CN19 Healthcare professionals' perception about end-of-life conversations: An observational cross-sectional study

Abstract

End-of-life (EOL) conversations are one of the most challenging aspects for Healthcare Professionals (HPs). It is crucial to collect patients' wishes about life-sustaining treatments, advanced care planning, preferences about interventions' timeframe, and how to live the last phase of their life. Furthermore, the same concerns are present in the personal life of HPs. They reported feeling insufficiently skilled for EOL conversations. Also, although professional education programs on communication skills in clinical settings are mostly available; it is less common to stimulate HPs in reflecting on their values and preferences if they were near the end of life. This study aimed to describe HPs' wishes regarding interventions and treatments they would like if they were in the hypothetical condition of EOL. A descriptive correlation research design was used to determine whether there were any associations between personal and professional characteristics and EOL conversations' wishes of HPs in the north of Italy. Inclusion criteria were being nurses, physicians, nursing assistants, informed consent. Those who had already completed the questionnaire were excluded. The Conversation Starter Kit was adapted to a self-administered, web-based questionnaire format. A total of 737 HPs accepted to participate, and 467 questionnaires were returned. Most of them were completed by nurses (60%) and females (68%). The mean age was 45 (±11) years. If HPs had a terminal illness, hospice and rehabilitation inpatient unit’s HPs would prefer to know their prognosis when compared to surgical units' HPs OR=8.635 (95%CI 1.548 – 48.162) p=0.014 and OR=2.78 (95%CI 1.083-7.138) p=0.034, respectively. When compared to physicians, nursing assistants and nurses were over two times more likely to prefer receiving medical care even if treatments had severe side effects OR=2.755 (95%CI 1.218 – 6.23), p=0.015; and OR=2.551 (95%CI 1.206 – 4.982), p =0.006, respectively. This preference was 35% less likely to occur when HPs attended palliative care courses OR=0.655 (95%CI 0.431 – 0.997), p=0.048. This study may support HPs feel better equipped to address EOL conversations with patients and their families.