Comparison of the Attitudes of Nurses and Physicians toward Palliative Care in Neonatal Intensive Care Units.

Ha Na Jung, Hyeon Ok Ju
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Abstract

Purpose: This study aimed to compare the attitudes of nurses and physicians toward neonatal palliative care and identify the barriers to and facilitators of neonatal palliative care, with the goal of improving palliative care for infants in neonatal intensive care units (NICUs).

Methods: This cross-sectional study analyzed data from the NICUs of seven general hospitals with 112 nurses and 52 physicians participating. Data were collected using the Neonatal Palliative Care Attitude Scale questionnaire.

Results: Only 12.5% of nurses and 11.5% of physicians reported that they had sufficient education in neonatal palliative care. In contrast, 89.3% of the nurses and 84.6% of the physicians reported that they needed further education. The common facilitators for both nurses and physicians were 1) agreement by all members of the department regarding the provision of palliative care and 2) informing parents about palliative care options. The common barriers for both nurses and physicians were 1) policies or guidelines supporting palliative care were not available, 2) counseling was not available, 3) technological imperatives, and 4) parental demands for continuing life support. Insufficient resources, staff, and time were also identified as barriers for nurses, whereas these were not identified as barriers for physicians.

Conclusion: It is necessary to develop hospital or national guidelines and educational programs on neonatal palliative care, and it is equally necessary to spread social awareness of the importance of neonatal palliative care.

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新生儿重症监护病房护士与医师对姑息治疗态度的比较。
目的:本研究旨在比较护士和医生对新生儿姑息治疗的态度,找出新生儿姑息治疗的障碍和促进因素,以改善新生儿重症监护病房(NICUs)婴儿的姑息治疗。方法:本横断面研究分析了7家综合医院的新生儿重症监护病房的数据,共有112名护士和52名医生参与。数据收集采用新生儿姑息治疗态度量表问卷。结果:只有12.5%的护士和11.5%的医生报告他们有足够的新生儿姑息治疗教育。相比之下,89.3%的护士和84.6%的医生报告说他们需要继续接受教育。护士和医生的共同促进因素是:1)科室所有成员就提供姑息治疗达成一致;2)告知家长姑息治疗的选择。对于护士和医生来说,常见的障碍是:1)没有支持姑息治疗的政策或指南,2)没有咨询,3)技术要求,4)父母对持续生命支持的要求。资源、人员和时间不足也被认为是护士的障碍,而这些没有被认为是医生的障碍。结论:制定医院或国家新生儿姑息治疗指南和教育项目是必要的,同时也需要在社会上普及新生儿姑息治疗的重要性。
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