FACTORS ASSOCIATED WITH BEREAVEMENT NURSING CARE SELF-COMPETENCE AMONG CRITICAL CARE NURSES: A SEQUENTIAL EXPLANATORY MIXED METHOD STUDY

Abstract

Background Grief and bereavement are universal human experiences and are associated with significant health effects. Critical care nurses play an important role in supporting family members during bereavement, and their self-competence is a key factor that affects the quality of care that is delivered to bereaved family members. Thus, it is essential to examine the factors associated with nurses’ bereavement nursing care self-competence.

Aim To investigate the influential factors of bereavement nursing care self-competence in knowledge, skills and self-awareness among critical care nurses, and to explore the nurses’ perceptions of bereavement care in the critical care settings of a tertiary hospital in Singapore.

Methods The study was conducted in a public tertiary hospital in Singapore and used a sequential explanatory mixed method design, comprising a quantitative phase followed by a qualitative phase. In the quantitative phase, a cross-sectional survey design was utilised to identify the personal and organisational factors associated with bereavement nursing care self-competence among critical care nurses. In the qualitative phase, a qualitative descriptive exploratory design was utilised to explore the critical care nurses’ perceptions of the care provided to bereaved family members. The findings of both phases were then integrated and the findings of the qualitative phase were used to explain the results of the quantitative phase.

Results A total of 137 participants were included in the quantitative phase. The factors associated with bereavement nursing care knowledge were found to be religion, training in palliative or bereavement care, and organisational support. Years of critical care experience and organisational support were found to be factors associated with bereavement nursing care skills. Organisational support was the sole factor associated with bereavement nursing care self-awareness. For the qualitative phase, 16 participants joined the study. A total of 158 codes were identified, from which five themes and 15 subthemes emerged. The five themes of the study were Family responses, Holistic care, Psychological impacts, Self-competence, and Organisational dynamic.

Conclusion This study illustrated the importance of organisational support in influencing critical care nurses’ bereavement nursing care self-competence in knowledge, skills and self-awareness. The experiences and perceptions of nurses on bereavement care in critical settings were also integrated to provide a deeper understanding of the findings. It was found that self-competence in bereavement knowledge, skills and self-awareness could be augmented by improving organisational support and ensuring that critical care nurses receive palliative care training. Further studies could examine interventions to enhance organisational support, and the effectiveness that training can have in improving nurses’ bereavement nursing care self-competence.