Background:
Due to a high demand for palliative care in the inpatient setting, hospital nurses without structured palliative care education are expected to provide care for dying patients and those with complex clinical conditions. This study was proposed to assess the knowledge base of hospital nurses with respect to palliative care. The study design also included nurses’ self-competence, personal attitudes, and experience regarding the delivery of palliative care.
Design and Participants:
A cross-sectional design was used to assess 129 hospital nurses from three hospitals in Colorado. Eligible participants were registered nurses, employed for at least 6 months and involved in direct patient care. Nurses in administrative roles who did not provide clinical care were excluded from participation. Participants were required to read and speak English. Participation was voluntary and information was obtained from emails with links to online questionnaires evaluating palliative care knowledge, attitudes towards end-of-life care and palliative care self-competence.
Results:
Samples were obtained from 129 nurses with a mean age of 43 years with an average of 15.5 years of experience. Mean scores were found in the knowledge of palliative care principles, positive attitudes regarding care and self-competence. Lower scores were seen with respect to psychosocial and spiritual care. Discomfort was noted when nurses were required to discuss death or to address a patient’s spiritual needs. There were significant differences in the amount of palliative care education nurses receive and personal experience with caregiving. When uncomfortable discussing these topics, a paternalistic attitude was often expressed. When nurses had higher educational backgrounds and a higher degree of self-competence, increased positive attitudes regarding end-of-life care was observed.
Commentary: This study reviewed voluntary responses from 129 hospital nurses providing inpatient care. Results indicate that the experience of the nursing staff varies widely with respect to palliative care resulting in lower self-competence and less positive attitudes about end-of-life care. Nurses had the lowest scores with respect to the psychosocial and spiritual care of patients and often felt uneasy having conversations about end of life or end of life care. These results indicate the need for educational interventions for nurses in the inpatient setting that include psychosocial, spiritual, pain management and communication in order to provide consistent competence when delivering quality palliative care.
Bottom Line: To provide quality inpatient palliative care, educational interventions must be employed to nurses in hospital settings. A consistent knowledge base, communication skills regarding spiritual care and dying and positive attitudes regarding the end of life will result in increased competence when palliative care is needed.
Source: Hebeshy MI, Copeland D. Palliative Care Knowledge, Attitudes, and Self-Competence of Nurses Working in Hospital Settings. Journal of Palliative Care. 2025;0(0). doi:10.1177/08258597251341981
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