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Li X, Wang XS, Huang H, Liu M, Wu Y, Qiu J, Zhang B, Cui L, Hui D. National survey on the availability of oncology palliative care services at tertiary general and cancer hospitals in China. BMC Palliat Care 2023; 22:144. [PMID: 37770965 PMCID: PMC10536755 DOI: 10.1186/s12904-023-01259-5] [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: 05/03/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND This nationwide survey studied the level of palliative care (PC) access for Chinese patients with cancer among cancer care providers either in tertiary general hospitals or cancer hospitals in China. METHODS Using a probability-proportionate-to-size method, we identified local tertiary general hospitals with oncology departments to match cancer hospitals at the same geographic area. A PC program leader or a designee at each hospital reported available PC services, including staffing, inpatient and outpatient services, education, and research, with most questions adapted from a previous national survey on PC. The primary outcome was availability of a PC service. RESULTS Most responders reported that some type of PC service (possibly called "comprehensive cancer care," "pain and symptom management," or "supportive care") was available at their institution (84.3% of tertiary general hospitals, 82.8% of cancer hospitals). However, cancer hospitals were significantly more likely than tertiary general hospitals to have a PC department or specialist (34.1% vs. 15.5%, p < 0.001). The most popular services were pain consultation (> 92%), symptom management (> 77%), comprehensive care plans (~ 60%), obtaining advanced directives and do-not-resuscitate orders (~ 45%), referrals to hospice (> 32%), and psychiatric assessment (> 25%). Cancer hospitals were also more likely than tertiary general hospitals to report having inpatient beds for PC (46.3% vs. 30.5%; p = 0.010), outpatient PC clinics (28.0% vs. 16.8%; p = 0.029), educational programs (18.2% vs. 9.0%, p = 0.014), and research programs (17.2% vs. 9.3%, p < 0.001). CONCLUSIONS Cancer hospitals are more likely to offer PC than are tertiary general hospitals in China. Our findings highlight opportunities to further increase the PC capacity in Chinese hospitals.
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Affiliation(s)
- Xiaomei Li
- Department of Geriatric Medicine, The Second Medical Center, Chinese PLA General Hospital, Haidian District, 28Th, Fuxing Road, Beijing, 100853, People's Republic of China.
| | - Xin Shelley Wang
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Haili Huang
- Department of Medical Oncology, The Second Medical Center, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Miao Liu
- Graduate School, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Yinan Wu
- Publicity Department, Beijing Hospital, Beijing, People's Republic of China
| | - Jiaojiao Qiu
- Department of Geriatric Medicine, The Second Medical Center, Chinese PLA General Hospital, Haidian District, 28Th, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Boran Zhang
- Department of Geriatric Medicine, The Second Medical Center, Chinese PLA General Hospital, Haidian District, 28Th, Fuxing Road, Beijing, 100853, People's Republic of China
| | - Linhong Cui
- Department of Geriatric Medicine, The Second Medical Center, Chinese PLA General Hospital, Haidian District, 28Th, Fuxing Road, Beijing, 100853, People's Republic of China
| | - David Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Li L, Wang F, Liang Q, Lin L, Shui X. Nurses knowledge of palliative care: systematic review and meta-analysis. BMJ Support Palliat Care 2023:spcare-2022-004104. [PMID: 37369574 DOI: 10.1136/spcare-2022-004104] [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: 11/27/2022] [Accepted: 05/23/2023] [Indexed: 06/29/2023]
Abstract
Lack of knowledge about palliative care is one of the most common reasons for hindering the delivery of high-quality palliative care. Nurses play a major role in providing palliative care, and the degree of their mastery of this knowledge is crucial to whether they can effectively deliver the ideal palliative care. Therefore, it is necessary to understand the level of palliative care knowledge in this population. As of 8 November 8, 2022, we performed systematic searches in 10 databases. Meta-analysis of quantitative data that measuring the level of palliative care knowledge of nurses using the Palliative Care Quiz for Nursing (PCQN) was conducted using Stata software (version: V.15). A pooled mean score <10 indicated a low/insufficient knowledge level. The funnel plot and Egger's regression test were used to detect publication bias, and finally, the robustness of the results was evaluated through sensitivity analysis. The pooled mean score for the level of nurses' knowledge of palliative care was 9.68 (95% CI: 9.40 to 9.96). Among the three dimensions of the PCQN scale, the pooled mean score for the '"Philosophy and Principles of Palliative Care'" section was 1.73 (95% CI: 1.38 to 2.08); the '"Pain and Other Symptom Control'" section was 6.73 (95% CI: 6.41 to 7.05); and the '"Psychological, Spiritual and Social Care'" section was 1.21 (95% CI: 0.72 to 1.69). It can be seen that nurses' mastery of palliative care knowledge is not sufficient. It is recommended that relevant departments formulate and promote the implementation of targeted measures to improve the knowledge level of this population.
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Affiliation(s)
- Ling Li
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, China
| | - Fang Wang
- Director's Office, Guang'an Hospital of Traditional Chinese Medicine, Guang'an, Sichuan, China
| | - Qian Liang
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, China
| | - Lunwei Lin
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, China
| | - Xiaoling Shui
- School of Nursing, Chengdu University of TCM, Chengdu, Sichuan, China
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Yuan N, Lv ZH, Wen YY, Sun CR, Tao TY, Qian D. The relationship between eHealth literacy and palliative care knowledge, attitudes, and practice among nurses: a cross-sectional study. BMC Nurs 2023; 22:76. [PMID: 36945007 PMCID: PMC10028766 DOI: 10.1186/s12912-023-01237-5] [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: 09/19/2022] [Accepted: 03/07/2023] [Indexed: 03/23/2023] Open
Abstract
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.
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Affiliation(s)
- Niu Yuan
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
| | - Zhang-Hong Lv
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Yuan-Yuan Wen
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Surgical Oncology, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Chun-Rong Sun
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Ear Nose Throat, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Ting-Yu Tao
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - Dan Qian
- Department of Nursing, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
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Cao Z, Wang Y, Zhang H. "It's a Tall Order but I'll Try": a qualitative study on Chinese nurses' cognition and experience responding to cancer patients' requests to hasten death. Support Care Cancer 2022; 30:7509-7515. [PMID: 35665858 DOI: 10.1007/s00520-022-07192-2] [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: 11/17/2021] [Accepted: 05/30/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study is to understand the cognition and experience of oncology nurses in China when responding to a patient's request to hasten death, to describe the obstacles that prevent their response, and to provide suggestions for dealing with the patient's request. METHODS Researchers conducted a qualitative study that consisted of open-ended, semi-structured interviews with 18 registered nurses who had more than 5 years of working experience in the oncology department at a large-scale urban hospital. We analyzed these data for content and themes. RESULTS How to deal with patients' requests to hasten death is a problem often encountered and handled by nurses in the Department of Oncology. Nurses have a certain understanding of the patients' requests to hasten death. This study abstracts four themes: (1) the nurses' cognition of the "Accelerate the process of death"; (2) the methods they use to deal with the patients' requests to hasten death; (3) the obstacles that prevent nurses from fulfilling the patients' requests to hasten death; and (4) their suggestions for improvement. CONCLUSION Nurses have a deep understanding of the real thoughts of patients who make a death request, and they hope to provide the corresponding psychological support and physical care. However, the lack of relevant knowledge, policy support, and cooperation of patients' families are obstacles that prevent them from taking action. Therefore, increasing relevant training for nurses, encouraging multi-department cooperation, and developing standardized nursing processes may lay a foundation for oncology nurses to better undertake and guide such conversations.
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Affiliation(s)
- Zhaoming Cao
- Department of Nursing, Nursing College of Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning, China
| | - Yingchun Wang
- Department of Oncology Department, Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Huijun Zhang
- Department of Nursing, Nursing College of Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning, China.
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Martínez-Sabater A, Chover-Sierra P, Chover-Sierra E. Spanish Nurses' Knowledge about Palliative Care. A National Online Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111227. [PMID: 34769747 PMCID: PMC8583050 DOI: 10.3390/ijerph182111227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/17/2021] [Accepted: 10/22/2021] [Indexed: 11/16/2022]
Abstract
(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.
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Affiliation(s)
- Antonio Martínez-Sabater
- Nursing Department, University of Valencia, 46010 Valencia, Spain; (A.M.-S.); (P.C.-S.)
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Faculty of Nursing and Podiatrics, University of Valencia, 46010 Valencia, Spain
- Grupo Investigación en Cuidados (INCLIVA), Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
- Hospital Clinico Universitario de Valencia, 46010 Valencia, Spain
| | - Pilar Chover-Sierra
- Nursing Department, University of Valencia, 46010 Valencia, Spain; (A.M.-S.); (P.C.-S.)
| | - Elena Chover-Sierra
- Nursing Department, University of Valencia, 46010 Valencia, Spain; (A.M.-S.); (P.C.-S.)
- Nursing Care and Education Research Group (GRIECE), GIUV2019-456, Faculty of Nursing and Podiatrics, University of Valencia, 46010 Valencia, Spain
- Internal Medicine Department, Consorcio Hospital General Universitario de Valencia, 46014 Valencia, Spain
- Correspondence:
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