Influence of Palliative Care Training on Nurses’ Attitudes towards End-of-Life Care during the COVID-19 Pandemic in Spain
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Collection
2.2. Data Analysis
3. Results
4. Discussion
Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
- Nuzzo, J.; Moss, B.; Khan, J.; Rutkow, L. COVID-19 Map Johns Hopkins University (JHU) [Internet]. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). 2020. Available online: https://coronavirus.jhu.edu/map.html (accessed on 14 November 2020).
- Nuzzo, J.; Moss, B.; Khan, J.; Rutkow, L. Mortality Analyses. Johns Hopkins University (JHU) [Internet]. COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). 2020. Available online: https://coronavirus.jhu.edu/data/mortality (accessed on 14 November 2020).
- Moazzami, B.; Razavi-Khorasani, N.; Dooghaie Moghadam, A.; Farokhi, E.; Rezaei, N. COVID-19 and telemedicine: Immediate action required for maintaining healthcare providers well-being. J. Clin. Virol. 2020, 126, 104345. [Google Scholar] [CrossRef]
- Vieta, E.; Pérez, V.; Arango, C. Psychiatry in the aftermath of COVID-19. Rev Psiquiatr Salud Ment. 2020, 13, 105–110. Available online: https://www.elsevier.es/es-revista-revista-psiquiatria-salud-mental-286-articulo-psychiatry-in-aftermath-covid-19-S188898912030029X (accessed on 14 November 2020). [CrossRef] [PubMed]
- Teng, Z.; Wei, Z.; Qiu, Y.; Tan, Y.; Chen, J.; Tang, H.; Wu, H.; Wu, R.; Huang, J. Psychological status and fatigue of frontline staff two months after the COVID-19 pandemic outbreak in China: A cross-sectional study. J. Affect. Disord. 2020, 275, 247–252. [Google Scholar] [CrossRef]
- Xiang, Y.T.; Yang, Y.; Li, W.; Zhang, L.; Zhang, Q.; Cheung, T.; Ng, C.H. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry 2020, 7, 228–229. [Google Scholar] [CrossRef][Green Version]
- Maté-Méndez, J.; Lleras de Frutos, M. Profesionales sanitarios: Afrontando el impacto emocional por la COVID-19 en un centro monográfico de cáncer. Med. Paliat 2020, 27, 209–216. Available online: https://www.medicinapaliativa.es/profesionales-sanitarios-afrontando-el-impacto-emocional-por-la-COVID-19-en-un-centro-monografico-de-cancer540 (accessed on 14 November 2020). [CrossRef]
- De la Rica Escuín, M.; García-Navarro, E.B.; García Salvador, I.; De la Ossa Sendra, M.J.; Chisbert-Alapont, E. Acompañamiento a los pacientes al final de la vida durante la pandemia COVID-19. Med. Paliat 2020, 27, 181–191. Available online: https://www.medicinapaliativa.es/Acompanamiento-a-los-pacientes-al-final-de-la-vida-durante-la-pandemia-por-COVID-19534 (accessed on 14 November 2020).
- Araujo Hernández, M.; García Navarro, S.; García-Navarro, E.B. Approaching grief and death in family members of patients with COVID-19: Narrative review. Enferm. Clin. 2020, 19, s112–s116. [Google Scholar] [CrossRef]
- Varin, D.; Levy-Soussan, M.; Chabert, A. Cuidados Paliativos y Acompañamiento: Un Proceso de Capital Importancia. Ejemplo del Caso de Francia. EMC-Tratado De Med. 2013, 17, 1–5. Available online: https://www.sciencedirect.com/science/article/abs/pii/S1636541012640707?via%3Dihub (accessed on 14 November 2020). [CrossRef]
- Smith, D.C.; Maher, M.F. Achieving a healthy death: The dying person’s attitudinal contributions. Hosp. J. 1993, 9, 21–32. [Google Scholar] [CrossRef] [PubMed]
- O’Connor, M.F. Grief: A Brief History of Research on How Body, Mind, and Brain Adapt. Psychosom. Med. 2019, 81, 731–738. [Google Scholar] [CrossRef]
- Stajduhar, K.I.; Martin, W.; Cairns, M. What makes grief difficult? Perspectives from bereaved family caregivers and healthcare providers of advanced cancer patients. Palliat. Support Care 2010, 8, 277–289. [Google Scholar] [CrossRef] [PubMed]
- Pascual Fernández, C. Análisis de los niveles de ansiedad ante la muerte de los profesionales de enfermería de cuidados críticos. NURE Investig. 2013, 50, 6. Available online: https://www.nureinvestigacion.es/OJS/index.php/nure/article/view/521/510 (accessed on 14 November 2020).
- Maza Cabrera, M.; Zavala Gutiérrez, M.; Merino Escobar, J.M. Actitud del profesional de enfermería ante la muerte de pacientes. Cienc. Y Enfermería 2009, 15, 39–48. [Google Scholar] [CrossRef][Green Version]
- Benbunan-Bentata, B.; Cruz-Quintana, F.; Roa-Venegas, J.; Villaverde-Gutiérrez, C.; Benbunan-Bentata, B. Afrontamiento del dolor y la muerte en estudiantes de Enfermería: Una propuesta de intervención. Int. J. Clin. Health Psychol. 2007, 7, 197–205. Available online: http://www.aepc.es/ijchp/articulos_pdf/ijchp-216.pdf (accessed on 14 November 2020).
- Schmidt-RioValle, J.; Montoya-Juarez, R.; Campos-Calderon, C.; Garcia-Caro, M.; Prados-Peña, D.; Cruz-Quintana, F. Efectos de un programa de formación en cuidados paliativos sobre el afrontamiento de la muerte. Med. Paliat 2012, 19, 113–120. Available online: https://www.elsevier.es/es-revista-medicina-paliativa-337-articulo-efectos-un-programa-formacion-cuidados-S1134248X11000127 (accessed on 14 November 2020). [CrossRef]
- Míguez Burgos, A.; Muñoz Simarro, D. Enfermería y el paciente en situación terminal. Enfermería Glob. 2009, 8, 2. Available online: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1695-61412009000200018&lng=es (accessed on 14 November 2020). [CrossRef]
- Costantini, M.; Sleeman, K.E.; Peruselli, C.; Higginson, I.J. Response and role of palliative care during the COVID-19 pandemic: A national telephone survey of hospices in Italy. Palliat. Med. 2020, 34, 889–895. [Google Scholar] [CrossRef]
- Rosa, W.E.; Ferrell, B.R.; Wiencek, C. Increasing Critical Care Nurse Engagement of Palliative Care During the COVID-19 Pandemic. Crit. Care Nurse 2020, 40, e28–e36. [Google Scholar] [CrossRef] [PubMed]
- Dunn, K.S.; Otten, C.; Stephens, E. Nursing experience and the care of dying patients. Oncol. Nurs. Forum 2005, 32, 97–104. [Google Scholar] [CrossRef][Green Version]
- Vallés Martínez, P.; García Salvador, I. Formación básica en cuidados paliativos: Estado actual en las universidades de enfermería españolas. Med. Paliat 2013, 20, 111–114. Available online: https://www.elsevier.es/es-revista-medicina-paliativa-337-articulo-formacion-basica-cuidados-paliativos-estado-S1134248X13000487 (accessed on 14 November 2020). [CrossRef]
- De Vlieger, M.; Gorchs, N.; Larkin, P.; Porchet, F. Guide for the Development of Palliative Nurse Education in Europe; EAPC: Milan, Italy, 2004. [Google Scholar]
- García Salvador, I.; Vallés Martínez, P.; Peris, G.; Utor Ponce, L.; Pérez Yuste, P.; López-Casero Beltran, N.; Robles Alonso, V.; Campos Monfort, P.; Chover Sierra, E.; Plaza Escribano, T.; et al. Recomendaciones de la Asociación Española de Enfermería en Cuidados Paliativos. Sobre la Formación de Grado en Enfermería, 1st ed.; Inspira Network: Madrid, Spain, 2019. [Google Scholar]
- WHO Expert Committee on Cancer Pain Relief and Active Supportive Care & World Health Organization. Alivio del Dolor y Tratamiento Paliativo del Cáncer; Organización Mundial de la Salud: Ginebra, Switzerland, 1990; pp. 1–82. [Google Scholar]
- Codorniu, N.; Guanter, L.; Molins, A.; Utor, L. Competencias Enfermeras en Cuidados Paliativos; Monografías SECPAL: Madrid, Spain, 2013. [Google Scholar]
- Espinoza, V.; Maritza Sanhueza, A.O. Miedo a la muerte y su relación con la inteligencia emocional de estudiantes de enfermería de Concepción. Acta Paul. De Enferm. 2012, 25, 607–613. Available online: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-21002012000400020&lng=en (accessed on 14 November 2020). [CrossRef][Green Version]
- Fernández Pérez, M. Ansiedad Y Temor a la Muerte en Profesionales Y Estudiantes de Enfermería de Extremadura. Bachelor’s Thesis, Universidad de Extremadura, Badajoz, Spain, 2016. Available online: http://hdl.handle.net/10662/3856 (accessed on 14 November 2020).
- Braun, M.; Gordon, D.; Uziely, B. Associations between oncology nurses’ attitudes toward death and caring for dying patients. Oncol. Nurs. Forum 2010, 37, E43-9. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Colell Brunet, R.; Limonero García, J.T.; Otero, M.D. Actitudes y emociones en estudiantes de enfermería ante la muerte y la enfermedad terminal. Investig. En Salud 2003, 2, 1. Available online: https://www.redalyc.org/articulo.oa?id=142/14250205 (accessed on 14 November 2020).
- Rojas-Ocaña, M.J.; Araujo-Hernández, M.; Romero-Castillo, R.; Román-Mata, S.S.; García-Navarro, E.B. Nursing as a Sustainability Factor of the Health System during the COVID-19 Pandemic: A Qualitative Study. Sustainability 2020, 12, 8099. [Google Scholar] [CrossRef]
- Ministerio de Sanidad Política Social e Igualdad. Dirección General de Ordenación Profesional, Cohesión del SNS y Alta Inspección. In Informe Sobre Profesionales de Enfermería. Oferta-Necesidad 2010-2025; Ministerio de Sanidad Política Social e Igualdad: Madrid, Spain, 2012; pp. 1–146. [Google Scholar]
- Arroyo Menéndez, M.; Finkel, L. Encuestas por Internet y nuevos procedimientos muestrales. Panor. Soc. 2019, 30, 41–53. Available online: https://www.funcas.es/wp-content/uploads/Migracion/Articulos/FUNCAS_PS/030art04.pdf (accessed on 2 August 2021).
- Bermejo, J.; Villacieros, M.; Hassoun, H. Actitudes hacia el cuidado de pacientes al final de la vida y miedo a la muerte en una muestra de estudiantes sociosanitarios. Med. Paliat 2017, 25, 168–174. Available online: https://www.elsevier.es/es-revista-medicina-paliativa-337-avance-resumen-actitudes-hacia-el-cuidado-pacientes-S1134248X18300065 (accessed on 14 November 2020). [CrossRef]
- Hurtado de Mendoza Sánchez, C. Percepción de Riesgos Psicosociales, Estrés, Ansiedad, Variables de Salud y Conciliación de la Vida Laboral-Familiar en Trabajadores Y Trabajadoras. Ph.D. Thesis, Universidad Complutense de Madrid, Madrid, Spain, 2013. Available online: https://eprints.ucm.es/23439/ (accessed on 14 November 2020).
- Generalitat Valenciana. Protocolo de Acompañamiento al Paciente en el Final de la Vida Durante la Pandemia COVID-19. Valencia. 2020. Available online: https://www.gva.es/contenidos/publicados/multimedia/prensa/20200411/doc/protocolo_acompanamiento_final_vida.pdf (accessed on 17 May 2020).
- Comunidad de Madrid. Protocolo de Atención a Pacientes y Familias al Final de la Vida Durante la Pandemia por COVID-19 en Centros Sociosanitarios. Madrid. 2020. Available online: https://www.comunidad.madrid/sites/default/files/doc/serviciossociales/protocolo_final_de_vida_residencias_Covid19_0.pdf (accessed on 17 May 2020).
- Junta de Castilla y León. Protocolo Integral de Actuaciones Específicas de Gravedad, Últimos Días y fallecimiento en la Crisis COVID-19. Valladolid. 2020. Available online: https://www.saludcastillayleon.es/es/Covid-19/informacion-profesionales/Atencion-Hospitalaria.Ficheros/1571031-020420_Protocolo%20integral%20de%20actuaci%C3%B3n%20ante%20situaciones%20espec%C3%ADficas%20de%20gravedad%2C%C3%BAltimos%20d%C3%ADas%20y%20fallecimiento%20en%20la%20crisis%20COVID-19.pdf (accessed on 17 May 2020).
- Consejería de Derechos Sociales y Bienestar del Principado de Asturias. Confinamiento y acompañamiento en el proceso de final de la vida. Centros Residenciales de Personas Mayores y Centros de Atención Social. Oviedo. 2020. Available online: https://www.socialasturias.es/servicios-sociales/profesionales/personas-mayores-y-discapacidad_1104_1_ap.html (accessed on 17 May 2020).
- Sullivan, A.M.; Lakoma, M.D.; Block, S.D. The status of medical education in end-of-life care: A national report. J. Gen. Intern. Med. 2003, 18, 685–695. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Espinoza-Venegas, M.; Luengo-Machuca, L.; Sanhueza-Alvarado, O. Actitudes en profesionales de enfermería chilenos hacia el cuidado al final de la vida. Análisis multivariado. Aquichan 2016, 16, 430–446. Available online: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S1657-59972016000400430&lng=en (accessed on 14 November 2020). [CrossRef][Green Version]
- Lange, M.; Thom, B.; Kline, N.E. Assessing nurses’ attitudes toward death and caring for dying patients in a comprehensive cancer center. Oncol. Nurs. Forum 2008, 35, 955–959. [Google Scholar] [CrossRef] [PubMed][Green Version]
- Guía se Cuidados Paliativos. Sociedad Española de Cuidados Paliativos. Available online: http://www.secpal.com/%5C%5CDocumentos%5CPaginas%5Cguiacp.pdf (accessed on 17 May 2020).
Socio-Demographic Data (N = 335) | |||||
---|---|---|---|---|---|
Variables | Mean in Years (SD) | n (%) | |||
Sex | Male | 44 (13.1) | |||
Female | 291 (86.9) | ||||
Age | Male | 40.26 (±10.81) | 42.57 (±10.94) | ||
Female | 39.91 (±10.77) | ||||
Years of professional practice | Male | 15.79 (±10.71) | 18.05 (±10.92) | ||
Female | 15.45 (±10.75) | ||||
Spanish Autonomous Region | Comunidad Valenciana | 67 (20) | |||
Castilla León | 48 (14.3) | ||||
Madrid | 34 (10.1) | ||||
Aragón | 33 (9.9) | ||||
Islas Baleares | 27 (8.1) | ||||
Cataluña | 26 (7.8) | ||||
Castilla La Mancha | 23 (6.9) | ||||
Andalucía | 20 (6) | ||||
Galicia | 20 (6) | ||||
Extremadura | 14 (4.2) | ||||
País Vasco | 7 (2.1) | ||||
Islas Canarias | 4 (1.2) | ||||
Murcia | 4 (1.2) | ||||
Asturias | 4 (1.2) | ||||
Navarra | 3 (0.9) | ||||
Cantabria | 1 (0.3) | ||||
Postgraduate Training | No | 156 (46.6) | |||
Yes | 176 (52.5) | ||||
NR/DK | 3 (0.9) | ||||
Training in Palliative Care | No | 161 (48.1) | |||
Yes | 171 (51) | ||||
NR/DK | 3 (0.9) | ||||
Usual Unit | Surgery | 14 (4) | |||
Geriatrics | 5 (1.4) | ||||
Oncology and Hematology | 22 (6.4) | ||||
Urology and Nephrology | 11 (3.2) | ||||
Internal Medicine and Infectious Diseases | 56 (16.2) | ||||
ICU and Resuscitation | 50 (14.5) | ||||
Emergency | 26 (7.5) | ||||
Palliative Care Unit | 35 (10.1) | ||||
Pneumology | 22 (6.4) | ||||
Gastrointestinal | 6 (1.7) | ||||
Operating Theatre | 10 (2.9) | ||||
Traumatology | 7 (2) | ||||
Cardiology | 6 (1.7) | ||||
Gynecology and Pediatrics | 5 (1.4) | ||||
Neurology | 5 (1.4) | ||||
Nursing Home or Public Health Centre | 37 (10.7) | ||||
Undefined Hospitalization | 15 (4.3) | ||||
Others | 14 (4) | ||||
Unit during COVID-19 pandemic | Specialized Care | Hospitalization | 224 (66.9) | ||
ICU | 52 (15.5) | ||||
Resuscitation (restructures due to COVID-19) | 18 (5.4) | ||||
Nursing Home or Public Health Centre | 41 (12.2) | ||||
Care of patients during COVID-19 pandemic | Care of COVID-19 patients in their last days | 273 (81.49) | |||
Care of non-COVID-19 patients in their last days | 264 (78.8) |
Yes | No | NR/DK | Total | p-Value | ||
---|---|---|---|---|---|---|
n (%) | n (%) | n (%) | n (%) | |||
Allowed farewell to COVID-19 patients | ||||||
Training in Palliative Care | Yes | 60 (22) | 64 (23.4) | 5 (1.8) | 129 (47.3) | 0.186 |
No | 58 (21.2) | 71 (26) | 12 (4.4) | 141 (51.6) | ||
NR/DK | 1 (0.4) | 1 (0.4) | 1 (0.4) | 3 (1.1) | ||
Total | 119 (43.6) | 136 (49.8) | 18 (6.6) | 273 (100) | ||
Allowed farewell to non-COVID-19 patients | ||||||
Training in Palliative Care | Yes | 114 (43.2) | 29 (11) | 6 (2.3) | 149 (56.4) | 0.645 |
No | 86 (32.6) | 18 (6.8) | 8 (3) | 112 (42.4) | ||
NR/DK | 3 (1.1) | 0 (0) | 0 (0) | 3 (1.1) | ||
Total | 203 (76.9) | 47 (17.8) | 14 (5.3) | 264 (100) |
Strongly Disagree (1) | Disagree (2) | Neither Disagree nor Agree (3) | Agree (4) | Strongly Agree (5) | ||
---|---|---|---|---|---|---|
Training in Palliative Care | n (%) | n (%) | n (%) | n (%) | n (%) | Total n (%) |
Stress due to professional practice: “I am very stressed in my job” | ||||||
Yes | 22 (12.9) | 25 (14.6) | 19 (11.1) | 58 (33.9) | 47 (27.5) | 171 (100) |
No | 11 (6.8) | 14 (8.7) | 19 (11.8) | 66 (41) | 51 (31.7) | 161 (100) |
NR/DK | 0 (0) | 0 (0) | 0 (0) | 3 (100) | 0 (0) | 3 (100) |
Motivation in professional practice: “I am very motivated in my job” | ||||||
Yes | 18 (10.5) | 32 (18.7) | 30 (17.5) | 57 (33.3) | 34 (19.9) | 171 (100) |
No | 17 (10.6) | 24 (14.9) | 40 (24.8) | 56 (34.8) | 24 (14.9) | 161 (100) |
NR/DK | 0 (0) | 0 (0) | 2 (66,6) | 0 (0) | 1 (33.3) | 3 (100) |
Satisfaction in professional practice: “I am very satisfied in my job” | ||||||
Yes | 13 (7.6) | 35 (20.8) | 23 (13.5) | 63 (36.8) | 37 (21.6) | 171 (100) |
No | 14 (8.7) | 31 (19.3) | 20 (12.4) | 67 (41.6) | 29 (18) | 161 (100) |
NR/DK | 0 (0) | 1 (33.3) | 1 (33.3) | 0 (0) | 1 (33.3) | 3 (100) |
Odds Ratio | Confidence Intervals (Lower95–Upper95) | p-Value | |||||||
---|---|---|---|---|---|---|---|---|---|
Variables | Stress Due to Professional Practice | Motivation in Professional Practice | Satisfaction in Professional Practice | Stress due to Professional Practice | Motivation in Professional Practice | Satisfaction in Professional Practice | Stress due to Professional Practice | Motivation in Professional Practice | Satisfaction in Professional Practice |
Training in Palliative Care | 0.752 | 1.131 | 1.214 | 0.498–1.134 | 0.76–1.685 | 0.808–1.827 | 0.174 | 0.545 | 0.351 |
Years of professional practice | 0.984 | 0.996 | 0.98 | 0.965–1.003 | 0.978–1.014 | 0.962–0999 | 0.091 | 0.646 | 0.037 |
Sex: Female | 0.754 | 1.019 | 1.058 | 0.43–1.314 | 0.591–1.753 | 0.594–1.88 | 0.32 | 0.945 | 0.847 |
Care of COVID-19 patients in their last days | 1.702 | 1.365 | 1.029–2.816 | 0.819–2.277 | 0.038 | 0.232 | |||
Having encountered deceased patients | 1.217 | 0.864 | 0.814–1831 | 0.578–1.29 | 0.34 | 0.474 | |||
To say goodbye to their family | 0.705 | 1.322 | 0.455–1.088 | 0.867–2.02 | 0.116 | 0.195 |
Attitudes about End-of-Life Care Score (N = 335) | |||||||||
---|---|---|---|---|---|---|---|---|---|
Item Value * | Sd (1) | D (2) | A (3) | SA (4) | |||||
Mean ± SD | n (%) | n (%) | n (%) | n (%) | Total n (%) | OD [CI] | p-Value | ||
1: Psychological suffering can be as hard as physical suffering. | |||||||||
Training in Palliative Care | Yes | 3.92 ± 0.343 | 1 (0.6) | 1 (0.6) | 8 (4.7) | 161 (94.2) | 171 (100) | 1.203 [0.444–3.313] | 0.715 |
No | 3.94 ± 0.242 | 0 (0) | 0 (0) | 10 (6.2) | 151 (93.8) | 161 (100) | |||
NR/DK | 4 ± 0 | 0 (0) | 0 (0) | 0 (0) | 3 (100) | 3 (100) | |||
2: Health care professionals have a responsibility to help patients at the end of their lives. | |||||||||
Training in Palliative Care | Yes | 3.95 ± 0.212 | 0 (0) | 0 (0) | 8 (4.7) | 163 (95.3) | 171 (100) | 1.228 [0.458–3.419] | 0.685 |
No | 3.93 ± 0.286 | 0 (0) | 1 (0.6) | 10 (6.2) | 150 (93.2) | 161 (100) | |||
NR/DK | 4 ± 0 | 0 (0) | 0 (0) | 0 (0) | 3 (100) | 3 (100) | |||
3: Health care professionals have a responsibility to help patients prepare for death. | |||||||||
Training in Palliative Care | Yes | 3.79 ± 0.475 | 1 (0.6) | 2 (1.2) | 29 (17) | 139 (81.3) | 171 (100) | 1.687 [0.981–2.931] | 0.06 |
No | 3.68 ± 0.529 | 0 (0) | 5 (3.1) | 41 (25.5) | 115 (71.4) | 161 (100) | |||
NR/DK | 4 ± 0 | 0 (0) | 0 (0) | 0 (0) | 3 (100) | 3 (100) | |||
4: Health care professionals have a responsibility to support the grieving family members after the death of the patient. | |||||||||
Training in Palliative Care | Yes | 3.47 ± 0.821 | 7 (4.1) | 15 (8.8) | 40 (23.4) | 109 (63.7) | 171 (100) | 1.936 [1.24–3.04] | 0.004 |
No | 3.27 ± 0.740 | 1 (0) | 25 (15.5) | 65 (40.4) | 70 (43.5) | 161 (100) | |||
NR/DK | 4 ± 0 | 0 (0) | 0 (0) | 0 (0) | 3 (100) | 3 (100) | |||
5: Depression can be treated in patients at the end-of-life. | |||||||||
Training in Palliative Care | Yes | 3.39 ± 0.714 | 1 (0.6) | 20 (11.7) | 61 (35.7) | 89 (52) | 171 (100) | 1.693 [1.092–2.634] | 0.019 |
No | 3.17 ± 0.729 | 2 (1.2) | 25 (15.5) | 77 (47.8) | 57 (35.4) | 161 (100) | |||
NR/DK | 3.33 ± 0.577 | 0 (0) | 0 (0) | 2 (66.7) | 1 (33.3) | 3 (100) | |||
6: It is possible to explain the terminal prognosis to the patient and still maintain hope. | |||||||||
Training in Palliative Care | Yes | 2.88 ± 0.839 | 9 (5.3) | 44 (25.7) | 76 (44.4) | 42 (24.6) | 171 (100) | 1.624 [1.061–2.494] | 0.026 |
No | 2.60 ± 0.808 | 16 (9.9) | 49 (30.4) | 79 (49.1) | 17 (10.6) | 161 (100) | |||
NR/DK | 2.33 ± 0.577 | 0 (0) | 2 (66.7) | 1 (33.3) | 0 (0) | 3 (100) | |||
Item Value * | Sd (4) | D (3) | A (2) | SA (1) | |||||
7: Caring for patients at the end-of-life is depressing. | |||||||||
Training in Palliative Care | Yes | 3.19 ±0.958 | 85 (49.7) | 45 (26.3) | 29 (17) | 12 (7) | 171 (100) | 0.48 [0.313–0.733] | 0.001 |
No | 2.80 ± 0.934 | 41 (25.5) | 63 (39.1) | 41 (25.5) | 16 (9.9) | 161 (100) | |||
NR/DK | 3.67 ± 0.577 | 2 (66.7) | 1 (33.3) | 0 (0) | 0 (0) | 3 (100) | |||
8: I feel guilty after the patient’s death. | |||||||||
Training in Palliative Care | Yes | 3.43 ± 0.728 | 96 (56.1) | 55 (32.2) | 18 (10.5) | 2 (1.2) | 171 (100) | 0.724 [0.465–1.126] | 0.153 |
No | 3.27 ± 0.873 | 83 (51.6) | 45 (28) | 27 (16.8) | 6 (3.7) | 161 (100) | |||
NR/DK | 2.67 ± 0.577 | 0 (0) | 2 (66.7) | 1 (33.3) | 0 (0) | 3 (100) | |||
9: I am afraid of having to deal with the emotional stress of relatives after the death of the patient. | |||||||||
Training in Palliative Care | Yes | 2.87 ± 1.032 | 61 (35.7) | 47 (27.5) | 43 (25.1) | 20 (11.7) | 171 (100) | 0.582 [0.383–0.883] | 0.011 |
No | 2.48 ± 1.031 | 33 (20.5) | 44 (27.3) | 52 (32.3) | 32 (19.9) | 161 (100) | |||
NR/DK | 2.33 ± 1.528 | 1 (33.3) | 0 (0) | 1 (33.3) | 1 (33.3) | 3 (100) |
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Chisbert-Alapont, E.; García-Salvador, I.; De La Ossa-Sendra, M.J.; García-Navarro, E.B.; De La Rica-Escuín, M. Influence of Palliative Care Training on Nurses’ Attitudes towards End-of-Life Care during the COVID-19 Pandemic in Spain. Int. J. Environ. Res. Public Health 2021, 18, 11249. https://doi.org/10.3390/ijerph182111249
Chisbert-Alapont E, García-Salvador I, De La Ossa-Sendra MJ, García-Navarro EB, De La Rica-Escuín M. Influence of Palliative Care Training on Nurses’ Attitudes towards End-of-Life Care during the COVID-19 Pandemic in Spain. International Journal of Environmental Research and Public Health. 2021; 18(21):11249. https://doi.org/10.3390/ijerph182111249
Chicago/Turabian StyleChisbert-Alapont, Encarna, Isidro García-Salvador, María Jesús De La Ossa-Sendra, Esperanza Begoña García-Navarro, and Marisa De La Rica-Escuín. 2021. "Influence of Palliative Care Training on Nurses’ Attitudes towards End-of-Life Care during the COVID-19 Pandemic in Spain" International Journal of Environmental Research and Public Health 18, no. 21: 11249. https://doi.org/10.3390/ijerph182111249