Acute Crit Care.  2023 Nov;38(4):469-478. 10.4266/acc.2023.00430.

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

Affiliations
  • 1Faculty of Nursing, Al-Ahliyya Amman University, Amman, Jordan
  • 2Faculty of Health Science, Higher Colleges of Technologies, Fujairah, United Arab Emirates
  • 3Faculty of Nursing, Applied Science Private University, Amman, Jordan
  • 4School of Nursing, The University of Jordan, Amman, Jordan
  • 5Community Health Nursing Department, School of Nursing, The University of Jordan, Amman, Jordan

Abstract

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.

Keyword

attitudes; Jordan; knowledge; nurses; palliative care

Reference

1. World Health Organization. Health topics: palliative care [Internet]. World Health Organization;2023. [cited 2023 Aug 1]. Available at: https://www.who.int/health-topics/palliative-care.
2. World Health Organization. Palliative care [Internet]. World Health Organization;2020. [cited 2023 Aug 1]. Available at: https://www.who.int/news-room/fact-sheets/detail/palliative-care.
3. Canadian Hospice Palliative Care Association. Global atlas highlights unmet need for palliative care [Internet]. Canadian Hospice Palliative Care Association;2014. [cited 2023 Aug 1]. Available at: https://www.chpca.ca/news/global-atlas-highlights-unmet-need-for-palliative-care/.
4. Seow H, Sutradhar R, Burge F, McGrail K, Guthrie DM, Lawson B, et al. End-of-life outcomes with or without early palliative care: a propensity score matched, population-based cancer cohort study. BMJ Open. 2021; 11:e041432.
Article
5. Zemplényi AT, Csikós Á, Fadgyas-Freyler P, Csanádi M, Kaló Z, Pozsgai É, et al. Early palliative care associated with lower costs for adults with advanced cancer: evidence from Hungary. Eur J Cancer Care (Engl). 2021; 30:e13473.
Article
6. Bowen L. The multidisciplinary team in palliative care: a case reflection. Indian J Palliat Care. 2014; 20:142–5.
Article
7. Schroeder K, Lorenz K. Nursing and the future of palliative care. Asia Pac J Oncol Nurs. 2018; 5:4–8.
Article
8. Chen L, Li XH, Pan X, Pan QN, Huang HQ, Tao PY, et al. Nurses’ knowledge, attitudes, and willingness to practice hospice care: an analysis of influencing factors. PLoS One. 2022; 17:e0259647.
Article
9. Lin HY, Chen CI, Lu CY, Lin SC, Huang CY. Nurses’ knowledge, attitude, and competence regarding palliative and end-of-life care: a path analysis. PeerJ. 2021; 9:e11864.
Article
10. Shen Y, Nilmanat K, Promnoi C. Palliative care nursing competence of Chinese oncology nurses and its related factors. J Hosp Palliat Nurs. 2019; 21:404–11.
Article
11. Iranmanesh S, Razban F, Tirgari B, Zahra G. Nurses’ knowledge about palliative care in Southeast Iran. Palliat Support Care. 2014; 12:203–10.
Article
12. Hao Y, Zhan L, Huang M, Cui X, Zhou Y, Xu E. Nurses’ knowledge and attitudes towards palliative care and death: a learning intervention. BMC Palliat Care. 2021; 20:50.
Article
13. Wilson O, Avalos G, Dowling M. Knowledge of palliative care and attitudes towards nursing the dying patient. Br J Nurs. 2016; 25:600–5.
Article
14. Nepal P, Garbuja CK, Nepal M. Clinical nurses’ knowledge and attitude on palliative care: a cross-sectional study. J Lumbini Med Coll. 2021; 9:7.
15. Razban F, Tirgari B, Iranmanesh S. Nurses’ knowledge about and attitude towards palliative care in Southeast Iran. Asian J Nurs Educ Res. 2015; 5:399–404.
Article
16. Maria K, Evanthia V, Petros KA, Dimitris N. Assessment of knowledge and associated factors towards palliative care among Greek nurses. Assessment. 2016; 3:381–95.
Article
17. Etafa W, Wakuma B, Fetensa G, Tsegaye R, Abdisa E, Oluma A, et al. Nurses’ knowledge about palliative care and attitude towards end-of-life care in public hospitals in Wollega zones: multicenter cross-sectional study. PLoS One. 2020; 15:e0238357.
18. Kassa H, Murugan R, Zewdu F, Hailu M, Woldeyohannes D. Assessment of knowledge, attitude and practice and associated factors towards palliative care among nurses working in selected hospitals, Addis Ababa, Ethiopia. BMC Palliat Care. 2014; 13:6.
Article
19. Farmani AH, Mirhafez SR, Kavosi A, Moghadam Pasha A, Jamali Nasab A, Mohammadi G, et al. Dataset on the nurses’ knowledge, attitude and practice towards palliative care. Data Brief. 2018; 22:319–25.
Article
20. Chover-Sierra E, Martínez-Sabater A, Lapeña-Moñux Y. Knowledge in palliative care of nursing professionals at a Spanish hospital. Rev Lat Am Enfermagem. 2017; 25:e2847.
Article
21. Zeru T, Berihu H, Gerensea H, Teklay G, Teklu T, Gebrehiwot H, et al. Assessment of knowledge and attitude towards palliative care and associated factors among nurses working in selected Tigray hospitals, northern Ethiopia: a cross-sectional study. Pan Afr Med J. 2020; 35:121.
Article
22. Omran S, Obeidat R. Palliative care nursing in Jordan. J Palliat Care Med. 2015; S4:005.
Article
23. Al Qadire M. Knowledge of palliative care: an online survey. Nurse Educ Today. 2014; 34:714–8.
Article
24. Zahran Z, Hamdan KM, Hamdan-Mansour AM, Allari RS, Alzayyat AA, Shaheen AM. Nursing students’ attitudes towards death and caring for dying patients. Nurs Open. 2022; 9:614–23.
Article
25. Ross MM, McDonald B, McGuinness J. The palliative care quiz for nursing (PCQN): the development of an instrument to measure nurses’ knowledge of palliative care. J Adv Nurs. 1996; 23:126–37.
Article
26. Kim JS, Kim J, Gelegjamts D. Knowledge, attitude and self-efficacy towards palliative care among nurses in Mongolia: a cross-sectional descriptive study. PLoS One. 2020; 15:e0236390.
Article
27. Frommelt KH. The effects of death education on nurses' attitudes toward caring for terminally ill persons and their families. Am J Hosp Palliat Care. 1991; 8:37–43.
Article
28. Mastroianni C, Piredda M, Taboga C, Mirabella F, Marfoli E, Casale G, et al. Frommelt attitudes toward care of the dying scale form B: psychometric testing of the Italian version for students. Omega (Westport). 2015; 70:227–50.
Article
29. Stjernswärd J, Ferris FD, Khleif SN, Jamous W, Treish IM, Milhem M, et al. Jordan palliative care initiative: a WHO Demonstration Project. J Pain Symptom Manage. 2007; 33:628–33.
Article
30. Al Qadire M. Nurses’ knowledge about palliative care: a cross-sectional survey. J Hosp Palliat Nurs. 2014; 16:23–30.
31. Warnock C. Breaking bad news: issues relating to nursing practice. Nurs Stand. 2014; 28:51–8.
Article
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