Influence of Good Death Perception, Moral Anguish, and End-of-life Care Attitude on End-of-life Care Performance of General Hospital Health Managers

This study attempted to identify the influence of good death perception, moral anguish, and End-of-life (EOL) care attitudes on the End-of-life (EOL) care performance of General Hospital Health Managers (GHHMs). This study was a quantitative and descriptive survey. The respondents of this study were 156 GHHMs working in three general hospitals with 300 beds or more and one general hospital with 100 beds or more in one of the cities in South Korea. The survey data were obtained from September 20 to October 20, 2021, and a total of 156 responses were analyzed by multiple linear regression using IBM SPSS/WIN 24.0 program. Results of the study revealed that it can be said that the higher the good death perception and the higher the moral anguish, the better the EOL care performance. The total explanatory power was 23.4%, and good death perception and moral distress explained EOL care performance by 23.4%. Furthermore, the general hospital managers' good health perception, moral anguish improved the performance and work satisfaction among nurses. It was necessary to implement a systematic EOL care education program to facilitate quality EOL care. Communication problems and lack of time are obstacles to EOL care performance, so hospital managers and the head of the nursing department provide communication-related education to EOL care GHHMs and allocate appropriate manpower so that GHHMs can actively and efficiently perform EOL care. It can be said that the higher the good death perception, the higher the moral anguish, and the higher the degree of EOL care performance. This study was meaningful in revealing good death perception, and moral agony in clinical practice have a significant effect on EOL care performance.

Moderating Effect of Nurse's Character on the Relationship between Attitudes toward Nursing Care of the Dying and Performance of Terminal Care in South Korea

This study aimed to investigate the moderating effect of nurses’ characteristics on the relationship between attitudes toward nursing care and terminal care performance of hospice nurses. The participants included nurses working in hospice care units in general hospitals in South Korea. Data collected from August 1 to 31, 2020 were analyzed using t-test, ANOVA, Pearson′s correlation coefficients, and hierarchical multiple regression. The performance of terminal care was positively correlated with attitudes toward nursing care of the dying (r = 0.45, p < 0.001) and nurses’ characteristics (r = 0.60, p < 0.001). There was also a positive correlation (r = 0.58, p < 0.001) between attitudes toward nursing care for dying patients and nurses′ characteristics. Nurses’ characteristics had a significant moderating effect on the relationship between attitudes toward nursing care of the dying and performance of terminal care. This means that the nurses’ character had a buffering effect on the relationship between attitudes toward nursing care of the dying and performance of terminal care in hospice care units. These findings suggest that continuous and repetitive educational programs on terminal care need to be enhanced, and strategies to strengthen attitudes toward nursing care of the dying and nurses’ character need to be included in these programs.