11:e2082. [PMID: 38268300 PMCID: PMC10757569 DOI: 10.1002/nop2.2082] [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: 06/07/2023] [Revised: 12/03/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024] Open
Abstract
AIM This study is to investigate the current status of knowledge, attitude and self-reported practice in hospice care among nurses in Hainan, China, and then to analyse its influencing factors and mediating effects. This provides a basis for formulating scientific and standardized hospice care training programmes for nurses. METHODS This cross-sectional study investigated knowledge, attitude and self-reported practice in hospice care among 1819 nurses in Hainan, China. Convenience sampling was used to select participants from 45 hospitals and nursing homes in 14 cities and counties from October to December 2021. A scale of knowledge, attitude and self-reported practice of healthcare providers in hospice care (Chinese version) was administered to collect data during the study period. Statistical analyses, including t-tests, one-way ANOVA, post-hoc analysis and multiple linear regression, assessed the status of knowledge, attitude and self-reported practice of hospice care in nurses and identified influencing factors. The PROCESS macro program model 4.0 was employed to explore the mediating effect of attitude on knowledge and self-reported practice in hospice care. RESULTS Nurses in Hainan displayed low knowledge (mean = 7.68, SD = 3.53), moderate attitudes (mean = 88.13, SD = 12.10) and self-reported practice (mean = 51.81, SD = 9.82) in hospice care. Current employment and willingness to engage in hospice care were significant factors influencing knowledge, attitude and self-reported practice in hospice care. Attitude partially mediated the relationship between knowledge and self-reported practice. PATIENT OR PUBLIC CONTRIBUTION This study focuses on nurses' knowledge, attitude and self-reported practice in hospice care and does not directly involve patients or the public. However, the findings enhance hospice care provided to patients and the broader community by improving nurses' knowledge and skills. This study informs evidence-based training programmes and interventions, benefiting those in need of hospice care services.
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Affiliation(s)
- Wen Tu
- International Nursing SchoolHainan Medical UniversityHaikouHainanChina
- College of NursingUniversity of UtahSalt Lake CityUtahUSA
| | - Huiying Fan
- International Nursing SchoolHainan Medical UniversityHaikouHainanChina
| | - Wenling Liu
- International Nursing SchoolHainan Medical UniversityHaikouHainanChina
| | - Xiaoting Zhao
- International Nursing SchoolHainan Medical UniversityHaikouHainanChina
| | - Mingdong Li
- Department of Orthopedics and Traumatology, Hainan General HospitalHainan Affiliated Hospital of Hainan Medical UniversityHaikouHainanChina
| | - Xing Gao
- International Nursing SchoolHainan Medical UniversityHaikouHainanChina
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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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Hamdan KM, Al-Bashaireh AM, Al-Dalahmeh M, Saifan AR, Albqoor MA, Shaheen AM. Palliative care knowledge and attitudes toward end-of-life care among intensive care unit nurses in Jordan. Acute Crit Care 2023; 38:469-478. [PMID: 38052512 DOI: 10.4266/acc.2023.00430] [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: 02/15/2023] [Accepted: 08/03/2023] [Indexed: 12/07/2023] Open
Abstract
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.
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Affiliation(s)
| | - Ahmad M Al-Bashaireh
- Faculty of Health Science, Higher Colleges of Technologies, Fujairah, United Arab Emirates
| | | | | | | | - Abeer M Shaheen
- Community Health Nursing Department, School of Nursing, The University of Jordan, Amman, Jordan
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Li X, Kongsuwan W, Yodchai K. Attitude toward care of the dying and practice of peaceful end-of-life care in community hospitals in China. Int Nurs Rev 2023; 70:345-354. [PMID: 36580069 DOI: 10.1111/inr.12812] [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: 12/15/2021] [Accepted: 11/08/2022] [Indexed: 12/30/2022]
Abstract
AIM To evaluate nurses' attitude toward caring for dying patients, their practice of peaceful end-of-life care in community hospitals, and the association between these two variables. BACKGROUND Community hospitals play an important role in the peaceful end-of-life care. For nurses, one of the key points of offering high-level care is to improve attitude. However, there are very few studies exploring how the attitude of nurses toward caring for dying patients relates to the practice of peaceful end-of-life care in community hospitals across China. METHODS A total of 363 questionnaires were included in this study. Simple random sampling was used to recruit participants from six community hospitals in China. A new instrument, Nurses' Practice of Peaceful End-of-Life Care Instrument (NP-PECI), was developed according to the Theory of Peaceful End of Life to assess the practice of nurses. Besides, Frommelt Attitudes toward Care of the Dying (FATCOD) was adopted to assess nurses for their attitude toward caring for dying patients. RESULTS The nurses' attitude toward caring for dying patients showed a significant positive correlation with their practice of peaceful end-of-life care statistically (r = 0.175, p < 0.01). CONCLUSION For community nurses, it is necessary to improve the attitude of nurses toward the practice of caring for dying patients, thus enhancing the outcome of peaceful end-of-life care. IMPLICATIONS FOR NURSING PRACTICE The Theory of Peaceful End of Life provides a theoretical framework and guideline on the practice of clinical nursing for quality control of peaceful end-of-life care, which is significant for improving the palliative care system. In the future, it is worth developing programs based on the Theory of Peaceful End of Life. IMPLICATIONS FOR NURSING POLICY For healthcare policy makers, this study can be helpful to refine the existing palliative care support policies and strategies targeted at community hospitals and their nurses.
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Affiliation(s)
- Xia Li
- Master of Nursing Science Student in Adult and Gerontological Nursing (International Program), Faculty of Nursing, Prince of Songkla University, Hat-Yai, Songkhla, Thailand
| | - Waraporn Kongsuwan
- Associate Professor, Faculty of Nursing, Prince of Songkla University, Hat-Yai, Songkhla, Thailand
| | - Kantaporn Yodchai
- Associate Professor, Faculty of Nursing, Prince of Songkla University, Hat-Yai, Songkhla, Thailand
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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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Zhu Y, Yang B, Li X, Wu B, Guo Q, Xu L, Zhao Y. Development of the Nurses' Willingness to Engage in Palliative Care Scale. J Hosp Palliat Nurs 2022; 24:00129191-990000000-00031. [PMID: 35900930 PMCID: PMC9616599 DOI: 10.1097/njh.0000000000000898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Nurses play an important role in palliative care, and their willingness to engage in such work is thus crucial. The purpose of this study was to develop, and test the reliability and validity of, the Nurses' Willingness to Engage in Palliative Care Scale. The sample consisted of 224 Chinese nurses with a mean age of 32.36 (SD, 5.986) years. The critical ratio method was used for item analysis. Reliability was assessed by calculating Cronbach α. Content validity was assessed by calculating a content validity index based on ratings from 5 nursing experts. Structural validity was calculated by exploratory factor analysis. The developed scale consists of 20 items over 4 dimensions (attitude toward the behavior, subjective norms, perceived behavioral control, and behavioral intention) and has high content validity (0.97). The reliability of the scale was found to be sufficient (Cronbach α = .896). Four common factors were extracted from exploratory factor analysis, and the cumulative variance explained was 68.938%. The Nurses' Willingness to Engage in Palliative Care Scale has good reliability and validity and can be used to assess nurses' willingness to work in palliative care units.
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