Palliative care in adult intensive care units: A nationwide survey

Abstract

Background There are no data on the provision of palliative nursing care in Egyptian adult intensive care units (ICUs). The Palliative and End‐Of‐Life (PEOL) Care Index is reliable and content valid; however, its construct and criterion validities have not been examined. Aims and objectives First, to assess palliative care education, practice, and perceived competence among adult ICU nurses in Egypt. Second, to explore factors related to palliative care nursing practice and perceived competence. Third, to assess the construct and criterion validities of the PEOL Care Index. Design A cross‐sectional survey. Methods Nurse managers and staff nurses in 33 adult ICUs completed self‐administered questionnaires. The questionnaires assessed nurses' palliative care practice and perceived competence. A multilevel regression analysis was used to determine the best predictors of palliative care practice and perceived competence. Theory evidence construct validity and predictive criterion validity of the PEOL Care Index were examined. Results Thirty‐three nurse managers and 403 staff nurses participated in the study—response rate = 100% and 72.5%, respectively. On a 0‐100 scale, the mean scores of undergraduate education, practice, and perceived competence were 54.0 ± 18.7, 49.7 ± 18.1, and 54.5 ± 17.0, respectively. Palliative care practice was significantly related to receiving in‐service training on palliative care or end‐of‐life care (regression coefficients: 3.39), higher job satisfaction (0.97), and higher organizational support (1.85). Palliative care perceived competence was significantly related to older nurses' age (0.20), higher job satisfaction (0.97), and higher palliative care undergraduate education (0.63). Conclusions Palliative care education, practice, and perceived competence among adult ICU nurses in Egypt are inadequate, especially in terms of spiritual and cultural care. The PEOL Care Index is construct and criterion valid. Relevance to clinical practice Palliative care education should begin in nursing schools and extend through clinical in‐services. Guidelines should be developed to maximize staff collaboration and the utilization of chaplains in ICUs.

Effects of End-of-life Care Stress, Calling, and Resilience on End-of-life Care Performance - A Descriptive Correlational Study

“…Thus, education and training programs for nurses providing EOLC should be tailored to speci c work units. ICU nurses showed increased competency in palliative care with more service training in palliative care or EOLC [41]. Previous studies observed high needs for role de nition and practice authority for advanced practice nurses [40] and a need for education [42].…”

Predictors of end-of-life care stress, calling, and resilience on end-of-life care performance: a descriptive correlational study

“…Thus, education and training programs for nurses providing EOLC may be tailored to specific work units. ICU nurses showed increased competency in palliative care with more service training in palliative care or EOLC [ 50 ]. Previous studies observed high needs for role definition and practice authority for advanced practice nurses [ 49 ] and a need for education [ 51 ].…”

Do Nursing Staff Accept no Artificial Nutrition and Hydration for Terminal Patients?

“…Studies have indicated that those who were older had a higher level of education and had longer years of work experience had better knowledge resources as well as better skills in utilizing the resources. Nursing staff who worked at the oncology or hospice unit had more experience in care [18,19,21] and also diligently cultivated clinical talents [13]. In particular, clinical nursing staff who had participated in hospice care training had a more positive attitude towards non-ANH in terminal patients when the patient's body system deteriorates [15,21,22], and a significantly positive correlation was observed when clinical nursing staff had a better understanding of the concept of hospice care and the timing and decision-making for ANH, they had a more positive attitude towards accepting ANH [5,14,15,21,22].…”

“…With regard to the attitude of non-ANH to terminal patients, the difficulties as well as obstacles encountered when withdrawing ANH in clinical practice, also reveal the expectations of terminal patients and their family. This issue is a challenge [5][6][7][8][9][10][11][12][13][14]15,20,21] faced by clinical nursing staff everyday and is worth further investigation. Intervention with hospice care from the perspective of Taiwanese food culture allows further investigation of the relationships between local customs, family values and homology of medicine, food, and ANH as well as of the factors relating to these relationships, which can provide a reference for future educational strategy for clinical practice.…”