The level of nurses’ knowledge about and attitude towards caring for dying patients and relationship with evidence-based practice among nurses of primary health care organisations in Kazakhstan: a cross‑sectional study

Objective: To analyze the knowledge in palliative care and the attitudes toward caring for the dying of nurses who carry out their professional activity in primary care in Spain. Design: A cross-sectional descriptive observational study was carried out among Spanish primary care centers. Participants: A total of 244 nurses who had completed their primary care work and agreed to participate in this study were included. Main measurements: The level of knowledge in palliative care was analyzed using the PCQN-SV scale, and attitudes toward care of the dying were measured with the FATCOD-S scale, both of which are instruments that are validated in Spain. Results: Regarding the level of knowledge in palliative care, at a global level, the results revealed that 60% of the answers in the PCQN-SV were correct, with different results for each of the three subscales that compose it. When analyzing the attitudes of primary care nurses toward the care of the dying, an average of 132.21 out of 150 was obtained, representing a positive attitude. On the other hand, when analyzing these results in terms of knowledge and attitudes according to the population’s characteristics, we see that participants with both experience and training in palliative care present a better level of knowledge and a higher score regarding their attitudes toward care of the dying. However, the differences are only significant regarding the level of knowledge in palliative care. When analyzing the data from the two scales together, it is noteworthy that the participants with the most positive attitudes (highest scores on the FATCOD-S) also have the highest percentages of correct answers on the PCQN-SV.

Palliative Care (PC) is an interdisciplinary specialty focused on relieving symptoms and optimizing quality of life for people living with serious illnesses and their families. A great need for PC exists in Saudi Arabia due to its aging population and prevalence of cancer and other chronic diseases. Home healthcare can make PC more accessible to patients, but clinicians must be equipped with the PC knowledge and skills to perform their roles. This study was a descriptive, correlational examination of PC practices and knowledge of home care nurses recruited from military hospitals in Saudi Arabia. We surveyed participants using the Palliative Care Quiz for Nursing (PCQN) and the Modified Global Home Health Nursing Care Assessment Questionnaire. The mean PCQN score was 8.40, indicating low levels of PC knowledge. A nurses' demographic and physical, spiritual, religious, cultural, linguistic, ethical, and legal aspects of care revealed significant associations. Given the low levels of PC knowledge and skills, we recommend focusing on education, training, and research. Universities should review their curriculum to ensure PC content. Hospitals should provide training programs focused on all aspects of PC, specifically emotional and spiritual, without limiting training to physical aspects of care. Future research is also needed to inform policy in this area.

BackgroundPalliative care is nowadays essential in nursing care, due to the increasing number of patients who require attention in final stages of their life.Nurses need to acquire specific knowledge and abilities to provide quality palliative care. Palliative Care Quiz for Nurses is a questionnaire that evaluates their basic knowledge about palliative care.The Palliative Care Quiz for Nurses (PCQN) is useful to evaluate basic knowledge about palliative care, but its adaptation into the Spanish language and the analysis of its effectiveness and utility for Spanish culture is lacking.PurposeTo report the adaptation into the Spanish language and the psychometric analysis of the Palliative Care Quiz for Nurses.MethodThe Palliative Care Quiz for Nurses-Spanish Version (PCQN-SV) was obtained from a process including translation, back-translation, comparison with versions in other languages, revision by experts, and pilot study. Content validity and reliability of questionnaire were analyzed. Difficulty and discrimination indexes of each item were also calculated according to Item Response Theory (IRT).FindingsAdequate internal consistency was found (S-CVI = 0.83); Cronbach's alpha coefficient of 0.67 and KR-20 test result of 0,72 reflected the reliability of PCQN-SV. The questionnaire had a global difficulty index of 0,55, with six items which could be considered as difficult or very difficult, and five items with could be considered easy or very easy. The discrimination indexes of the 20 items, show us that eight items are good or very good while six items are bad to discriminate between good and bad respondents.DiscussionAlthough in shows internal consistency, reliability and difficulty indexes similar to those obtained by versions of PCQN in other languages, a reformulation of the items with lowest content validity or discrimination indexes and those showing difficulties with their comprehension is an aspect to take into account in order to improve the PCQN-SV.ConclusionThe PCQN-SV is a useful Spanish language instrument for measuring Spanish nurses’ knowledge in palliative care and it is adequate to establish international comparisons.

This paper describes the process and outcomes of a study to develop a tool to measure nurses' knowledge of palliative care. The development of the palliative care quiz for nursing (PCQN) entailed the convening of an advisory committee, a wide process of consultation, the development of a conceptual framework, determination of format, generating of items and pre-testing, piloting and further testing of the quiz. The PCQN is a 20-item true, false and 'I don't know' test of knowledge that is easily administered and has utility for assessing knowledge, stimulating discussion and identifying misconceptions about palliative care nursing.

Palliative care is aimed at the patient's recovery process in accepting the illness he is suffering from, and palliative care is to reduce the suffering experienced by the patient. This study aimed to determine nurses' level of knowledge and caring behavior in palliative care. This type of research is quantitative with a cross-sectional approach. The sampling technique uses convenience sampling. The sample of this study is nurses finding 63. The measuring instruments used in this study are Palliative Care Quiz For Nursing (PCQN) and Caring Behaviors Inventory (CBI). Statistical analysis using Spearman rank correlation test. The study results obtained a 2-tailed Sig value of 0.000 (p-value> 0.005), thus indicating a relationship between knowledge and nurse behavior. This research is expected to illustrate Nurse's nursing behavior in providing care to palliative patients.

Objetivo: evaluar los conocimientos que tiene el personal de enfermería del Hospital General Celaya sobre cuidados paliativos. Método: estudio cuantitativo, descriptivo, observacional y transversal, llevado a cabo entre octubre del 2017 y enero del 2018 en un hospital de segundo nivel, en las áreas de medicina interna, unidad de cuidados intensivos, cirugía y urgencias, en las que se atienden pacientes con necesidad de cuidados paliativos; muestreo de tipo consecutivo con 40 enfermeras. Se utilizó el Cuestionario sobre conocimientos en cuidados paliativos por el personal de salud, de 34 ítems con respuesta de tipo dicotómica: verdadero o falso. Se respetaron los principios bioéticos para investigación en seres humanos y se mantuvo el anonimato de los participantes. Se calculó la media de respuestas correctas, su porcentaje y ANOVA para diferencia entre grupos. Resultados: en los conocimientos sobre cuidados paliativos, los participantes obtuvieron una media de respuestas correctas de 22,30 (mínimo de respuestas correctas = 16, máximo de respuestas correctas = 27) y un 65,58 % del conocimiento en cuidados paliativos. El porcentaje de conocimiento en cuidados paliativos más alto se obtuvo en la dimensión Familia (83,5 %) seguido de Espiritualidad (83,12 %); en cambio, la dimensión Conocimientos diversos fue la más baja con un promedio de respuestas correctas del 55,83 %. En cuanto a la media de respuestas correctas la más alta estuvo en la dimensión Familia (4,17) y la más baja en Conocimientos generales (2,92). Conclusiones: las enfermeras participantes poseen un conocimiento que puede mejorarse; sin embargo, es necesaria la formación en cuidados paliativos desde la educación básica hasta la de especialización.

Providing quality end-of-life care to individuals with advanced dementia is crucial. To date, little attention has been paid to palliative care knowledge and attitudes toward palliative care for people with advanced dementia in Spain. To investigate the knowledge of and attitudes toward palliative care for advanced dementia among registered nurses and physicians in Spain. A descriptive, cross-sectional survey design was used. This study included a convenience sample of 402 nurses (n = 290) and physicians (n = 112). Two instruments were administered: demographic characteristics and Spanish version of the Questionnaire of Palliative Care for Advanced Dementia (qPAD-SV). Descriptive statistics and multiple regression were used for data analysis. Overall, the nurses and physicians had moderate mean scores for both knowledge of and attitudes regarding palliative care for advanced dementia. Physicians had a higher level of knowledge (p < 0.05) compared to nurses. Additionally, physicians and nursing staff who had professional experience/ education in geriatrics and those who had received palliative care and hospice training had greater (p < 0.01) knowledge of palliative care. In addition, healthcare professionals who had received dementia care training and who had worked in nursing homes had higher levels (p < 0.05) of knowledge and attitudes toward palliative care. This study indicates the need to provide nurses and physicians with more education for select groups of professionals who have had limited education and experience in caring for older adults with advanced dementia.

BackgroundPalliative care is a patient-centred, integrated approach for improving quality of life for both patients facing life-threatening illnesses and for their families. Although there has been increased interest in palliative care for non-cancer patients, the palliative care competency of nurses who care for non-cancer patients has rarely been investigated. This study described the palliative care knowledge, attitude, confidence, and educational needs in nurses who care for patients with congestive heart failure, stroke, end-stage renal disease, and end-stage liver disease; explored the relationships between those variables; and identified factors affecting nurses’ palliative care confidence.MethodsA cross-sectional, descriptive, correlational design was employed; data collection was conducted at a tertiary hospital in Seoul, Korea. Nurses who were working in general wards and intensive care units (N = 102) completed valid and reliable self-administered questionnaires. Descriptive statistics, frequencies, independent t-tests, one-way ANOVA, Pearson’s correlations, and multiple regression were conducted to analyse the data.ResultsNurses’ palliative care knowledge level was low (9.73 ± 2.10; range = 0–20) and their attitude toward palliative care was moderate (87.97 ± 6.93, range: 30–120). Knowledge was significantly correlated with attitude (r = .29, p = .003). Nurses were highly confident in pain and symptom management but demonstrated high educational needs for managing human and material resources to provide palliative care. Previous training in hospice, palliative, and EOL care was a significant and modifiable factor that affected nurses’ confidence (std. β = 0.25, p = .010).ConclusionsTo facilitate high-quality palliative care for non-cancer patients and families, nursing education programs should be developed to address nurses’ knowledge level, confidence level, and educational needs. This study provides relevant information that can be utilised to develop palliative care educational programs for nurses who care for non-cancer patients.

Background: Evidence-based practice (EBP) in oncology nursing is a clinical decision-making approach in nursing care that improves quality care and outcomes in health care but is not yet standard in clinical settings. Objectives: The purpose of this study was to determine EBP knowledge, attitude and practice of oncology nurses. Methods: Cross sectional study used the self-administered Evidence-Based Practice Questionnaire (EBPQ) developed by Upton and Upton in the United Kingdom. Simple random sampling technique was used toselect the sample. The sample size was 139 nurses working in tertiary level cancer hospital Chitwan. Results: Out of 139 respondents, all of them were female. Mean age of the respondents was 31.9712 sd±7.30390 where minimum age found to be 20 years and maximum was 55 years. In regards to marital status 74.1% of the respondents were married, remaining 24.9% were unmarried. In terms of education more than half (56.8%) of respondents had Bachelor in Nursing Science (BNS) degree, 24.5% had Bachelor of Science in Nursing degree, 11.5% had proficiency certificate level degree and remaining 7.2% had master degree. The mean year of experience was = 8 years sd±6.77809 with minimum 6 month, Maximum=28 years. In terms of designation, most of the respondents (76.3%) were working in staff nurse post. In three sub scale of evidence based practice, Good level of knowledge 41.7%, positive attitude 40.3%and good practice 41.7% was found to be on less than fifty percent of the respondents. Poor level of knowledge, negative attitude and poor practice was found among 34.5%, 30.9% and 34.5% respectively. Fair level of knowledge, neutral attitude and fair practice was reported by 23.5%, 28.8% %23.7% respectively. Findings shows that knowledge, attitude and practice is significantly associated with level of education of the respondents (p=.000) at 0.05 level of significance. Findings further shows there exist significant correlation between knowledge attitude and practice among respondents on evidence based nursing practice. Respondents’ practice has significantly positive correlation with attitude (r=.774 &amp; p=.000). Similarly knowledge of the respondents positively correlated with practice significantly ( r=.765 &amp; p=.000). So like attitude of the respondents is positively correlated with knowledge at statistically significant level. ( r=.891 and p= .000). There is a weak correlation of work experience with, attitude and practice where, r=.219 p=.009, r=176 p=.039 respectively. Knowledge was not correlated with year of experience. Conclusion: Research findings reported the strong correlation between knowledge attitude and practice, acknowledged a lack of full preparation in the EBP process to engage in and implement EBP consistently. Nurses working in the oncology setting should be provided the mentorship and support to obtain continuing education for better implementation of evidence based practice in their working institutions.

BackgroundThere is a growing need for palliative care globally due to the rapid aging of the population and improvement in cancer survival rates. Adequate knowledge and a positive attitude are vital for palliative care nurses. The study’s purpose was to examine nurses’ knowledge and attitudes toward palliative care.MethodsA cross-sectional design with convenience sampling was used. The study included 182 intensive care unit (ICU) nurses from Jordanian hospitals in all sectors. Self-administered questionnaires were used to assess nurses' knowledge and attitudes toward palliative care. Descriptive statistics, analysis of variance, and the Kruskal-Wallis H test were used to analyze the data.ResultsWe measured nurses’ knowledge using the Palliative Care Quiz for Nursing, and we measured nurses' attitudes using the Frommelt Attitude Toward Care of the Dying scale. The mean total knowledge and attitude scores were 8.88 (standard deviation [SD], 2.52) and 103.14 (SD, 12.31), respectively. The lowest level of knowledge was in psychosocial and spiritual care (mean±SD 0.51±0.70). The percentage of nurses with unfavorable attitudes was 53.3%. Significant differences in knowledge and attitude levels were observed according to educational level, experience, and hospital type.ConclusionsICU nurses have insufficient knowledge and inappropriate attitudes toward palliative care. Knowledge of psychological and spiritual aspects of palliative care was particularly lacking as were appropriate attitudes towards communication with dying patients. Improving knowledge and attitudes toward palliative care in nursing schools and hospitals would help overcome this problem.

Background It is crucial that future nurses be prepared with the knowledge and skills to provide palliative care (PC). Aims This study aimed to investigate Mongolian nursing students’ PC knowledge and attitudes towards end-of-life (EOL) care, as well as identify related predictors. Methods Participants were 141 students who enrolled in nursing program in Mongolia. Results Mean Palliative Care Quiz for Nursing (PCQN) score was 7.15 out of 20. The mean Frommelt Attitudes Toward Care of the Dying (FATCOD) score was 64.2 out of 100. Older age, male gender, and higher satisfaction with nursing school were significant predictors of higher levels of palliative care knowledge. Living in traditional Mongolian housing (Ger) and having clinical EOL experience were significant predictors of positive attitudes towards EOL care. Conclusions Mongolian senior nursing students were inadequately prepared to provide PC. PC nursing education in Mongolia needs to be improved to meet an appropriate global standard.

Purpose: The aim of this study was to describe competency in evidence-based practice (EBP) among clinical nurses and to explore critical thinking disposition (CTD) and organizational culture (OC) as possible predictors for competency in EBP. Also this study was conducted to identify baseline data for purpose of developing evidence-based OC to ensure safety of patients and to improve quality of nursing services in clinical setting. Methods: With a descriptive correlation study design, a competency in EBP questionnaire was administered to a convenience sample of nurses (N=393) from a single general hospital in Gyeonggi Province. Results: The overall mean score for competency in EBP was 3.03±0.53. Factors influencing competency in EBP were education (β=0.23, p<.001), attendance at lectures on EBP (β=0.18, p<.001), intellectual eagerness & healthy skepticism (β=0.27, p<.001) among CTD, and hierarchy-oriented OC (β=0.14, p=.005), which explained about 35% of the total variance. Conclusion: Critical thinking and competency in EBP should be part of nursing education especially for undergraduate students as well as strengthening clinical practice by activation of EBP. The results of this study that hierarchy-oriented OC, is a significant predictor for competency in EBP is difficult to accept. Its seemed to require further exploration.

Cancer and palliative care in Africa.

Objective: Palliative care is an intervention that improves the quality of life of patients. Nurses have a primary role in providing palliative care. Their knowledge and attitudes toward palliative care is important in care delivery. There is minimal information in Sri Lanka to document the knowledge and attitude of palliative care among nurses. Therefore, the present study was conducted to assess the knowledge and attitude of palliative care among nurses in Sri Lanka. Method: A cross-sectional, descriptive study was conducted on 200 selected nurses at Colombo North Teaching Hospital, Sri Lanka fulfilling the inclusion criteria. Socio-demographic information of the study participants was obtained through a self-administered questionnaire. The awareness and attitude levels toward the PC were assessed using the Palliative Care Knowledge Test (PCKT) and Frommelt Attitude Toward Care of the Dying, respectively. Results: More than half of the participants (55%) had an inadequate knowledge level regarding the palliative care (<50% for the PCKT score). Regarding the attitude on the palliative care, the majority stated nursing care to a dying person is a worthwhile experience (92%; n = 184). Many of them disagreed with avoiding the care of dying patients (strongly disagree: 37%; n = 74, disagree: 52.5%; n = 105). Overall, 85.5% of study participants had a positive attitude towards the palliative care. According to binary logistic regression, gender (P = .04; OR = 3.57; CI = 1.03-12.41) and working setup (P < .001) were significantly associated with having a positive attitude. The knowledge level was higher among nurses working in surgical wards (OR = 7.84). Those with >10 years of experience were statistically significant to have a positive attitude (P = .02; OR = 1.35; CI = 1.13-5.50). Conclusion: The nurses had inadequate knowledge of the PC even though they had a positive attitude toward it. Therefore, it is essential to uplift the awareness level among health workers. This warrants the need for palliative care education in the nursing curriculum and continuous professional development.

Public Awareness and Perceptions of Palliative and Comfort Care