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

End-of-Life Care Competency in Long-term Care Facilities for Care Providers in Thailand: A Delphi Study

The global shift toward an aging population, evident in Thailand, highlights the critical need for end-of-life care (EOLC) competencies among care providers in long-term care facilities (LTCFs). As the number of older people requiring complex and compassionate care at the end of life continues to rise, the competencies required for care providers in Thai LTCFs remain underexplored. This study aimed to identify the key competencies required to deliver effective EOLC in Thai LTCFs. A Delphi method was used, engaging a panel of 12 experts, including nurses, academics, and LTCF managers. The study achieved consensus on 7 core competencies, encompassing 32 subcompetencies essential for high-quality EOLC. These competencies include knowledge of EOLC, caregiving skills, communication, leadership, innovation, ethical decision-making, and professional development. This study provides a culturally relevant framework for EOLC competencies in Thai LTCFs, emphasizing the importance of integrating technical and interpersonal skills to enhance the quality of care for older people in their final stages of life. These findings can inform educational programs and policy development, ensuring that care providers are adequately prepared to meet the complex needs of this vulnerable population.

Shared decision-making competency and its associated factors among palliative care nurses: a cross-sectional study in China

BACKGROUND

The role of nurses in shared decision-making (SDM) within the healthcare decision-making process has increasingly gained attention The ability of nurses to engage in effective SDM can significantly impact patient outcomes and satisfaction with care. Given the palliative care continues to evolve, this study aimed to investigate the level of SDM competency and explore associated factors among palliative care nurses in China.

METHODS

A cross-sectional study was conducted between June and July 2024. The convenience sample was recruited from five online Chinese palliative care nurse groups. Anonymous data were collected through a self-designed sociodemographic questionnaire, the Shared Decision-Making Competency Scale (SDMCS) and the Empathy Ability Scale (EAS). Multivariate linear regression was performed to explore the factors associated with SDM competency.

RESULTS

A total of 429 palliative care nurses from 30 provinces or municipalities across China participated in this study. The Chinese palliative care nurses had a high level of SDM competency (mean total SDMCS 211.72 ± 25.75) and high empathic ability (EA), (mean total EAS 132.63 ± 20.30). There was a positive correlation between EA and SDM competency (r = 0.704, P < 0.01). The EA (β = 0.683, P<0.001), experiences of SDM training (β=-0.155, P<0.001) and educational background (β=-0.142, P = 0.007) were statistically significant factors influencing nurses' SDM competency based on multiple linear regression analysis. These associated factors could explain 55.4% of the difference in SDM competency.

CONCLUSIONS

This study found that palliative care nurses in China exhibited high levels of SDM competency and a high level of EA. Nurses with postgraduate education, SDM training experience, and high EA demonstrated higher levels of SDM competency compared to those without these attributes. The findings underscore the importance of incorporating structured SDM training programs in nursing education and professional development initiatives, particularly focused on building empathy skills.

Reliability and Validity of the Chinese Version of the Nurses' Cancer Pain Management Competency Scale

BACKGROUND

The Nurses' Cancer Pain Management Competency Scale (NCPMCS) is a tool to explore nurses' competencies and subjective experiences in cancer pain management, and to help nurses understand their current shortcomings in cancer pain management. The scale, currently available only in English and translated into Chinese for wider adoption abroad, provides a tool for Chinese nurses to assess their level of cancer pain management. Furthermore, based on the scale's specific score, they can evaluate their lack of understanding about cancer pain management, advance research into this area, and enhance their capacity to control cancer pain while providing patient care.

OBJECTIVE

The purpose of this study was to translate and localize the new scale, and to measure its reliability and validity. The study was also to provide a way to quickly and accurately measure the competency of cancer pain management among nursing staff in China.

METHODS

The Bristling translation approach was used to translate, translate back, and culturally modify the English version of the cancer pain management competency scale for nurses to create the Chinese version. A convenience sample was used for the study, 220 clinical nurses from three Grade III hospitals in Zhengzhou, Henan Province, China, were chosen by convenience sampling. The Chinese version of the scale was used for this investigation.

RESULTS

The Cancer Pain Management Competency Scale for Nurses has 14 items over 4 dimensions in its Chinese form. From the exploratory factor analysis, four common components were recovered; the cumulative variance rate was 81.994%, the scale's Cronbach's α coefficient was 0.902, and the Cronbach's α coefficient for each dimension ranged from 0.800 to 0.938. Retest reliability was 0.915, scale content validity was 0.865, and Spearman-Brown's broken half reliability was 0.808.

CONCLUSION

Nurses' cancer pain management competency in clinics can be assessed using the Chinese version of the Nurses' Cancer Pain Management Competency Scale, which has strong validity and reliability.

Nursing informatics competency and its associated factors among palliative care nurses: an online survey in mainland China

BACKGROUND

Nursing informatics (NI) competency is a required core competency for high-quality care in digitally enabled healthcare environments. Given the increasing reliance on digital health in palliative care settings, it becomes crucial to evaluate the NI competency of nurses to ensure the seamless integration and effective utilization of digital health in their clinical practice. This study aimed to investigate the level of NI competency and explore its associated factors among palliative care nurses in mainland China.

METHODS

A cross-sectional design was conducted for this study, involving a total of 409 palliative care nurses from 302 hospitals in mainland China. Anonymous data were collected through a self-designed sociodemographic questionnaire, the Nursing Informatics Competency Scale (NICS) and the Innovative Self-Efficacy Scale.

RESULTS

The total score of the NICS was 129.19 ± 22.02, which indicated that Chinese palliative care nurses had a moderate level of NI competency. There was a positive correlation between innovative self-efficacy and NI competency (r = 0.602, P < 0.01). The hospital level and innovative self-efficacy were identified as statistically significant factors influencing nurses' NI competency based on multiple linear regression analysis results. These associated factors could explain 35.1% of the difference in NI competency.

CONCLUSIONS

This study found that palliative care nurses in mainland China exhibited moderate levels of NI competency and identified the hospital level and innovative self-efficacy as associated factors of nurses' NI competency. Measures such as developing supported strategies, including targeted NI training programs by nursing education managers of primary-level hospitals and creating a positive culture of innovation by healthcare institutions can be considered to improve the level of NI competency among Chinese palliative care nurses.

Understanding nursing personnel's health while working in end-of-life care-A hermeneutical study

AIM

This study aimed to explore nursing personnel's health while working in end-of-life care.

INTRODUCTION

End-of-life care is challenging both for nursing personnel and for the healthcare organisation, as retaining nursing staff is difficult. Although end-of-life care involves the risk of burnout, it also encompasses protective factors that can lead to personal and professional development and satisfaction, and that can enable personnel to encounter their own inner selves. In order to focus on the health of nursing personnel we chose the theory of caritative caring as our theoretical perspective.

METHOD

A qualitative inductive research design with a hermeneutical approach was chosen to explore nursing personnel's health while working in end-of-life care. Two assistant nurses and six registered nurses with experience in end-of-life care at a palliative care unit participated. The study was approved by a Regional Ethical Review Board.

RESULTS

The results are presented on three levels: rational, structural and existential. In the rational level, fellowship and togetherness with colleagues, as well as being able to distinguish between private life and work were important for nursing personnel's strategies for maintaining their health. At the structural level, social togetherness, sharing emotions and being involved in each other's emotions were important for nursing personnel's health. The existential level showed that the nursing personnel's own existential situation was affected when their inner self was emotionally affected by the patients' suffering. The awareness of suffering, life and death made the nursing personnel feel inner security, both as nursing professionals and as human beings.

CONCLUSION

A common perspective based on a theory of caritative care may be helpful for retaining nursing personnel. While the study highlights nursing personnel's health while working in an end-of-life care context, the results may also be applicable to nursing professionals' health in other contexts.

Evaluating ICU nurses' education, practice, and competence in palliative and end-of-life care in Saudi Arabia: A cross-sectional study

Background

In palliative and end-of-life (PEOL) care, especially within intensive care units (ICUs), nurses' unique skills are critical, yet their expertise remains under-explored, particularly in Saudi Arabia.

Objective

This study aimed to evaluate the education, practice, and perceived competence of adult ICU nurses in Saudi Arabia regarding PEOL care and to pinpoint key factors that influence this aspect of healthcare delivery.

Methods

A cross-sectional design was utilized in this study. Participants were recruited from five public hospitals and one specialized center in Hail, Saudi Arabia. Data were gathered in September 2023 using the PEOL Care Index, which measures various care dimensions on a Likert scale in Arabic and English. IBM SPSS Statistics 29.0 was used for statistical analysis, particularly to conduct ANOVA, t-test, and multiple regression.

Results

142 out of the targeted 171 ICU nurses completed the survey, yielding a response rate of 83.04%. Although 81% of the nurses had experience caring for dying patients, only 30.3% had received in-service PEOL care training. Those with this training demonstrated significantly higher scores in education, clinical practice, and perceived competence than their counterparts (p <0.05). Mean scores across these areas were 69.67, 71.01, and 71.61, respectively. In-service training positively correlated with these metrics (p <0.05). Multiple regressions also revealed that in-service training, job satisfaction, and communication authority are strong influencers, explaining 21.6% of the variation in clinical practice and 16.9% in perceived competence.

Conclusion

The study highlighted the proficiency of ICU nurses in PEOL care, emphasizing that in-service training, job satisfaction, and the authority to communicate effectively with patients and their families significantly improved clinical practice and nurses' competence in PEOL care. This underlines the critical need for healthcare institutions to acknowledge and address these key factors to optimize patient care outcomes.

Cognition and attitudes of hospice care among healthcare providers: a case study of Sichuan Province

BACKGROUND

Under the background of the increasing aging population and cancer burden in China, the role of hospice care has become increasingly prominent. The government has paid more attention to the development of hospice care and set up pilot hospitals to promote hospice care. Moreover, healthcare providers play a leading role in hospice care services. To improve the quality of hospice care, the National Health Commission of the People's Republic of China proposed to set up hospice care training bases in municipal or above-level hospitals with hospice care or relevant work foundations, and train healthcare providers on hospice care. This study aimed to investigate the current situation of cognition and attitudes about hospice care among healthcare providers and provide a theoretical basis for hospital training.

METHODS

We used a quantitative design. A questionnaire survey was conducted among 1591 healthcare providers from August 2022 to November 2022. SPSS 22.0 software was used to analyze the data.

RESULTS

As a significant way of continuing education for healthcare providers, hospital training hasn't been effectively exploited in hospice care education. The average score of hospice care knowledge among participants was (7.74 ± 2.242) and the average score of hospice care attitudes among participants was (4.55 ± 1.503). According to multivariate linear regression analysis, sex (p < 0.001), education levels (p < 0.001), and professional titles (p = 0.018) of participants had significant difference on the score of hospice care knowledge; education levels (p = 0.009) and professional titles (p = 0.016) of participants had significant difference on the score of hospice care attitudes.

CONCLUSIONS

There were some misunderstandings about hospice care among healthcare providers and their attitudes towards hospice care were inactive. It's suggested that hospitals should carry out professional and systematic education courses to help healthcare providers understand hospice care correctly, and participate in hospice care services actively.

Nurses' Perception and Performance of End-of-Life Care in a Tertiary Hospital

Purpose

This study aimed to identify levels of perception and performance of end-of-life care among nurses and to investigate correlations between perception and performance.

Methods

This cross-sectional descriptive survey included 321 nurses from a tertiary hospital in Seoul, Korea. The participants had at least 6 months of work experience and had been involved in end-of-life care at least once, in either ward or intensive care unit settings. A structured questionnaire was utilized to assess their perception and performance of end-of-life care.

Results

The mean score for perception of end-of-life care was 3.23±0.34, while the score for performance of end-of-life care was 3.08±0.34. There was a significant positive correlation between nurses' perception of end-of-life care and their performance in this area (r=0.78, P<0.001).

Conclusion

It is necessary to change perceptions regarding end-of-life care and to develop systematic and standardized education programs including content such as assessing the hydration status of dying patients, evaluating mental aspects such as suicidal ideation, and providing spiritual care for nurses working in end-of-life departments.

Implementation and evaluation of an end-of-life care education program for oncology nurses working in medical-surgical wards: A quasi-experimental study

Background

The issue of a good death for cancer patients is becoming more prevalent. Hence, nurses' end-of-life work performance and stress levels in medical-surgical wards can significantly impact the quality of life of cancer patients and their caregivers. This study aimed to develop an end-of-life care education program for nurses taking care of cancer patients in medical-surgical ward and verify the program's preliminary effect.

Method

Quasi-experimental research using a one-group pretest-posttest design was carried out for this study. The end-of-life care manual for nurses in general wards were developed through expert validation. Initial in-person and follow-on online self-education sessions were conducted based on the end-of-life care manual. A total of 70 nurses participated in the end-of-life care education program. End-of-life care stress and end-of-life care performance were measured as preliminary program effects. An online survey was conducted before the initial in-person education and after the follow-up online education.

Results

The end-of-life care education program effectively improved general ward nurses' end-of-life care performance. This performance was improved in the physical and psychological domains. However, this program did not improve the nurses' performance in end-of-life care in the spiritual domain. Furthermore, it did not effectively reduce the stress on end-of-life care, indicating that improvements should be made.

Conclusions

The improvement of effective end-of-life care education programs for nurses caring for cancer patients in general wards is required. Most importantly, efforts at the hospital organization level are necessary to reduce the stress of end-of-life care by improving the working environment. Additionally, it is necessary to conduct preemptive tailored intervention programs for nurses, such as a resilience improvement program.

Psychometric Evaluation of the Nurses' Cancer Pain Management Competency Scale

BACKGROUND

There is lack of instruments for assessing nurses' comprehensive pain management competency.

AIM

This study aimed to assess the psychometric properties of the Nurses' Cancer Pain Management Competency Scale and to conduct a cursory survey of the pain management educational needs/resources of nurses caring for patients with cancer pain.

METHOD

A convenience sample of 230 Korean nurses who met the eligibility criteria completed the researcher developed the Nurses' Cancer Pain Management Competency Scale and a pain management educational needs/resources survey. The Nurses' Cancer Pain Management Competency Scale was based on the pain management core competencies identified by Fishman et al (2013). Internal consistency was assessed using Cronbach's alpha, and construct validity was examined using exploratory factor analysis with varimax rotation.

RESULTS

Cronbach's alpha of the scale was 0.89. Nurse cancer pain management competency includes four factors, which accounted for 68.44% of the variance: the context of pain management, pain assessment and measurement, management of pain, and multidimensional nature of pain. Approximately 42% of nurses had no available protocols related to cancer pain management. Nurses preferred multi-component educational modalities, including simulation-based learning.

CONCLUSIONS

Findings support internal consistency reliability and content and construct validity of the Nurses' Cancer Pain Management Competency Scale that can help examine pain management competency of nurses. Adopting an evidence-based clinical cancer pain management-related protocol and multi-component training programs are needed to achieve optimal cancer pain management competency in nurses.