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Seol and Koh: Critical Care Nurses’ Attitudes toward Hospice and Palliative Care and their Related Factors
Original Article

Perspectives in Nursing Science 2015;12(2):94-105.

Published online: 19 October 2015

DOI: https://doi.org/10.16952/pns.2015.12.2.94

Critical Care Nurses’ Attitudes toward Hospice and Palliative Care and their Related Factors

Eun Mi Seol1, Chin Kang Koh2,

1RN, Department of Nursing, Seoul National University Hospital, Seoul

2Associate Professor, College of Nursing, Seoul National University, Seoul, Korea

Corresponding author: Koh, Chin Kang College of Nursing, Seoul National University, 103 Daehak-ro, Jongro-gu, Seoul 03080, Korea. Tel: +82-2-740-8813, Fax: +82-2-766-1852, E-mail: ckoh@snu.ac.kr

Received 1 October 2015       Revised 6 October 2015       Accepted 6 October 2015

Copyright © 2015 The Research Institute of Nursing Science, Seoul National University

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

The study purpose was to describe critical care nurses’ attitudes toward hospice and palliative care and their related factors. Methods: In this cross-sectional descriptive study, 175 critical care nurses who worked at a general hospital in Seoul participated via self-report survey. The Frommelt Attitude Toward Care of the Dying Scale was used to measure their attitudes, and a palliative care quiz for nursing was used to measure their knowledge about hospice and palliative care. Results: Education level, duration of nursing employment, duration of critical care nursing employment, and knowledge about hospice and palliative care were significantly associated with nurses’ attitudes. In the multiple regression analysis, education level, and duration of nursing employment were significant predictors of nurses’ attitudes. Conclusion: These findings suggest that education programs to improve nurses’ knowledge about hospice and palliative care should be developed. These will help critical care nurses obtain a positive attitude toward hospice and palliative care.

Keywords: Critical care nurses, Hospice, Palliative care, Attitude, Knowledge

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Table 1.
General Characteristics of the Subjects (N=127)
Characteristics Categories n (%) M±SD
Gender Male 9 (7.1)  
Female 118 (92.9)  
Age (year) 23~29 99 (78) 27.39±3.53
30~39 27 (21.3)  
≥40 1 (0.8)  
Marital status Single 104 (81.9)  
Married 23 (18.1)  
Widowed 0 (0.0)  
Divorced or separated 0 (0.0)  
Religion Christian 31 (24.4)  
Buddhism 14 (11.0)  
Catholic 20 (15.7)  
None 60 (47.2)  
Others 2 (1.6)  
Religion period (year)     9.44±11.39
Frequency of religious activities Hardly at all 34 (26.8)  
2~3 Times a month 12 (9.4)  
1 Time a week 11 (8.7)  
2~3 Times a week 3 (2.4)  
4~5 Times a week 1 (0.8)  
Everyday 2 (1.6)  
Education Diploma 12 (9.4)  
Bachelor 109 (85.8)  
Of Master 2 (1.6)  
≥Master 4 (3.1)  
Hospice and palliative education experience (day) Yes 9 (7.1) 2.25±14.60
No 118 (92.9)  
Hospice and palliative heard of experience Yes 64 (50.4)  
No 63 (49.6)  
Mortality experience an acquaintance Yes 30 (23.6)  
No 97 (76.4)  
Table 2.
Characteristics related to Work-related Characteristics (N=127)
Characteristics Categories n (%) M±SD
Types of ICU MICU 41 (32.3)  
SICU 46 (36.2)  
EICU 14 (11.0)  
RICU 15 (11.8)  
CCU 11 (8.7)  
Others 0 (0.0)  
Length of clinical career (month) 1~24 45 (35.4) 49.60±38.80
25~60 42 (33.1)  
≥61 40 (31.5)  
Length of ICU career (month) 1~24 46 (36.2) 44.63±33.64
25~60 44 (34.6)  
≥61 37 (29.1)  
Number of end-of-life care (week) 0 29 (22.8) 1.8±2.9
≥1 98 (77.2)  
Right model of hospice and palliative care in the ICU Consultative model 67 (52.8)  
Integrative model 46 (36.2)  
Don't know 14 (11.0)  

ICU=Intensive care unit; MICU=Medical intensive care unit; SICU=Surgical intensive care unit; EICU=Emergency intensive care unit; RICU=Respiratory intensive care unit; CCU=Coronary care unit.

Table 3.
Differences in Attitude toward Hospice and Palliative Care of ICU Nurses by General Characteristics (N=127)
Variables Categories Attitude toward hospice and palliative care
n M±SD t or F p
Gender Male 9 101.77±5.44 -2.56 .798
Female 118 102.41±7.30    
Age (year) 23~29 99 102.36±7.00 0.74 .478
≥30 28 102.07±7.85    
Marital status Single 104 102.88±6.80 1.73 .086
Married 23 100.64±8.42    
Religion Christian 31 104.74±7.94 1.80 .133
Buddhism 14 104.42±8.83    
Catholic 20 101.00±7.33    
None 60 101.15±6.04    
Others 2 101.50±6.36    
Hospice and palliative education experience Yes 9 104.55±11.17 0.62 .550
No 118 102.20±6.81    
Hospice and palliative heard of experience Yes 64 101.60±7.10 -1.19 .234
No 63 103.12±7.16    
Mortality experience an acquaintance Yes 30 101.40±7.83 -8.46 .399
No 97 102.67±6.97    
Education Diploma 12 98.16±5.96a 3.45 .035
Bachelor 109 103.03±7.20b    
≥Of master 6 98.66±5.53ab    

LSD test: a ＜ b; ICU=Intensive care unit.

Table 4.
Differences in Attitude toward Hospice and Palliative Care of ICU Nurses by Work-related Characteristics (N=127)
Variables Categories Attitude toward hospice and palliative care
n M±SD t or F p
Types of ICU MICU 41 102.85±5.39 1.71 .151
SICU 46 102.13±5.66    
EICU 14 99.71±12.41    
RICU 15 101.06±7.61    
CCU 11 106.72±0.43    
Others 0      
Length of clinical career (month) 1~24 46 101.86±6.61b 6.06 .003
25~60 44 100.09±5.72a    
≥61 37 105.32±8.22c    
Length of ICU career (month) 1~24 46 102.43±7.59ab 5.22 .007
25~60 44 100.04±5.92a    
≥61 37 105.05±7.22b    
Number of end-of-life care (week) 0 29 100.83±5.83 3.02 .225
≥1 98 100.50±7.16    

LSD test: a＜b＜c; ICU=Intensive care unit; MICU=Medical intensive care unit; SICU=Surgical intensive care unit; EICU=Emergency intensive care unit; RICU=Respiratory intensive care unit; CCU=Coronary care unit.

Table 5.
Correlation between Attitude and Knowledge toward Hospice and Palliative Care of ICU Nurses (N=127)
Domain Attitude toward hospice and palliative care of ICU nurses
r p
Knowledge toward hospice and palliative care of ICU nurses ICU=Intensive care unit. .205 .021

ICU=Intensive care unit.

Table 6.
Correlation between Domains of Attitude and Knowledge toward Hospice and Palliative Care of ICU Nurses (N=127)
Domains   Attitude toward hospice and palliative care of ICU nurses
Personal attitude Family attitude
r p r p
Knowledge toward hospice and palliative care of ICU nurses Pain and symptom management .067 .455 .027 .765
Philosophy and principles .184 .039 .182 .041
  Psychosocial .290 .001 .055 .364

ICU=Intensive care unit.

Table 7.
Analysis of affecting factors to Attitude toward Hospice and Palliative Care of ICU Nurses (N=127)
Variables B SE β t p R2 change
(Constant) 42.11 3.15   11.92 ＜.001  
Education 0.17 0.10 .15 2.02 .033 .127
Length of clinical career (month) 0.31 0.04 .21 3.19 .013 .079
Length of ICU career (month) 0.05 0.04 .03 1.25 .213  
Knowledge toward hospice and palliative care of ICU nurses 0.17 0.07 .31 3.63 ＜.001 .154
R2=.36, Adjusted R2=.32, F=10.13, p＜.001

ICU=Intensive care unit; SE=Standard error.

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