Nurses’ knowledge, attitude, and competence regarding palliative and end-of-life care: a path analysis

Abstract

Background Nurses’ knowledge regarding palliative and end-of-life (EOL) care has been documented, but the competence of nurses in Taiwan has not been deeply analyzed and may affect the use of EOL care. Purpose We aimed to (1) assess the palliative care knowledge, competence and attitude of nurses in a general hospital and (2) examine the paths connecting nurses’ demographic characteristics, previous experiences, knowledge, competence, and attitude. Method A correlational, cross-sectional survey design was implemented to recruit 682 eligible nurses. The questionnaires included demographic information and palliative and EOL care knowledge, attitude, and competence scales. Path analysis was employed for statistical analysis using structural equation modeling. Results Overall, 76% of the questions assessing palliative and hospice knowledge were answered correctly. Nurses’ palliative attitudes were divided into “positive perception” and “negative perception”. “Positive perception” was highly correlated with competence (r = 0.48, p < 0.001), but “negative perception” was not significantly correlated with competence (r = −0.07, p = 0.25). “Positive perception” (β = −0.01, p = 0.84) and competence (β = 0.02, p = 0.80) were not related to palliative knowledge. “Negative perception”, however, was negatively associated with palliative knowledge (β = −0.20, p < 0.01). Conclusions This study suggests continuing education to decrease nurses’ “negative perception” attitude regarding the provision of information to patients and families to provide better palliative and EOL care. Implications for Practice Nurses’ attitudes and competences with respect to palliative care and EOL care are critical. Areas for further research and advanced palliative and EOL care-related education and training are suggested and may be applied in future clinical interventions.

Nurses’ Attitude Toward the Pediatric End of Life Care at Hiwa Cancer Hospital in Sulaimany-Iraq

“…regarding nurses workplace, more than one quarter of the nurses were working in different units of the pediatric ward, like the inpatient unit, outpatient unit, and isolation unit, ,and the rest of the nurses were working in different units in Hiwa Cancer Hospital, such as the oncology unit , hematology unit , male and female outpatient units,... etc. The findings consistence with the results of study done in Taiwan by (Lin et al, 2021). They found that around one quarter of the nurses work in pediatric wards, and the majority of nurses care for patients at the end of life stage.…”

Attitude toward care of the dying and practice of peaceful end‐of‐life care in community hospitals in China

“…The NP-PECI was developed by the researchers in line with the Theory of Peaceful End of Life to assess nurses' peaceful end-of-life care (Li et al, 2021). There are 30 items categorized into five domains of the Theory of Peaceful End-of-Life.…”

“…As revealed by a survey conducted among 553 nurses in Malaysia, one of the significant influencing factors in the level of palliative care was their attitude toward caring for dying persons, and more excellent practice was provided by those nurses with higher‐level attitude toward caring for the dying (Hussin et al., 2018). Another study from Taiwan revealed that good attitude was closely correlated with competence ( r = 0.48, p < 0.001) (Lin et al., 2021). Therefore, it is considered worthwhile to study attitude toward care for dying and its relationship to peaceful end‐of‐life care among nurses.…”

Knowledge and Practice Behaviors Toward the Care of the Dying Among Chinese Oncology Nurses

“…10 Although some end-of-life nursing education training programs have been developed by different nursing associations or institutions in China in recent years, these continued training programs are still not popularized, and varied implementation of training programs may result in inconsistencies in training outcomes. 4,11 Previous studies [12][13][14] have focused on oncology nurses' knowledge and practices regarding palliative care or endof-life care, but there is a paucity of research aimed at exploring their knowledge and practices specific to the professional care during the last days and hours of life. Freeman 15 proposed that nurses were not intentionally distant or unfeeling when it came to caring for the dying and that they simply did not know what to do.…”

“…Moreover, researchers from other countries have found mixed and inconsistent associations between nurses' background characteristics and their knowledge and practices. 13,14,16,17 Therefore, this study aimed to investigate knowledge and practice behaviors in relation to the care of dying patients among Chinese nurses working in oncology settings and analyze demographic and employment-related factors that influence their knowledge and practices in caring for dying patients.…”