The Quality of Palliative Care at the End-of-Life in the Intensive Care Unit：A Comparison Between Physiciansˈ and Nursesˈ Perceptions

• Main Authors: Ying-Ju Ke, 柯盈如
• Other Authors: Chia-Chin Lin
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/5899cu

碩士 === 臺北醫學大學 === 護理學研究所 === 102 === The purpose of the study is to assess the knowledge and attitudes regarding advance directives from doctors and nurses. Another aim is to find out the nurses’ involvement in end-of-life decisions making and the quality of palliative care in the intensive care unit. This study adopted a cross-sectional design, using self-assessment questionnaire to 56 doctors and 120 nurses working in Northern Taiwan ICU during November 2013 and December 2013. The survey concluded: (a) Doctors have more knowledge regarding advance directives than nurses. (b) Both doctors and nurses keep positive attitudes of end-of-life decision making (c) Most clinicians consider doctors will discuss with nurses about end-of-life decision making. 95% nurses think they should participate in end-of-life decision making, whereas around 80% doctors and 60% nurses agreed to get consensus when end-of-life decision was made. (d) During palliative care, the quality of symptom management and comfort care was considered performed well. However, emotional and organizational support for ICU clinicians, spiritual support of patients and families, continuity of care were considered to be insufficient. (e) From nurses’ self-assessment result, the predicting factors of the quality of palliative care were significantly related to nurses’ gender, participation, as well as the attitude toward advance directives in end of life care. The results of this study can be applied as a reference for effective guideline and assessment tools for quality of palliative care in the intensive care unit. In addition, this study suggest that it’s important to get nurses more involved in end-of-life decision making so as to improve the quality of palliative care in the future.