Neonatal Palliative Care Attitude Scale: Development of an Instrument to Measure the Barriers to and Facilitators of Palliative Care in Neonatal Nursing

Abstract

The subscales identified by this analysis identified items that measured both barriers to and facilitators of palliative care practice in neonatal nursing. While establishing preliminary reliability of the instrument by using exploratory factor-analysis techniques, further testing of this instrument with different samples of neonatal nurses is necessary using a confirmatory factor-analysis approach.

Perception, Knowledge and Barriers to End of Life Palliative Care among Neonatal and Pediatric Intensive Care Physicians

“…To obtain a comparable response from neonatologists and pediatric intensivists, in this study we have defined palliative care as appropriate and approved by World Health Organisation. Also to our best knowledge only a few studies including the current study have described both barriers and facilitators [12,13].…”

Moral distress and the Australian aged care worker: A mixed methods study

“…These decisions may facilitate or directly contribute to situations of moral distress (Austin et al, 2003b;Godfrey & Smith, 2002;Green & Jeffers, 2006;Tiedje, 2000). Typically, this is discussed in the context of a lack of resources (Kain, Gardner, & Yates, 2009;Nordam, Torjuul, & Sørlie, 2005). For example, in the discussion on humanitarian nursing challenges, Almonte (2009) describes the relative inability to provide any tangible level of health care to indigenous populations due to a lack of health care resources as a contributing factor to moral distress.…”

“…Typically, the highest intensity of moral distress is related to low staffing levels within the ward (Ohnishi et al, 2010). Others concur with this relationship between moral distress and staffing levels (Kain et al, 2009;Oberle & Hughes, 2001;Silen et al, 2008). Secondly, staffing patterns that limit access to patient care or implementing managed care policies have been identified as a compounding variable (Grace, Fry, & Schultz, 2003).…”

“…They "…may believe that the care they are providing is actually harming the patient, and yet they have no way to influence the care decision about continuing her life" (p.161). The provision of overly aggressive or futile treatment is a concept that emerges strongly as one causing moral distress (Brazil et al, 2010;Epstein, 2010;Ferrell, 2006;Kain et al, 2009;Oberle & Hughes, 2001). …”

“…For example, at a more macro level, economic factors (Silen et al, 2008) including issues of efficiency, cost containment and resource allocation (Tiedje, 2000); all compounding staffing levels (Corley et al, 2005;Kain et al, 2009;Oberle & Hughes, 2001;Silen et al, 2008) and access to care, (Brazil et al, 2010) and all in turn contribute to moral distress.…”