Frommelt Attitude Toward Care Of The Dying Research Articles

Improving nursing students attitudes to end of life care using a 360° video vignette

Extended reality (XR) simulation has been shown to be a valuable teaching-learning strategy. A pilot quasi-experimental study pretest-posttest using one group design was utilized using the Frommelt Attitude Toward Care of the Dying (FATCOD) Scale B. A paired t-test demonstrated a significant difference in scores noted at p=0.5. XR simulation that exposes novice student nurses to death and dying may foster more positive attitudes in caring for dying patients.

Primary Care Physicians' Knowledge and Attitudes Regarding Palliative Care in Northeast Malaysia.

Palliative care in Malaysia has progressed steadily since its inception in 1991, and it has been integrated gradually into primary health care in the past decade. This study aims to assess the level of knowledge and the attitudes towards palliative care and its associated factors among primary care physicians. A cross-sectional study was conducted among primary care physicians using two validated questionnaires: the Palliative Care Knowledge Test (PCKT) and Frommelt's Attitude Toward Care of the Dying (FATCOD). The data were analysed using descriptive and linear regression statistics. A total of 241 primary care physicians from 27 different health clinics participated in the study. The mean PCKT score was 8.68 (2.94), whereas the mean FATCOD score was 106.8 (9.14). The maximum score for each questionnaire was 20 and 150, respectively. There was a significant positive relationship between knowledge and attitudes toward palliative care, with a p-value of 0.003 (CI 0.22-1.04) and an r-value of 0.42. Palliative care knowledge among primary care physicians is still low despite their overall positive attitude towards the service. This finding suggests the urgent need for more education and training on palliative care for primary care physicians in Malaysia.

Attitude toward care of the dying and practice of peaceful end-of-life care in community hospitals in China.

To evaluate nurses' attitude toward caring for dying patients, their practice of peaceful end-of-life care in community hospitals, and the association between these two variables. Community hospitals play an important role in the peaceful end-of-life care. For nurses, one of the key points of offering high-level care is to improve attitude. However, there are very few studies exploring how the attitude of nurses toward caring for dying patients relates to the practice of peaceful end-of-life care in community hospitals across China. A total of 363 questionnaires were included in this study. Simple random sampling was used to recruit participants from six community hospitals in China. A new instrument, Nurses' Practice of Peaceful End-of-Life Care Instrument (NP-PECI), was developed according to the Theory of Peaceful End of Life to assess the practice of nurses. Besides, Frommelt Attitudes toward Care of the Dying (FATCOD) was adopted to assess nurses for their attitude toward caring for dying patients. The nurses' attitude toward caring for dying patients showed a significant positive correlation with their practice of peaceful end-of-life care statistically (r=0.175, p<0.01). For community nurses, it is necessary to improve the attitude of nurses toward the practice of caring for dying patients, thus enhancing the outcome of peaceful end-of-life care. The Theory of Peaceful End of Life provides a theoretical framework and guideline on the practice of clinical nursing for quality control of peaceful end-of-life care, which is significant for improving the palliative care system. In the future, it is worth developing programs based on the Theory of Peaceful End of Life. For healthcare policy makers, this study can be helpful to refine the existing palliative care support policies and strategies targeted at community hospitals and their nurses.

The Attitude of Intensive Care and Oncology Nurses Regarding the Care of the Dying Individual and Coping Methods

Objective: This study was designed to determine the attitudes of intensive care and oncology nurses towards the care of the dying individual and their coping methods.Materials and Methods: The sample of the study consisted of 96 nurses working in intensive care units and oncology clinics in a university hospital between January and February 2020. Data were collected using the Characteristics of the Nurse and The Frommelt Attitude Toward Care of the Dying (FATCOD) scale.Results: 27.2% of the nurses included in the study were working in Oncology clinics, 72.9% of them in Intensive Care Units, and 45.8% of them were working in the clinic they had been in for 1-5 years. The total FATCOD mean score of the nurses was determined to be 80.04 ± 8.80. It was found that the attitudes of nurses who did not think that death is natural, towards the care of the dying individual were significantly higher (p&amp;lt;0.05).Conclusion: It was found that attitudes of nurses who did not consider death to be natural were more positive. Considering these results, it may be suggested to organize trainings on social support, with negative and inadequacy feelings coping methods, and end-of-life care for nurses working in oncology and intensive care units.

Nurses' symptom management and views on death and caring for heart failure and chronic obstructive pulmonary disease.

The number of older adult patients in Japan is increasing and symptom management is needed not only for cancer patients, but also non-cancer patients. This study investigated nurses' symptom management and their views on death and caring for heart failure (HF) and chronic obstructive pulmonary disease (COPD). A cross-sectional survey using a questionnaire was conducted. Survey items were implementation of assessment and non-pharmacological interventions for 14 symptoms at the end-of-life stage, participation in palliative care training courses and attitude toward death and caring, as assessed by the Frommelt attitude toward care of the dying (FATCOD) Scale. A total of 266 (78.5%) nurses responded. More than 90% implemented symptom assessment of dyspnea and cough for both HF and COPD. The mean FATCOD score was 114.7, participation in on-the-job palliative care training courses (p<0.01), and difficulty with near-death issues (p<0.01) were significantly associated with the FATCOD. These results suggest that nurses assessed the major symptoms of HF and COPD. Training courses are important to promote palliative care for non-cancer patients.

Nursing Students' Compassion and Their Attitudes Toward Death and the Care of the Dying: An Intervention Study ın Turkey.

This pretest-posttest quasi-experimental study investigated the effect of an educational intervention on nursing students' compassion levels and their attitudes toward death and the care of the dying. Data were collected using the Death Attitude Profile - Revised (DAP-R), the Frommelt Attitude Toward Care Of The Dying (FATCOD) Scale, and the Compassion Scale (CS). The intervention improved participants' DAP-R scores. Participants had higher posttest FATCOD scores than the pretest scores. However, the difference was statistically insignificant. Participants had high CS scores. There was a slight increase in CS scores after the intervention. The results showed that the intervention improved participants' attitudes toward death and the care of the dying. The results also showed that compassion was an important factor.

Undergraduate nursing students’ palliative care knowledge and attitudes towards end-of-life care: a cross-sectional descriptive study

Background It is crucial that future nurses be prepared with the knowledge and skills to provide palliative care (PC). Aims This study aimed to investigate Mongolian nursing students’ PC knowledge and attitudes towards end-of-life (EOL) care, as well as identify related predictors. Methods Participants were 141 students who enrolled in nursing program in Mongolia. Results Mean Palliative Care Quiz for Nursing (PCQN) score was 7.15 out of 20. The mean Frommelt Attitudes Toward Care of the Dying (FATCOD) score was 64.2 out of 100. Older age, male gender, and higher satisfaction with nursing school were significant predictors of higher levels of palliative care knowledge. Living in traditional Mongolian housing (Ger) and having clinical EOL experience were significant predictors of positive attitudes towards EOL care. Conclusions Mongolian senior nursing students were inadequately prepared to provide PC. PC nursing education in Mongolia needs to be improved to meet an appropriate global standard.

Hospital Nurses' Perception of Death and Self-Reported Performance of End-of-Life Care: Mediating Role of Attitude towards End-of-Life Care.

Few studies have explored how nurses in acute care hospitals perceive and perform end-of-life care in Korea. Therefore, this study aimed to evaluate the influence of nurses’ perceptions of death on end-of-life care performance and analyze the mediating role of attitude towards end-of-life care among hospital nurses. This cross-sectional study included a total of 250 nurses who have had experience with end-of-life care from four general hospitals in Korea. We used the Korean validated tools with the View of Life and Death Scale, the Frommelt Attitudes Toward Care of the Dying (FATCOD) scale, and the performance of end-of-life care. Hierarchical linear regression and mediation analysis, applying the bootstrapping method. The results of hierarchical linear regression showed that nurses’ positive perceptions of death and attitude towards end-of-life care were significantly associated with their performance of end-of-life care. A mediation analysis further revealed that nurses’ attitude towards end-of-life care mediates the relationship between the perceptions of death and performance of end-of-life care. Our findings suggest that supportive and practical death educational programs should be designed, based on nurses’ professional experience and work environment, which will enable them to provide better end-of-life care.

Assessment of knowledge and attitude towards palliative care and associated factors among nurses working in selected Tigray hospitals, northern Ethiopia: a cross-sectional study.

IntroductionPalliative care is a multidisciplinary approach which is focused on both the patient and their family. Therefore the objectives of the study is to assess the knowledge and attitude towards palliative care and its associated factors among nurses in Tigray, Northern Ethiopia, 2018.MethodsAn institutional based cross-sectional quantitative study design was carried out using 355 nurses working in selected hospitals in Tigray region from February to March, 2018. Systematic random sampling was used to select six governmental hospitals. We used triangulation in the study method, making use of both Frommelt's Attitude Toward Care of the Dying (FATCOD) scale, and Palliative Care Quiz for Nursing (PCQN) knowledge. SPSS were applied for data entry and analysis. Statistical significance was declared at P<0.05. The goodness of fit the final logistic model was tested by using the Hosmer and Lemeshow test at a value of > 0.05.ResultsAll the participants were able to respond. Out of the total study participants, 223 (62.8%) had good knowledge and 200 (56.3%) had a favorable attitude towards Palliative care. A medical ward had (AOR = 3.413, CI = 1.388-8.392, P = 0.019), trained Nurses [AOR = 3.488; CI = 1.735-7.015; P = 0.00) significant associated with nurses knowledge towards palliative care. Nurses working in the lemlem Karl (AOR=2.541; 95% CI; 0.013(1.106-5.835), nurses who had a 20-30 years ago had unfavorable attitude (AOR = 2.660; 95% CI; 0.002(1.386-5.106) were significant.ConclusionThe nurses had poor knowledge. However, their attitude towards palliative care (PC) was favorable.

Effectiveness of High-Fidelity Simulation in Nursing Education for End-of-Life Care: A Quasi-experimental Design.

Background:Providing end of life (EOL) care is a component of palliative care but dealing with dying patients and their family members is stressful for the healthcare providers. To prepare them for providing EOL care, the high-fidelity simulation could be used as a pedagogy in which real-life scenarios are used on the computerized manikins mimicking the real patients.Aims:The aim of this study was to measure the effectiveness of high-fidelity simulation to teach EOL care in the palliative nursing course in the undergraduate nursing education program at the School of Nursing and Midwifery at Aga Khan University which is private university in Karachi, Pakistan.Methods:This study was approved by the ethics review committee of Aga Khan University. It was hypothesized that exposure to high-fidelity simulation will lead to an increased positive attitude in participants towards the care of dying. A quasi-experimental design was used. In line with the design, there was no control group. The same group of students (n = 42) were assessed through Frommelt Attitudes Toward Care of the Dying (FATCOD) Part B assessment tool. Permission for using this tool was obtained from Dr. Katherine Frommelt, the author of this tool. Research participants filled this tool before and after the intervention, i.e., providing EOL care to a patient in a high-fidelity simulation lab.Results:Out of 30-FATCOD items, significant attitude change was detected on 11-items of which 8 were positively worded statements and 3 were negatively worded statements. As per the hypothesis, it was expected for the positively worded statements that the mean score for the posttest would be significantly greater than the pretest mean score (pretest score < posttest score). The hypothesis was proved for items 1, 4, 10, 18, 22, 25, 27, and 30 as their t-value was significant at 0.05 alpha value (one-tailed). For the negatively worded statements, it was expected that the mean score for the posttest would be significantly lower than the pretest (pretest score > posttest score). The hypothesis was proved for items 5, 6, and 11 as their t-value was significant at 0.05 alpha value (one-tailed).Conclusion:In this research teaching, EOL care through high-fidelity simulation had improved the attitudes of students toward providing care. This pedagogy also provided the participants with a learning opportunity to deal with their own emotions. These findings provide a way forward for teaching EOL and other complex skills of clinical practice.

The Difference of Students Attitudes Who Have and Who Have Not Yet Received Palliative Classes on Palliative Nursing Action in Universitas Advent Indonesia of West Bandung District

This research is motivated because there are still many students who do not know the real palliative care. The reason is because they have not yet received Palliative theory in class. This is important because they will be dealing directly with palliative patients when practicing in the hospital so that they know that they are doing the right thing in caring for palliative patients while the palliative nursing course is still only applied in the learning curriculum. The main purpos of the study is to analyze whether there is a significant difference between the attitudes of students who have and who have not received a palliative nursing class toward palliative nursing in Universitas Advent Indonesia, Bandung Barat Regency. The research method used is descriptive quantitative. The population in this study were Level III and Level IV S1 Study Program students in Universitas Advent Indonesia. A sample of 84 students (42 students who have received a Palliative Nursing class and 42 students who have not yet received a palliative nursing class) were determined by purposive sampling. The instrument and material used were Frommelt's Attitude Toward Care of the Dying (FATCOD) attitude questionnaire score consisting of 24 questions using a Likert scale. Results: there were significant differences between the attitudes of students who have not and those who have received a Palliative class toward Nursing actions Palliative significance (2 tailed) 0.019 &lt;0.005 means that there are significant differences. Conclusion: After conducting research, it is known that there is a significant difference between the attitudes of students who have not and those who have already received palliative nursing classes in treating palliative patients. The results of this study are expected to be beneficial for students, lecturers, and researchers in order to improve the quality of palliative nursing in Indonesia.

Attitudes toward hospice care among undergraduate traditional Chinese medicine nursing students and its influencing factors

Objective To understand the attitude toward hospice care and its influencing factors among undergraduate nursing students majoring in Traditional Chinese Medicine (TCM) , and to provide basis for nursing educators to formulate hospice care training strategies. Methods Using convenient sampling method, a total of 827 undergraduate nursing students from 3 TCM universities in Shandong, Shanxi and He'nan provinces were selected as subjects from September to October 2018. The general information questionnaire and the Chinese version of Frommelt Attitude Toward Care of the Dying (FATCOD) were used. Multiple linear regression was used to analyze influencing factors. Results The total score of FATCOD among the 827 undergraduate TCM nursing students was (101.32±9.15) . Univariate linear regression results showed that gender, single-child status, willingness to choose nursing major, attitudes toward nursing, the situation where students discussed death with family, experience with funerals, experience with terminal relatives, willingness to take care terminal patients were all factors that could affect the attitudes toward hospice care among nursing students (t/F=-3.066, -2.783, 3.289, 12.577, 10.638, 2.680, -2.251, 8.697; P<0.05) . Multiple linear regression analysis results showed that gender, single-child status, attitudes toward nursing, willingness to take care terminal patients, experience with funerals, the situation where students discussed death with family, experience with terminal relatives have an impact on the attitude toward hospice care (P<0.05) . Conclusions The attitude toward hospice care among undergraduate TCM nursing students needs to be further improved. Educators should adopt various methods of teaching to carry out death education according to the influencing factors, and to cultivate proper perception of death and improve the enthusiasm for hospice care. Key words: Students, nursing; Attitude; Death; Hospice care; Influencing factors

Nursing Student’s Attitude toward Care for the Dying

Dying and death are experiences that are painful for the ones experiencing it and their loved ones caring for them. Nurses are frequently exposed to the care of death and dying patients. This experience often gives rise to their level of anxiety and undesired attitudes that reflect on the quality of care they give to the patients. It is a challenge for nurses to care for dying patients and this has raised a special interest in the recent years. This descriptive-comparative study was conducted to determine the attitude of student nurses towards the care for the dying, with an adapted instrument from the Frommelt Attitude toward Care of the Dying (FATCOD) with the reliability score of .81. The respondents who participated in this study were 98 nursing students, where the majority was female (75%). Convenience sampling method was used to gather the data. Findings of this study showed a mean of 4.16, indicating that majority of the nursing students has a positive attitude towards care for dying patients. There are no significant differences in the nursing students’ attitudes when exposure to dying patients is considered (p = 0.99). This indicated that whether they are exposed to the dying patient or not, they all have positive attitude in taking care of the terminally ill patient. It is important for the school to keep such positive attitude of the students and prepare them in taking care of dying patients.

Just in KASE

Caring for the dying patient can be distressing for nursing students. End-of-life (EoL) care is an essential skill for the professional nurse, and the nursing student must prepare to provide quality care to these patients. The purposes of this study were to describe the knowledge, self-efficacy, and attitudes toward EoL care among nursing students at a northeastern traditional baccalaureate program and examine correlations between student demographics and outcomes. Nursing students from the sophomore to senior levels were sent an online survey consisting of demographic questions, the Frommelt Attitude Toward Care of the Dying (FATCOD) scale, and Knowledge Assessment and Self-Efficacy Assessment instruments. Multivariate modeling was used to identify correlates of student knowledge, self-efficacy, and attitudes. A total of 69 sophomore (22%), junior (52%), and senior (26%) nursing students completed the survey. Class year was the only correlate of knowledge, whereas student’s attitudes and class year affected their self-efficacy. Students’ attitudes toward EOL care were correlated with ethnicity, previous experience with EOL care, age, and self-efficacy. Enhancing student exposure to EOL care in the clinical environment positively affects their attitudes toward caring for the dying patient. Nursing schools should consider actively incorporating EoL care experiences into their clinical rotations.

Oncology nurses' perceptions of end-of-life care in a tertiary cancer centre in Qatar.

Nurses who work in oncology settings may lack the knowledge and skills required for end-of-life (EoL) care. A clear understanding of nurses' perceptions of EoL care is crucial for the successful improvement of care for terminally ill patients with cancer. Although many studies have underlined nurses' perspectives on EoL care, this is the first such study conducted on oncology nurses in Qatar. This study primarily sought to measure nurses' perceptions of EoL care at the National Center for Cancer Care and Research (NCCCR) in Qatar. A quantitative, cross-sectional, self-reported study. Nurses at the NCCCR reported their perceptions of EoL care using the Frommelt Attitudes Toward Care of the Dying (FATCOD) scale, which consisted of 30 items scored on a five-point Likert scale. Seventy-eight nurses working in oncology settings completed the tool. Approximately one third (33-35%) of the participants had positive perceptions of EoL care. The majority (67%) of the participants were uncertain or ambivalent regarding EoL events and situations. There was no significant relationship between the participants' profiles and their perceptions of EoL care. However, very few of them had completed educational courses in death and dying. Nurses have an important impact on EoL care, and continuous education is necessary to improve their confidence when they work with dying patients and their families. An in-house programme to help nurses cope with compassionate exhaustion and humanistic and relational care is highly recommended.

Just in KASE: Evaluating Nursing Students’ Knowledge, Attitudes and Self-Efficacy to Care for the Dying Patient (S721)

•Describe nursing student knowledge, self-efficacy and attitudes around caring for the dying patient across class years.•Discuss the relationship between nursing student experience with caring for a dying patient and their attitudes around caring for the dying patient. Caring for the dying patient can be distressing for nursing students. End of life (EOL) care is an essential skill for the professional nurse and the nursing student must prepare to provide quality care to these patients, while maintaining their own emotional health. Little is known about current student nurse knowledge, self-efficacy or attitudes towards EOL care. Describe the knowledge, self-efficacy, and attitudes towards EOL care among nursing students at a northeastern traditional baccalaureate program and examine correlations between student demographics and outcomes. Nursing students from the sophomore to senior levels were sent an online survey consisting of demographic questions, the Frommelt Attitude Toward Care of the Dying (FATCOD), the Knowledge Assessment, and Self-Efficacy Assessment Instruments. The response rate was 25%. Multivariate modeling was used to identify correlates of student knowledge, self-efficacy and attitudes. Sixty-nine sophomore (22%), junior (52%), and senior (26%) nursing students completed the survey. The sample was 87% white, 98% female and 71% had cared for a dying person, either in clinical or personal life. On average, students scored 5.8 (out of 7) on knowledge, scored 35 (out of 48) on self-efficacy and held positive attitudes towards EOL care. Class year was the only correlate of knowledge, while student’s attitudes and class year impacted their self-efficacy. Students’ attitudes towards EOL care were correlated with ethnicity, previous experience with EOL care, age and self-efficacy. Enhancing student exposure to EOL care in the clinical environment positively impacts their attitudes towards caring for the dying patient.

Evaluation of a Peer Nurse Coach Quality Improvement Project on New Nurse Hire Attitudes Toward Care for the Dying

Despite growth of hospices in the United States, there is increased use of intensive care and late referrals to hospice, and most patients die in hospitals. A national survey indicates that these patients can experience persistent pain, dyspnea, anxiety, and depression, and they and their families also have unmet needs for respectful treatment. Nursing leaders perceived that new nurse hires lacked end-of-life training and were uncomfortable caring for dying patients. Evidence from 2009 to 2011 using Frommelt Attitudes toward Care of the Dying (FATCOD) questionnaires collected during classroom exercises confirmed this and indicated areas for quality improvement. After further review, a peer nurse coach model was selected for the intervention. New nurse hire FATCOD data from 2009 to 2011 were used to design the intervention. This article examines FATCOD data collected immediately before the quality improvement project and data collected 5 months after to evaluate the impact of end-of-life peer nurse coaching on new nurse hire attitudes toward end-of-life care. The difference in total scores was not significant, although there were significant positive improvements in individual questionnaire items. Overall, the peer nurse coach model holds promise as a mechanism for engaging new nurse hires and for improving end-of-life care.

Development and Psychometric Testing Chinese Version of the Frommelt Attitude Toward Care of the Dying Scale, Form B in Nurses and Nursing Students.

Nursing students' and nurses' attitudes toward caring for the dying need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in the Chinese language. The aim of this study was to examine the reliability and validity of the Chinese version of the FATCOD scale. A convenience sample of 154 nurses and 200 nursing students was recruited. The Chinese version of the FATCOD was used to test construct validity, concurrent validity, convergent validity, and internal consistency. The Cronbach's alpha coefficient of the Chinese version of the FATCOD scale, Form B (FATCOD-B-C) was 0.790. The Cronbach's alpha coefficients for each subscale ranged from 0.610 to 0.863. The test-retest reliability was satisfactory (r = 0.959, P < 0.001). The overall content validity index was 0.92. Seven factors were identified in exploratory factor analysis. The results provide preliminary support for the reliability and validity of the FATCOD-B-C in nurses and nursing students. Additional psychometric testing is recommended to confirm the factor analysis, but this study provides further evidence of the applicability of the FATCOD-B-C in clinical care services.

Nurses' Involvement in Patients' Dying and Death: Scale development and validation.

This study reports the development of a measurement scale, The Nurses' Involvement in Patients' Dying and Death Scale (NIPDYDS), which fully captures the experiences of nurses caring for patients' dying and death. Potential items were extracted from narrative data gathered systematically and comprehensively from in-depth interviews with nurses engaged in caring for patients' dying and death. Factor analyses revealed four factors, consisting of 40 total items, with two factors related to the positive aspects of the experience (Deep involvement in facing dying and death and Increased competence in facing dying and death) and two factors related to the negative aspects of the experience (Uncertainty and difficulty dealing with dying and death and Accustomed to dying and death). Validity and reliability of the scale were found to be acceptable. The factorial structure of the NIPDYDS was contrasted to Frommelt's (1991) FATCOD (The Frommelt Attitude Toward Care of the Dying Scale), and the usefulness and limitations of the NIPDYDS were discussed.

Caring for dying patients: attitude of nursing students and effects of education.

Background:Education about caring for dying patients could be effective in changing nursing students’ attitude toward caring for dying patients.Aim:The aim of the present study was to examine the nursing students’ attitude toward caring for dying patients and effects of education on their attitude.Materials and Methods:The present study enjoys a quasi-experimental method with using one-group pre-test/post-test design conducted in Bam in southeast of Iran. The attitude of nursing students was measured using Frommelt Attitude Toward Care of the Dying (FATCOD) scale before and after an educational intervention. Data were analyzed using non-parametric tests in Statistical Package for the Social Sciences (SPSS) 18 software.Results:Of 32 students, 30 participated in this study (response rate of 94%). Only 20% of the students reported previous experience of dying patients in their clinical courses. Students showed moderately negative to neutral attitudes toward caring for dying patients. Education has improved students’ attitude significantly (mean score of FATCOD before study were 3.5 ± 0.43 and after intervention were 4.7 ± 0.33) (P < 0.001).Conclusion:Educational programs about death and caring for dying patients should be added to undergraduate nursing curricula. Further research recommended examining nursing students’ knowledge about caring for dying patients and the effect of education on their knowledge.