NURSES’ ATTITUDE TOWARD THE PEDIATRIC END OF LIFE CARE AT HIWA CANCER HOSPITAL IN SULAIMANY-IRAQ

Abdalrahman, Shadan Zahid; Majeed, Bahar Nasradeen

doi:10.33899/mjn.2022.170467

Journals List

NURSES’ ATTITUDE TOWARD THE PEDIATRIC END OF LIFE CARE AT HIWA CANCER HOSPITAL IN SULAIMANY-IRAQ

Mosul Journal of Nursing

Article 10, Volume 10, Issue 1, 2022, Pages 70-75 PDF (386.25 K)

Document Type: Original Articles

DOI: 10.33899/mjn.2022.170467

Authors

Shadan Zahid Abdalrahman¹; Bahar Nasradeen Majeed²

¹Master Student, University Nurse, Hiwa Cancer Hospital, Sulaimani -Iraq

²Lecturer College Of Nursing, University of Sulaimani-Iraq.

Abstract

Background: End-of-life care refers to all aspects of the care relating to dying, and bereavement which are provided towards the end of life, end of life care is nowadays essential in nursing care, due to the increasing number of patients who require attention in the final stages of their life, the negative attitude among nurses is one of the most common barriers to the quality end of life care.
Objective: To assess attitude of the nurses working at Hiwa Cancer Hospital toward pediatric end of life care in Sulaimani city.
Methods: Quantitative approach / Descriptive analytic study design has been carried out on (111) nurses working in Hiwa cancer hospital. Data were collected using standard questionnaires which is Frommelt Attitude toward Care of the Dying scale data analyzed using statistical package of social science version (24).
Results: The findings of this study show that out of twenty-four items of nurses attitude about end of life care , nurses have good attitude in twelve items, fair attitude in nine-items and poor attitude in three items, with total mean and standard deviation 2.345±0.68 and good level of attitude as general, present study demonstrate that level of education, work place, received training course about end of life care, attending seminar, workshop about pediatric end of life care had significant association with the attitude of nurses towards pediatric end of life care.
Conclusion and Recommendation: Overall nurses have good attitude about end of life care. It’s essential for nurses who were at fair or poor attitude about end of life care to be familiarized with the concepts of EoLC through trainings, workshops and formal or informal education in both academic and hospital settings.

Keywords

Attitude; Nurses; End of life care

Full Text

NURSES’ ATTITUDE TOWARD THE PEDIATRIC END OF LIFE CARE AT HIWA CANCER HOSPITAL IN SULAIMANY-IRAQ

Author

Shadan Zahid Abdalrahman: Master Student, University Nurse, Hiwa Cancer Hospital, Sulaimani -Iraq.

Supervised by:

Dr.Bahar Nasradeen Majeed: Lecturer College Of Nursing, University of Sulaimani-Iraq.

Corresponding Author: Shadan Zahid Abdalrahman

Gmail: shadan[email protected]

Mobile: 07703587476

Abstract

Objective: To assess attitude of the nurses working at Hiwa Cancer Hospital toward pediatric end of life care in Sulaimani city.

Methods: Quantitative approach / Descriptive analytic study design has been carried out on (111) nurses working in Hiwa cancer hospital. Data were collected using standard questionnaires which is Frommelt Attitude toward Care of the Dying scale data analyzed using statistical package of social science version (24).

Results: The findings of this study show that out of twenty-four items of nurses attitude about end of life care , nurses have good attitude in twelve items, fair attitude in nine-items and poor attitude in three items, with total mean and standard deviation 2.345±0.68 and good level of attitude as general, present study demonstrate that level of education, work place, received training course about end of life care, attending seminar, workshop about pediatric end of life care had significant association with the attitude of nurses towards pediatric end of life care.

Conclusion and Recommendation: Overall nurses have good attitude about end of life care. It’s essential for nurses who were at fair or poor attitude about end of life care to be familiarized with the concepts of EoLC through trainings, workshops and formal or informal education in both academic and hospital settings.

Key words: Attitude, Nurses, End of life care

Introduction:

In children End-of-life care is the support and care that is provided to the child and family when a child’s clinical condition has reached a stage where the child is dying or is likely to die soon., In USA 20,000 children (age 1 to 19 years) who die annually from serious illness do not receive high-quality end-of-life care., a study of children with advanced cancer revealed that 48% had pain, 46% fatigue, and 37% irritability. In addition, many bereaved and non-bereaved parents experience psychological distress, poor health behaviors, work impairment, and financial hardship [1].

Life-threatening diseases like cancer cause a decrease in the quality of life and they bring about various problems including physical, psychosocial, and spiritual, and especially pain, in patients with diseases that cannot be treated despite the advances in medicine, approaches aiming at reducing the patient’s distress and improving the quality of life should be applied, in accordance with this view, the approach of end of life care has been developed in order to meet the needs of patients and their relatives [2].

End-of-life care is one of the routine activities of nurses; nurses’ feeling of poor preparation and stress contributes nurses to the exacerbation of negative attitudes toward death and caring for the dying that may further impact on the standard of care [3].

Method

Quantitative approach / Descriptive analytic study design has been carried out in Hiwa Cancer Hospital ,to assess attitude of the nurses working at Hiwa Cancer Hospital toward pediatric end of life care in Sulaimani city from the period of April/2021to end September 2021.This study was accepted by the Scientific Committee at the College of Nursing, accordingly approved by ethical committee at College of Medicine/University of Sulaimani. An official letter has been submitted from the College of Nursing/University of Sulaimani to the General Directorate of Health (DOH) in Sulaimani in order to obtain agreement for the purpose of data collection . Consequently, an agreement letter has been submitted from DOH to Hiwa Cancer Hospital. Convenient sample technique will be used for the purpose of data collection. sample size of (111) nurses working in hiwa cancer hospital selected to participate in current study for data collection ,the nurses were chosen according to inclusion criteria which are nurses work in Hiwa cancer hospital, and nurses willing to participate in the study .

A questionnaire form was used for data collection consist of two parts: part one developed by the researcher composed of nurses’ socio-demographic characteristics which include: age, gender, level of education ,and nurse’s familiarity concerning their professional experience which include: years of experience ,experience of working in palliative care unit, work place, receive training about end of life care, care for patients at the end of life stage, reading article, brochures, books about end of life care , attending seminar ,workshop about end of life care.

Part two is standard tool about Frommelt Attitudes Towards Care of the Dying (FATCOD) which consist of 24 items with 5 point Likert scale. 1 = strongly disagree, 2 = disagree, 3 = unsure, 4 = agree, and 5 = strongly agree. 12 of the items were written positively and the rest 12 items written negatively,the score of negative items were reversed to calculate the attitude.

Items	Scales	Scores	Weight average (mean)	Results
Attitudes for (24) questions	Poor attitudes	1	1.0 – 1.66	Poor attitudes
	Fair attitudes	2	1.66 – 2.33	Fair attitudes
	Good attitudes	3	2.34 – 3.00	Good attitudes

Although the questionnaire form was standard but validity of the questionnaire was determined through a panel of (10) experts, whom asked to review the items for clarity, adequacy and relevancy, slight modification done . Pilot study was carried out on 10 nurses who excluded from study sample to identify the barriers that may face researcher during data collection to estimate the time of data collection , , as well as to determine the stability and clarity of the tool .Alpha Cronbach test was used to get the result of the reliability of the participations, as a result, the value of alpha Cronbach equals to (0.954), the result of alpha Cronbach and validity shows the highly reliable of the questionnaire.

All statistical computation is enhanced using statistical method (SPSS 24). The data had been coded, tabulated, and presented in a descriptive form. In this study the data were analyzed by using the basic statistical methods which include: alpha-Cronbach has been used for testing the reliability of the questionnaire, descriptive statistical data analysis (Frequency, percentage, Mean and stranded deviation) Inferential data analysis: (Chi square: Parametric Test (In dependent samples T-Test ) .The significant level of all statistical procedures was determined at (F test), P< 0.000.-There are criteria of the probability level of determining the significance of the test P -value as:High significant (P< 0.001) , Significant (P< 0.05) , Non-significant (P> 0.05).

Table (1) Distribution of the sample according to their Socio demographic characteristics

Variables	Items	Frequency	%
Age	Less than 26 years old	14	12.6
	26-35 years old	64	57.7
	More than 35 years old	33	29.7
	Mean ±S.D	33.35 ~35 ± 7.93
Gender	Male	48	43.2
Gender	Female	63	56.8
Level of education / graduated from	Preparatory nursing school	6	5.4
	Institute	58	52.3
	College	39	35.1
	Higher education	8	7.2
Total		111	100

Table (1) shows that majority of sample their age ranged between 26-35 years old which account 57.7%, while only 12.6% of sample their age was less than 26 years old, about gender highest percentage of sample 56.8% were female and the rest of sample was male. 52.3% of the participants were graduated from technical institute follow by 35.1% of sample graduated from college, and only 5.4%of sample was graduated from preparatory nursing school.

Table (2): Distribution of nurse’s familiarity according to their professional experience

Variables		Items	Frequency	%
Years of experience in nursing professional \ employment		1 – 10 years	75	67.6
		11 – 20 years	25	22.5
		More than 20 years	11	9.9
		Mean ±S.D	10.38 ~ 10 ± 7.44
Do you have an experience of working in palliative care unit?		Yes	34	30.6
		No	77	69.4
If yes How long your experience?		1 – 3	25	73.5
If yes How long your experience?		4 – 6	9	26.5
working place		Pediatric	24	21.6
		Pediatric outpatient	4	3.6
		Pediatric isolation	5	4.5
		Oncology	14	12.6
		Hematology	16	14.4
		Male outpatient	12	10.8
		Female outpatient	13	11.7
		BMT	12	10.8
		Adult isolation	5	4.5
		Palliative	6	5.4
Have you ever attended or received training about end of life care?		Yes	32	28.8
		No	79	71.2
If yes	Where did you attend training about end of life care? How many days	Inside country	26	23.4
		Outside country	6	5.4
		1 -5 days	19	59.38
		More than 5 days	13	40.63
Did you care for patients at the end of life stage?		Yes	90	81.1
Did you care for patients at the end of life stage?		No	21	18.9
Have you ever read articles/brochures/books about end of life care?		Yes	38	34.2
		No	73	65.8
Have you ever attended any seminar, workshop about pediatric end of life care?		Yes	23	20.7
		No	88	79.3
Total			111	100

Table (2) represents the nurse's familiarity according to their professional experience. the highest percentage of the sample 69.4% their experience in nursing as general ranged between one to ten years, as well as only 9.9% of sample their experience was more than 20 years, while nurses experience in palliative care record only 30.6% among that 73.5% of them were had experience about 1-3 years and lowest percentage of them which account 26.5%were had experience about 4-6 years.

in regard to nurses workplace highest percentage of the sample which accounts 21.6% were working in pediatric ward, it’s worth to mention that only a few percentages 5.4% of nurses were working in the palliative care unit,

Concerning the care of patients at end of life stage, the highest percentage of nurses 81.1% cared for patients at end of life stage, and only 18.9%were not faced with any patients at end of life stage.

Regarding nurses attending training courses about the end of life care, only 28.8% of the sample were attended training courses about the end of life care and among those 23.4%of them were attended training courses inside the country, about the duration of course 59.38 %of sample their course was about 1 to 5 days.

In addition to that highest percentage of sample, 65.8% never read article or brusher about the end of life care, as well as 79.3% of the sample, were not attended any seminar or workshop about the pediatric end of life care.

Table (3): distribution of sample concerning nurse’s attitude about end of life care

Questions	SDA	DA	UN	AG	SAG	Mean (S.D)	P.A	F.A	G.A	Mean (S.D)	L.A
	F	F	F	F	F		F	F	F
	%	%	%	%	%		%	%	%
1. Palliative care is given only for dying patient.	6	16	29	40	20	3.47	60	29	22	1.66 (0.79)	P.A
1. Palliative care is given only for dying patient.	5.4	14.4	26.1	36	18	(1.11)	54.1	26.1	19.8	1.66 (0.79)	P.A
2.As a patient nears death; the nurse should withdraw from his/her involvement	32	58	11	4	6	2.05	10	11	90	2.72 (0.62)	G.A
	28.8	52.3	9.9	3.6	5.4	(1.01)	9	9.9	81.1	2.72 (0.62)	G.A
3. Giving nursing care to the chronically sick patient is a worthwhile learning experience.	2	1	10	50	48	4.27	3	10	98	2.86 (0.42)	G.A
	1.8	0.9	9	45	43.2	(0.8)	2.7	9	88.3	2.86 (0.42)	G.A
4.It is beneficial for the chronically sick person to verbalize his/her feelings	0	2	6	43	60	4.45	2	6	103	2.91 (0.34)	G.A
	0.0	1.8	5.4	38.7	54.1	(0.68)	1.8	5.4	92.8	2.91 (0.34)	G.A
5. Family members who stay close to a dying person often interfere with a professionals' job with the patient.	1	6	24	47	33	3.94	7	24	80	2.66 (0.6)	G.A
	0.9	5.4	21.6	42.3	29.7	(0.92)	6.3	21.6	72.1	2.66 (0.6)	G.A
6. The length of time required to give nursing care to a dying person would frustrate me.	8	52	23	21	7	2.7	28	23	60	2.29 (0.85)	F.A
	7.2	46.8	20.7	18.9	6.3	(1.05)	25.2	20.7	54.1	2.29 (0.85)	F.A
7.Families should be concerned about helping their dying member to make the best of his/her remaining life.	1	2	5	45	58	4.41	3	5	103	2.9 (0.38)	G.A
	0.9	1.8	4.5	40.5	52.3	(0.74)	2.7	4.5	92.8	2.9 (0.38)	G.A
8.Family should maintain as normal an environment as possible for their dying member	0	1	4	54	52	4.41	1	4	106	2.95 (0.26)	G.A
	0	0.9	3.6	48.6	46.8	(0.61)	0.9	3.6	95.5	2.95 (0.26)	G.A
9.The nurse should not be the one to talk about death with the dying person.	0	4	10	35	62	4.39	4	10	97	2.84 (0.46)	G.A
	0	3.6	9	31.5	55.9	(0.8)	3.6	9	87.4	2.84 (0.46)	G.A
10.The family should be involved in the physical care of the dying person.	0	6	7	47	51	4.28	98	7	6	1.17 (0.5)	P.A
	0	5.4	6.3	42.3	45.9	(0.81)	88.3	6.3	5.4	1.17 (0.5)	P.A
11.It is difficult to form a close relationship with the family of a dying member.	9	35	37	22	8	2.86	30	37	44	2.19 (0.81)	F.A
	8.1	31.5	33.3	19.8	7.2	(1.06)	27	33.3	39.6	2.19 (0.81)	F.A
12.There are times when death is welcomed by the dying person	6	23	32	37	13	3.25	29	32	50	2.19 (0.83)	F.A
	5.4	20.7	28.8	33.3	11.7	(1.08)	26.1	28.8	45	2.19 (0.83)	F.A
13.Nursing care for the patient's family should continue throughout the period of grief and bereavement.	29	42	17	13	10	2.39	71	17	23	1.59 (0.82)	G.A
	26.1	37.8	15.3	11.7	9	(1.25)	64	15.3	20.7	1.59 (0.82)	G.A
14.The dying person and his/her family should be the in-charge decision makers.	1	7	10	39	54	4.24	8	10	93	2.88 (0.57)	G.A
	0.9	6.3	9	35.1	48.6	(0.93)	7.2	9	83.8	2.88 (0.57)	G.A
15.Addiction to pain relieving medication should not be a nursing concern when dealing with a dying person.	2	12	9	53	35	3.96	14	9	88	2.86 (0.69)	G.A
	1.8	10.8	8.1	47.7	31.5	(1.0)	12.6	8.1	79.3	2.86 (0.69)	G.A
16.Nursing care should extend to the family of the dying person	3	20	28	41	19	3.47	23	28	60	2.64 (0.8)	F.A
	2.7	18	25.2	36.9	17.1	(1.06)	20.7	25.2	54.1	2.64 (0.8)	F.A
17.When a patient asks, “Nurse am I dying? ‘I think it is best to change the subject to something cheerful.	0	7	4	48	52	4.31	100	4	7	1.17 (0.51)	P.A
	0.0	6.3	3.6	43.2	46.8	(0.82)	90.1	3.6	6.3	1.17 (0.51)	P.A
18.I am afraid to become friends with chronically sick and dying patients	8	36	27	31	9	2.97	40	27	44	2.05 (0.87)	F.A
	7.2	32.4	24.3	27.9	8.1	(1.1)	36	24.3	39.6	2.05 (0.87)	F.A
19.I would be uncomfortable if I entered the room of a terminally ill person and found him/her crying	6	48	10	34	13	3.00	47	10	54	2.07 (0.96)	F.A
	5.4	43.2	9	30.6	11.7	(1.2)	42.3	9	48.6	2.07 (0.96)	F.A
20.I would be uncomfortable talking about impending death with the dying Person	3	31	13	40	24	3.46	64	13	34	1.73 (0.9)	F.A
	2.7	27.9	11.7	36	21.6	(1.19)	57.7	11.7	30.6	1.73 (0.9)	F.A
21..It is possible for nurses to help patients prepare for d	1	13	20	45	32	3.85	14	20	77	2.85 (0.71)	G.A
	0.9	11.7	18	40.5	28.8	(1.01)	12.6	18	69.4	2.85 (0.71)	G.A
22.Death is not the worst thing that can happen to a person	6	21	14	44	26	3.57	27	14	70	2.69 (0.85)	G.A
22.Death is not the worst thing that can happen to a person	5.4	18.9	12.6	39.6	23.4	(1.2)	24.3	12.6	63.1	2.69 (0.85)	G.A
23.I would feel like running away when the person actually died	15	47	15	21	13	2.73	34	15	62	2.25 (0.9)	F.A
	13.5	42.3	13.5	18.9	11.7	(1.25)	30.6	13.5	55.9	2.25 (0.9)	F.A
24.I would not want to be assigned to care for a dying person	17	40	15	25	14	2.81	39	15	57	2.16 (0.92)	F.A
	15.3	36	13.5	22.5	12.6	(1.3)	35.1	13.5	51.4	2.16 (0.92)	F.A
Sum: nurse’s attitude about end of life care	156	530	380	879	719	3.55	756	380	1528	2.345 (0.68)	F.A
Sum: nurse’s attitude about end of life care	5.86	19.8	14.2	33	26.99	(1.25)	28.3	14.2	57.3	2.345 (0.68)	F.A

Note: SA=strongly agree, AG=agree, UN=unsure, DA=disagree and SDA= strongly disagree S.D: Stander deviation, P.A : Poor attitudes, F.A: Fair attitudes. G.A: Good attitudes. L.A: level of attitude Weight average (mean) for 3point Likert scales: 1.0-1.66 : Poor attitudes , 1.67-2.33: Fair attitudes,2.34-3.0: Good attitudes

Table (3) reveal the distribution of nurses according to their attitude in five Likert scales and in three level of attitude, it shows that out of twenty-four items nurses have good attitude in twelve items, fair attitude in nine-item and poor attitude in three items, with total mean and standard deviation 2.345±0.68 and good level of attitude in general

Table (4): Association between nurse’s attitude about end of life care and their Socio demographic characteristics

items	N	Mean	S.D	Significant test	P-value
Age
Less than 26 years	14	2.2649	0.15980	1.07 **	0.346
26-35 years old	64	2.3132	0.19345
More than 35 years old	33	2.2551	0.21794
Gender
Male	48	2.3160	0.20875	1.222 *	0.225
Female	63	2.2698	0.18781	1.222 *	0.225
Level of education
Preparatory nursing school	6	2.0972	0.20861	3.627 **	0.015
Institute	58	2.2658	0.18680
College	39	2.3472	0.19644
Higher education	8	2.3281	0.17878
Note // * is the parametric Test (In dependent samples T-Test) ** is the is the parametric Test (One Way ANOVA –F-Test)

Table (4) shows that statistically significant association were found between nurses attitude about end of life care with level of education (p=0.015) because the result of the p-value was less than the common alpha 0.05. But there were no statistically significant association between nurses attitude about end of life care with gender (p=0.225), age (p=0.346) and years of experience (p=0.277).

Table (5): Association between nurse’s attitude about end of life care and nurse’s familiarity according to their professional experience

Items	N	Mean		S.D	Significant test		P-value
Years of experience in nursing professional \ employment
1 – 10 years old	75		2.2928	0.19289		1.301*	0.277
11 – 20 years old	25		2.3183	0.19465
More than 20 years old	11		2.2045	0.23008
Do you have an experience of working in palliative care unit?
Yes	34		2.3365	0.18006		1.557 *	0.122
No	77		2.2727	0.20654
Work place
Pediatric	24		2.2708	0.23183		3.843*	0.000
Pediatric outpatient	4		2.2500	0.12266
Pediatric isolation	5		2.2750	0.13372
Oncology	14		2.6660	0.38119
Hematology	16		2.5920	0.38925
Male outpatient	12		2.5314	0.37697
Female out patient	13		2.3971	0.22656
BMT	12		2.2361	0.29212
Adult isolation	5		2.2833	0.09033
Palliative	6		2.1806	0.19837
Have you ever attended or received training about end of life care?
Yes	32	2.3698		0.19479	2.798 *		0.006
No	79	2.2574		0.19045
Did you care for patients at the end of life stage?
Yes	90	2.2903		0.20664	0.054 *		0.957
No	21	2.2877		0.15696
Have you ever read articles/brochures/books about end of life care?
Yes	38	2.3140		0.27348	1.122 *		0.264
No	73	2.2631		0.19860
Have you ever attended any seminar, workshop about pediatric end of life care?
Yes	23	2.3779		0.23897	2.198 *		0.03
No	88	2.2597		0.22730
Note // * is the parametric Test (In dependent samples T-Test)

Table (5) Explore the association between nurse’s attitude about end of life care and nurse’s familiarity according to their professional experience .it shows that statistically highly significant association were found between nurse’s attitude with nurses work place, while significant association found between receiving training course(p=0.006), ,and attending seminar or workshop (p=0.006), about end of life care with nurses attitude , statistically no significant association were found between nurses attitude with nurses experience of working in palliative care unit, care for patients at the end of life stage, read articles/brochures/books about end of life care.

Discussion

The findings in current study provide valuable information about nurses attitude toward end of life care among cancer patients, concerning nurses demographic characteristics more than half of sample were female and their age ranged between (26-35) years old with mean of age (33.35), present finding agree with the result of study done in Turkey [4], they mention that proportion of female higher than male, and highest percentage of their sample their age ranged between (26-35) years old.

Regarding nurses level of education, more than half of nurses graduated from nursing institute, it’s worth to mention that few percentages of sample were graduated from preparatory school of nursing and college of nursing, findings inconsistent with a study done in Rwanda [5], in their study majority of sample have diploma degree in nursing.

In regard to nurse's familiarity according to their professional experience, more than two third of sample their experience in nursing as general ranged between one to ten years with mean (10.38)in contrast a study done in Kazakhstan[6] found that highest percentage of sample have twenty to twenty nine years experiences, but unfortunately less than one third of nurses have experience in palliative care among those approximately three quarter of sample their experience ranged between one to three years due to palliative and end of life care unit was established about six years it’s a new department , in another hand a study done in Indonesia[7] they mention that more than half of their sample five to ten years’ experience in nursing .and majority of nurses had experience in caring for end of life patients. About nurses workplace more than one quarter of the nurses were working in different units of pediatric ward like inpatient unit, outpatient unit and isolation unit ,and the rest of nurses were working in different unites in Hiwa cancer hospital like oncology , hematology , male and female outpatient, ect….. the findings consistence with result of study done in Taiwan [8] they found that around one quarter of the nurses work in pediatric ward, majority of nurses cared for patients at end of life stage.

unfortunately less than one third of sample were participated in training courses, and more than half of them their training course arranged between only one to five days which is done mostly inside country , this result disagree with the findings of study done by Ahmad and his colleagues[9] they found that more than half of nurses had obtained training course and the majority of them for less than 1 week.

In addition to that about two third of nurses were never read any article or brusher about the end of life care, and more than three quarter of sample were not attended in any seminar or workshop about the pediatric end of life care, which agree with another study done in 2020[3] the result shows that only one third of the nurses read about end of life care.

Part two of study is the standard questionnaire that consist twenty four items related to nurses attitude about end of life care, the analysis clearly demonstrate that total mean and standard deviation in all twenty four items of nurses attitude about end of life care was (2.345±0.68) which indicated to that nurses in hiwa cancer hospital have good attitude about end of life care, the same findings explore that nurses have good attitude in twelve items, fair attitude in nine-items and poor attitude in three items,

This findings of this study were congruent with a study done in Pakistan[10] which illustrated that the most of the nurses had favorable attitude about end of life care , also findings were not confirmed by another study which done in Sudan [2], in their result the most respondents' attitudes levels towards palliative care were moderate attitude, but present findings disagree with result of another study done in titled (Nurses’ Attitude Toward Caring for Dying Patients in a Nigerian Teaching Hospital) [12], which showed that most nurses had negative attitude about end of life care .

Based on analysis for demographic data age, gender, doesn’t reflect any significant association on the nurse’s attitude toward palliative care, but statistically significant association were found between nurses attitude and nurses level of education at p value 0.015, this result congruent with a study done in 2019 [13] they mention that significant association found between nurses attitude and level of education.

In this study no significant association found between nurses attitude about end of life care with nurse’s experience ,nurses work place, while statistically significant association found between attitude about end of life care with nurses received training course about end of life care , this result agree with findings of the study done in titled (Assessment of Nurses’ Knowledge, Attitude, Practice and Associated Factors Towards Palliative Care) [14] in their results nurses who had been trained had more likely two times favorable attitude towards end of life care as compared to those had not been trained but their results inconsistent with present study in term of nursing experiences and nurses work place.

Findings shows that, statistically no significant association found between nurses attitude about end of life care with nurses’ who had palliative care service experience, nurses who had interest to reading about end of life care . In contrast, one study reported that nurses who had palliative care service experience were less likely showed a positive attitude than nurses who had no palliative service experience towards end of life care, and nurses who read articles/brochures about palliative care were more likely displayed a positive attitude than nurses who did not read articles/brochures about palliative care [3].

In addition of that there were no association between nurses attitude with nurses cared for patients at the end of life stage which disagree with a study done by Abate and colleagues[15] .Finally significant association were found between nurses attitude with nurses who attended seminar, workshop about pediatric end of life care .

Conclusion and Recommendation: Overall nurses have good attitude about end of life care, it’s essential for nurses who were at fair or poor attitude about end of life care to be familiarized with the concepts of EoLC through trainings, workshops and formal or informal education in both academic and hospital settings.

References:

Johnston E, Rosenberg A, Kamal A. Pediatric-Specific End-of-Life Care Quality Measures: An Unmet Need of a Vulnerable Population. Journal of Oncology Practice. 2017;13(10):e874-e880. DOI: 10.1200/JOP.2017.021766

Bilal M. The Knowledge of Palliative Care and the Attitude Toward it among the Nurses at Sabia General Hospital 2018. Sudan Journal of Medical Sciences. 2018;13(4):301 DOI 10.18502/sjms.v13i4.3606.

Etafa W, Wakuma B, Fetensa G, Tsegaye R, Abdisa E, Oluma A et al. Nurses’ knowledge about palliative care and attitude towards end- of-life care in public hospitals in Wollega zones: A multicenter cross-sectional study. PLOS ONE. 2020;15(10):e0238357 doi.org/10.1371/journal.pone.0238357.

Cevik B, Kav S. Attitudes and Experiences of Nurses Toward Death and Caring for Dying Patients in Turkey. Cancer Nursing. 2013;36(6):E58-E65 doi: 10.1097/NCC.0b013e318276924c..

Marie Claire K. assessment of nurses’ knowledge and attitude about palliative care among nurses at university teaching hospital of kigali. College of Medicine and Health Sciences [Internet]. 2017 [cited 29 October 2021];. Available from: http://hdl.handle.net/123456789/285

Teleshova G. Nurses’ knowledge and attitudes to palliative care [Internet]. Urn.fi. 2021 [cited 29 October 2021]. Available from: https://urn.fi/URN:NBN:fi:amk-2020082519860

A'la M, Farikhah Z, Hakam M. Nurses' Attitude Toward End of Life Care in Emergency Departement and Intensive Care Unit In Rural Hospital. IJNP (Indonesian Journal of Nursing Practices). 2020;4(1) DOI:10.18196/ijnp.41103.

Lin H, Chen C, Lu C, Lin S, Huang C. Nurses’ knowledge, attitude, and competence regarding palliative and end-of-life care: a path analysis. PeerJ. 2021;9:e11864 doi: 10.7717/peerj.11864.

Ahmad A, Lubna H, Imad F, Faeda E, Sumaya S. The Nurses' Knowledge and Attitudes towards the Palliative Care. Journal of Education and Practice. 2015;Vol.6,(No.4) (Paper) ISSN 2222-288X.

Parveen A, Sultana K, Waqas A, Tasneem S, Jabeen R, Faiz A et al. Knowledge and Attitude of Nurses About Palliative Care. Journal of Bioresource Management. 2020;7(1):68-73 DOI: https://doi.org/10.35691/JBM.0202.0122.

Abate A, Amdie F, Bayu N, Gebeyehu D, G/Mariam T. Knowledge, attitude and associated factors towards end of life care among nurses’ working in Amhara Referral Hospitals, Northwest Ethiopia: a cross-sectional study. BMC Research Notes. 2019;12(1) https://doi.org/10.1186/s13104-019-4567-7.

Faronbi J, Akinyoola O, Faronbi G, Bello C, Kuteyi F, Olabisi I. Nurses’ Attitude Toward Caring for Dying Patients in a Nigerian Teaching Hospital. SAGE Open Nursing. 2021;7:237796082110052.DOI:10.1177%2F23779608211005213.

Gedamu S, Berhane E, Dires A, Anteneh S, Goshiye D, et al. Knowledge and Attitude of Nurses towards Palliative Care in Government Hospitals of Addis Ababa, Ethiopia. J Nurs Care(2019) 8: 486 URI: http://localhost:80/xmlui/handle/123456789/9331.

Zewdu F, Kassa H, Hailu M, Murugan R, Woldeyohannes D. Knowledge, attitude and practice and associated factors towards palliative care among nurses working in selected hospitals, Addis Ababa, Ethiopia. European Journal of Cancer. 2017;72:S161 DOI: 10.5829/idosi.abr.2016.10.2.10397.

Mohammad O. Abu Hasheesh and Shalabia Al-Sayed AboZeid et al Nurses' characteristics and their attitudes toward death and caring for dying patients in a public hospital in Jordan, Health science journal. 2013(7)

NURSES’ ATTITUDE TOWARD THE PEDIATRIC END OF LIFE CARE AT HIWA CANCER HOSPITAL IN SULAIMANY-IRAQ

References

Bilal M. The Knowledge of Palliative Care and the Attitude Toward it among the Nurses at Sabia General Hospital 2018. Sudan Journal of Medical Sciences. 2018;13(4):301 DOI 10.18502/sjms.v13i4.3606.

Cevik B, Kav S. Attitudes and Experiences of Nurses Toward Death and Caring for Dying Patients in Turkey. Cancer Nursing. 2013;36(6):E58-E65 doi: 10.1097/NCC.0b013e318276924c..

Teleshova G. Nurses’ knowledge and attitudes to palliative care [Internet]. Urn.fi. 2021 [cited 29 October 2021]. Available from: https://urn.fi/URN:NBN:fi:amk-2020082519860

Lin H, Chen C, Lu C, Lin S, Huang C. Nurses’ knowledge, attitude, and competence regarding palliative and end-of-life care: a path analysis. PeerJ. 2021;9:e11864 doi: 10.7717/peerj.11864.

Ahmad A, Lubna H, Imad F, Faeda E, Sumaya S. The Nurses' Knowledge and Attitudes towards the Palliative Care. Journal of Education and Practice. 2015;Vol.6,(No.4) (Paper) ISSN 2222-288X.

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