Factors associated with critical care nurses’ engagement in end-of-life care practices

Abstract

Introduction - Critical care nurses frequently engage in the provision of end-of-life care (EOLC). Identification of factors associated with specific EOLC practices can inform practice development to improve the care that patients and their families receive and support nurses in the provision of this care. Objectives - To identify factors associated with critical care nurses’ engagement in six areas of EOLC practice: Information sharing, environmental modification, emotional support, patient and family centred decision making, symptom management and spiritual support. Methods - Using data obtained from a national survey of 392 critical care nurses (response rate 25%), univariate general linear models were built for each EOLC practice area. Results - Findings revealed that more positive scores on scales reflecting palliative values and support for patient and family preferences were associated with more frequent engagement in the EOLC practices examined in this study. Nurses who reported higher levels of preparedness and access to opportunities for knowledge acquisition were more likely to report engaging in interpersonal practices that supported patient and family decision making and emotional support of patients and their families. Contextual factors had a limited influence as explanatory variables. Conclusions - Critical care nurses’ personal values are at the core of their practice intentions. Development of positive values among nurses towards EOLC can thus contribute to quality care for patients and their families. Additionally, education opportunities to enhance preparation and strategies that assist critical care nurses to support patient and family preferences will contribute to increased participation in the EOLC practice areas identified in this study.