NURSES’ ATTITUDE TOWARD THE PEDIATRIC END OF LIFE CARE AT HIWA CANCER HOSPITAL IN SULAIMANY-IRAQ
Abstract
Background: End-of-life care refers to all aspects of the care relating to dying, and bereavement which are provided towards the end of life, end of life care is nowadays essential in nursing care, due to the increasing number of patients who require attention in the final stages of their life, the negative attitude among nurses is one of the most common barriers to the quality end of life care. Objective: To assess attitude of the nurses working at Hiwa Cancer Hospital toward pediatric end of life care in Sulaimani city. Methods: Quantitative approach / Descriptive analytic study design has been carried out on (111) nurses working in Hiwa cancer hospital. Data were collected using standard questionnaires which is Frommelt Attitude toward Care of the Dying scale data analyzed using statistical package of social science version (24). Results: The findings of this study show that out of twenty-four items of nurses attitude about end of life care , nurses have good attitude in twelve items, fair attitude in nine-items and poor attitude in three items, with total mean and standard deviation 2.3450.68 and good level of attitude as general, present study demonstrate that level of education, work place, received training course about end of life care, attending seminar, workshop about pediatric end of life care had significant association with the attitude of nurses towards pediatric end of life care. Conclusion and Recommendation: Overall nurses have good attitude about end of life care. Its essential for nurses who were at fair or poor attitude about end of life care to be familiarized with the concepts of EoLC through trainings, workshops and formal or informal education in both academic and hospital settings.
References
- , they mention that proportion of female higher than male, and highest percentage of their sample their age ranged between (26-35) years old.
- Regarding nurses level of education, more than half of nurses graduated from nursing institute, its worth to mention that few percentages of sample were graduated from preparatory school of nursing and college of nursing, findings inconsistent with a study done in Rwanda
- , in their result the most respondents' attitudes levels towards palliative care were moderate attitude, but present findings disagree with result of another study done in titled (Nurses Attitude Toward Caring for Dying Patients in a Nigerian Teaching Hospital)
- , in their study majority of sample have diploma degree in nursing.
- In regard to nurse's familiarity according to their professional experience, more than two third of sample their experience in nursing as general ranged between one to ten years with mean (10.38)in contrast a study done in Kazakhstan
- , which showed that most nurses had negative attitude about end of life care .
- Based on analysis for demographic data age, gender, doesnt reflect any significant association on the nurses attitude toward palliative care, but statistically significant association were found between nurses attitude and nurses level of education at p value 0.015, this result congruent with a study done in 2019
- .
- End-of-life care is one of the routine activities of nurses; nurses feeling of poor preparation and stress contributes nurses to the exacerbation of negative attitudes toward death and caring for the dying that may further impact on the standard of care
- .
- In addition of that there were no association between nurses attitude with nurses cared for patients at the end of life stage which disagree with a study done by Abate and colleagues
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- Life-threatening diseases like cancer cause a decrease in the quality of life and they bring about various problems including physical, psychosocial, and spiritual, and especially pain, in patients with diseases that cannot be treated despite the advances in medicine, approaches aiming at reducing the patients distress and improving the quality of life should be applied, in accordance with this view, the approach of end of life care has been developed in order to meet the needs of patients and their relatives
- found that highest percentage of sample have twenty to twenty nine years experiences, but unfortunately less than one third of nurses have experience in palliative care among those approximately three quarter of sample their experience ranged between one to three years due to palliative and end of life care unit was established about six years its a new department , in another hand a study done in Indonesia
- the result shows that only one third of the nurses read about end of life care.
- Part two of study is the standard questionnaire that consist twenty four items related to nurses attitude about end of life care, the analysis clearly demonstrate that total mean and standard deviation in all twenty four items of nurses attitude about end of life care was (2.3450.68) which indicated to that nurses in hiwa cancer hospital have good attitude about end of life care, the same findings explore that nurses have good attitude in twelve items, fair attitude in nine-items and poor attitude in three items,
- This findings of this study were congruent with a study done in Pakistan
- they found that around one quarter of the nurses work in pediatric ward, majority of nurses cared for patients at end of life stage.
- unfortunately less than one third of sample were participated in training courses, and more than half of them their training course arranged between only one to five days which is done mostly inside country , this result disagree with the findings of study done by Ahmad and his colleagues
- they found that more than half of nurses had obtained training course and the majority of them for less than 1 week.
- In addition to that about two third of nurses were never read any article or brusher about the end of life care, and more than three quarter of sample were not attended in any seminar or workshop about the pediatric end of life care, which agree with another study done in 2020
- they mention that more than half of their sample five to ten years experience in nursing .and majority of nurses had experience in caring for end of life patients. About nurses workplace more than one quarter of the nurses were working in different units of pediatric ward like inpatient unit, outpatient unit and isolation unit ,and the rest of nurses were working in different unites in Hiwa cancer hospital like oncology , hematology , male and female outpatient, ect.. the findings consistence with result of study done in Taiwan
- they mention that significant association found between nurses attitude and level of education.
- In this study no significant association found between nurses attitude about end of life care with nurses experience ,nurses work place, while statistically significant association found between attitude about end of life care with nurses received training course about end of life care , this result agree with findings of the study done in titled (Assessment of Nurses Knowledge, Attitude, Practice and Associated Factors Towards Palliative Care)
- which illustrated that the most of the nurses had favorable attitude about end of life care , also findings were not confirmed by another study which done in Sudan