Abstract
This study aimed to expand on previous research elucidating the effects of dispositional resilience and self-efficacy on practice in advanced care planning (ACP) of terminally ill patients among Taiwanese nurses using path modeling. This cross-sectional study was conducted using cluster sampling. Data were collected using demographics, nurses’ knowledge, attitude, and practice of ACP (KAP-ACP) inventory, Dispositional Resilience Scale, and General Self-Efficacy Scale. A total of 266 nurses from a tertiary medical center in northern Taiwan participated in this study in 2019. The results showed that gender and ward were significant K-ACP predictors among nurses. The ACP knowledge, ward, and experience of caring for terminally ill friends or relatives were significant A-ACP predictors, whereas ACP attitudes, dispositional resilience, self-efficacy, ward, and the frequency of caring for terminally ill patients were the key predictors of P-ACP. The path modeling showed that dispositional resilience; self-efficacy; medical, surgical, hematology and oncology wards; previous experience in caring for terminally ill friends or relatives; participating in the do-not-resuscitate signature; and the frequency of caring for terminally ill patients directly influenced ACP practices. We recommend that nurses enhance their dispositional resilience and self-efficacy, which may encourage them to appreciate the value of ACP practice of terminally ill patients and improve the quality of care.
Highlights
Due to advancements in medical treatment, people’s life expectancy has been prolonged
Almost half (45.5%) of the participants worked at the intensive care units (ICUs), 64.7% of the participants had no experience in caring for terminally ill friends or relatives, 82.3% had participated in DNR signature, and 64.3% had received education related to advanced care planning (ACP)
The number of female nurses in the study was far more than male nurses, the results of this study showed that being a female nurse and working at a medical ward were positive predictors of ACP knowledge of terminally ill patients among nurses
Summary
Due to advancements in medical treatment, people’s life expectancy has been prolonged. When facing the terminal stage of a disease in their patients, medical staff may apply active medical treatment due to family pressure, which enables patients to stay alive and prolong the process of dying due to the use of life support medical interventions In this process, patients often experience a lot of physical and psychological pain [1]. Patients cannot fully express their wishes while still aware and awake. Their family members often make medical decisions in the terminal stage, rather than the patients themselves, which leads to regrets that patients could not have a good death [1]
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