The Effect of Practice toward Do-Not-Resuscitate among Taiwanese Nursing Staff Using Path Modeling

Abstract

This study aimed to elucidate the predictors and the effects of path modeling on the knowledge, attitude, and practice toward do-not-resuscitate (DNR) among the Taiwanese nursing staff. This study was a cross-sectional, descriptive design using stratified cluster sampling. We collected data on demographics, knowledge, attitude, and practice as measured by the DNR inventory (KAP-DNR), Mindful Attention Awareness Scale, General Self-Efficacy Scale, and Dispositional Resilience Scale. Participants were 194 nursing staff from a medical center in northern Taiwan in 2019. The results showed that participation in DNR signature and education related to palliative care were significant positive predictors of knowledge toward DNR. The DNR predictors toward attitude included DNR knowledge, mindfulness, self-efficacy, dispositional resilience, and religious belief of nurses. Generally, the critical predictors of DNR practice were DNR attitude, dispositional resilience, and male nurses. In path modeling, we identified that self-efficacy, dispositional resilience, master’s degree, and religious belief directly influenced practice constituting DNR. Based on the findings of this study, we propose that nurses should improve their self-efficacy and dispositional resilience through training programs. Encouraging staff to undertake further education and have religious beliefs can enhance the practice of DNR and provide better end-of-life care.

The Relationship between Mindfulness and Emotional Intelligence as a Protective Factor for Healthcare Professionals: Systematic Review

“…Because of this, they need to find a balance between their emotional investment in patients and detachment, which allows them to effectively respond to both the demands of the organization as well as the patients' needs [70]. According to Wu et al, mindfulness promotes a positive attitude amongst healthcare professionals toward the do-not-resuscitate signature, and results in better care for terminally ill patients as it enhances their confidence to discuss end-of-life care decisions with patients and their families [71].…”

Study on the Formation Mechanism of Medical and Health Organization Staff’s Emergency Preparedness Behavioral Intention: From the Perspective of Psychological Capital

“…For example, before the disaster, if the MHO staff noticed that the people around them (superiors, colleagues, and subordinates) were making preventive preparations, they were more likely to participate actively in emergency prevention and preparedness. Conversely, subjective norms also reflect the degree of support of external factors for MHO staff's emergency preparedness behavior to a certain extent and play a vital role in the formation of individual emergency attitudes and perceived behavioral control [42,43]. For example, when MHO staff think that not taking precautions will bring them practical benefits, and the people around them do not show any particular aversion to this behavior, they are likely to treat emergency preparedness with a negative attitude.…”

Effects of Dispositional Resilience and Self-Efficacy on Practice in Advanced Care Planning of Terminally Ill Patients among Taiwanese Nurses: A Study Using Path Modeling

“…Our results showed that nurses with better ACP attitudes also had better ACP practice with terminally ill patients. Many previous studies have shown similar results [8,10,25]. Attitudes refer to the participant's feelings about the problem, while practice is the way of expressing an attitude.…”

“…In addition, nurses with better dispositional resilience tend to show better ACP practice among nurses. Various studies have shown that dispositional resilience was correlated with practice [25,[32][33][34]. Dispositional resilience is a kind of hardiness, a personality trait regarding how people cope with stressful events [12].…”