Critical Care Nurses' Knowledge, Practice, Obstacles and Helpful Measures Towards Palliative Care for Critically Ill Patients
American Journal of Nursing Science
Volume 6, Issue 4, August 2017, Pages: 293-303
Received: Apr. 8, 2017;
Accepted: Apr. 27, 2017;
Published: Jul. 5, 2017
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Afaf Abd El-Aziz Basal, Medical Surgical Nursing, Faculty of Nursing, Tanta University, Tanta, Egypt
Gehan Abd El-Hakim Younis, Critical Care Nursing, Faculty of Nursing, Tanta University, Tanta, Egypt
Palliative care (PC) is a specialized medical care for people with serious illnesses. It focuses on providing patients with relief from the symptoms, pain and stress of serious illness. The aim of the study is to assess critical care nurses’ knowledge, practice, Obstacles and helpful measures toward palliative care for critically ill patients. The research design of this study was a descriptive design. It was conducted at Medical Intensive Care Unit (ICU) at Tanta University Hospital and oncology ICU at oncology institute, Tanta, Egypt. Three tools were used for collecting data. Tool I is a structured interview questionnaire sheet to collect data about nurses' sociodemographic data and knowledge. Tool II is an observational checklist for nurses’ practice regarding palliative care and tool III is nurses' perception of obstacles and helpful measures towards palliative care for critically ill patients. The results of the study reported that more than three quarter (77.1%) and (48.6%) of critical care nurses in medical and oncology ICUs, respectively, had unsatisfactory score of knowledge. More than half (51.4%) and 25.7% of nurses in Medical and Oncology ICUs respectively had poor practice while more than one third (34.3%) and 40% of nurses in medical and oncology department respectively had good practice score. From this paper, it was concluded that nurses in intensive care units at the Tanta University Hospital had unsatisfactory knowledge and practice regarding palliative care which is considered as an important aspect of improving quality of care. The most obstacles for providing palliative care are “not enough time to provide quality end of life. It was recommended that educational and in-service training programs should be conducted by the nursing personal in both hospital and intensive care settings about palliative care.
Afaf Abd El-Aziz Basal,
Gehan Abd El-Hakim Younis,
Critical Care Nurses' Knowledge, Practice, Obstacles and Helpful Measures Towards Palliative Care for Critically Ill Patients, American Journal of Nursing Science.
Vol. 6, No. 4,
2017, pp. 293-303.
Aslakson R, Cheng J, Vollen D, Galusca D and Galusca P. Evidence-Based Palliative Care in the Intensive Care Unit: A Systematic Review of Interventions, J Palliat Med. 2014; 17 (2): 219-35.
Puntillo K, Arai S, Cohen N, Gropper M, Nauhaus J, Paul S and Miaskowski C. Symptoms experienced by intensive care unit patients at high risk of dying. Crit Care Med. 2010; 38: 2155-60.
Nelson J, Meier D, Litke A, Natale D, Siegel E, Morrison S. The symptom burden of chronic critical illness. Crit Care Med. 2004; 32: 1527-34.
Nelson J, Puntillo K, Pronovost P, Walker A, McAdam J, Ilaoa D and Penrod J. In their own words: Patients and families define high-quality palliative care in the intensive care unit. Crit Care Med 2010; 38: 808-18.
Sharon L and Docherty. Searching for the Dying Point Providers Experiences with Palliative Care in Pediatric Acute Care, Ped. Ng. 2007; 33 (4): 335-41.
Patrick A, Palmieri. The Anatomy and Physiology of Error in a Verse Health Care Events Advances in Health Care Management, 2008; 7: 33-68.
Ayed A, Saye j, Harazneh L, FashafshehI and Eqtait F. The Nurses' Knowledge and Attitudes towards the Palliative Care, Journal of Education and Practice. 2015; 6 (4): 91-99.
Connor M. Understanding the Influence of Palliative Nursing: A Global Perspective Int J Palliate Nursing, 2009; 15 (7): 316-7.
Reink L, Shannon S and Engelberg R. Nurses Identification of Important Yet Under-Utilized End of Life Care Skills for Patients with Life Limiting or Terminal Illness, J Palliate Med. (2010); 13 (6): 753-59.
Harris M, Gaudet J, O’ Reardon C. Nursing care for patients at end of life in the adult intensive care unit, Journal of Nursing Education and Practice, 2014; 4 (6).
Clarke E, Curtis J, Luce J. Quality indicators for end-of-life care in the intensive care unit, Crit Care Med. 2003; 31 (9): 2255-62.
Granek L, Krzyzanowska M and Tozer R. Oncologists' strategies and barriers to effective communication about the end of life, J Oncol Pract. 2013; 9 (4): 129-34.
Ahmed N, Bestall J and Ahmedzai H. Systematic review of the problems and issue of accessing specialist palliative care by patients, careers and health social care professionals, Palliat Med. 2004; (18): 525-42.
Carlton B. The Barriers to and Evidence for Palliative Care, Journal of Pediatric Hematology/Oncology. (2011); (33): 132–35.
Bradley E, Cherlin E, McCorkle R, Fried T, Kasl S and Cicchetti D. Nurses’ use of palliative care practices in the acute care setting. J Prof Nurs. 2001; 17 (1): 14–22.
Egan KA, Abbott P. Interdisciplinary team training- preparing new employees for the specialty of hospice and palliative care. J Hosp Palliat Nurs, 2002; 4.
Das A and Haseena T. Knowledge and Attitude of Staff Nurses Regarding Palliative Care, International Journal of Science and Research (IJSR), 2015; 4 (11).
Aslakson R, Cheng J and Vollenweider D. Evidence-based palliative care in the intensive care unit: A systematic review of interventions, Journal of palliative medicine, 2014; 17 (2).
Prem V, Karvannan H, Kumar S, Karthikbabu S, and Syed N. Study of Nurses’ Knowledge about Palliative Care: A Quantitative Cross-sectional Survey, Indian J Palliat Care. 2012; 18 (2): 122–27.
Beckstrand R and Kirchhoff K. providing end-of-life care to patients: critical care nurses’ perceived obstacles and supportive behaviors, American Journal of Critical Care. 2005; 14 (5).
Moawad G A. Nurses' perception of obstacles and supportive behaviors in providing end of life care to critically ill pediatric patients, Journal of Biology, Agriculture and Healthcare, 2013; 3 (2): 95-105.
Liu J, Mok E and Wong T. Caring in nursing: investigating the meaning of caring from the perspective of cancer patients in Beij ing, China. J. Clin. Nursing. 2006; (15): 188-96.
El-Nagar S and Lawend J. Impact of Palliative Care Education on Nurses' Knowledge, Attitude and Experience regarding Care of Chronically Ill Children Journal of Natural Sciences Research. 2013; 3 (11): 94-103.
Alshehri H and Ismaile S. Nurses' experience of communication with palliative patients: Saudi experience, International Journal of Advanced Nursing Studies. 2016; 5 (2): 102-8.
Khader K, Jarrah S and Alasad J. Influence of nurses' characteristics and education on their attitudes towards death and dying: A review of Literature, International Journal of Nursing and Midwifery, 2010; 2 (1): 1-9.
Kassa H, Murugan R, Zewdu F, Hailu M, and Woldeyohannes D. Assessment of knowledge, attitude and practice and associated factors towards palliative care among nurses working in selected hospitals, Addis Ababa, Ethiopia, BMC Palliative Care, 2014.
Abu-Saad H and Dimassi H: Pallative care in Lebanon: knowledge, attitude and practice of physician and nurses. J Med Liban, 2007; 55 (3): 121-128.
Iranmanesh S, Razban F, Tirgari B and Zahra G. knowledge about palliative care in Southeast Iran, alliative& Supportive Car. (2014); 12 (3): 203-10.
Al Qadire M. Knowledge of palliative care: An online survey, Nurse Education Today J Palliat Care Med, 2015; 1-4.
Sorifa B and Mosphea K. Knowledge and Practice of Staff Nurses on Palliative Care, IJHRMLP, 2015; 01 (2): 41-45.
Anteneh S, Kassa H, Demeke T and Guadu T. Assessment of Nurses’ Knowledge, Attitude, Practice and Associated Factors towards Palliative Care: In the Case of Amhara Region Hospitals, Advances in Biological Research, 2016; 10 (2): 110-23.
Beckstrand R, Kirchhoff K. Providing end-of-life care to patients: critical care nurses’ perceived obstacles and supportive behaviors, American Journal of Critical Care, 2005; 14 (5): 395-403.
Campbell L. End of life care in the ICU: current practice and future Hopes. Crit Care NursClin North Am, 2002; 14: 197-200.
Pierce S. improving end-of-life care: gathering suggestions from family members. Nurs Forum. April-June. 1999; 34: 5-14.
Morsy W, Elfeky H and Mohammed S. Nurses’ Knowledge and Practices about Palliative Care among Cancer Patient in a University Hospital – Egypt, Advances in Life Science and Technology. 2014; 24: 100-13 available at www.iiste.org.
De Kock F. Factors Influencing Nurses’ Attitudes towards Caring for Dying Patients in Oncology Settings in the Western Cape Metropole. MSc. Degree Thesis, Stellenbosch University, 2011.
Grant L, Downing J, Namukwaya E, Leng M, Murray SA: Palliative care in Africa. BMJ Support Palliative Care, 2011; 1: 118-22.
Ali W and Ayoub N. Nurses’attitude towards caring for dying patient in Mansoura University Hospitals. J Med Biomed Sci, 2010; 1 (1): 16-23.