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Factors associated with nurses' perceptions about quality of end-of-life care

Hussin EOD, Wong LP, Chong MC, Subramanian P

Int Nurs Rev, 2018 Jun;65(2):200-208.
PMID: 29430644 DOI: 10.1111/inr.12428

AIM: To examine the factors associated with nurses' perceptions of the quality of end-of-life care.
BACKGROUND: With increasing demand for hospitals to provide end-of-life care, the low quality of palliative care provided in hospital settings is an issue of growing concern in developing countries. Most dying patients receive their care from general nurses, irrespective of the nurses' specialty or level of training.
METHOD: A structured cross-sectional questionnaire survey was conducted of 553 nurses working at a teaching hospital in Malaysia.
RESULTS: The mean scores for nurses' knowledge about end-of-life care, their attitudes towards end-of-life care and the perceived quality of end-of-life care were low. The factors identified as significantly associated with the quality of end-of-life care were nurses' levels of knowledge and their attitudes towards end-of-life care.
DISCUSSION: Factors that contributed to the low quality of end-of-life care were inadequate knowledge and negative attitudes. These findings may reflect that end-of-life care education is not well integrated into nursing education.
CONCLUSION: The findings of this study suggest that there is a need to increase the nurses' level of knowledge and improve their attitude towards end-of-life care in order to enhance the quality of care provided to dying patients.
IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurse managers and hospital policymakers should develop strategies to enhance nurses' level of knowledge, as well as providing adequate emotional support for nurses who care for dying patients and their families. Nurses should be proactive in increasing their knowledge and adopting more positive attitudes towards end-of-life care.

Matched MeSH terms: Terminal Care/psychology*
Exploring terminally ill patients' and their families' perceptions of holistic care in Malaysia

Loh KY

Int J Palliat Nurs, 2006 Jan;12(1):38-41.
PMID: 16493304 DOI: 10.12968/ijpn.2006.12.1.20396

AIM: To document the perception of terminally ill patients and their family members on the care provided to them, and to look at the components of holistic care that are viewed as inadequate.
METHODS: Thirty cancer patients from a 10-bed palliative ward and their family members who were the chief carers were interviewed. They were asked to give their perceptions on four major areas of care: physical, social, psychological and spiritual. The participants were asked to report which area(s) of the service were inadequate.
RESULTS: Most patients and family members perceived that they received adequate physical care. However, the psychosocial and spiritual aspect of care were perceived as inadequate by the majority of patients and their families. None of the patients interviewed had ever been asked about spiritual distress.
CONCLUSION: The holistic model of care in caring for terminally ill patients is not practised fully. Further development in the psychosocial and spiritual aspects of care is necessary. There is a need to conduct further research to address these domains.

Matched MeSH terms: Terminal Care/psychology*
Fulltext Role of the Nasogastric Tube and Lingzhi (Ganoderma lucidum) in Palliative Care

Wang X, Huang Y, Radha Krishna L, Puvanendran R

J Pain Symptom Manage, 2016 Apr;51(4):794-799.
PMID: 26891608 DOI: 10.1016/j.jpainsymman.2015.11.028

Decision-making on behalf of an incapacitated patient at the end of life is a complex process, particularly in family-centric societies. The situation is more complex when attempts are made to accommodate Eastern concepts of end-of-life care with more conventional Western approaches. In this case report of an incapacitated 74-year-old Singaporean man of Malay descent with relapsed Stage 4 diffuse large B cell lymphoma who was without an established lasting power of attorney, we highlight the difficult deliberations that ensue when the patient's family, acting as his proxy, elected to administer lingzhi through his nasogastric tube (NGT). Focusing on the questions pertaining to end-of-life decision-making in Asia, we consider the issues surrounding the use of NGT and lingzhi in palliative care (PC) and the implementation of NGT for administering lingzhi in a PC setting, particularly in light of a dearth of data on such treatment measures among PC patients.

Matched MeSH terms: Terminal Care/psychology

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