1Faculty of Nursing, Al-Ahliyya Amman University, Amman, Jordan
2Faculty of Health Science, Higher Colleges of Technology, Abu Dhabi, United Arab Emirates
3Faculty of Nursing, Applied Science Private University, Amman, Jordan
4School of Nursing, The University of Jordan, Amman, Jordan
5Community Health Nursing Department, School of Nursing, The University of Jordan, Amman, Jordan
Copyright © 2023 The Korean Society of Critical Care Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST
No potential conflict of interest relevant to this article was reported.
FUNDING
None.
AUTHOR CONTRIBUTIONS
Conceptualization: KMH, MAA. Methodology: KMH, MAA. Formal analysis: KMH, AMA. Data curation: KMH, AMA, MAD, AMS. Visualization: all authors. Project administration: KMH. Writing–original draft: KMH, AMA, ARS, MAA, AMS. Writing–review & editing: KMH, AMA, ARS, MAA, AMS.
Item | Disagreement (strongly disagree & disagree) | Neutral | Agreement (agree & strongly agree) |
---|---|---|---|
1. Giving nursing care to the dying person is a worthwhile learning experience. | 25 (13.7) | 18 (9.9) | 139 (76.4) |
2. Death is not the worst thing that can happen to a person. | 41 (22.5) | 54 (29.7) | 87 (47.8) |
3. I would be uncomfortable talking about impending death with the dying person.a) | 28 (15.4) | 53 (29.1) | 101 (55.5) |
4. Nursing care for the patient's family should continue throughout the period of grief and bereavement. | 24 (13.2) | 29 (15.9) | 129 (70.9) |
5. I would not want to be assigned to care for a dying person. | 69 (37.9) | 58 (31.9) | 55 (30.2) |
6. The nurse should not be the one to talk about death with the dying person. | 36 (19.8) | 47 (25.8) | 99 (54.4) |
7. The length of time required to give nursing care to a dying person would frustrate me. | 60 (33.0) | 52 (28.6) | 70 (38.5) |
8. I would be upset when the dying person I was caring for gave up hope of getting better. | 21 (11.5) | 57 (31.3) | 104 (57.1) |
9. It is difficult to form a close relationship with the family of a dying person. | 59 (32.4) | 36 (19.8) | 87 (47.8) |
10. There are times when death is welcomed by the dying person. | 50 (27.5) | 45 (24.7) | 87 (47.8) |
11. When a patient asks, "Nurse am I dying?", I think it is best to change the subject to something cheerful. | 58 (31.9) | 32 (17.6) | 92 (50.5) |
12. The family should be involved in the physical care of the dying person. | 25 (13.7) | 17 (9.3) | 140 (76.9) |
13. I would hope the person I'm caring for dies when I am not present. | 45 (24.7) | 58 (31.9) | 79 (43.4) |
14. I am afraid to become friends with a dying person. | 47 (25.8) | 43 (23.6) | 92 (50.5) |
15. I would feel like running away when the person actually died. | 69 (37.9) | 41 (22.5) | 72 (39.6) |
16. Families need emotional support to accept the behavior changes of the dying person. | 19 (10.4) | 25 (13.7) | 99 (54.4) |
17. As a patient nears death, the nurse should withdraw from his/her involvement with the patient. | 87 (47.8) | 34 (18.7) | 61 (33.5) |
18. Families should be concerned about helping their dying member make the best of his/her remaining life. | 18 (9.9) | 28 (15.4) | 8136 (74.7) |
19. The dying person should not be allowed to make decisions about his/her physical care. | 92 (50.5) | 41 (22.5) | 49 (26.9) |
20. Families should maintain as normal an environment as possible for their dying member. | 18 (9.9) | 29 (15.9) | 135 (74.2) |
21. It is beneficial for the dying person to verbalize his/her feelings. | 14 (7.7) | 28 (15.4) | 140 (76.9) |
22. Nursing care should extend to the family of the dying person. | 23 (12.6) | 35 (19.2) | 124 (68.1) |
23. Nurses should permit dying persons to have flexible visiting schedules. | 15 (8.2) | 26 (14.3) | 141 (77.5) |
24. The dying person and his/her family should be the in-charge decision-makers. | 28 (15.4) | 47 (25.8) | 107 (58.8) |
25. Addiction to pain relieving medication should not be a nursing concern when dealing with a dying person. | 41 (22.5) | 51 (28.0) | 90 (49.5) |
26. I would be uncomfortable if I entered the room of a terminally ill person and found him/her crying. | 32 (17.6) | 32 (17.6) | 117 (64.8) |
27. Dying persons should be given honest answers about their condition. | 20 (11.0) | 62 (34.1) | 100 (54.9) |
28. Educating families about death and dying is not a nursing responsibility. | 57 (31.3) | 58 (31.9) | 67 (36.8) |
29. Family members who stay close to a dying person often interfere with the professionals’ job with the patient. | 38 (20.9) | 56 (30.8) | 88 (48.4) |
30. It is possible for nurses to help patients prepare for death. | 28 (15.4) | 58 (31.9) | 96 (52.7) |
Scale | Mean±SD | Median (IQR) | |
FATCOD total score | 103.14±12.31 | 103.00 (97.00–109.25) |
Item | Disagreement (strongly disagree & disagree) | Neutral | Agreement (agree & strongly agree) |
---|---|---|---|
1. Giving nursing care to the dying person is a worthwhile learning experience. | 25 (13.7) | 18 (9.9) | 139 (76.4) |
2. Death is not the worst thing that can happen to a person. | 41 (22.5) | 54 (29.7) | 87 (47.8) |
3. I would be uncomfortable talking about impending death with the dying person. |
28 (15.4) | 53 (29.1) | 101 (55.5) |
4. Nursing care for the patient's family should continue throughout the period of grief and bereavement. | 24 (13.2) | 29 (15.9) | 129 (70.9) |
5. I would not want to be assigned to care for a dying person. | 69 (37.9) | 58 (31.9) | 55 (30.2) |
6. The nurse should not be the one to talk about death with the dying person. | 36 (19.8) | 47 (25.8) | 99 (54.4) |
7. The length of time required to give nursing care to a dying person would frustrate me. | 60 (33.0) | 52 (28.6) | 70 (38.5) |
8. I would be upset when the dying person I was caring for gave up hope of getting better. | 21 (11.5) | 57 (31.3) | 104 (57.1) |
9. It is difficult to form a close relationship with the family of a dying person. | 59 (32.4) | 36 (19.8) | 87 (47.8) |
10. There are times when death is welcomed by the dying person. | 50 (27.5) | 45 (24.7) | 87 (47.8) |
11. When a patient asks, "Nurse am I dying?", I think it is best to change the subject to something cheerful. | 58 (31.9) | 32 (17.6) | 92 (50.5) |
12. The family should be involved in the physical care of the dying person. | 25 (13.7) | 17 (9.3) | 140 (76.9) |
13. I would hope the person I'm caring for dies when I am not present. | 45 (24.7) | 58 (31.9) | 79 (43.4) |
14. I am afraid to become friends with a dying person. | 47 (25.8) | 43 (23.6) | 92 (50.5) |
15. I would feel like running away when the person actually died. | 69 (37.9) | 41 (22.5) | 72 (39.6) |
16. Families need emotional support to accept the behavior changes of the dying person. | 19 (10.4) | 25 (13.7) | 99 (54.4) |
17. As a patient nears death, the nurse should withdraw from his/her involvement with the patient. | 87 (47.8) | 34 (18.7) | 61 (33.5) |
18. Families should be concerned about helping their dying member make the best of his/her remaining life. | 18 (9.9) | 28 (15.4) | 8136 (74.7) |
19. The dying person should not be allowed to make decisions about his/her physical care. | 92 (50.5) | 41 (22.5) | 49 (26.9) |
20. Families should maintain as normal an environment as possible for their dying member. | 18 (9.9) | 29 (15.9) | 135 (74.2) |
21. It is beneficial for the dying person to verbalize his/her feelings. | 14 (7.7) | 28 (15.4) | 140 (76.9) |
22. Nursing care should extend to the family of the dying person. | 23 (12.6) | 35 (19.2) | 124 (68.1) |
23. Nurses should permit dying persons to have flexible visiting schedules. | 15 (8.2) | 26 (14.3) | 141 (77.5) |
24. The dying person and his/her family should be the in-charge decision-makers. | 28 (15.4) | 47 (25.8) | 107 (58.8) |
25. Addiction to pain relieving medication should not be a nursing concern when dealing with a dying person. | 41 (22.5) | 51 (28.0) | 90 (49.5) |
26. I would be uncomfortable if I entered the room of a terminally ill person and found him/her crying. | 32 (17.6) | 32 (17.6) | 117 (64.8) |
27. Dying persons should be given honest answers about their condition. | 20 (11.0) | 62 (34.1) | 100 (54.9) |
28. Educating families about death and dying is not a nursing responsibility. | 57 (31.3) | 58 (31.9) | 67 (36.8) |
29. Family members who stay close to a dying person often interfere with the professionals’ job with the patient. | 38 (20.9) | 56 (30.8) | 88 (48.4) |
30. It is possible for nurses to help patients prepare for death. | 28 (15.4) | 58 (31.9) | 96 (52.7) |
Scale | Mean±SD | Median (IQR) | |
FATCOD total score | 103.14±12.31 | 103.00 (97.00–109.25) |
Characteristics | Value (n=182) |
---|---|
Age (yr) | 30.3±6.2 |
<30 | 97 (53.3) |
30–39 | 66 (36.3) |
≥40 | 19 (10.4) |
Total years of nursing experience | 7.8±6.0 |
ICU years of experience | 4.9±4.4 |
1 | 51 (28.0) |
2–5 | 73 (40.1) |
6–9 | 28 (15.4) |
≥10 | 30 (16.5) |
Sex | |
Male | 89 (48.9) |
Female | 93 (51.1) |
Level of education | |
Diploma | 5 (2.7) |
Bachelor | 139 (75.8) |
Master | 34 (18.7) |
PhD | 5 (2.7) |
Hospital sector | |
Governmental | 51 (28.0) |
Private | 100 (54.9) |
Military | 11 (6.0) |
Educational | 20 (11.0) |
Item | Correct answer | Wrong answer |
---|---|---|
1. Palliative care is appropriate only in situations where there is evidence of a downhill trajectory or deterioration. (F) | 56 (30.8) | 126 (69.2) |
2. Morphine is the standard used to compare the analgesic effect of other opioids. (T) | 141 (77.5) | 41 (22.5) |
3. The extent of the disease determines the method of pain treatment. (F) | 31 (17.0) | 151 (83.0) |
4. Adjuvant therapies are important in managing pain. (T) | 147 (80.8) | 35 (19.2) |
5. It is crucial for family members to remain at the bedside until death occurs. (F) | 26 (14.3) | 156 (85.7) |
6. During the last days of life, the drowsiness associated with electrolyte imbalance may decrease the need for sedation. (T) | 101 (55.5) | 81 (44.5) |
7. Drug addiction is a major problem when morphine is used on a long-term basis for the management of pain. (F) | 75 (41.2) | 107 (58.8) |
8. Individuals who are taking opioids should also follow a bowel regime. (T) | 144 (79.1) | 38 (20.9) |
9. The provision of palliative care requires emotional detachment. (F) | 83 (45.6) | 99 (54.4) |
10. During the terminal stages of an illness, drugs that can cause respiratory depression are appropriate for the treatment for severe dyspnea. (T) | 69 (37.9) | 113 (62.1) |
11. Men generally reconcile their grief more quickly than women. (F) | 40 (22.0) | 142 (78.0) |
12. The philosophy of palliative care is compatible with that of aggressive treatment. (T) | 99 (54.4) | 83 (45.6) |
13. The use of placebos is appropriate in the treatment of some types of pain. (F) | 79 (43.4) | 103 (56.6) |
14. In high doses, codeine causes more nausea and vomiting than morphine. (T) | 113 (62.1) | 69 (37.9) |
15. Suffering and physical pain are synonymous. (F) | 42 (23.1) | 140 (76.9) |
16. Demerol is not an effective analgesic in the control of chronic pain. (T) | 90 (49.5) | 92 (50.5) |
17. The accumulation of losses renders burnout inevitable for those who seek work in palliative care. (F) | 23 (12.6) | 159 (87.4) |
18. Manifestations of chronic pain are different from those of acute pain. (T) | 125 (68.7) | 57 (31.3) |
19. The loss of a distant or contentious relationship is easier to resolve than the loss of one that is close or intimate. (F) | 26 (14.3) | 156 (85.7) |
20. The pain threshold is lowered by anxiety or fatigue. (T) | 107 (58.8) | 75 (41.2) |
Scales/subscales | Mean±SD | Median (IQR) |
PCQN total score | 8.88±2.52 | 9.00 (7.75–11.00) |
Philosophy and principles of palliative care | 1.43±0.84 | 1.00 (1.00–2.00) |
Pain and symptoms management | 6.95±2.19 | 7.00 (6.00–9.00) |
Psychosocial and spiritual care | 0.51±0.70 | 0.00 (0.00–1.00) |
Characteristics | n | Mean±SD | Rank mean | Kruskal-Wallis H | df | P-value |
---|---|---|---|---|---|---|
PCQN score | ||||||
Age (yr) | 0.05 | 2 | 0.977 | |||
<30 | 97 | 8.9±2.5 | 92.2 | |||
30–39 | 66 | 8.8±2.6 | 90.7 | |||
≥40 | 19 | 9.0±2.6 | 89.9 | |||
Level of education | 7.80 | 3 | 0.050 | |||
Diploma | 5 | 10.2±2.1 | 120.6 | |||
Bachelor | 138 | 8.7±2.6 | 88.4 | |||
Master | 34 | 9.0±2.0 | 91.4 | |||
PhD | 5 | 11.6±2.2 | 147.6 | |||
ICU's years of experience | 12.33 | 3 | 0.006 | |||
1 | 51 | 8.1±2.2 | 71.7 | |||
2–5 | 73 | 9.3±2.9 | 103.5 | |||
6–9 | 28 | 9.5±1.6 | 101.0 | |||
≥10 | 30 | 8.7±2.4 | 87.1 | |||
Type of hospital | 9.44 | 3 | 0.024 | |||
Governmental | 51 | 8.1±2.7 | 75.5 | |||
Private | 100 | 9.3±2.4 | 99.8 | |||
Military | 11 | 8.2±2.2 | 72.8 | |||
Educational | 20 | 9.4±2.2 | 101.4 | |||
FATCOD score | ||||||
Age (yr) | 2.86 | 2 | 0.239 | |||
< 30 | 97 | 103.7±9.8 | 94.3 | |||
30–39 | 66 | 101.1±15.0 | 83.7 | |||
≥40 | 19 | 107.4±12.7 | 104.5 | |||
Level of education | 12.98 | 3 | 0.005 | |||
Diploma | 5 | 102.4±5.2 | 85.3 | |||
Bachelor | 138 | 102.6±12.8 | 89.7 | |||
Master | 34 | 102.8±9.7 | 87.4 | |||
PhD | 5 | 122.2±3.2 | 174.9 | |||
ICU's years of experience | 1.54 | 3 | 0.673 | |||
1 | 51 | 102.0±9.1 | 86.2 | |||
2–5 | 73 | 103.5±14.7 | 94.1 | |||
6–9 | 28 | 103.9±9.2 | 99.3 | |||
≥10 | 30 | 103.6±13.5 | 86.9 | |||
Type of hospital | 7.86 | 3 | 0.049 | |||
Governmental | 51 | 101.6±12.0 | 84.5 | |||
Private | 100 | 104.9±13.4 | 100.8 | |||
Military | 11 | 100.0±10.2 | 75.5 | |||
Educational | 20 | 100.2±6.9 | 71.7 |
Values are presented as number (%) unless otherwise indicated. ICU: intensive care unit; FATCOD: Frommelt Attitude Toward Care of the Dying; SD: standard deviation; IQR: interquartile range. Negative items were reverse coded.
Values are presented as mean±standard deviation or number (%). ICU: intensive care unit; PhD: doctor of philosophy.
Values are presented as number (%) unless otherwise indicated. ICU: intensive care unit; PCQN: Palliative Care Quiz for Nursing; F: false; T: true; SD: standard deviation; IQR: interquartile range.
PCQN: Palliative Care Quiz for Nursing; PhD: doctor of philosophy; FATCOD: Frommelt Attitude Toward Care of the Dying; SD: standard deviation; ICU: intensive care unit.