Nurses and health care assistants: Evaluation of attitude towards the care of patients who are terminally ill with cancer.

Abstract

158 Background: Terminally ill cancer patients (pts) are often hospitalized in the last 3 months of life, and a large number of them die in hospital. They require specific care provided by a team of health professionals with expertise in palliative (PC) and end-of-life care (EoLC). The aim of this analysis is to investigate the attitudes of nurses (Ns) and health care assistants (HCAs) towards terminally ill patients in a Cancer Center (CC). Methods: From July to November 2017 we applied the Frommelt Attitudes Toward Care of the Dying FORM-B Scale (FATCOD) to Ns and HCAs working in a CC, situated in a metropolitan area in Italy. FATCOD is a validated tool in its Italian version, composed of 30 questions investigating 6 specific areas: Fear (Fe), Communication (Co), Relationship (Rs), Care of the family (CoF), Family as Caring (FaC), Active Care (Ac). Each question has 5 answer options: strongly disagree, disagree, don’t know, agree, strongly agree, with scores from 1, negative, to 5, positive attitude. The total score ranges from 30 to 150. Results: We administered 116 questionnaires, 102 (87.9%) were completed. 81 Ns were involved (79.4%, 31/50 males/females) and 21 HCAs (20.6%, 4/17 males/females). The median age of Ns was 39 years (range 20-50) and 43 for the HCAs (range 30-50). The median duration of employment was 10 years for both groups (range 0-20). The median score achieved by both groups was 110.3 (range 78-140). Ns obtained a score of 112.1 (range 98.7-125.5), HCAs of 103.4 (range 89.4-117.7). Our analysis shows a positive attitude in both groups across 3 areas ( FaC, CoF, AC) and a negative one in others (Fe, Co, Rs), with a statistically significant concordance between the 2 groups (p=0.0037). Conclusions: Data shows NS and HCAs negative attitude in 3 important areas, with scores below the average results reported in literature. Based on our results, we proposed some intervention strategies. We organized periodic meetings with our psychologists. Our Institution introduced the PERCS ( Program to Enhance Relational and Communication Skills) and specific programs in medical and nursing schools of our university, favoring the earliest approach to PC and EoLC. We also provided seminars in PC to Ns and HCAs working in the CC.