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一项关于护士对临终关怀态度及影响因素的多中心横断面研究:潜在类别分析

A multicenter cross-sectional study on nurses' attitudes toward end-of-life care and influencing factors: a latent profile analysis.

作者信息

Zheng Hongling, Li Rui, Ma Hongli, Cheng Qinqin, Zhang Yuxia, Gong Youwen, Luo Lei

机构信息

Breast Surgery Department, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.

Nursing Department, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

BMC Nurs. 2025 Jun 5;24(1):645. doi: 10.1186/s12912-025-03240-4.

Abstract

BACKGROUND

Nurses' attitudes and beliefs regarding end-of-life issues significantly impact the quality of care provided to dying patients. While several studies have explored medical students' attitudes toward end-of-life care, there is a lack of in-depth analysis of the internal variations and factors influencing clinical nurses' attitudes toward death. This study aimed to identify different profiles of attitude toward care for dying patients and explore the factors influencing each profile.

METHODS

This multicenter cross-sectional study recruited 1698 participants using convenience sampling from 60 hospitals across Sichuan Province, China. Data were collected from February 1 to April 30, 2024. The study utilized a self-designed General Information Questionnaire, Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B), Templer-Death Anxiety Scale (T-DAS), and Meaning in Life Questionnaire (MLQ). Binary regression analysis and Latent Profile Analysis (LPA) are used to identify the latent classes and factors impacting the classes of attitudes toward caring for the dying patients.

RESULTS

Nurses' attitudes toward caring for dying patients were categorized into two distinct profiles: the positive attitude group (40.9%, N = 673) and the negative attitude group (59.1%, N = 971). The mean scores for these profiles were 103.67 ± 0.40 and 94.10 ± 0.22, respectively, with a significant difference between them (F = 480.282, P <0.001). The key factors contributing to these differences included bereavement experience within 1-year, prior death education training, sense of meaning in life, and death anxiety (P < 0.05).

CONCLUSION

Nurses' attitudes toward caring for dying patients can be classified into positive and negative attitude profiles, with key influencing factors including bereavement experience, death education training, sense of meaning in life, and death anxiety. Healthcare administrators, educators, and policymakers should develop targeted interventions based on the specific features of each category and influencing factors to enhance end-of-life care practices.

摘要

背景

护士对临终问题的态度和信念对为临终患者提供的护理质量有重大影响。虽然有几项研究探讨了医学生对临终护理的态度,但缺乏对影响临床护士死亡态度的内部差异和因素的深入分析。本研究旨在确定对临终患者护理态度的不同类型,并探讨影响每种类型的因素。

方法

本多中心横断面研究采用便利抽样法,从中国四川省60家医院招募了1698名参与者。数据收集于2024年2月1日至4月30日。该研究使用了自行设计的一般信息问卷、弗洛梅尔临终关怀态度量表B型(FATCOD-B)、坦普勒死亡焦虑量表(T-DAS)和生命意义问卷(MLQ)。二元回归分析和潜在类别分析(LPA)用于识别潜在类别以及影响对临终患者护理态度类别的因素。

结果

护士对临终患者护理的态度分为两种不同类型:积极态度组(40.9%,N = 673)和消极态度组(59.1%,N = 971)。这些类型的平均得分分别为103.67±0.40和94.10±0.22,两者之间存在显著差异(F = 480.282,P <0.001)。造成这些差异的关键因素包括1年内的丧亲经历、先前的死亡教育培训、生命意义感和死亡焦虑(P <0.05)。

结论

护士对临终患者护理的态度可分为积极和消极态度类型,关键影响因素包括丧亲经历、死亡教育培训方案、生命意义感和死亡焦虑。医疗保健管理人员、教育工作者和政策制定者应根据每类的具体特征和影响因素制定有针对性的干预措施,以加强临终护理实践。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f87d/12142887/39da8288b095/12912_2025_3240_Fig1_HTML.jpg

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