Nurses' Attitude toward Caring for Terminal Patient in Long-Term Care Setting

Tuesday, 14 July 2009

Miho Matsui, RN, PhD
School of Health Sciences, Nagasaki University, Nagasaki-shi, Japan

Learning Objective 1: The leaner will be able to understand nurses' attitude toward caring for elderly patients at terminal stage.

Learning Objective 2: The leaner will be able to provide hospital and palliative care for elderly patients.

Purpose: Elderly patients are rapidly increasing in various facilities in Japan, and terminal care is critical to those patients. Health care professionals’ attitude are influential to provide care, however, it is little known about nurses’ attitude toward terminal care for elderly patients.
The purpose of this study was to examine nurses’ attitude toward caring terminal ill patients in long term care setting.
Methods: A self-administered questionnaire that included demographics, awareness of hospice and palliative care for elderly patients, Japanese version of Frommelt Attitude Toward Care of the Dying (FATCOD) which includes two subscales: positive attitude toward caring for the dying patient and perception of patient- and family-centered care, was provided to nurses belonging to long term care ward in Nagasaki, Japan. The questionnaire was distributed to 191 adults. Of these, 150 (78.5%) fully completed the questionnaire.
Results: The mean age was 39.7, and 140 (93.3%) were female. Of the 150 nurses, 93.2% experienced terminal care of elderly patient in their clinical practice.  Awareness of hospice and palliative care were that 81.1% reported they felt necessary to provide hospice and palliative care for elderly, and 83.3% thought they should take care of terminal patient in their facility if patient and their family requested. The average score of FATCOD was 105.5 (SD=13.4, range=75-142), positive attitude toward caring for the dying patient 53.2 (SD=9.6), and perception of patient- and family-centered care 48.7 (SD=5.6), which means lower score compared to previous survey in acute care setting.
Conclusion: Most nurses in this study experienced terminal care for elderly patient, however, the nurses’ attitude toward caring terminal patients indicated lower score than in acute setting. These results suggest that education to enhance nurses' palliative care skill for elderly patient and their family is needed in long term care setting.