Perceived quality of palliative care in intensive care units among doctors and nurses in Taiwan

Ying-Xuan Ke, Sophia H Hu, Naomi Takemura, Chia-Chin Lin

研究成果: 雜誌貢獻文章

摘要

OBJECTIVE: To compare perceptions of various aspects of palliative care for doctors and nurses; and examine factors contributing to perceived quality palliative care in intensive care units (ICUs).

DESIGN: A cross-sectional survey study conducted from November to December 2013. Questionnaires used were Knowledge, Attitudinal and Experiential Survey on Advance Directives (ADs), Clarke's Quality of Palliative Care and Nurses' Participation in the end-of-life (EOL) decision-making process.

SETTING: Seven adult medical and surgical ICUs at a medical center in Northern Taiwan.

PARTICIPANTS: In total, 172 doctors and nurses who worked in adult ICU for more than 3 months.

MAIN OUTCOME MEASURES: Nurses' and doctors' perception of quality palliative care.

RESULTS: Nurses provided better care than doctors in symptom management, comfort care and spiritual care; their participation in EOL decision-making was the sole modifiable contributor to perceived quality palliative care in ICUs (β = 0.24, P < 0.01). Both doctors and nurses had positive attitudes towards ADs (mean = 4.05/10; standard deviation [SD] = 1.38) while their knowledge of ADs was poor (mean = 29.72/40; SD = 3.00). More than half of nurses currently participated in EOL decision-making and over 80% of doctors and nurses agreed both parties should engage in EOL decision-making process. Majority of doctors (83.9%) reckoned nurses agreed with their EOL decisions while a significant percentage (40%) of nurses were uncertain about doctors' decisions (χ2 = 12.07, P < 0.01).

CONCLUSIONS: Nurses' participation in EOL decision-making and strengthening spiritual care are imperative to rendering quality palliative care in ICUs. Potential disagreements arose during EOL decision-making between doctors and nurses; and insufficient knowledge of ADs should be addressed.

指紋

Quality of Health Care
Taiwan
Palliative Care
Intensive Care Units
Nurses
Advance Directives
Decision Making
Cross-Sectional Studies
Critical Care

引用此文

@article{b3e3fcd6b5b14476a54f633ef1f3c673,
title = "Perceived quality of palliative care in intensive care units among doctors and nurses in Taiwan",
abstract = "OBJECTIVE: To compare perceptions of various aspects of palliative care for doctors and nurses; and examine factors contributing to perceived quality palliative care in intensive care units (ICUs).DESIGN: A cross-sectional survey study conducted from November to December 2013. Questionnaires used were Knowledge, Attitudinal and Experiential Survey on Advance Directives (ADs), Clarke's Quality of Palliative Care and Nurses' Participation in the end-of-life (EOL) decision-making process.SETTING: Seven adult medical and surgical ICUs at a medical center in Northern Taiwan.PARTICIPANTS: In total, 172 doctors and nurses who worked in adult ICU for more than 3 months.MAIN OUTCOME MEASURES: Nurses' and doctors' perception of quality palliative care.RESULTS: Nurses provided better care than doctors in symptom management, comfort care and spiritual care; their participation in EOL decision-making was the sole modifiable contributor to perceived quality palliative care in ICUs (β = 0.24, P < 0.01). Both doctors and nurses had positive attitudes towards ADs (mean = 4.05/10; standard deviation [SD] = 1.38) while their knowledge of ADs was poor (mean = 29.72/40; SD = 3.00). More than half of nurses currently participated in EOL decision-making and over 80{\%} of doctors and nurses agreed both parties should engage in EOL decision-making process. Majority of doctors (83.9{\%}) reckoned nurses agreed with their EOL decisions while a significant percentage (40{\%}) of nurses were uncertain about doctors' decisions (χ2 = 12.07, P < 0.01).CONCLUSIONS: Nurses' participation in EOL decision-making and strengthening spiritual care are imperative to rendering quality palliative care in ICUs. Potential disagreements arose during EOL decision-making between doctors and nurses; and insufficient knowledge of ADs should be addressed.",
author = "Ying-Xuan Ke and Hu, {Sophia H} and Naomi Takemura and Chia-Chin Lin",
note = "{\circledC} The Author(s) 2019. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.",
year = "2019",
month = "3",
day = "11",
doi = "10.1093/intqhc/mzz003",
language = "English",
journal = "International Journal for Quality in Health Care",
issn = "1353-4505",
publisher = "Oxford University Press",

}

TY - JOUR

T1 - Perceived quality of palliative care in intensive care units among doctors and nurses in Taiwan

AU - Ke, Ying-Xuan

AU - Hu, Sophia H

AU - Takemura, Naomi

AU - Lin, Chia-Chin

N1 - © The Author(s) 2019. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PY - 2019/3/11

Y1 - 2019/3/11

N2 - OBJECTIVE: To compare perceptions of various aspects of palliative care for doctors and nurses; and examine factors contributing to perceived quality palliative care in intensive care units (ICUs).DESIGN: A cross-sectional survey study conducted from November to December 2013. Questionnaires used were Knowledge, Attitudinal and Experiential Survey on Advance Directives (ADs), Clarke's Quality of Palliative Care and Nurses' Participation in the end-of-life (EOL) decision-making process.SETTING: Seven adult medical and surgical ICUs at a medical center in Northern Taiwan.PARTICIPANTS: In total, 172 doctors and nurses who worked in adult ICU for more than 3 months.MAIN OUTCOME MEASURES: Nurses' and doctors' perception of quality palliative care.RESULTS: Nurses provided better care than doctors in symptom management, comfort care and spiritual care; their participation in EOL decision-making was the sole modifiable contributor to perceived quality palliative care in ICUs (β = 0.24, P < 0.01). Both doctors and nurses had positive attitudes towards ADs (mean = 4.05/10; standard deviation [SD] = 1.38) while their knowledge of ADs was poor (mean = 29.72/40; SD = 3.00). More than half of nurses currently participated in EOL decision-making and over 80% of doctors and nurses agreed both parties should engage in EOL decision-making process. Majority of doctors (83.9%) reckoned nurses agreed with their EOL decisions while a significant percentage (40%) of nurses were uncertain about doctors' decisions (χ2 = 12.07, P < 0.01).CONCLUSIONS: Nurses' participation in EOL decision-making and strengthening spiritual care are imperative to rendering quality palliative care in ICUs. Potential disagreements arose during EOL decision-making between doctors and nurses; and insufficient knowledge of ADs should be addressed.

AB - OBJECTIVE: To compare perceptions of various aspects of palliative care for doctors and nurses; and examine factors contributing to perceived quality palliative care in intensive care units (ICUs).DESIGN: A cross-sectional survey study conducted from November to December 2013. Questionnaires used were Knowledge, Attitudinal and Experiential Survey on Advance Directives (ADs), Clarke's Quality of Palliative Care and Nurses' Participation in the end-of-life (EOL) decision-making process.SETTING: Seven adult medical and surgical ICUs at a medical center in Northern Taiwan.PARTICIPANTS: In total, 172 doctors and nurses who worked in adult ICU for more than 3 months.MAIN OUTCOME MEASURES: Nurses' and doctors' perception of quality palliative care.RESULTS: Nurses provided better care than doctors in symptom management, comfort care and spiritual care; their participation in EOL decision-making was the sole modifiable contributor to perceived quality palliative care in ICUs (β = 0.24, P < 0.01). Both doctors and nurses had positive attitudes towards ADs (mean = 4.05/10; standard deviation [SD] = 1.38) while their knowledge of ADs was poor (mean = 29.72/40; SD = 3.00). More than half of nurses currently participated in EOL decision-making and over 80% of doctors and nurses agreed both parties should engage in EOL decision-making process. Majority of doctors (83.9%) reckoned nurses agreed with their EOL decisions while a significant percentage (40%) of nurses were uncertain about doctors' decisions (χ2 = 12.07, P < 0.01).CONCLUSIONS: Nurses' participation in EOL decision-making and strengthening spiritual care are imperative to rendering quality palliative care in ICUs. Potential disagreements arose during EOL decision-making between doctors and nurses; and insufficient knowledge of ADs should be addressed.

U2 - 10.1093/intqhc/mzz003

DO - 10.1093/intqhc/mzz003

M3 - Article

C2 - 30855672

JO - International Journal for Quality in Health Care

JF - International Journal for Quality in Health Care

SN - 1353-4505

ER -