Neonatal Nurses' Perceptions of Palliative Care in the Neonatal Intensive Care Unit

Chin, Susan Di Nonno; Paraszczuk, Ann Marie; Eckardt, Patricia; Bressler, Toby

doi:10.1097/nmc.0000000000000738

Cited by 17 publications

(31 citation statements)

References 33 publications

(60 reference statements)

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“…In addition, an English version, the Iranian version and the Czech version of NiPCAS created other subscales. In Chin et al ( 24 ), subscales of Unite Culture, Resources, and Perceived Inappropriate Care were found after performing EFA. In Forouzi et al ( 26 ), subscales of Insufficient Resources, Inappropriate Personal and Social Attitudes, Inappropriate Organizational Culture, and Inadequate Nursing Proficiency were formed after measuring content validity.…”

Section: Discussionmentioning

confidence: 99%

“…Kain ( 21 ) developed the Neonatal Palliative Care Attitude Scale (NiPCAS) to measure nurses' attitudes toward NPC. Psychometric validation of the NiPCAS has also been proven satisfactory in further studies in countries and regions including Australia ( 21 ), United States ( 22 – 24 ), Italy ( 25 ), Southeast Iran ( 26 ), Czech Republic ( 27 ), Turkey ( 28 , 29 ), Portugal ( 30 ), and Taiwan ( 31 ). In order to explore the attitudes of NICU clinicians in mainland China, Gu and colleagues translated the traditional Chinese version of the NiPCAS into Simplified Chinese ( 32 ).…”

Section: Introductionmentioning

confidence: 90%

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Development of the Simplified Chinese version of neonatal palliative care attitude scale

et al. 2022

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BackgroundThe provision of palliative care for neonates who are not expected to survive has been slow in mainland China, and this model of care remains in its early stages. Evaluating nurses' attitudes toward neonatal palliative care (NPC) has the potential to provide valuable insight into barriers impeding NPC implementation. This study aimed to translate and adapt the traditional Chinese version of the Neonatal Palliative Care Attitude Scale (NiPCAS) into Simplified Chinese to assess its psychometric properties.MethodsThe NiPCAS is a valid and reliable instrument to measure nurses' attitudes for evidence-based practice. To date, the scale has not been used largely in mainland China. With translation and cultural adaptation, the traditional Chinese version of the NiPCAS was developed into a Simplified Chinese version. Its reliability was tested using internal consistency and test-retest reliability, and its validity was measured using the content validity index and exploratory factor analysis.ResultsA total of 595 neonatal nurses from mainland China were recruited. Twenty-six items in the scale were translated into Simplified Chinese. The scale demonstrated excellent reliability with a Cronbach's α coefficient of 0.87 and a test-retest reliability of 0.88. To support the Simplified Chinese version of NiPCAS, the scale content validity score was 0.98, and the exploratory factor analysis revealed five factors representing the conceptual dimensions of the scale.ConclusionThis study demonstrated the psychometric properties of the Simplified Chinese version of NiPCAS, validated its use as a viable tool for measuring neonatal nurses' attitudes toward NPC, and identified facilitators and barriers to NPC adoption. Our findings suggested supported clinical application in the context of mainland China. A confirmatory factor-analysis approach with a different sample of neonatal nurses is required for further testing of the instrument in the future.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 90%

Development of the Simplified Chinese version of neonatal palliative care attitude scale

et al. 2022

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“…Additional barriers noted by nurses in the Australian study were: (1) technological imperatives; and (2) lack of ideal physical environment. Among studies on neonatal palliative care completed in the United States (30)(31)(32), participants identified facilitators not mentioned in our study: (1)…”

Section: Comparisonmentioning

confidence: 99%

“…Extant research outside of mainland China has identified the barriers and facilitators that nurses identify in providing neonatal palliative care. Kain in Australia (5), Wright (30), Kyc (31), and Chin (32) in the United States, Cerratti in Italy (33), Chen in Taiwan (34), and Forouzi in Southeast Iran (35) investigated NICU nurses' attitude to neonatal palliative care using the Neonatal Palliative Care Attitude Scale. In addition, Gu explored conditions in mainland China as well (36).…”

Section: Introductionmentioning

confidence: 99%

Facilitators and Barriers Affecting Implementation of Neonatal Palliative Care by Nurses in Mainland China

et al. 2022

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Neonatal nurses in mainland China encounter various challenges when it comes to delivering palliative care to neonates. The aim of this study was to determine the barriers and facilitators of neonatal nurses' attitudes to palliative care for neonates in mainland China. A simplified Chinese version of the Neonatal Palliative Care Attitude Scale was piloted, administered, and analyzed using survey methods. Nurses in neonatal intensive care units in mainland China regardless of experience in the field were invited to take part in. Over a five-month period in 2019, we surveyed neonatal nurses from 40 hospitals in five provinces of China. The response rate was 92.5% (N = 550). This study identified eight facilitators and four barriers to neonatal palliative care implementation. In terms of nurses' attitudes on providing palliative care, younger and older nurses were more positive, whereas middle-aged nurses were less so. Nurses' emotional wellbeing was rarely impacted by neonatal death. They considered neonatal palliative care, particularly pain management, to be just as important as curative treatment. Parents were invited to participate in decision-making by nurses. Nurses reported having access to professional counseling and talking about their concerns with other healthcare professionals. The following barriers to neonatal palliative care were identified in this study that were not observed in the original English version scale research in 2009: a lack of clinicians, time, clinical skills, systematic education, neonatal palliative care experience, and social acceptance. Future research is required to investigate each barrier in order to improve the implementation of neonatal palliative care in mainland China.

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“…Numerous studies highlighted the need to enhance nurses' confidence in palliative care and grief through continuing education [6,14,16]. Likewise, to relieve anxiety among healthcare providers, continuing educational training is crucial when providing neonatal palliative care, namely when communicating DNR options with families and pain management for dying neonates [12,13,17,18].…”

Section: Introductionmentioning

confidence: 99%

Neonatal palliative care: Assessing the nurses educational needs for terminally ill patients

et al. 2023

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Background For terminally sick neonates and their families, it’s crucial to provide holistic nursing care that incorporates both curative and palliative care as much as feasible. It is well known that the biggest obstacle to delivering palliative care for neonatal children is a lack of training for nurses. Aim: The aim of this research is to investigate the experiences of nurses who provide care for neonates who are terminally ill as well as their educational requirements for neonatal palliative care. Method A cross-sectional descriptive study was conducted among 200 nurses working in a tertiary center providing care for terminally ill neonates in Saudi Arabia. Data was collected from using Neonatal Palliative Care Questionnaire (QNPC) from January 2021 to March 2021. Results Two hundred nurses were surveyed (the response rate was 79%). The mean age of the 158 participants was 35.67 (standard deviation (SD): 7.43), and the majority were female (151; 95.6%). The majority were bachelor’s holders (119; 75.3%), with more than 5 years of experience in providing care for neonates (100; 63.3%). Most of the participants reported not receiving any education about palliative care (115; 72.8%). Nurses reported a moderate level of experience in all areas of neonatal palliative care. The total mean score of palliative care experiences of neonates was 3.42 (SD: 1.35). However, the majority of nurses reported little experience discussing the transition period to palliative care for neonates 2.95 (SD: 1.93), the discussion of code status (DNR) during terminal illness of neonates 3.11 (SD: 1.54) and spiritual support 2.90 (SD: 1.55). Conclusion The assessment of the fundamental skills of neonatal palliative care by nurses was insufficient. To enhance the quality of care, it is crucial to incorporate education on neonatal palliative care into programs for nursing staff development.

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Neonatal Nurses' Perceptions of Palliative Care in the Neonatal Intensive Care Unit

Cited by 17 publications

References 33 publications

Development of the Simplified Chinese version of neonatal palliative care attitude scale

Development of the Simplified Chinese version of neonatal palliative care attitude scale

Facilitators and Barriers Affecting Implementation of Neonatal Palliative Care by Nurses in Mainland China

Neonatal palliative care: Assessing the nurses educational needs for terminally ill patients

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