Attitudes and influencing factors of nursing assistants towards hospice and palliative care nursing in chinese nursing homes: a cross-sectional study

Abstract

Background Hospice and palliative care nursing (HPCN) in China is mainly available at public primary care institutions, where nursing homes (NHs) are rarely involved. Nursing assistants (NAs) play an essential role in HPCN multidisciplinary teams, but little is known about their attitudes towards HPCN and related factors. Methods A cross-sectional study was designed to evaluate NAs’ attitudes towards HPCN with an indigenised scale in Shanghai. A total of 165 formal NAs were recruited from 3 urban and 2 suburban NHs between October 2021 and January 2022. The questionnaire was composed of four parts: demographic characteristics, attitudes (20 items with four sub-concepts), knowledge (nine items), and training needs (nine items). Descriptive statistics, independent samples t-test, one-way ANOVA, Pearson’s correlation, and multiple linear regression were performed to analyse NAs’ attitudes, influencing factors, and their correlations. Results A total of 156 questionnaires were valid. The mean score of attitudes was 72.44 ± 9.56 (range:55–99), with a mean item score of 3.6 ± 0.5 (range:1–5). The highest score rate was “perception of the benefits for the life quality promotion” (81.23%), and the lowest score rate was “perception of the threats from the worsening conditions of advanced patients” (59.92%). NAs’ attitudes towards HPCN were positively correlated with their knowledge score (r = 0.46, P < 0.01) and training needs (r = 0.33, P < 0.01). Marital status (β = 0.185), previous training experience (β = 0.201), location of NHs (β = 0.193), knowledge (β = 0.294), and training needs (β = 0.157) for HPCN constituted significant predictors of attitudes (P < 0.05), which explained 30.8% of the overall variance. Conclusion NAs’ attitudes towards HPCN were moderate, but their knowledge should be improved. Targeted training is highly recommended to improve the participation of positive and enabled NAs and to promote high-quality universal coverage of HPCN in NHs.

Nurse assistants’ perception of caring for older persons who are dying in their own home

“…The findings in this study align with other studies that show a need for improvement in delivering good palliative care [ 11 – 17 , 39 ] providing continuous training and practical guidance for NAs together with RNs could improve care quality. Such training and guidance could, for example, concern factors such as ensuring patients undergo an oral assessment, assessing pain, offering an end-of-life conversation, and how to hold post-bereavement meetings.…”

“…However, several studies from different parts of the world show that there is a need for improvement for healthcare providers to be able to deliver good palliative care. One study from China shows that NAs’ attitudes to palliative care are moderate and that they need more knowledge [ 11 ] to promote high quality palliative care. A Swedish study [ 12 ] identified healthcare providers’ need for managing existential aspects of the ageing body, life and death, and engaging in existential conversations when appropriate.…”

Suitable and quality palliative care, a look with a human approach from the nursing role

“…Por tal razón consideramos que las competencias de los enfermeros profesionales son valiosas, indispensables y de gran importancia para poder desempeñar un óptimo servicio con eficiencia y calidad. Con estos indicadores se podrían obtener resultados que nos llevarían a realizar planes de mejora frente a este tipo de población y por ende buscar estrategias de formación para este grupo de profesionales que con lleve a beneficiar a los pacientes y familiares que estén pasando por este tipo enfermedades y a su vez al personal de salud en cuánto adquirir liderazgo en este campo, obtener reconocimiento, oportunidades en el ámbito laboral y económico (Ye et al, 2023).…”