Modelling end-of-life care practices: Factors associated with critical care nurse engagement in care provision

Abstract

To identify factors associated with critical care nurses' engagement in end-of-life care practices. Multivariable regression modelling was undertaken on 392 responses to an online self-report survey of end-of-life care practices and factors influencing practice by Australian critical care nurses'. Univariate general linear models were built for six end-of-life care practice areas. Six statistically significant (p<0.001) models were developed: Information sharing F(3, 377)=40.53, adjusted R(2) 23.8%; Environmental modification F(5, 380)=19.55, adjusted R(2) 19.4%; Emotional support F(10, 366)=12.10, adjusted R(2) 22.8%; Patient and family centred decision making F(8, 362)=17.61 adjusted R(2) 26.4%; Symptom management F(8, 376)=7.10, adjusted R(2) 11.3%; and Spiritual support F(9, 367)=14.66, adjusted R(2) 24.6%. Stronger agreement with values consistent with a palliative approach, and greater support for patient and family preferences were associated with higher levels of engagement in end-of-life care practices. Higher levels of preparedness and access to opportunities for knowledge acquisition were associated with engagement in the interpersonal practices of patient and family centred decision making and emotional support. This study provides evidence for interventions to address factors associated with nurse engagement to increase participation in all end-of-life care practice areas.