Cancer Unit Nurses’ End-of-Life Care-Related Stress, Under standing and Training Needs

Abstract

This study was performed to identify the level of stress perceived by nurses who attend dying patients in the cancer care unit; their understanding regarding end-of-life care and related training needs. Methods: A cross-sectional descriptive study was conducted with 151 nurses stationed at the cancer care units of four general hospitals located in Seoul and Gyeonggi province in Korea. Data were collected using self-reported questionnaires and the response rate was 96%. The data were analyzed using t-test, ANOVA and Pearson's correlation analysis. SPSS 12.0 was used for data analysis. Results: Nurses experienced a high level of stress in the end-of-life care settings. Their understanding of end-of-life care was above the mid-point of the scale while their training needs for end-of-life care was relatively high. The more experienced the nurses were, the more stressed they were, particularly due to excessive workload. Nurses who served longer in the cancer unit tended to show greater needs for end-of-life care training. Conclusion: This study found nurses perform end-of-life care with a high level of stress but with insufficient understanding, and thus, showed great needs for related training. Such findings can be useful to develop an end-of-life care training program for nurses.

Understanding Nurses’ Experiences and Perceptions of End-of-Life Care for Cancer Patients in Korea: A Scoping Review

“…The reliability of each questionnaire is reported in Table 2. The most frequently applied tool was Lee's Bereavement Care Stress Scale (BCSS), 41 which was used in 5 studies, 21,28,30,32,24 followed by Park and Choi's Terminal Care Performance Scale 35 in 3 studies 21,32,26 and Lazarus and Folkman's Cope with Stress Scale in 3 studies. 21,30,34 Thorson and Powell's Anxiety Scale was used in 2 studies, 28,30 and the 19 other measures were each used in only a single study.…”

“…In 2 studies, 19,22 researcherdeveloped questionnaires were used to measure nurses' EOL 257 Jung and Matthews care participation and prior training 19 and nurses' EOL care performance competency and training needs. 22 Cognitive Variables (Knowledge/Attitude/Perception) Of a total of 11 studies measuring nurses' cognitive variables associated with providing EOL care for cancer patients, 23,27,29,28,30,24,34,22,25,31,33 nurses' knowledge of EOL care was examined in 1 study. 23 In that study, the mean score on the Palliative Care Quiz for Nursing (PCQN) among nurses (N ¼ 368) working in oncology, general, and intensive care units was 8.96/20.…”

“…The mean PCQN score of the oncology nurses was 10.63, which was significantly higher than the mean scores of nurses working in other units (p < .001). In 2 other studies, nurses' self-efficacy for EOL care (N ¼ 156) 30 and oncology nurses' understanding of EOL care (N ¼ 151) 24 were examined; the mean self-efficacy score was 2.67/4, and the mean understanding of EOL care score was 2.64/4. In addition, attitudes toward death of nurses who experienced EOL care were examined in 4 studies.…”

“…Emotional variables of nurses associated with providing EOL care for cancer patients were examined in 8 studies. 20,36,29,21,28,30,32,24 The emotional variables measured were participants' suffering level during EOL care 20 using Jo's Nurses' Suffering Experience Scale, bereavement care stress 21,28,30,32,24 using the BCSS, cancer care stress 36 using the Stress Measurement Tool, depression level 30 using the Korean Beck's Depression Index, and emotional burnout 29 through indepth interviews. In 5 studies using the BCSS, 21,28,30,32,24 mean total bereavement care stress scores were high, ranging from 3.75 to 3.96 of 5, and the stress factors generating the highest scores were conflicts involving limitations of medical services 21,30 and overwork.…”

“…20,36,29,21,28,30,32,24 The emotional variables measured were participants' suffering level during EOL care 20 using Jo's Nurses' Suffering Experience Scale, bereavement care stress 21,28,30,32,24 using the BCSS, cancer care stress 36 using the Stress Measurement Tool, depression level 30 using the Korean Beck's Depression Index, and emotional burnout 29 through indepth interviews. In 5 studies using the BCSS, 21,28,30,32,24 mean total bereavement care stress scores were high, ranging from 3.75 to 3.96 of 5, and the stress factors generating the highest scores were conflicts involving limitations of medical services 21,30 and overwork. 24,28 In addition, scores for total bereavement care stress differed significantly depending on career duration (p < .001-¼.005), 21,32 having education about oncology nursing (p ¼ .002), 21 department (p ¼ .032), 31 and institution type (p ¼ .001).…”