Factors Influencing the Self-Reported Palliative Care Practices of Acute Care Nurses.

Abstract

Background: Provision of palliative care in acute care settings is significantly lacking despite evidence that early integration leads to better patient/family-related outcomes and improved healthcare cost and efficiency.

Objective: This study investigated influencing factors that affect the nature and frequency of palliative care practices of acute care nurses.

Methods: A descriptive, cross-sectional design was used to examine the effects of personal and environmental factors on nurses' palliative care practices in the acute care setting. Registered nurses (N = 325) completed an electronic survey including a demographic questionnaire and 6 other measures to measure the study variables (palliative care practices, palliative care knowledge, self-efficacy, perceived competency, attitudes toward care of the dying, and perceived barriers). Hierarchical multiple linear regression evaluated the degree to which each set of variables explained the variance in self-reported frequency of palliative care practices while controlling for the others.

Results: The final regression model with demographics, personal factors, and environmental factors accounted for 32.1% of the variance in the frequency of nurses' self-reported palliative care practices and was significant (F_{[14, 238]} = 8.050, P < .001). Step one (demographics) explained 12.3% of the variance (F_{[7, 245]} = 4.916, P < .001). Step two (personal factors) explained 19.4% (F_{[5, 240]} = 13.678, P < .001). Step three (environmental factors) explained 0.4% (F_{[2, 238]} = 9.053, P = .519).

Conclusions: Personal factors, especially self-efficacy and attitudes toward care of the dying, are the most significant influencing factors to the frequency of acute care nurses' palliative care practices.