With longer life expectancy and advancement in medical technology, the dying process of people with incurable chronic diseases would be lengthened resulting in an increase in the demand for end-of-life (EOL) care. As a key provider of patient care, all nurses, regardless of their ranks, are required to learn and develop their competency in this specific area. This is considered essential to ensure quality patient care in the coming decades. Although the investigations on knowledge and attitude have been carried out in previous studies, they were focused mainly for graduated nurses and medical practitioners. There was a recent study using cluster analysis to group nursing students from different pre-registration programmes into respective categories. There is a paucity of study to examine the perceived knowledge, perceived competency and attitude of final year nursing students in EOL care.
Aim
The aim of the present study was to investigate the correlations between knowledge, attitude and perceived competency of final year baccalaureate nursing students in EOL care.
Methods
Convenience sampling was adopted in the cross-sectional exploratory study. The participants included 186 final year nursing students from four universities and one tertiary institution in Hong Kong. The participants were required to complete a questionnaire consisted of demographics, knowledge, perceived competency and attitude on EOL care. The learning experience in EOL care comprised of the opportunities to observe, perform and receive feedback from supervisors on EOL care in the clinical practicums. The remaining three questionnaires were adopted and modified from previous similar studies.
Results
There were 92.5% of the participants in the age of 20-25, 75.8% of the participants were female, 37.6% were having full time working experiences. Regarding the learning experiences, about one-third, 32.8% of the participants had the opportunities to observe EOL care 3-4 times in clinical practicum. For participation in EOL care, 39.2% of the participants had participated in EOL care for 1-2 times, 12.9% had never been participated while 13.4% had participated for 5-6 time during clinical practicum. For feedback received from supervisors, 40.3% of the participants had not received any feedback while 39.8% received only 1-2 times during the clinical practices.
For knowledge score, the mean score was 7.17/10 (SD 1.83), with higher score indicates higher level of knowledge. For perceived competency, the scores ranged from 12-46/50 (SD 5.52), a higher score means higher perceived competency. For attitude, the scores ranged from 11-34/40 (SD 3.63), in which a lower score indicates more positive attitude. For correlations, there were positive correlations between receiving feedback and the number of chances to observe EOL, correlation coefficient = 0.337. Regarding attitude, the correlation coefficient between observed QOL was -2.0, for participation was -0.203 and -0.227 for knowledge.
Conclusion
Nursing students generally showed good knowledge in EOL care as this is part of the curriculum required for completion of bachelor degree nursing programme. In a similar vein, the students demonstrated good perceived competency in EOL care. Nevertheless, they had a less favourable attitude towards care EOL care. To enhance students in learning of EOL care, clinical teachers are strongly encouraged to provide sufficient opportunities for students to observe and participate in EOL care to strengthen their competency to deliver the specific care to clients. Most importantly, teachers should be the role model in providing EOL care as it is not only for dissemination of knowledge but to develop a positive and favourable attitude toward EOL care for the new generation of nurses.
See more of: Evidence-Based Practice Sessions: Oral Paper & Posters