Knowledge in palliative care of nursing professionals at a Spanish hospital

Do spirituality and emotional intelligence improve the perception of the ability to provide care at the end of life? The role of knowledge and self-efficacy

OBJECTIVES

Spirituality, emotional intelligence, and palliative care (PC) knowledge have a positive and direct influence on self-efficacy and on perception of preparation and ability to provide end-of-life (EOL) care. The aim of this work is to propose a conceptual model that relates spirituality, emotional intelligence, PC knowledge, self-efficacy, and the preparation and ability to provide EOL care by doctors and nurses.

METHODS

Quantitative, exploratory, descriptive, and inferential study applied to doctors and nurses in a hospital in the north of Portugal, between May and July 2022. The data collection instrument includes a questionnaire. The relationships between latent variables were evaluated using structural equation models by the partial least squares method using the Smart PLS 3.0 software. It was obtained the previous authorization of the ethics committee.

RESULTS

The results (n = 380) indicate that self-efficacy, spirituality, and PC knowledge have a positive influence on the ability to provide EOL care. Emotional intelligence and spirituality have a direct and positive effect on self-efficacy. There is no direct influence of emotional intelligence on the ability to provide EOL care, but emotional intelligence has an indirect effect mediated by self-efficacy.

SIGNIFICANCE OF RESULTS

Spirituality, self-efficacy, and emotional intelligence are very important for the ability of doctors and nurses to provide EOL care. The identification of predictive factors of the ability to provide EOL care and the determination of the relationship between them can improve the provision of EOL care, reduction of health costs, timely and early referral of people to PC, and increase life quality.

Palliative care knowledge and attitudes toward end-of-life care among intensive care unit nurses in Jordan

BACKGROUND

There is a growing need for palliative care globally due to the rapid aging of the population and improvement in cancer survival rates. Adequate knowledge and a positive attitude are vital for palliative care nurses. The study's purpose was to examine nurses' knowledge and attitudes toward palliative care.

METHODS

A cross-sectional design with convenience sampling was used. The study included 182 intensive care unit (ICU) nurses from Jordanian hospitals in all sectors. Self-administered questionnaires were used to assess nurses' knowledge and attitudes toward palliative care. Descriptive statistics, analysis of variance, and the Kruskal-Wallis H test were used to analyze the data.

RESULTS

We measured nurses' knowledge using the Palliative Care Quiz for Nursing, and we measured nurses' attitudes using the Frommelt Attitude Toward Care of the Dying scale. The mean total knowledge and attitude scores were 8.88 (standard deviation [SD], 2.52) and 103.14 (SD, 12.31), respectively. The lowest level of knowledge was in psychosocial and spiritual care (mean, 0.51±0.70). The percentage of nurses with unfavorable attitudes was 53.3%. Significant differences in knowledge and attitude levels were observed according to educational level, experience, and hospital type.

CONCLUSIONS

ICU nurses have insufficient knowledge and inappropriate attitudes toward palliative care. Knowledge of psychological and spiritual aspects of palliative care was particularly lacking as were appropriate attitudes towards communication with dying patients. Improving knowledge and attitudes toward palliative care in nursing schools and hospitals would help overcome this problem.

Perception of Nurses' Knowledge about Palliative Care in West Bank/ Palestine: Levels and Influencing Factors

Objective: Healthcare professionals particularly nurses should be professionally prepared with knowledge about the standards of palliative care and their roles in providing palliative care. Nurses' knowledge about palliative care and influencing factors has not been examined adequately in Arab countries including Palestine. Thus, this study aimed to assess the adequacy of knowledge level and influencing factors (socio-demographic) about palliative care among nurses in West Bank/ Palestine. Methods: A descriptive-correlational design was utilized. A cluster random sampling method was applied to select 12 hospitals from the three regions in West Bank. Then, four hospitals were selected from each region using a simple random method. All registered nurses working in critical care units and medical and surgical wards in the selected hospitals were recruited. The sample consists of 424 registered nurses and data were collected using Palliative Care Quiz for Nursing (PCQN). Results: The Findings revealed that nurses' level of knowledge about palliative care was low/inadequate (M = 7.75, SD = 2.96). Knowledge about palliative care was influenced by age (B = -.106; p < 0.05), gender (B = -.223; p < 0.001), and hospital ward (B = -.597; p < 0.001), in which younger nurses, females, and those who work in critical care units reported higher levels of knowledge about palliative care. Conclusions: Findings of this study emphasized the need for developing educational and training courses, seminars, and workshops on palliative care to increase nurses' knowledge in order to enhance the quality of patient care. Also, policymakers should develop national strategic plans and policies regarding palliative care and apply these plans in all hospitals in West Bank/ Palestine.

Nurses knowledge of palliative care: systematic review and meta-analysis

Lack of knowledge about palliative care is one of the most common reasons for hindering the delivery of high-quality palliative care. Nurses play a major role in providing palliative care, and the degree of their mastery of this knowledge is crucial to whether they can effectively deliver the ideal palliative care. Therefore, it is necessary to understand the level of palliative care knowledge in this population. As of 8 November 8, 2022, we performed systematic searches in 10 databases. Meta-analysis of quantitative data that measuring the level of palliative care knowledge of nurses using the Palliative Care Quiz for Nursing (PCQN) was conducted using Stata software (version: V.15). A pooled mean score <10 indicated a low/insufficient knowledge level. The funnel plot and Egger's regression test were used to detect publication bias, and finally, the robustness of the results was evaluated through sensitivity analysis. The pooled mean score for the level of nurses' knowledge of palliative care was 9.68 (95% CI: 9.40 to 9.96). Among the three dimensions of the PCQN scale, the pooled mean score for the '"Philosophy and Principles of Palliative Care'" section was 1.73 (95% CI: 1.38 to 2.08); the '"Pain and Other Symptom Control'" section was 6.73 (95% CI: 6.41 to 7.05); and the '"Psychological, Spiritual and Social Care'" section was 1.21 (95% CI: 0.72 to 1.69). It can be seen that nurses' mastery of palliative care knowledge is not sufficient. It is recommended that relevant departments formulate and promote the implementation of targeted measures to improve the knowledge level of this population.

Knowledge and associated factors towards palliative care among nurses in Ethiopia: A systematic review and meta-analysis

Palliative care is a holistic care that emphasises on relieving pain and other symptoms of a critical illness, irrespective of age, diagnosis, or stage of illness. It improves the quality of life of the individual. Since nurses spend the longest time with patients, they are the heart of the palliative care team who deliver high standards of care. This study was intended to assess the pooled prevalence of knowledge and associated factors towards palliative care among nurses in Ethiopia. During this study, a comprehensive search was performed by using different databases. A funnel plot and Egger’s test were used to evaluate a publication bias. I² statistic was used to check the heterogeneity between the studies. The subgroup analysis was also conducted for this study. A total of 11 studies with 3330 study participants were included in this systematic review and meta-analysis. The systematic review and meta-analysis showed that the pooled prevalence of knowledge towards palliative care among nurses in Ethiopia was 42.31% (95% confidence interval = [32.41, 52.21]). Educational status (adjusted odds ratio = 2.69, 95% confidence interval = [1.11, 4.25]), experience of caring for a dying patient (adjusted odds ratio = 3.15, 95% confidence interval = [1.17, 5.13]), and training on palliative care (adjusted odds ratio = 2.53, 95% confidence interval = [1.42, 3.64]) were factors significantly associated with the knowledge of nurses towards palliative care. This study indicated that the pooled prevalence of knowledge towards palliative care among nurses in Ethiopia was low. Educational status, experience of caring for a dying patient, and training on palliative care were factors significantly associated with the knowledge of nurses towards palliative care. Thus, training on palliative care and education is suggested for nurses to improve their knowledge towards palliative care.

Systematic review registration: PROSPERO CRD42021247590

[Assessment of basic training needs in palliative care in primary healthcare nurses in Spain]

AIM

Asses training, perception of readiness and training needs in palliative care (PC) theoretical and practical of primary care nurses in Spain, through descriptive cross-sectional study.

DESIGN

Descriptive cross-sectional study.

SETTING

Primary care nurses in Spain with online access.

PARTICIPANTS

Primary care nurses in Spain, January and February 2021. 344 responses, 339 met the inclusion criteria.

MAIN NEASUREMENTS

Sociodemographic variables, PC training, training needs were analyzed. Through Google Forms online questionnaire and INCUE Instrument. Descriptive analyses were performed and the results were compared using the exact symmetry test and the Mann-Whitney test.

RESULTS

82,6% women, with an average age of 45.5years. 86.1% of the nurses had training in PC, been basic in the 45.4%. Only 40.5% feel quite or very prepared to take care for palliative patients. Nurses demanded more training in psycho-emotional and grief and coping with losses. 83.76% passed the theoretical block compared to 43.36% of the practical, detecting higher training needs in the last (P<.001). The passed rates varied depending on the educational level.

CONCLUSIONS

Nursing training in PC in primary care continues to be deficient, especially in practical application. Targeted training is necessary to have an impact on the care of people with palliative needs and their families.

Spanish Nurses' Knowledge about Palliative Care. A National Online Survey

(1) Background: Nurses can find people with advanced diseases or in their last days of life during their professional careers and in many different care settings. For this reason, they need to have at least a basic level of palliative care education since they are the professional cohort treating these patients in a very close way. This research aims to determine the level of knowledge in palliative care of Spanish nurses and establish any possible difference based on their experience and training in palliative care. (2) Methods: A cross-sectional design using survey methods (distributed an online questionnaire) aimed at Spanish registered nurses. A validated questionnaire (PCQN-SV) was used to determine the level of knowledge in palliative care; information on some variables to characterize the population was also collected (experience and education in palliative care, years of professional experience, academic level, and others). Uni and bivariate descriptive analyses were performed. A binary logistic regression model was also developed to identify those variables that influenced obtaining results higher than the population’s average. (3) Results: Spanish nurses have a medium–low level of knowledge in palliative care, higher in those who have previous experience or education in this area. Statistically significant differences were also found according to the area in which their caring activity was developed. (4) Conclusions: It is necessary to implement strategies for the basic training of nursing professionals in palliative care to offer quality care to people in advanced stages of illnesses or at the end of their lives.

Knowledge on Palliative Care and Associated Factors among Nurses in Ethiopia: A Systematic Review and Meta-Analysis

Background

Palliative care is a multidisciplinary team-based care for patients facing life-threatening illness and their families which addresses their physical, psychological, social, and spiritual needs to improve the quality of care. There is a strategy for an increase in palliative care services by integrating with the healthcare system. Therefore, this systematic review and meta-analysis was aimed to assess the overall pooled prevalence of nurses' knowledge towards palliative care in Ethiopia.

Method

PubMed/MEDLINE, HINARI, EMBASE, Scopus, Google Scholar, and African Journals OnLine (AJOL) were the databases used to search for articles. Cochrane I 2 statistics and Egger's test were done to check heterogeneity and publication bias, respectively. Subgroup analysis by region, study period, and sample size was done due to the presence of heterogeneity. Sensitivity analysis was also done to detect the presence or absence of an influential study.

Result

Nine studies with a total of 2709 study participants were included in the final analysis. The overall pooled prevalence of nurses' knowledge towards palliative care was 45.57% (95% CI: 35.27-55.87). Educational status and palliative care training were significantly associated factors with the level of nurses' knowledge towards palliative care. B.S. degree holder nurses (AOR = 3.01; 95% CI: 1.50-6.02) and nurses who had palliative care training (AOR = 4.64; 95% CI: 2.37-9.08) were found to be significantly associated factors with the nurses' level of knowledge.

Conclusion

More than half of nurses had poor knowledge of palliative care. Educational status of nurses and palliative care training were significantly associated factors with the nurses' level of knowledge about palliative care. Therefore, palliative care training and improving nurses' careers through continuous professional development should be focused on regularly to improve nurses' knowledge about palliative care.

Palliative Care Quiz for Nurses-Indonesian Version (PCQN-I): A Cross-cultural Adaptation, Validity, and Reliability Study

Aim

The study is aimed to perform a cross-cultural adaptation of the palliative care quiz for nurses in an Indonesian context to evaluate its psychometric properties.

Methods

A two-phase design was used in this study, including cross-cultural adaptation and psychometric testing. The PCQN-I was tested on a convenience sample of health-care providers recruited from 20 primary health-care (PHC) centers in Yogyakarta, Indonesia, from July to October 2017.

Results

The cross-cultural adaptation ultimately resulted in a total of 20 items from the PCQN-I. An expert committee revised the words in Item 4 from "adjuvant therapies" to "adjuvant therapies/additional therapies," in Item 5 from "bowel regimen" to "gastrointestinal therapies," and Item 16 from "Demerol" to "Pethidine" based on the Indonesian context. The experts retained Item 5 "It is crucial for family members to remain at the bedside until death occurs," although none of the participants (n = 40) involved in the pilot testing could answer it correctly, and Item 19 "The loss of a distant or contentious relationship is easier to resolve than the loss of one that is close or intimate" although few participants responded correctly. A total of 150 health-care providers consisting of 100 nurses and 50 physicians were involved in the psychometric testing. The scale-level content validity index/Ave of the PCQN-I was 97 and 93 in terms of its relevancy and clarity, respectively. The reliability was calculated as the Kuder-Richardson formula 20 score was 0.71.

Conclusions

The PCQN-I is a valid and reliable instrument for assessing palliative care knowledge among PHC providers. Further research is warranted to examine its reliability in different clinical settings.

Undergraduate nursing students' knowledge, attitudes and self-efficacy regarding palliative care in China: A descriptive correlational study

Aim

To describe nursing students' knowledge, attitudes and self-efficacy about palliative care and to examine the associations between these variables in China.

Design

A descriptive correlational study.

Methods

Undergraduate nursing students (N = 187) at the end of third year of education from a university were surveyed. Measurements included the Chinese versions of the Palliative Care Quiz for Nursing, the Death Attitude Profile-Revised, the Frommelt Attitude Toward Care of the Dying Scale and the Palliative Care Self-Efficacy Scale. Descriptive and correlational analyses were performed.

Results

Although most nursing students had favourable attitudes towards death and caring for the dying, students had low level of knowledge and self-efficacy regarding palliative care, suggesting the need for integrating palliative care education into nursing curriculum in China. Moreover, special attention should be paid to psychosocial and spiritual care teaching and preparing students to psychologically deal with the challenges in the process of patient's dying.

Knowledge and comfort related to palliative care among Indonesian primary health care providers

This study investigated Indonesian primary health care providers' knowledge and comfort towards palliative care. A descriptive cross-sectional design was used. From August 2017 to February 2018, the research team approached 70 primary care centres in the Yogyakarta province of Indonesia and invited health care providers to complete the Palliative Care Quiz for Nursing - Indonesia and describe their comfort in caring for terminally ill patients. Data were obtained from 516 health care providers. The mean (±s.d.) score of palliative care knowledge was low (7.8±3.3 of a possible score of 20). Current comfort level in providing palliative care was also low (1.6±2.7 of a possible score of 10). Only 11.3% of palliative care knowledge was explained by respondents understanding of palliative care definition, their education levels and experience in providing palliative care in hospital. However, 82.9% of provider comfort was explained by their experiences for caring for terminally ill patients in primary healthcare centres, palliative care training and years of work experience in primary healthcare centres. Indonesian evidence-based palliative care standards and guidelines must be established with education offered to all providers.

Knowledge, attitude and self-efficacy towards palliative care among nurses in Mongolia: A cross-sectional descriptive study

Background

Nurses have a primary role in providing palliative and end-of-life (EOL) care. Their knowledge of EOL care, attitudes toward care of the dying, and palliative care self-efficacy are important in care delivery. Little is known regarding palliative care preparedness among Mongolian nurses. This study examines palliative care knowledge, attitude towards death and dying, and self-efficacy among Mongolian nurses, and examines predictors of self-efficacy.

Methods

A cross-sectional descriptive study was conducted. Participants were 141 nurses employed at the National Cancer Center in Mongolia. Data was collected using a self-administered questionnaire.

Results

The median score for the knowledge of palliative care was 8.0/20. “Psychosocial and spiritual care” was the lowest score on the palliative care knowledge subscale. The mean score for attitude toward care of the dying was 69.1%, indicating positive attitudes. The mean score for the palliative care self-efficacy was 33.8/48. Nurses reported low self-efficacy toward communicating with dying patients and their families, and managing delirium. Palliative care knowledge and duration of experience as an oncology nurse significantly predicted self-efficacy toward palliative care, accounting for 14.0% of the variance.

Conclusions

Palliative education for nurses should address the knowledge gaps in EOL care and focus in increasing palliative care self-efficacy. Considering palliative care knowledge and nursing experience as an oncology nurse were significant predictors of self-efficacy toward palliative care, more effort is needed to fill the knowledge gaps in EOL care among nurses, especially for less experienced nurses.

Agreement of Nursing Home Staff With Palliative Care Principles: A PACE Cross-sectional Study Among Nurses and Care Assistants in Five European Countries

CONTEXT

To provide high-quality palliative care to nursing home residents, staff need to understand the basic principles of palliative care.

OBJECTIVES

To evaluate the extent of agreement with the basic principles of palliative care of nurses and care assistants working in nursing homes in five European countries and to identify correlates.

METHODS

This is a cross-sectional study in 214 homes in Belgium, England, Italy, the Netherlands, and Poland. Agreement with basic principles of palliative care was measured with the Rotterdam MOVE2PC. We calculated percentages and odds ratios of agreement and an overall score between 0 (no agreement) and 5 (total agreement).

RESULTS

Most staff in all countries agreed that palliative care involves more than pain treatment (58% Poland to 82% Belgium) and includes spiritual care (62% Italy to 76% Belgium) and care for family or relatives (56% Italy to 92% Belgium). Between 51% (the Netherlands) and 64% (Belgium) correctly disagreed that palliative care should start in the last week of life and 24% (Belgium) to 53% (Poland) agreed that palliative care and intensive life-prolonging treatment can be combined. The overall agreement score ranged between 1.82 (Italy) and 3.36 (England). Older staff (0.26; 95% confidence interval [CI]: 0.09-0.43, P = 0.003), nurses (0.59; 95% CI: 0.43-0.75, P < 0.001), and staff who had undertaken palliative care training scored higher (0.21; 95% CI: 0.08-0.34, P = 0.002).

CONCLUSIONS

The level of agreement of nursing home staff with basic principles of palliative care was only moderate and differed between countries. Efforts to improve the understanding of basic palliative care are needed.

Undergraduate nursing students' knowledge about palliative care and attitudes towards end-of-life care: A three-cohort, cross-sectional survey

BACKGROUND

Ensuring adequate knowledge about palliative care and positive attitudes towards death and dying are crucial educational aspects when preparing undergraduate nursing students to respond effectively to the complexities of care for people affected by a progressive, life-limiting illness. In undergraduate nursing education in Greece, the level of students' attained knowledge and developed attitudes towards palliative and end-of-life care remain unknown.

PURPOSE

To investigate undergraduate nursing students' knowledge about palliative care and attitudes towards death and end-of-life care, and explore demographic and academic factors as potential moderators of student knowledge and attitudes.

METHODS

We conducted a descriptive, cross-sectional, questionnaire-based survey. We recruited 2nd, 3rd and 4th year undergraduate nursing students from the country's two University Faculties. Participants completed a demographic form, the Palliative Care Quiz for Nursing (PCQN), and the Frommelt Attitudes Towards Care of the Dying (FATCOD) questionnaire.

RESULTS

The final sample was 529 students (response rate = 87.6%). Mean total PCQN scores revealed low levels of knowledge. Knowledge about pain/symptom management and psychosocial/spiritual care was insufficient. Mean total FATCOD scores indicated positive, liberal and supportive attitudes towards end-of-life care, with 60% of respondents keen to care for a dying person and their family. We noted less positive attitudes mainly in relation to student comfort with the care of a dying person and his/her imminent death. Academic parameters (year of study) and student demographic characteristics (older age) were the most significant moderators of both knowledge and attitudes. Greater knowledge about palliative care was a relatively weak, yet significant, predictor of more liberal attitudes towards care of the dying.

CONCLUSION

Our findings suggest that structured courses in palliative care can be a core part of undergraduate nursing education. Specific attention could be given to such areas patient-health professional communication, misconceptions and biases towards death and dying, and comfort in caring for the dying in order to prepare student nurses to psychologically deal with the sensitive and challenging process of death and dying.

Utility of social networks and online data collection in nursing research: Analysis of Spanish nurses' level of knowledge about palliative care

INTRODUCTION

Internet-based social networks are used by nurses with different purposes, including the creation of working groups and to share and create knowledge.

PURPOSE

To evaluate the utility of social networks in the dissemination of an online questionnaire and to measure Spanish RNs' knowledge about palliative care.

METHODS

A descriptive cross-sectional study was carried out. Using social networks we distributed an online questionnaire with the Spanish version of Palliative Care Quiz for Nurses (PCQN-SV) throughout August 2015.

RESULTS

A direct relationship between the number of responses and the questionnaire's apparitions in each social network was found. Comparing the results obtained by the 446 RNs participating in this study with those obtained in the study to pilot the PCQN-SV we identify that differences found are related to the participants' features (years of experience and hours of training in palliative care) and not to the type of questionnaire they answered.

CONCLUSIONS

Social networks have shown to be a useful tool for nursing research by its ability, to recruit participants as well as to collect data, so their role as an instrument of research should be considered.