An Evaluation of Aged-Care Workers’ Knowledge of and Attitudes Toward the Palliative Approach

Abstract

This study, a cross-sectional survey, evaluated the knowledge of the palliative approach to care of an entire care workforce in an Australian residential aged-care organization (n = 116, 30% response rate). Knowledge deficits were found at all staff levels: RNs lacked a full comprehension of pain and symptom management, and personal care attendants' knowledge scores were not statistically different from those of ancillary staff. RN division 1 reported a more positive attitude toward caring for dying patients than other staff groups. Increasing experience in the field was found to be the main determinant of knowledge of, and attitudes toward, the palliative approach, while increasing hours of palliative care education and higher post-school educational level conferred some benefit. Study findings provide strong impetus for education in the palliative approach to care for the entire interdisciplinary team. With targeted education and support, older residents' needs for a palliative approach to care can be identified by all members of the care team, and appropriate response and/or referral can be achieved.

‘Close to’ a palliative approach: nurses' and care aides' descriptions of caring for people with advancing chronic life‐limiting conditions

“…The participants were not nurses who specialised in palliative care per se , but rather worked in nonspecialty settings where people with progressing chronic conditions are cared for and die – settings where a palliative approach is particularly salient. Similar to findings of recent studies in Australia (Ford & McInerney , Tait et al . ) and the U.S. (Autor et al .…”

“…The participants were not nurses who specialised in palliative care per se, but rather worked in nonspecialty settings where people with progressing chronic conditions are cared for and diesettings where a palliative approach is particularly salient. Similar to findings of recent studies in Australia (Ford & McInerney 2011, Tait et al 2015 and the U.S. (Autor et al 2013), nurses lacked knowledge about (1) when a palliative approach was applicable, especially in the face of a mix of active treatment (i.e. curative) and supportive care, (2) facilitating challenging conversations about goals of care and (3) the scope of their role in the context of an interprofessional team.…”

Attitudes of Nonpalliative Care Nurses towards Palliative Care

“…In this study, the attitudes of nurses towards death and dying were similar to those obtained in another Australian based study [14] that used the FATCOD scale and achieved a mean score of 119.8 ± 11.1. However, when compared to other published literature, the total FATCOD score in our study was higher than Turkish [13], Spanish [15], and Japanese [12] nurses, where the mean scores were 99.9 ± 8.7, 116.8 ± 11.4, and 107.2 ± 12.1, respectively.…”

“…In another study however with 367 Japanese nurses working in convalescent homes, younger nurses demonstrated more positive attitudes compared to the older nurses [12]. In contrast, an Australian study that investigates 116 nurses working within a residential aged care organization found no association between age and attitudes towards death and dying [14]. Cultural differences in beliefs and values also play a role in the health care professionals' attitudes towards death and dying, thus impacting the provision of palliative care [18][19][20].…”

“…A review of the research literature suggests that the attitudes of nurses towards death and dying have a direct impact on the quality of palliative care delivered to terminally ill patients and their family members [10,11]. Several studies examining predictors of attitudes have indicated that the attitudes of nurses towards death and dying are highly influenced by factors including their age [12], education level [13,14], years of nursing experience [14], job classification [14], education in end of life care [10,12,14,15], and time spent caring for terminally ill patients [15,16]. The evidence however is not conclusive; for example, there is controversy in the literature concerning the impact of the age of nurses on attitudes towards death and dying.…”