Nurses' perceptions of intensive care unit palliative care at end of life

Abstract

Background Significant barriers can block the provision of palliative care at the end of life in the intensive care unit (ICU). However, the relationship between perceptions of ICU quality palliative care and barriers to palliative care at the end of life is not well documented. Aims and objectives To describe ICU nurses' perceptions of quality palliative end‐of‐life care, barrier intensity and frequency to palliative care and their association with one another. Design This was a descriptive, correlational, cross‐sectional design. Methods A convenience sample of 126 ICU nurses from two hospitals in Israel was recruited for the study. Participants completed three pencil‐and‐paper questionnaires (a personal characteristics questionnaire, the Quality of Palliative Care in the ICU and a revised Survey of Oncology Nurses' Perceptions of End‐of‐Life Care). Respondents were recruited during staff meetings or while on duty in the ICU. Ethical approval was obtained for the study from participating hospitals. Results The item mean score of the quality of palliative end‐of‐life care was 7·5/10 (SD = 1·23). The item mean barrier intensity and frequency scores were 3·05/5 (SD = 0·76) and 3·30/5 (SD = 0·61), respectively. A correlation of r = 0·46, p < 0·001 was found between barrier frequency and intensity and r = −0·19, p = 0·04 between barrier frequency and quality palliative end‐of‐life care. Conclusions ICU nurses perceived the quality of palliative care at the end of life as moderate despite reports of moderate barrier levels. The frequency of barriers was weakly associated with quality palliative end‐of‐life care. However, barrier intensity did not correlate with quality palliative end‐of‐life care at a statistically significant level. Further research that investigates other factors associated with quality ICU palliative care is recommended. Relevance to clinical practice Barriers to palliative care are still common in the ICU. Increased training and education are recommended to decrease barriers and improve the quality of ICU palliative care.

Nurses’ perceptions of barriers and supportive behaviors in end-of-life care in the intensive care unit: a cross-sectional study

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Analysis of The Status Quo and Influencing Factors of The Death Coping Self-Efficacy of Clinical Nurses: A Cross-Sectional Study

“…Literature has also pointed out that most of the nurses are aware of the insu cient education and training in death-related care at the end of life. In particular, the new staff in the intensive care unit, who take care of the patients with complex diseases, often feel inadequate to care for the patients at the end of their lives, resulting in physical and mental exhaustion, poor working ability, and increased staff turnover rate [9,10]. The emergency medical staff generally consider that the patients are exposed to the emergency unit for a short period; therefore, there are practical di culties in providing end-stage care to them [10].…”