肿瘤内科护士对死亡态度的调查及对临终护理质量的影响

Death attitude of nurses in oncology department and its influences on quality of hospice nursing

目的调查肿瘤内科护士对死亡的态度及对临终护理质量的影响。方法2016年1月至2018年12月采用一般调查问卷、死亡态度量表及临终关怀态度量表对肿瘤内科75名护士进行调查,分析其死亡态度情况及影响因素,拟定临终关怀护理质量评价指标体系咨询问卷评价临终护理质量。结果75名护士对死亡态度调查总分为(105.28±12.59)分,其中自然接受得分最高(4.45±0.61)分;临终护理质量得分(126.32±24.15)分;不同性别、工作年限、个人信仰及死亡教育情况的护士死亡态度得分差异有统计学意义(均P<0.05),而不同年龄、文化程度、职称、聘用方式、婚姻状况、参与过患者临终处置情况及参与过亲朋临终处置情况的护士死亡态度得分差异无统计学意义(P>0.05);影响因素分析显示,性别、工作年限、个人信仰和死亡教育为护士对死亡态度的独立影响因素(P<0.05);临终护理质量评分与自然接受得分呈正相关(r=0.612,P<0.05);而与其他维度得分呈负相关(死亡恐惧r=-0.562,死亡逃避r=-0.517,逃离接受r=-0.465,趋近接受r=-0.285,P<0.05)。结论肿瘤内科护士大多数对死亡呈正向接受的态度,性别、工作年限、个人信仰和死亡教育为护士死亡态度的影响因素,且死亡态度直接影响临终护理质量,应加强护士的死亡教育,提高护理服务质量。

Objective To survey the death attitude of nurses in oncology department and its influences on quality of hospice nursing.Methods From January 2016 to December 2018,75 nurses from oncology department were surveyed by using a general questionnaire with Death Attitude Scale and Hospice Care Attitude Scale.The death attitude and influencing factors were analyzed.The consultation questionnaires of hospice care nursing quality evaluation index system were drawn up to evaluate quality of hospice nursing.Results The total score of death attitude in the 75 nurses was(105.28±12.59)points,in which the natural acceptance score(4.45±0.61 points)was the highest.During survey period,score of hospice nursing quality was(126.32±24.15)points.There were significant differences in death attitude scores among nurses with different genders,working years,personal beliefs and death education(P<0.05).There was no significant difference in death attitude scores among nurses with different ages,education level,professional titles,employment methods,marital status,participation in hospice disposition of patients or relatives and friends(P>0.05).Influence factor analysis showed that gender,working years,personal beliefs and death education were independent influencing factors of death attitudes(P<0.05).The score of hospice nursing quality was positively correlated with the natural acceptance score(r=0.612,P<0.05)while negatively correlated with other factors including death fear(r=-0.562),death evasion(r=-0.517),escape acceptance(r=-0.465)and approaching acceptance(r=-0.285),and all P<0.05.Conclusion Most of nurses in oncology department are positively acceptant to death.The gender,working years,personal beliefs and receiving death education are influencing factors for death attitude in nurses.The death attitude directly affects quality of hospice care.The death education for nurses should be strengthened to improve quality of nursing services.