Gachon University, College of Nursing, Incheon, South Korea.
Mercer University, Georgia Baptist College of Nursing 3001 Mercer University Drive, Atlanta, Georgia, USA.
Jpn J Nurs Sci. 2023 Jan;20(1):e12508. doi: 10.1111/jjns.12508. Epub 2022 Aug 29.
Little is known about attitudes toward advance directives and factors associated with them among emergency and palliative care nurses who often or daily face end-of-life circumstances. Thus, we aimed to compare the levels of attitudes toward advance directives, communication skills, knowledge about end-of-life care (knowledge), and awareness of the concept of a good death (good death awareness) between emergency and palliative care nurses, and to examine factors associated with attitudes toward advance directives in the total sample.
In this cross-sectional, correlational study, data were collected from 153 nurses (59 emergency and 94 palliative care nurses) at three tertiary hospitals using online or offline surveys and were analyzed using t-tests and multiple linear regression analysis.
The levels of attitudes, communication skills, knowledge, and good death awareness were moderate in both groups. Attitudes in emergency compared to palliative care nurses were less positive (46.78 vs. 48.38; p = .044), and knowledge was significantly lower (13.64 vs. 15.00; p = .004). Communication skills and good death awareness between the two groups were similar. In the total sample, emergency practice (B = -1.59, p = .024), and lower levels of good death awareness (B = 0.30, p < .001), communication skills (B = 0.18, p = .001), and education (B = -2.84, p = .015) were associated with less positive attitudes (F = 9.52, p < .001; R = 0.35).
The findings demonstrate the need for improvements in attitudes, knowledge, communication skills, and good death awareness in both groups, especially emergency nurses. Two modifiable targets of interventions to improve nurses' attitudes were also noted.
在经常或每天面临临终情况的急诊和姑息治疗护士中，人们对他们的预先指示态度以及相关因素知之甚少。因此，我们旨在比较急诊和姑息治疗护士对预先指示的态度、沟通技巧、临终关怀知识（知识）和对美好死亡概念的认识（美好死亡意识）水平，并检查总样本中与预先指示态度相关的因素。
在这项横断面相关性研究中，从三家三甲医院的 153 名护士（59 名急诊护士和 94 名姑息治疗护士）中收集了数据，使用在线或离线调查，并使用 t 检验和多元线性回归分析进行了分析。
两组的态度、沟通技巧、知识和美好死亡意识水平均为中等。与姑息治疗护士相比，急诊护士的态度不太积极（46.78 对 48.38；p = 0.044），知识水平明显较低（13.64 对 15.00；p = 0.004）。两组之间的沟通技巧和美好死亡意识相似。在总样本中，急诊实践（B = -1.59，p = 0.024）和较低水平的美好死亡意识（B = 0.30，p < 0.001），沟通技巧（B = 0.18，p = 0.001）和教育（B = -2.84，p = 0.015）与不太积极的态度相关（F = 9.52，p < 0.001；R 2 = 0.35）。
研究结果表明，两组，尤其是急诊护士，都需要改善态度，知识，沟通技巧和美好死亡意识。还注意到了改善护士态度的两项可修改目标。
