School of Nursing, University of Wollongong, New South Wales, Wollongong, Australia.
College of Applied Medical Sciences, University of Hafr Al Batin, Hafr Al Batin, Kingdom of Saudi Arabia.
Nurs Open. 2023 Dec;10(12):7796-7810. doi: 10.1002/nop2.2027. Epub 2023 Oct 16.
To examine registered nurses' (RNs) behavioural, normative and control beliefs about end-of-life care for patients who are diagnosed with advanced and life-limiting illnesses; and to identify the barriers and facilitators they experience when providing end-of-life care.
A sequential explanatory mixed methods study.
An online cross-sectional survey was conducted using the Care for Terminally Ill Patient tool among 1293 RNs working across five hospitals in the Kingdom of Saudi Arabia. Online individual semi-structured interviews with a subgroup of survey respondents were then undertaken. Data were collected between October 2020 to February 2021.
A total of 415 RNs completed the online survey, with 16 of them participating in individual interviews. Over half of the participants expressed the belief that end-of-life care is most efficiently delivered through multidisciplinary team collaboration. The majority of participants also believed that discussing end-of-life care with patients or families leads to feelings of hopelessness. Paradoxically, the study revealed that more than half of the participants held the negative belief that patients at the end of life should optimally receive a combination of both curative and palliative care services. The results showed that nurses' beliefs were significantly associated with their age, religion, ward type, level of education and frequency of providing end-of-life care. Data from the qualitative interviews identified four themes that explored RNs' beliefs and its related factors. The four themes were 'holistic care', 'diversity of beliefs', 'dynamics of truth-telling' and 'experiences of providing end-of-life care.'
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Wherever possible, patients at the end-of-life should be cared for in specialist settings by multidisciplinary teams to ensure effective, high-quality care. Where this is not possible, organisations should ensure that teams of multidisciplinary staff, including nurses, receive education and resources to support end-of-life care in non-specialist settings. Hospitals that employ foreign-trained nurses should consider providing targeted education to enhance their cultural competence and reduce the impact of different beliefs on end-of-life care.
探讨诊断患有晚期和生命有限疾病的患者的临终护理的注册护士（RNs）的行为、规范和控制信念；并确定他们在提供临终护理时遇到的障碍和促进因素。
顺序解释性混合方法研究。
使用 Care for Terminally Ill Patient 工具在沙特阿拉伯王国的五家医院工作的 1293 名 RN 中进行了在线横断面调查。然后对调查受访者的一个子组进行了在线个人半结构化访谈。数据收集于 2020 年 10 月至 2021 年 2 月之间进行。
共有 415 名护士完成了在线调查，其中 16 名护士参加了个人访谈。超过一半的参与者表示相信临终关怀最有效地通过多学科团队合作来提供。大多数参与者还认为与患者或家属讨论临终关怀会导致绝望感。矛盾的是，研究表明，超过一半的参与者持有负面信念，即生命末期的患者应该最优地接受治愈和姑息治疗服务的结合。结果表明，护士的信念与他们的年龄、宗教、病房类型、教育水平和提供临终关怀的频率显著相关。来自定性访谈的数据确定了四个主题，探讨了护士的信念及其相关因素。这四个主题是“整体护理”、“信念的多样性”、“说实话的动态”和“提供临终关怀的经验”。
对专业和/或患者护理的影响：在可能的情况下，生命末期的患者应在专科环境中由多学科团队照顾，以确保提供有效、高质量的护理。在不可能的情况下，组织应确保包括护士在内的多学科工作人员团队接受教育和资源支持非专科环境中的临终关怀。雇用外国培训护士的医院应考虑提供有针对性的教育，以提高他们的文化能力并减少不同信念对临终关怀的影响。
