Nurses' practices and their influencing factors in palliative care

Abstract

BackgroundIn 2017, the Chinese government launched a pilot project in palliative care, in which Shanghai was a pioneer. Nurses play a key role in palliative care services as they are the main providers improving the quality of services for patients and their families. However, little is known about practices and influencing factors in the field of palliative care from a nursing perspective in China. This is an original empirical study that has meticulously analyzed the interrelationship and intensity between practices and other factors among nurses in the initial stage of palliative care in primary healthcare institutions in Shanghai, China.MethodsA descriptive-correlational study design was used to sample 2,829 eligible palliative care nurses by purposive sampling survey in 225 healthcare institutions in Shanghai, China. Descriptive analyses were performed using IBM SPSS 24.0 software. Structural equation modeling was applied to analyze the data by AMOS 20.0. Data were collected using the well-designed Knowledge, Attitudes, and Practices of Hospice Care (KAPHC) scale.ResultsThe final model showed a good model fit. Self-efficacy directly influenced practices (β = 0.506, P < 0.01) and indirectly influenced practices (β = 0.028, P < 0.01) through intention. Subjective norm directly influenced practices (β = 0.082, P < 0.01) and indirectly influenced practices (β = 0.030, P < 0.01) through intention. Intention (β = 0.152, P < 0.01) and knowledge (β = 0.068, P < 0.01) directly influenced practices. Perceived susceptibility (β = −0.027, P < 0.01), perceived benefits (β = −0.017, P < 0.01), and perceived barriers (β = −0.014, P < 0.01) indirectly influenced practices through intention.ConclusionThis study provided evidence of the associations of knowledge, perceived susceptibility, benefits, barriers, subjective norm, self-efficacy, intention, and practices among nurses concerning palliative care and interventions improving their actual work practices. Our findings revealed that self-efficacy, intention, and subjective norms greatly influenced practices. It is imperative to take interventions that focus precisely on self-efficacy, intention, and subjective norms to improve nurses' practices.

Status and influencing factors of knowledge, attitude and self‐reported practice regarding hospice care among nurses in Hainan, China: A cross‐sectional study

“…The study found that attitude was a mediator between knowledge and self-reported practice among nurses. Consistent with previous research Xu et al, 2023), knowledge has a direct effect on self-reported practice. We believe this would be due to knowledge improving nurses' confidence to practise hospice care.…”

Registered Nurses' beliefs about end‐of‐life care: A mixed method study

“…Second, as defined by Ajzen and Fishbein (1980) normative beliefs relate to an individual's view of a particular behaviour from a societal perspective. More specifically, it refers to the individual's beliefs that individuals or groups think they should or should not perform the behaviour, such as the RN's colleagues, patients or family members (Xu et al, 2023).…”

“…Second, as defined by Ajzen and Fishbein ( 1980 ) normative beliefs relate to an individual's view of a particular behaviour from a societal perspective. More specifically, it refers to the individual's beliefs that individuals or groups think they should or should not perform the behaviour, such as the RN's colleagues, patients or family members (Xu et al, 2023 ). Third, control beliefs encompass an individual's skills and abilities, as well as the facilitators and barriers to actual performance which when taken together, are important determinants of the behaviour (White et al, 2022 ).…”

Evaluating ICU nurses’ education, practice, and competence in palliative and end-of-life care in Saudi Arabia: A cross-sectional study

“…Previous studies have evaluated a broad range of factors influencing PEOL care practice among nurses, including perceived advantages and obstacles, subjective norms, religious beliefs, intention, self-efficacy, skills, knowledge, qualifications, attitudes, experience, education, culture, and age (Alshammari et al, 2023 ; Jeong et al, 2020 ; Soikkeli Jalonen et al, 2020 ; Xu et al, 2023 ). From their studies, Alshammari et al ( 2023 ) and Carvajal et al ( 2019 ) concluded that nurses constantly emphasized the role of support from more experienced colleagues and collaboration with patients’ families in delivering impactful PEOL care.…”