Management of palliative care for oncology patients and ICU nursing staff attitude towards death

Abstract

Introduction: As nurses come into daily contact with terminal patients, the management of palliative care, and the attitude of the nursing staff towards death is an issue that is of great concern. In Greece, in contrast to countries abroad, the management of palliative care and the attitude of the nurses towards death have not been adequately researched. Purpose: The purpose of this study is to investigate the management of palliative care for oncology patients in the ICU, as well as the attitude, perception and behavior of nursing staff towards death. Material-method: The study population consisted of 100 nurses working at Theagenio (Cancer Hospital of Thessaloniki). Two questionnaires were used in the study: The DAP-R questionnaire on the perception and behavior of nursing staff towards death and the Frommelt questionnaire (FATCOD) on end-stage patient care. A study was also conducted on 30 end-stage oncology patients at the ICU of Theagenio, in order to investigate their management of palliative care. Results: The results of the study show that the duration of hospitalization of patients in the ICU is significantly related to protein intake and GCS. Patients who received a low protein content in the ICU survived less than those who received a higher protein content, while patients with low GCS at the time of admission to the ICU died in a shorter period of time. Regarding the attitude of nurses towards death, Greek nurses generally seem to have a less positive attitude compared to the international research. In addition, a statistically significant difference was found in the attitude of nurses towards death, in the acceptance but also in the avoidance of death, linked to the level of their education. Conclusions: Intensive care can prolong the death process of end-stage patients, as the chance of survival or return to a life of tolerable quality is minimal to zero. For this reason, it may be preferable for these patients to spend the last days of their lives in a familiar environment. The attitude of the nursing staff towards death and palliative care could be improved not only with specialized knowledge and training, but also by preparing the nurses to face death.