School of Public Health, Shanghai University of Traditional Chinese Medicine, Cailun Rd#1200, Pudong New Area, Shanghai, 201203, China.
BMC Palliat Care. 2023 Apr 25;22(1):49. doi: 10.1186/s12904-023-01175-8.
Hospice and palliative care nursing (HPCN) in China is mainly available at public primary care institutions, where nursing homes (NHs) are rarely involved. Nursing assistants (NAs) play an essential role in HPCN multidisciplinary teams, but little is known about their attitudes towards HPCN and related factors.
A cross-sectional study was designed to evaluate NAs' attitudes towards HPCN with an indigenised scale in Shanghai. A total of 165 formal NAs were recruited from 3 urban and 2 suburban NHs between October 2021 and January 2022. The questionnaire was composed of four parts: demographic characteristics, attitudes (20 items with four sub-concepts), knowledge (nine items), and training needs (nine items). Descriptive statistics, independent samples t-test, one-way ANOVA, Pearson's correlation, and multiple linear regression were performed to analyse NAs' attitudes, influencing factors, and their correlations.
A total of 156 questionnaires were valid. The mean score of attitudes was 72.44 ± 9.56 (range:55-99), with a mean item score of 3.6 ± 0.5 (range:1-5). The highest score rate was "perception of the benefits for the life quality promotion" (81.23%), and the lowest score rate was "perception of the threats from the worsening conditions of advanced patients" (59.92%). NAs' attitudes towards HPCN were positively correlated with their knowledge score (r = 0.46, P < 0.01) and training needs (r = 0.33, P < 0.01). Marital status (β = 0.185), previous training experience (β = 0.201), location of NHs (β = 0.193), knowledge (β = 0.294), and training needs (β = 0.157) for HPCN constituted significant predictors of attitudes (P < 0.05), which explained 30.8% of the overall variance.
NAs' attitudes towards HPCN were moderate, but their knowledge should be improved. Targeted training is highly recommended to improve the participation of positive and enabled NAs and to promote high-quality universal coverage of HPCN in NHs.
在中国，缓和医疗和姑息护理（HPCN）主要在公立基层医疗机构开展，养老院（NHs）很少参与其中。护理助理（NAs）在 HPCN 多学科团队中发挥着重要作用，但人们对他们对 HPCN 的态度及其相关因素知之甚少。
本研究采用本土化量表，设计了一项横断面研究来评估上海护理助理对 HPCN 的态度。2021 年 10 月至 2022 年 1 月，从 3 家城市和 2 家郊区 NH 共招募了 165 名正式护理助理。问卷由四部分组成：人口统计学特征、态度（20 项，4 个亚概念）、知识（9 项）和培训需求（9 项）。采用描述性统计、独立样本 t 检验、单因素方差分析、Pearson 相关和多元线性回归分析护理助理的态度、影响因素及其相关性。
共回收有效问卷 156 份。态度平均得分为 72.44±9.56（范围：55-99），平均项目得分为 3.6±0.5（范围：1-5）。得分最高的项目是“提高生活质量的益处感知”（81.23%），得分最低的项目是“对晚期患者病情恶化威胁的感知”（59.92%）。护理助理对 HPCN 的态度与知识得分（r=0.46，P<0.01）和培训需求（r=0.33，P<0.01）呈正相关。婚姻状况（β=0.185）、既往培训经历（β=0.201）、NH 位置（β=0.193）、HPCN 知识（β=0.294）和培训需求（β=0.157）是态度的显著预测因素（P<0.05），可解释总方差的 30.8%。
护理助理对 HPCN 的态度处于中等水平，但知识有待提高。建议进行有针对性的培训，以提高积极且有能力的护理助理的参与度，促进 NH 中高质量的普遍覆盖 HPCN。
