Investigation of Student Nurses’Attitudes towards End-of-Life Care and Their Influencing Factors

Background: This cross-sectional investigative study aimed to determine student nurses’ attitudes towards end-of-life care. Methods: This study used a descriptive research design with stratified sampling to survey student nurses enrolled in one of four nursing colleges in China from January 2023 to December 2023. Student nurses’ general demographic and prior related information, attitudes towards death and attitudes towards end-of-life care were determined using a general information questionnaire, the Death Attitude Profile—Revised scale and the Professional End-of-Life Attitude Scale (PEAS), respectively. Results: The total PEAS score was 122.91 ± 16.123. Significant differences were noted in the attitude towards end-of-life care scores according to sources of end-of-life care knowledge (P Conclusions: Student nurses lacked an optimistic attitude towards end-of-life care, which was influenced by differences in the sources of end-of-life care knowledge.

Individualized Aromatherapy in End-of-Life Cancer Patients Care:A Case Report

As one of the methods of palliative care,aromatherapy has been applied gradually in clinical nursing work in China in recent years.Through aromatherapy,terminal cancer patients can get not only relieves of physical symptoms,but also spiritual relaxation and peace,thus have improved quality of life at the end stage.In this paper,we report in detail about how aromatherapy was applied for symptom control in a cancer patient with unknown primary malignancy and multiple metastasis and its effects on the terminal life of this patient.

End-of-life care in a cardiology department： have we improved？

Background End-of-life care is not usually a priority in cardiology departments. We sought to evaluate the changes in end-of-life care after the introduction of a do-not-resuscitate （DNR） order protocol. Methods ＆ Results Retrospective analysis of all deaths in a cardiology department in two periods, before and after the introduction of the protocol. Comparison of demographic characteristics, use of DNR orders, and end-of-life care issues between both periods, according to the presence in the second period of the new DNR sheet （Group A）, a conven- tional DNR order （Group B） or the absence of any DNR order （Group C）. The number of deaths was similar in both periods （n = 198 vs. n = 197）. The rate of patients dying with a DNR order increased significantly （57.1% vs. 68.5%; P = 0.02）. Only 4% of patients in both periods were aware of the decision taken about cardiopulmonary resuscitation. Patients in Group A received the DNR order one day earlier, and 24.5% received it within the first 24 h of admission （vs. 2.6% in the first period; P 〈 0.001）. All patients in Group A with an implantable cardioverter defibrillator （ICD） had shock therapies deactivated （vs. 25.0% in the first period; P = 0.02）. Conclusions The introduction of a DNR order protocol may improve end-of-life care in cardiac patients by increasing the use and shortening the time of registration of DNR orders. It may also contribute to increase ICD deactivation in patients with these orders in place. However, the introduction of the sheet in late stages of the disease failed to improve patient participation.

Learning from the Film “Mitorishi (Transition Doula)”—Application to Understanding the End-of-Life in a Gerontological Nursing Practice Course in Japan

Purpose: This study aims to detail what nursing students learned from watching the film “Mitorishi”, which was used among the teaching materials in a gerontological nursing practice course in nursing education in Japan, and demonstrate the applicability of using the film as an element relevant to the teaching of end-of-life care in Japan. Methods: The participants were fourth-year nursing students at University A who had watched the film “Mitorishi” during the course, had submitted a report on what they learned, and provided informed consent to the study participation. The reports submitted by the participants were used as data and analyzed qualitatively using the content analysis approach. Results: The analysis identified the following five categories (number of codes): Characteristics of life during the final days (9), Importance of views on life and death (3), Importance of end-of-life care (3), Assistance in preparation for the final days of life (13), and Understanding the profession of transition doula (9). Discussion: The five categories show that the students have learned about the “role of nurses at the time of end-of-life care” while “visualizing end-of-life care” and learning “preparedness for end-of-life care”. These findings suggest that using the film “Mitorishi” in the teaching curriculum is effective for learning about end-of-life care for older people.

Rôles et vécus des pharmaciens d’officine dans les soins palliatifsàdomicile en France Role and Experience ofCommunity Pharmacists in Home Palliative Care in France

The need for home palliative care is increasing in allWestern countries.Community pharmacists are local professionals whose role in end-of-life care at home remains poorly understood.The aim of this study is to understand how community pharmacists see their role in end-of-life home care in France,and to analyze their experiences of this care.An online questionnaire was distributed to community pharmacists working in France between December 2022 and March 2023.Of the 136 respondents to the questionnaire,87%had accompanied at least one patient at the end of life in the 3 months preceding the survey.Therapeutic education(88%of respondents),psychological support for caregivers(85%of respondents),securing treatment(82%of respondents)and monitoring therapeutic compliance(80%of respondents)are the behaviors validated by the greatest number of participants.The majority of professionals surveyed had a positive overall experience of managing patients at the end of life.These results pave the way for pharmacists to better support end-of-life patients at home.

Factors Influencing Student Nurses’ Willingness to Care for Mentally Ill Patients with Highly Infectious Diseases in Nigeria: A Cross-Sectional Study

Background: Individuals experiencing mental illness and diagnosed with highly infectious diseases (HID) are doubly stigmatized. Identifying the factors influencing student’s willingness to care for this special population is essential not only to inform stigma reduction strategies but also to provide useful information towards building a critical mass of future compassionate caregivers with ultimate goal of improving the quality of nursing care for mentally ill persons. Methodology: A cross-sectional descriptive research design was utilized to examine 200 participants from a training institution in Ebonyi state. Data was collected using validated author constructed instrument. Descriptive and inferential statistics were utilized to analyze data. Result: Multiple logistic regression analysis revealed that the variables were statistically significant at χ2(4) = 23.133, p < 0.001. This demonstrates that all factors (gender, marital status, incentives, and family type) influence student nurses’ willingness to work with mentally ill patients who have highly infectious diseases. Conclusion: The findings of this study suggest that appropriate institutional policies, additional training, and incentives should be adopted to boost student motivation.

Palliative Care, Suffering, Death Trajectory: A View of End-of-Life Care (EOL) Related Issues in Sub-Saharan Africa (SSA)

Palliative care in the sub-Saharan Africa (SSA) region despite some progress made since the first hospice was opened in Zimbabwe in 1979, still lags far behind that of countries with developed economies, and relatively suffers from not being wholly included into mainstream public health service delivery in SSA. The situation is made worse due to relatively poor and pervasive socio-politico-economic factors and the challenge of the changing and increasing non-communicable disease epidemiology in SSA countries. This situation results in a tension between scarce resources and service needs/provision which prevails in a good number of SSA countries. In large part the situation where palliative care, end of life and the death trajectory converge in SSA countries currently portrays one of scarcity of resources and suffering for those ill SSA patients who need the services. This article is an overview of the current situation as pertains to palliative care services in the SSA region and some of the factors that contribute to or perpetuate the current state of palliative care delivery in SSA countries.

Palliative care with adequate pain relief challenges the need for euthanasia legislation

Background:In today’s society the ongoing discussion about euthanasia triggers emotionally charged debates surrounding the delicate balance between valuing life and respecting an individual’s autonomy.With the persistence of this debate,there has been the emergence of the concept of the so-called alternative:palliative care.Positioned as a substitute for euthanasia,palliative care aims to alleviate suffering in terminally ill patients without engaging in the ethical dilemmas associated with euthanasia.Methods:This paper explores the facets of palliative care highlighting its core objectives such as providing adequate pain relief as a compassionate alternative to euthanasia.Results:By examining palliative care as a comprehensive approach to end of life support,this study challenges the perceived necessity of euthanasia and advocates,for compassionate and dignified end of life experiences.Conclusion:In conclusion,palliative care emerges as a viable and ethically sound alternative to euthanasia,emphasizing the importance of compassionate end-of-life care and pain management.

Nurses’ Experiences of Using the Liverpool Care Pathway Plan in Hospitalized Patients with Heart Failure in the End-of-Life Stage: A Qualitative Content Analysis

Background: The introduction of care pathway plans for end-of-life cares such as the Liverpool Care Pathway (LCP) reveals a unique possibility for inter professional collaboration. Knowledge of symptom relief and how to meet the patients’ needs at the last stage of the palliative phase are essential for the nurses’ approach and care actions, but the documentation of such implementations is still rare and sometimes criticized. Aim: To explore and describe nurses’ experiences of using the LCP plan with patients hospitalized with heart failure at the end-of-life stage. An explorative design was applied, using qualitative content analysis of 20 interviews with nurses practicing the LCP plan in two district hospitals in Norway. Results: The nurses found the LCP plan as quality assurance for treatment and care in patients with heart failure in the last hours and days of life. The use of the LCP plan implied: 1) individualized adjustment, 2) symptom relief and 3) a holistic approach. Conclusion: Nurses experienced that using the LCP plan as a comprehensive action plan contributed in the decision making process and improved inter professional communication. Using the LCP plan should be seen as a tool to practice individualized and holistic nursing to patients at the end-of-life and their families, as well as a purposeful relief of symptoms associated with heart failure.

Meta-analysis of the willingness rate of community home-based care in China

Objective:To systematically evaluate the willingness rate of the community to provide for the aged at home and analyze its influencing factors.Methods:By searching the CNKI,VIP,Wanfang,we collected literature on the willingness of the elderly in the community to provide for the aged from 2011 to 2021,extracted the data,and evaluated the quality of the included literature.Then,CMA 2.0 software was used for Meta-analysis.Results:A total of 13 articles were included in this study,and 16,402 people over 60 years old were surveyed,1782 people were willing to provide for the aged at home in the community,with a total willingness rate of 11%(95%CI:9%to 26%).The results of subgroup analysis showed that there was a statistically significant difference in the community home care willingness rate of elderly people with different gender,education levels,marital status,monthly income,living alone,the number of children,and residence(P<0.05).There was not any statistically significant difference in the willingness rate of the elderly with different ages,chronic diseases,self-care ability,and loneliness(P>0.05).Conclusion:The overall willingness rate of the elderly in the community of the elderly is relatively low in China.Gender,education level,marital status,monthly income,living alone,number of children,and residence are factors affecting the prediction of community elderly will.

A conceptual analysis of the meaning of comfort at the end-of-life using the Walker and Avant(2014)Framework

Objective:The aim of the authors is to clarify the concept of comfort at the end-of-life in order to support understandings of fundamental nursing care needed at this stage of healthcare.Methods:The Walker and Avant framework was applied to develop a deeper understanding of the concept of comfort at the end of life.Results:Five defining attributes of comfort in the end-of-life were identified and they are having a peaceful home-life environment,trust and consolation,proximity and social-cultural support,alleviation of suffering,and a process of integrated intervention by nurses.Conclusions:At the end-of-life patients commonly experience physical,psychological,social-cultural,and environmental discomfort.Patients’families also encounter significant challenges.However,their comfort needs are often secondary to that of the patient.Additionally,a lack of clarity exists regarding the holistic meaning of comfort at the end-of-life,which can largely be confined to understandings of physical comfort for the patient,with a limited understanding of addressing family/caregivers’needs.Therefore,this concept analysis may provide some guidance in this regard and also provides support toward a more integrated understanding of the concept.

Nurses towards End-of-Life Situations: Sympathy vs. Empathy

Background: Nurses providing end-of-life care play an important role in providing support to both the patient and his/her family during one of their most difficult time. Patients in this stage do not only require physical care but emotional support as well. Aside from being a care provider, nurses should be able to utilize their knowledge in therapeutic communication in order for the patients and his/her family members to verbalize their feelings and concerns. Objective: The purpose of this study is to identify whether nurses project sympathy or empathy while providing end-of-life care. It also aims to determine their lived experiences while proving care at this stage. Methodology: This study utilized the mixed convergent parallel design wherein both the quantitative research and qualitative research were employed. Result and Discussion: A factor analysis was conducted on 12 items with maximum likelihood extraction method and oblique (Promax) rotation method. The Kaiser-Meyer-Olkin (KMO) measure verified the sampling adequacy for the analysis, KMO = 0.792 (“meritorious” according to Kaiser (1974)). Bartlett’s Test of Sphericity (χ2 (66) = 1007.294, p α = 0.881, sympathy α = 0.804, and cognitive empathy α = 0.728). Correlations among the factors were r = 0.315 for affective empathy and sympathy, r = 0.295 for sympathy and cognitive empathy, and r = 0.356 for affective empathy and cognitive empathy. Emergent key themes and subthemes are based on participants’ responses. The key themes are heart-touching moments of nurses in providing end-of-life care, challenges encountered by nurses in providing end-of-life care and adaptive strategies used by nurses to the challenges they face in providing end-of-life care. Conclusion: Most nurses during end-of-life care express affective empathy, followed by sympathy and lastly cognitive empathy. Nurses are encouraged to show and practice affective and cognitive empathy rather than using sympathy in caring patient and dealing with family member in the end-of-life situations. Despite the challenges that nurses faced, they are able to provide quality care by utilizing several adaptive strategies such as listening and understanding, showing empathy, providing holistic care, being spiritual and being aware of the role as caregiver.

儒家生命伦理融入老年护理学课程思政的实践效果

目的:探讨儒家生命伦理融入老年护理学课程思政的实践效果。方法:采取整群抽样法,以2018级312名(对照组)和2019级266名(试验组)本科护生为研究对象,对照组采用常规教学模式,试验组开展融入儒家生命伦理的老年护理学课程思政教学,课程结束后调查试验组护生对课程思政的内容和效果的感受,分析两组护生关怀能力、服务老年人意愿和考试成绩。结果:试验组266名护生中96.2%认为我国传统文化对医学生有可借鉴的智慧和思想,83.1%认为教学设计参与性和启发性较好,92.5%对课程评价总体满意。与老人共同生活的时间、家庭关系、对老龄化问题的关注程度会影响护生服务老年人意愿(P<0.05)。试验组护生关怀能力、服务老年人意愿、考试成绩均高于对照组(P<0.05)。结论:将儒家生命伦理融入老年护理学课程思政的教学设计有助于提升护生关怀能力和服务老年人意愿,促进其道德品质提升,更好地满足社会对老年护理人才的需求。

专科护生联合护士团体上门照护意愿及影响因素分析

目的分析“互联网+护理”背景下专科护生联合护士团体上门照护居家老年人的意愿并探讨其影响因素。方法采取便利抽样法,于2022年5-6月选取湖南省5所高职高专院校1335名护生,采用自行设计的《“互联网+护理”护生联合护士团体照护意愿调查表》进行“互联网+护理”团体照护意愿调查。结果64.12%护生愿意联合护士团队上门为老年人提供居家护理服务,logistic回归分析显示,高年级、参与过志愿服务的经历、有与老年人共同生活的经历、有为居家老年人提供上门服务的经历、接受过“互联网+护理”相关学习、从事过临床或社区护理工作的专科护生愿意参与“互联网+护理”团体照护服务(P<0.05)。结论专科护生参与“互联网+护理”团体照护意愿较高,建议在“互联网+护理”背景下鼓励护士带领护生到老年人家中提供上门服务,同时,高校在开展校院合作的过程中应加强“互联网+护理”培训工作,为老年人提供服务的同时培养“互联网+护理”发展的后备力量,实现“互联网+护理”持续稳定健康发展。

我国家庭养老照料研究的进展、反思与展望

目前我国家庭养老照料研究主要包括家庭在养老照料中的作用、家庭结构的变化及其对养老照料的影响、家庭养老照料的现实困境、支持体系等方面。现有研究的文献数量快速增长,重点关注家庭养老照料的现实压力,以社会学研究方法为主,体现了家庭变迁与文化传统,研究结论既有共识也有分歧。现有研究对家庭养老照料的需求识别、研究视角、研究方法、理论基础、照料意愿、照料能力、支持体系等方面的研究还存在一些不足。未来需要进一步深化家庭养老照料研究:历史、现实与未来相结合,不同机构与团队相结合,被照料者与照料者研究相结合,理论、实践与政策研究相结合,定性与定量相结合,多学科方法相结合,宏观、中观与微观研究相结合,积极探求家庭养老照料的中国方案与中国策略。

护理专业学生从事老年护理意愿现状调查及分析

通过一般资料问卷和老年人态度量表(KAOP)对护理专业学生从事老年护理意愿现状进行调查,调查发现护理专业学生从事老年护理意愿较低,对老年人的态度处于中等偏低水平。究其影响因素来看,是否与老年人共同生活,以及对老年人的态度情况是主要影响因素。相应地,形成尊老爱老的良好社会风尚,改变对老年人的态度则是提高护理专业学生从事老年护理意愿的重要措施。

医疗服务提供者和接受者对“互联网+”缓和医疗服务认知、态度、意愿及需求现状调查

目的:了解天津市医疗服务提供者和接受者对“互联网+”缓和医疗服务认知、态度、意愿及需求情况,并分析影响意愿的因素。方法:采用便利抽样法,于2023年3月至5月使用自行编制的“医疗服务提供者问卷”和“医疗服务接受者问卷”对天津市2所三级甲等医院的282名医疗服务提供者和100名医疗服务接受者进行调查。结果:医疗服务提供者认知、态度、意愿得分分别为(4.28±1.61)分、(33.56±9.55)分和(9.79±3.40)分。医疗服务接受者认知、态度、意愿得分分别为(5.10±2.36)分、(2.70±1.21)分和(2.09±0.87)分。工作年限和态度是医疗服务提供者实践意愿的影响因素(P<0.05);认知是医疗服务接受者使用意愿的影响因素(P<0.05)。结论:医疗服务提供者和接受者对于“互联网+”缓和医疗服务的认知水平偏低,二者对其持有支持态度和不同的需求,医疗服务接受者和年资高的医疗服务提供者的意愿相对较低。今后需继续加强对移动医疗和缓和医疗的科普教育,并根据需求设计人性化、方便、实用、安全性高的移动医疗平台,助力缓和医疗发展。

社会交换理论视角下的城市社区老年人互助养老意愿影响因素研究

互助养老服务是机构养老服务、社区居家养老服务的有益补充。如何保障互助养老服务健康、可持续发展是一个亟须解决的社会问题。社会交换理论认为,城市社区老年人参与互助养老服务的意愿取决于预期收益、预期成本、信任和参与风险的综合影响。通过问卷调查,利用Amos25软件对已构建的概念模型以及提出的假设进行实证检验和路径分析。结果表明:城市社区老年人参与互助养老服务的意愿,随着预期收益的增加和信任度的提高,呈现出正向增长的趋势,随着预期成本增加和参与风险增强,呈现出负向增长的趋势;互助养老服务的健康运行需要建立一系列的激励机制、保障机制并需要进行广泛宣传。

基于安德森模型的老年人安宁疗护接受意愿影响因素的研究进展

以安德森模型为框架指导,从前倾因素、使能因素、需求因素3个维度对老年人安宁疗护接受意愿的影响因素进行综述,突出受不同因素影响下的老年人群特征,以期为推动安宁疗护的实践研究及针对性地制定提升老年人安宁疗护服务利用意愿的方法及策略提供依据。

基于优劣尺度法的老年人居家照护服务选择偏好及支付意愿分析

目的探析老年人对居家照护服务的选择偏好及支付意愿,为推动长期护理保险制度及养老服务健康发展提供参考。方法基于优劣尺度法设计问卷,通过条件Logit回归分析老年人对居家照护服务各属性的选择偏好及老年人个体特征对其偏好的影响,并计算支付意愿。结果以个人自付额为参考,老年人对居家照护服务的选择偏好为:服务内容>服务质量>是否对服务过程进行监督或收集反馈意见(P均<0.05)。其中,老年人更偏好兼具生活照料和医疗护理的服务内容、较高的服务质量、能够进行监督或收集反馈意见的服务过程,并愿意为此分别多支付318.496元、767.508元、617.512元。老年人居家照护服务需求程度、子女数量和月均收入的差异会影响其选择偏好。结论居家照护服务发展应着力于居家医疗护理服务推广、服务质量提高和服务过程精细化管理。