Knowledge and attitudes toward end-of-life care among community health care providers and its influencing factors in China

Abstract

A majority of nurses struggled with a negative emotion of anger, doubt, fear, or anxious, uncomfortable in the face of death and dying. However, little was known about community health care providers’ in China. Therefore, we conducted a study to investigate their knowledge and attitudes toward end-of-life care and analyze its influencing factors. To provide reference for developing effective strategies to promote end-of-life care in China.A total of 132 community health care providers of 10 community health care centers in Changzhi city were investigated by a Questionnaire of Knowledge and Attitudes toward Caring for the Dying from May, 2017 to December, 2017, and data was analyzed by SPSS 22.0 software.Of the 132 community health care providers who were under investigation, 70 knew about hospice care, but they rated their overall content on end-of-life care as inadequacy, especially in communication skills and knowledge of pain management. The average score of attitudes was 3.47 (SD = 0.44), the lowest score was in the subscale of nurse−patient communication, which was 2.91 (SD = 0.65). Health care providers who had worked for more than 11 years, who had experiences of the death of relatives or friends, and who had previous experiences of caring for terminal patients had more positive attitudes toward caring for the dying (P < .05 for all). There was a significant relationship between community health care providers’ attitudes toward death and their attitudes toward end-of-life care (r = −0.282, P < .01). The significant predictors of attitudes toward end-of-life care were attitudes toward death (β = −0.342), experiences of the death of relatives (β=−0.207), experiences of caring for the dying (β = 0.185), and working experience (β = 0.171).Community health care providers had positive attitudes toward end-of-life care, but they lacked systematic and professional knowledge and skills of caring for the terminal patients. Education is the top priority. It is imperative to set up palliative care courses and life-death education courses, establish an indigenous end-of-life care model, and improve policies, systems, and laws to promote end-of-life care.

Hospice care self-efficacy among clinical medical staff working in the coronavirus disease 2019 (COVID-19) isolation wards of designated hospitals: a cross–sectional study

“…Medical staff from level 3 hospitals may have more access to continuous hospice education and may have better knowledge of and attitudes towards hospice care than those from lower level hospitals; this might be beneficial for their hospice care self-efficacy [ 48 , 49 ]. However, studies showed Chinese health care providers in general lacked systematic and professional knowledge and skills for caring for terminal patients [ 50 – 52 ]. A survey investigated 141 trainees in the 2016 National Hospice and Palliative Medicine Training Program and found that only 21.3% had attended any hospice and palliative care course prior [ 53 ].…”

Knowledge and attitudes about end-of-life decisions, good death and principles of medical ethics among doctors in tertiary care hospitals in Sri Lanka: a cross-sectional study

“…The relatively high knowledge score of the principles of a good death among the study participants is likely to be an overestimate due to a positive marking bias as reflected by over 50% marking the two incorrect responses as correct. As expected, doctors who had been caregivers for a relative with a terminal illness were better informed of the concept of a 'good death' [23]. In Sri Lanka, physician aid-in-dying is illegal.…”

SWOT Analysis on the Construction of Hospice Care Demonstration Center Under the Hierarchical Medical System in Southwest China

“…Our survey found that tertiary level hospitals accounted for 75% of the institutions providing hospice care services in the region in 2019. The development of hospice care in China was unbalanced with small coverage [15]. Additionally, the development of hospice care services had some problems, such as single form of service, lack of standard service content and unclear operation mode.…”

“…Third, hospice care was a special medical service, requiring high knowledge and skills of staff. However, currently, most practitioners in medical institutions in this region have not received formal professional education and training in hospice care services, and the professional knowledge and skills related to hospice care were insufficient [15][16][17]. None of the 182 hospice care practitioners surveyed had received any professional qualification training or assessment.…”