Analysis of Factors Related to the Terminal Care Attitudes of Nurses in Palliative Care Units

ABSTRACT

Purpose: This study aimed to clarify the factors contributing to nurses’ attitudes toward terminal care in palliative care units (PCUs). Methods: We conducted a cross-sectional study of nurses in PCUs across Japan using an anonymous self-administered questionnaire, which was mailed to 103 ward managers and 1,671 nurses in PCUs to collect data about nurses’ sociodemographic characteristics. Their attitudes towards terminal care were assessed using the Frommelt Attitudes Toward Care of the Dying Scale Form B (Japanese version). Multiple regression analyses were used to identify the factors associated with attitudes towards terminal care. Results: After excluding missing data, valid responses were obtained from 93 ward managers and 1,112 nurses (response rates of 90.3% and 66.5%, respectively). Based on multivariate analyses, the subdivisions of “positivity of nurses’ attitudes toward terminal care” and “high recognition of the patient- and family-centered care” were associated with working in PCUs voluntarily (β=0.159, β=0.131, p<0.01). The former subdivision was associated with ten personal factors, including “experience as a nurse in a PCU” (β=0.125, p<0.01), “having a certification of End-of-Life Nursing Education Consortium Japan version Core Curriculum” (β=0.065, p<0.05). The latter subdivision was associated with four factors enhancing the PCU environment including “support for creative activities of patients and their families” (β=0.114, p<0.01). Conclusion: This study has suggested that gaining the experience at PCUs with multidisciplinary members on a basic palliative care education, a supportive specialized palliative nursing education, and expanding care system in PCUs are important for the positivity of nurses’ attitudes toward terminal care.