1
|
Yang J, Kim HJ, Heo S, An M, Park S, Ounpraseuth S, Kim J. Factors associated with attitudes toward advance directives in nurses and comparisons of the levels between emergency nurses and palliative care nurses. Jpn J Nurs Sci 2023; 20:e12508. [PMID: 36054594 DOI: 10.1111/jjns.12508] [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: 05/19/2022] [Revised: 07/19/2022] [Accepted: 08/01/2022] [Indexed: 01/05/2023]
Abstract
AIM Little is known about attitudes toward advance directives and factors associated with them among emergency and palliative care nurses who often or daily face end-of-life circumstances. Thus, we aimed to compare the levels of attitudes toward advance directives, communication skills, knowledge about end-of-life care (knowledge), and awareness of the concept of a good death (good death awareness) between emergency and palliative care nurses, and to examine factors associated with attitudes toward advance directives in the total sample. METHODS In this cross-sectional, correlational study, data were collected from 153 nurses (59 emergency and 94 palliative care nurses) at three tertiary hospitals using online or offline surveys and were analyzed using t-tests and multiple linear regression analysis. RESULTS The levels of attitudes, communication skills, knowledge, and good death awareness were moderate in both groups. Attitudes in emergency compared to palliative care nurses were less positive (46.78 vs. 48.38; p = .044), and knowledge was significantly lower (13.64 vs. 15.00; p = .004). Communication skills and good death awareness between the two groups were similar. In the total sample, emergency practice (B = -1.59, p = .024), and lower levels of good death awareness (B = 0.30, p < .001), communication skills (B = 0.18, p = .001), and education (B = -2.84, p = .015) were associated with less positive attitudes (F = 9.52, p < .001; R2 = 0.35). CONCLUSIONS The findings demonstrate the need for improvements in attitudes, knowledge, communication skills, and good death awareness in both groups, especially emergency nurses. Two modifiable targets of interventions to improve nurses' attitudes were also noted.
Collapse
Affiliation(s)
- Jisun Yang
- Gachon University, College of Nursing, Incheon, South Korea
| | - Hee Jung Kim
- Gachon University, College of Nursing, Incheon, South Korea
| | - Seongkum Heo
- Mercer University, Georgia Baptist College of Nursing 3001 Mercer University Drive, Atlanta, Georgia, USA
| | - Minjeong An
- College of Nursing, Chonnam National University, Gwangju, South Korea
| | - SeongHu Park
- College of Nursing Sciences, Sungshin Women's University, Seoul, South Korea
| | - Songthip Ounpraseuth
- University of Arkansas for Medical Sciences, College of Public Health, Little Rock, Arkansas, USA
| | - JinShil Kim
- Gachon University, College of Nursing, Incheon, South Korea
| |
Collapse
|
2
|
Hewitt J, Alsaba N, May K, Noon HS, Rennie C, Marshall AP. Emergency department and intensive care unit health professionals' knowledge and application of the law that applies to end-of-life decision-making for adults: A scoping review of the literature. Aust Crit Care 2022:S1036-7314(22)00099-6. [PMID: 36096921 DOI: 10.1016/j.aucc.2022.08.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/01/2022] [Accepted: 08/07/2022] [Indexed: 10/14/2022] Open
Abstract
BACKGROUND Laws that regulate healthcare practice at the end of life reflect the values of the society where they apply. Traditionally, healthcare professionals rely on their clinical knowledge to inform treatment decisions, but the extent to which the law also informs health professionals' decision-making at the end of life is uncertain. OBJECTIVE The objective of this study was to describe what healthcare professionals working in emergency departments and intensive care units know about the law that relates to end-of-life decision-making for hospitalised adults and what affects its application. REVIEW METHOD This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. DATA SOURCES Data were sourced by searching the following databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL [via EBSCOhost]), Nursing and Allied Health and Health and Medical Collection (via ProQuest Central), Excerpta Medica dataBASE (Embase), PubMed, PsycINFO, and HeinOnline. RESULTS Systematic screening of the search results and application of inclusion criteria resulted in the identification of 18 quantitative and three qualitative articles that were reviewed, summarised, and reported. Ten of the quantitative studies assessed knowledge and attitudes to law or end-of-life decision-making using hypothetical scenarios or vignettes. Qualitative studies focussed on how the law was applied when end-of-life decisions were made. End-of-life decision-making is mostly based on the clinical needs of the patient, with the law having a secondary role. CONCLUSION Around the world, there are significant gaps in healthcare professionals' legal knowledge. Clinical factors are considered more important to end-of-life decision-making than legal factors. End-of-life decision-making is perceived to carry legal risk, and this results in the provision of nonbeneficial end-of-life care. Further qualitative research is needed to ascertain the clinician-related factors that affect the integration of law with end-of-life decision-making.
Collapse
Affiliation(s)
- Jayne Hewitt
- Griffith University, School of Nursing and Midwifery, Gold Coast Campus, Parklands Drive, Southport, Queensland, 4222, Australia; Griffith University, Griffith Law School, Law Futures Centre, Gold Coast Campus, Parklands Drive, Southport, Queensland, 4222, Australia; Gold Coast University Hospital, 1 Hospital Blvd, Southport, Queensland, 4215, Australia.
| | - Nemat Alsaba
- Gold Coast University Hospital, 1 Hospital Blvd, Southport, Queensland, 4215, Australia; Bond University, Faculty of Health Science and Medicine, 14 University Drive, Robina, Queensland, 4226, Australia.
| | - Katya May
- Griffith University, School of Nursing and Midwifery, Gold Coast Campus, Parklands Drive, Southport, Queensland, 4222, Australia; Gold Coast University Hospital, 1 Hospital Blvd, Southport, Queensland, 4215, Australia.
| | - Halima Sadia Noon
- Griffith University, School of Nursing and Midwifery, Gold Coast Campus, Parklands Drive, Southport, Queensland, 4222, Australia; James Cook University, College of Medicine and Dentistry, 1 James Cook Drive, Douglas, Townsville, Queensland, 4810, Australia.
| | - Cooper Rennie
- Griffith University, School of Medical Science, Nathan Campus, 170 Kessels Rd, Nathan, Queensland 4111, Australia.
| | - Andrea P Marshall
- Griffith University, School of Nursing and Midwifery, Gold Coast Campus, Parklands Drive, Southport, Queensland, 4222, Australia; Gold Coast University Hospital, 1 Hospital Blvd, Southport, Queensland, 4215, Australia.
| |
Collapse
|
3
|
Chaverra Castellar MI, Osorio Castaño JH. Voluntades anticipadas como referente ético de conocimiento en los enfermeros que laboran en servicios de oncología. REVISTA LATINOAMERICANA DE BIOÉTICA 2022. [DOI: 10.18359/rlbi.5694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
El propósito del presente artículo es identificar los conocimientos sobre la Voluntad Anticipada (VA) en enfermeros que laboran en servicios de oncología. Para ello, se utilizó como metodología un estudio observacional con intención analítica que midió el nivel de conocimiento a través de un cuestionario autodiligenciado. En él participaron 50 enfermeros, seleccionados por muestreo no probabilístico. Así, se analizaron las variables cualitativas con distribuciones de frecuencia, y las cuantitativas con estadística descriptiva y análisis bivariado. El nivel de conocimiento se categorizó así: 0 a 10 puntos (nivel bajo), 11 a 20 puntos (nivel medio), 21 a 30 puntos (nivel alto). Los resultados de la investigación arrojaron como dato que, para un grupo donde el 86 % eran mujeres, con promedio de edad de 37 años, el promedio de años de experiencia como enfermeros fue de 11.5 años. Por otra parte, el promedio de años de experiencia en el área de oncología fue de 6.2 años. De los que hacían parte de este último promedio, el 48 % tenían diplomado en oncología y el 46 % especialización. El 70 % de los participantes tenía un conocimiento medio, el 26 % un conocimiento alto, y el 4 %un nivel bajo. Cabe mencionar que solo el nivel de formación de postgrado se relacionó de manera significativa con el nivel de conocimientos. Como conclusión, se encontró que los profesionales en enfermería poseen un nivel de conocimiento medio sobre la legislación que aborda las voluntades anticipadas en Colombia y esto está relacionado con el nivel de formación.
Collapse
|