FACTORS INFLUENCING NURSES’ ATTITUDES TOWARDS END-OF-LIFECARE, DEATH, AND THEIR PERCEIVED QUALITY OF END-OF-LIFE CARE:A DESCRIPTIVE CORRELATIONAL STUDY

Abstract

Background: Demand for end-of-life care (EOLC) in acute general wards is increasing in ageing populations. It is important to know the influencing factors to promote nurses’ attitudes in delivering EOLC and their perception on the quality of EOLC. However, very little is known about this topic. Aim: To examine the factors influencing nurses’ attitude towards EOLC and death, as well as their perception on the quality of EOLC. Study Design: A cross-sectional descriptive correlational study was conducted. Methods: Data were collected from 213 nurses working in medical and surgical wards in a public tertiary hospital in Singapore from December 2017 to February 2018. Death Attitude Profile-Revised, Frommelt Attitudes Toward Care of the Dying, and Measuring the Quality of Palliative Care in the Intensive Care Unit Questionnaire were used to measure the outcomes. Data analysis was conducted using IBM SPSS 24.0. Findings: Nurses had moderately positive attitude towards EOLC, and portrayed high levels of neutral and approach acceptance of death. The perceived quality of EOLC was given a modest rating of 66.87%. Significant differences in attitudes and perception were found between sociodemographic sub-groups such as ethnicity and educational training, and significant correlations between attitude towards EOLC and death attitudes were found. Nurses’ perception of quality of EOLC were not influenced by any independent variables. Nurses’ attitudes towards EOLC was significantly influenced by their attitudes of death, while nurses’ death avoidance and approach acceptance are significantly influenced by race. Conclusion: The study highlighted the importance of the awareness of death attitudes amongst nurses which contributed to their attitudes towards EOLC, and influenced by their racial background. Hospitals should review their current educational programmes and emotional support system to promote quality of EOLC. Future studies could investigate the influence of nurses’ attitudes on the actual provision of EOLC.