Factors affecting nurses' attitude toward withdrawal of life-sustaining treatment for children

PURPOSE

The purpose of study was to investigate factors affecting nurses' attitudes toward withdrawal of life-sustaining treatment in children.

DESIGN AND METHODS

This descriptive survey study included 167 nurses working at children's hospitals or children's wards. Data were collected through a structured self-administered survey in November 2022. Data were analyzed using descriptive analysis, t-test, ANOVA, the Dunnett's T3 test, Pearson's correlation coefficient, and multiple linear regression.

RESULTS

Attitude toward withdrawal of life-sustaining treatment in children showed a significant positive correlation with knowledge of life-sustaining treatment decision-making (r = 0.38, p < .001) and meaning as a subcategory of moral sensitivity (r = 0.21, p 0.008). The factors affecting attitude toward withdrawal of life-sustaining treatment in children were knowledge of life-sustaining treatment decision-making (β =0.31, p < .001) and meaning (β = 0.18, p = .015). This model showed a 21.0% explanation of attitude toward withdrawal of life-sustaining treatment in children.

CONCLUSIONS

Developing an effective educational program designed to improve nurses' knowledge and attitude toward life-sustaining treatment decision-making is necessary.

PRACTICE IMPLICATIONS

It may have a positive influence on attitudes toward withdrawal of life-sustaining treatment in children by improving child nurses' knowledge about life-sustaining treatment decision-making and moral sensitivity.

Mediating Effects of Role Perception of Life-sustaining Treatment in the Relationship between Knowledge of Life-sustaining Treatment Plans and Attitudes toward Withdrawal of Life-sustaining Treatment among Nursing College Students

Purpose

This study examined the relationship between Knowledge of Life-sustaining Treatment Plans and Attitudes toward Withdrawal of Life-sustaining Treatment among nursing college students, and attempted to identify the mediating effect of Role Perception on Life-sustaining Treatment in that relationship. It is hoped that the findings will ultimately contribute to the development of active nursing strategies.

Methods

The participants were 142 nursing college students in the third and fourth years of study who had experienced clinical practice at two universities in cities Y and C. Data were collected from November 1 to 30, 2019. For data analysis, SPSS for Windows version 22.0 was used to calculate descriptive statistics, the t-test, Pearson's correlation coefficients, and multiple regression. To analyze the mediating effect, the Baron and Kenny bootstrapping method was used.

Results

Attitudes toward Withdrawal of Life-sustaining Treatment of nursing college students had a significant positive correlation with Knowledge of Life-sustaining Treatment Plans (r=0.34, P<0.001) and Role Perception on Life-sustaining Treatment (r=0.44, P<0.001). Role Perception on Life-sustaining Treatment partially mediated the relationship between Knowledge of Life-sustaining Treatment Plans and Attitudes toward Withdrawal of Life-sustaining Treatment (95% CI, 0.446~1.055).

Conclusion

Based on the results of this study, improving nursing college students' Role Perception on Life-sustaining Treatment could be used as a coping strategy to establish positive Attitudes toward Withdrawal of Life-sustaining Treatment.

Development of an Instrument to Measure Stress in Korean Nurses Performing End-of-Life Care for Children

PURPOSE

This study aims to develop a scale to assess the stress of nurses caring for terminally ill children and to test the validity and reliability of the scale.

BACKGROUND

Nurses caring for children experience various stressors that are different from those experienced by nurses caring for adult patients. It is important to understand the level of stress of nurses caring for dying children and their families. Instruments to measure these stress levels, however, are not available.

DESIGN

This study used a methodological approach.

METHOD

The initial items were identified through literature reviews and in-depth interviews. Content validation of the items was evaluated by seven experts. Participants were 357 pediatric nurses working at 11 institutions in six cities. Data were analyzed using item analysis, exploratory and confirmatory factor analysis, internal consistency, and test-retest. This study followed the STROBE checklist.

FINDINGS

The final scale consisted of 22 items chosen and classified into 5 factors (psychological difficulties, conflict with parents, difficulties in communication, lack of end-of-life care knowledge, and restricted working environment), which explained 61.13% of the total variance. The 5-subscale model was validated by confirmatory factor analysis. Cronbach's alpha for the total item was 0.90, and the intra-class correlation coefficient was 0.89.

CONCLUSION

This scale can be used to contribute toward the assessment of stress among nurses performing end-of-life care for children.

PRACTICE IMPLICATIONS

This scale will contribute to the improvement of the quality of life of not only nurses, but also children and their families in pediatric settings.