Perceptions Of Hospice Research Articles

Development of a Hospice Perceptions Instrument for Diverse Patients and Families: Establishing Content and Face Validity.

For many, the perception of "hospice" is synonymous with "death." Even clinicians struggle to have conversations that distinguish between hospice and palliative care for fear that discussing hospice may diminish hope. To date, there are no existing measurement tools to evaluate patient and family perceptions of hospice care. This research aimed to develop a Hospice Perceptions Instrument (HPI) to capture these perceptions among diverse patients and families. Building on previous studies and literature, 79 potential items were drafted for the instrument. Our interprofessional team independently and collectively evaluated these, resulting in 36 items rated on a 5-point Likert scale. Overarching domains include (1) hospice philosophy and definitions; (2) hospice services; (3) values; and (4) counter-perceptions. Sixteen national subject matter experts from various professions and roles were invited to participate in the content-validity index and five hospice caregivers were invited to participate in face validity. Fourteen experts responded, with ten meeting inclusion criteria: one physician, four nurses, three social workers, and two chaplains. Six of the ten identified as Black. Three items were removed (I-CVI ranged from 0.5-06), and nine items were revised (I-CVI ranged from 0.6-07). The overall Content Validity Index (CVI) was 0.83, indicating excellent content validity. After revisions, five hospice caregivers assessed face validity and no changes were made based on feedback. Results reveal a disconnect between professional expertise and patient/family voices related to hospice perceptions. Development of this instrument invites a better understanding of perceptions leading to new opportunities for patient/family engagement.

The History and the Structure of Hospices in Uzbekistan

In the modern world, there is a constant increase in the number of patients suffering from incurable forms of diseases in the terminal stage of development. This trend actualizes the study of palliative care, which is a special area of social and medical care for terminally ill people. Palliative care is an integrated part of cancer patient care. However, the situation in palliative care in Uzbekistan is very critical. Implementing palliative care and hospice into medicine began in 2017 in Tashkent, Uzbekistan. The first Children’s Hospice -Taskin was opened in 2022 in Tashkent, Uzbekistan. Despite the fact that 2 years have passed since the opening of the hospice in the Republic of Uzbekistan, the concept of hospice has not yet formed in the minds of the population, there is still an idea that people perceive the concept of “hospice” as a house of death. This article is intended to study the history and structure of palliative care in Uzbekistan and study the perception of hospice among the population.

간호대학생의 공감교육을 포함한 호스피스 완화간호 교육 프로그램이 공감 능력, 삶의 의미, 호스피스 완화간호에 대한 인식에 미치는 효과

Objectives This study was conducted to determine the effect of a hospice and palliative care education program, including empathy education, on nursing students' empathy ability, meaning of life, and perception of hospice and palliative care in fourth-year nursing students at a university. Methods The research design was a pre-post quasi-experimental design with a non-equivalent control group. The subjects of the study were experimental group 41 and control group 40, in fourth-year nursing students at a Women's College located in I City, the study period was from September 5th to December 6th, 2019. The hospice palliative nursing education program consisted of a total of 26 hours, including the empathy education program developed by Jeong Jin-ok and Kim Su (2019). Data analysis was done using frequency, percentage, mean, standard deviation, Chi-square test, t-test, paired t-test using with spss win 21.0. Results The experimental group that participated in the hospice and palliative care education program that included empathy education was found to have statistically significant differences in cognitive empathy(t=2.092, p=.040), emotional empathy(t=2.013, p=.048), meaning of life(t=2..203, p=.031), and perception of hospice and palliative care(t=2.533, p=.013) compared to the control group. Conclusions The research results show that a hospice and palliative care education program including empathy education improves nursing students' empathy ability, meaning of life, and perception of hospice and palliative care, so it will be helpful in developing and applying various educational methods and programs.

Clinical Nurses' perceptions of hospice, person-centered care and well-dying

This study’s purpose was to investigate the factors affecting well-dying of clinical nurses. Participants included 112 clinical nurses from 4 medium-sized hospitals and 2 university hospitals in Busan. Data was collected from 15 March to 10 April 2023, through structured questionnaires. The collected data was analyzed using the IBM SPSS Statistics 26.0 Program, through independent t-test, ANOVA, Pearson's correlation coefficient, and step-wised regression. As a result, the perception of well-ding in clinical nurses showed statistical differences according to gender (t=2.112, p=.037), marital status (t=2.403, p=.018), job position (F=4.806, p=.010) and type of shift (F=6.445, p=.002). The correlation between the perception of hospice and person-centered care (r=.450, p<.001), between the perception of hospice and well-dying (r=.517, p<.001), between person-centered acre and well-dying (r=.363, p<.001) was found to be positive correlation. The factors influencing well-dying were the perception of hospice (β=.40, p<.001), type of shift (β=.18, p=.038). The total explanatory power of these variables was 32.8%. Therefore, to enhance clinical nurses' well-dying, there need to be a certain curriculum including hospice and person-centered care. Through these efforts, we can expect to improve a positive attitude toward about death and can provide physical, social, mental and spiritual care to end-of-life patients.

Veteran's Attitudes and Knowledge of End-of-Life Care: A Pilot Study Using a Mixed Methods Approach.

Veterans make up a quarter of the deaths in the United States (US). However, little is known about their knowledge and preferences about end-of-life care and pain management. Given this, we were interested in how veterans' military experiences impact their end-of-life experiences and attitudes. Our exploratory study addressed the knowledge and perceptions of hospice and pain management at the end of life. The quantitative aspect was a survey using descriptive statistics that used a small (n = 14) subgroup from a randomly selected sample in the continental US. A small population-based sample (N = 123) used a blended sampling frame of randomly selected validated cell phone and landline numbers. The qualitative aspect examined eight targeted interviews of urban dwelling older veterans over age 60 residing in Northeast Ohio to get a deeper understanding of their knowledge and attitudes toward end-of-life care. Our findings suggest that veterans did not understand the difference between hospice and palliative care and expressed concerns regarding pain medication use at the end of life. Future research examining the concept of stoicism at the end of life among veterans and educational interventions are needed.

Development of a Hospice Perceptions Instrument for Diverse Patients and Families (Sci223)

Development of a Hospice Perceptions Instrument for Diverse Patients and Families (Sci223)

Adults above 65 years of intention to use homecare hospice and a study on the factors influencing the perception of hospice·palliative care service

BackgroundThis study is a descriptive correlation survey conducted to understand the effect of attitudes toward death, hospice palliative care perception, and knowledge on homecare hospice use intention for adult men and women aged 65 or older ones. AimThis study identified factors affecting the intention to use homecare hospice and the perception of hospice·palliative care for adults aged 65 or older. MethodsResearchers used tools which were intention to use homecare hospice, the hospice palliative care knowledge, death orientation, hospice palliative perception. ResultsThe higher the perception of hospice·palliative care, for men than women, then they are the higher the willingness to use homecare hospice. In addition, the factors influencing the perception of hospice·palliative care of subjects who are willing to use homecare hospice were education and hospice·palliative care knowledge. ConclusionBy improving hospice·palliative care perception by acquiring hospice·palliative care knowledge, people will choose the place where they want to die. In addition, once there is an increasing demand for it, nations and Institutions can help to set up support homecare hospice. For this, campaigns, and education to provide knowledge and improve perception of hospice·palliative care must be continued at the socio-cultural level.

Meaning of Hospice Care: Perceptions of Patients and Families.

Background: About half of hospice-eligible adults die without hospice each year. Misconceptions about hospice are frequently identified as barriers to utilization, but hospice perceptions are not well documented. Objectives and Setting/Subjects: To examine perceptions of hospice (initial and post-enrollment) among 90 U.S. patients/families actively enrolled in a large, metropolitan hospice in Texas, and to identify factors associated with participant perceptions. Design and Measurement: Concurrent mixed methods and cross-sectional design collecting data via research questionnaire with Likert scales and open-ended questions. Wilcoxon signed-rank test determined differences between recall of initial hospice perceptions at time of referral and perceptions while actively receiving services; Fisher's exact and Kruskal-Wallis tests were used to examine bivariate relationships between perceptions of hospice and satisfaction with physician communication and demographic variables. Qualitative statements were analyzed using an inductive, content analysis approach. Results: There was a significant difference between participants' perceptions of hospice recalled from initial conversations compared with current perceptions following hospice enrollment (z = -6.44, P < .01). Initial perceptions of hospice were significantly related to satisfaction with physician communication (P = .011) and diagnosis (P = .019). Qualitative themes range from negative (ie hospice = death) to positive (ie comfort, support, loving staff) with 65.6% of participants demonstrating positive increases in understanding. Conclusion: Participants' perceptions of hospice were positively associated with satisfaction with physician communication prior to hospice enrollment, and potentially impacted by the experience of care itself. During hospice discussions, clinicians should elicit patient and family perceptions in addition to providing descriptions of eligibility and services.

NURSING HOME STAFF’S PERCEPTIONS AND EXPERIENCES COLLABORATING WITH HOSPICE

Abstract Hospice has been associated with improved outcomes for terminally-ill patients and families, including in pain management, care satisfaction, and rates of hospitalizations. In 2016, 1/3 of Medicare hospice beneficiaries died in nursing homes (NH). The responsibilities for meeting the needs of the NH resident receiving hospice are shared by the NH staff and hospice team, making good communication and coordination of services between providers critical to the successful delivery of services. This exploratory study surveyed NH direct care and administrative staff about their perceptions of hospice, and barriers to collaboration. A total of 66 NH staff completed the online survey. The sample was 62.1% direct care staff (e.g., social work, nursing) and 37.8% administrators, predominately female (75%), non-Hispanic-white (43.9%), and employed full-time (87.8%). Over half of the NHs were non-profit organizations (56.1%). Respondents had on average 33.8 hours of hospice education and held positive hospice attitudes, with 76% strongly agreeing that hospice should be an option regardless of setting, and 87.8% believing they could collaborate with hospice toward the goal of a “good death.” Although participants cited barriers to hospice related to COVID-19, this was not associated with overall hospice attitudes. Respondents cited resistance from family as the primary barrier to hospice, indicating lack of knowledge and a need for family education. They also cited concerns surrounding duplication of roles. Family members in previous studies have identified care allocation as a challenge, based on expectations that hospice would bring additional contact/services instead of replacing NH services. Implications will be discussed.

Perceptions of Hospice and Transfusion Access Among Patients with Advanced Blood Cancers: Results from a Best-Worst Scaling Survey

Background: Patients with hematologic malignancies have low rates of hospice use, and when they do enroll, they often do so in the last three days of life. While lack of access to transfusions in hospice has been posited to be a key barrier to hospice use for this population, data are lacking regarding the perception of patients with blood cancers about the importance of transfusion access compared to traditional hospice services. We sought to characterize the utility of transfusions and hospice services from the perspective of patients with advanced blood cancers, who would potentially be eligible for hospice care.Methods: In October 2020, we began a web-based survey of patients with hematologic malignancies recruited from the clinics of two large cancer centers. Eligible patients were at least 18 years of age, had at least two outpatient visits to the cancer center, and had a physician-estimated prognosis of six months or less based on their hematologic oncologist answering “no” to a modified “surprise” question (Hudson KE, JPM 2018): “would you be surprised if this patient died within the next six months?” A physician-estimated prognosis of ≤ 6 months was used for study inclusion as this is an eligibility criterion for hospice. The survey was developed through literature review, a series of patient/caregiver focus groups (n=27) and cognitive debriefing with blood cancer patients (n=5). The survey included a best-worst scaling (BWS) section to assess patients' perceptions of the utility of various services routinely provided in hospice (visiting nurse, case manager, home health aide, chaplain, social worker, respite care) as well as non-routine services (transfusion access, transportation, peer support, telemedicine through videoconferencing). We asked patients to imagine a program developed to support quality of life for patients with blood cancers just like them. We then presented them with 10 questions with different combinations of the services in groups of 4 and participants were asked to select the service they considered “most important” and “least important” in deciding whether to sign up for the program. The BWS questions were constructed using a near balanced incomplete block design (Louviere JJ, Patient 2010). We conducted a hierarchical Bayesian analysis to ascertain a standardized utility score assigned to each service, a measure of the average propensity to choose a service as most important more often than least important. Analyses were conducted using Sawtooth (Sawtooth Software, Inc).Results: As of July 2021, 102 patients had completed the survey (response rate: 64.6%). The median age of respondents was 71 years (IQR 63, 77). The majority of respondents were male, white, and married/living with partner (Table). The most common diagnosis was acute leukemia (38.2%). Patients considered access to blood transfusions to have the highest importance (Figure) with a standardized utility score of 21.1, 95% confidence interval [CI] [19.6-22.6], followed by telemedicine (19.4, 95% CI [17.8-20.9]), transportation to/from medical appointments (13.4, 95% CI 11.7-15.1), and visiting nurses (10.8, 95% [9.5-12.2]. The three least important services perceived by respondents were access to respite care (4.7, 95% CI [3.9-5.6]), social workers (4.5, 95% CI [3.5-5.5]), and chaplains (2.3, 95% CI [1.3-3.3]).Conclusions: In this cohort of blood cancer patients who would potentially be eligible for hospice care, access to blood transfusions had the greatest level of importance relative to services routinely provided in hospice settings. The high value placed on transfusion access suggests that this factor plays a crucial role in hospice decision making. Accordingly, lack of transfusion access in many hospices likely reduces the propensity of patients with blood cancers to choose hospice. Innovative hospice delivery models that include access to palliative transfusions may have strong potential to increase hospice use and optimize end-of-life care for this patient population. [Display omitted] DisclosuresHuntington: Genentech: Consultancy; SeaGen: Consultancy; Thyme Inc: Consultancy; Servier: Consultancy; Novartis: Consultancy; Bayer: Honoraria; AstraZeneca: Consultancy, Honoraria; AbbVie: Consultancy; DTRM Biopharm: Research Funding; TG Therapeutics: Research Funding; Flatiron Health Inc.: Consultancy; Pharmacyclics: Consultancy, Honoraria; Celgene: Consultancy, Research Funding.

요양병원 간호사의 영적안녕과 죽음에 대한 태도가 호스피스 인식에 미치는 영향

Purpose: This study was conducted to evaluate the spiritual well-being, attitude toward death and hospice perception among nurse working in long-term care hospitals, as well as to identify the relationships between variables and examine factors influencing their hospice perception. Methods: Data were collected using a self-reported questionnaire completed by 152 at nurse working in long-term care hospitals eight long-term care hospital from october 15, 2019 to november 20, 2019. Data were analyzed using descriptive analysis, t-test, Pearson’s correlation coefficients and stepwise multiple regression with the SPSS 22.0 program. Results: Hospice perception among attitude toward death nurse working in long-term care hospitals were significantly correlated with spiritual well-being(r=.24, p=.002) and attitude toward death(r=.25, p=.002). spiritual well-being among attitude toward death was significantly correlated(r=.25, p<.001). The significant predictors of the hospice perception in nurse working in long-term care hospitals were position system (β=0.25, p<.001) and attitude toward death (β=0.20, p<.001), the experience of death close relatives (β=-0.20, p<.001). These variables explained 15.1% in total of hospice perception. Conclusion: Overall, these findings suggest that the hospice perception education program, including spiritual well-being and attitude toward death is necessary to enhance the positive hospice perception among nurse working in long-term care hospitals.

The Effects of Nurses' Knowledge of Withdrawal of Life-Sustaining Treatment, Death Anxiety, Perceptions of Hospice on Their Attitudes toward Withdrawal of Life-Sustaining Treatment.

This descriptive study investigated the effects of nurses' knowledge of withdrawal of life-sustaining treatment, death anxiety, and perceptions of hospice care on their attitudes toward withdrawal of life-sustaining treatment. Data were collected from 262 nurses at tertiary hospitals, general hospitals, or primary hospitals in Busan, Korea, and statistically analyzed using the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical regression analysis. The participants' scores were 3.68±0.45 (out of 5) for attitudes toward withdrawal of life-sustaining treatment, 0.65±0.15 (out of 1) for knowledge of withdrawal of life-sustaining treatment, 2.61±0.26 (out of 4) for death anxiety, and 4.06±0.43 (out of 5) for perceptions of hospice care. Furthermore, knowledge of withdrawal of life-sustaining treatment and perceptions of hospice care showed positive correlations with attitudes toward withdrawal of life-sustaining treatment, while death anxiety showed a negative correlation. The most significant factors influencing attitudes toward withdrawal of life-sustaining treatment were perceptions of hospice care, followed by having experienced caring for patients who withdrew life-sustaining treatment, death anxiety, having a spouse, and ethical values, and the overall explanatory power was 43.0%. This study showed that perceptions of hospice were an important factor influencing nurses' attitudes toward withdrawal of life-sustaining treatment. Therefore, it is necessary to develop and validate educational intervention programs that can improve perceptions of hospice care.

간호대학생의 사전연명의료의향서에 대한 지식, 태도 및 호스피스 인식정도에 관한 연구

본 연구는 간호대학생의 사전연명의료의향서에 대한 지식, 태도 및 호스피스 인식정도에 관한 연구로 연명의료결정법 시행 이후 간호 대학생들의 연명의료의향서에 대한 지식정도를 확인하여 향후 윤리적 갈등상황에서 올바르고 현명한 문제해결 능력을 갖추고자 하며 적극적인 대처로 간호 전문직 향상에 기여하고자 시도되었다. 그리고, 사회적 합의를 바탕으로 제정된 일명 연명의료결정법 시행 이후, 연명의료의향서제도에 대한 지식을 간호 대학생들에게 확인하였다는데 의의가 있으며 본 연구결과로 간호 대학생들의 사전연명의료의향서에 대한 지식, 태도, 호스피스 인식정도가 서로 상관관계가 있는 것으로 확인되었다. 이에 본 연구를 기반으로 간호 대학생들이 향후 다양한 실무현장에서 임종환자 간호와 연명의료에 대한 두려움보다는 대상자에 대한 긍정적인 대처 능력을 향상시키는 데 기초자료로 활용될 수 있을 것으로 기대된다.

Pacific meets west in addressing palliative care for Pacific populations in Aotearoa/New Zealand: a qualitative study

BackgroundWhile many Aotearoa/New Zealanders are receiving excellent palliative care the Pacific populations have limited access to available hospice and palliative care services. Little research has been conducted to identify barriers unique to Pacific populations accessing these services. The purpose of this study was to explore key stakeholders’ perspectives on the determinants of low access among Pacific populations to these services.MethodsForty-five semi-structured interviews were conducted face-to-face with hospice patients and their families, hospice/health providers and key informants from the Auckland and Wellington region of Aotearoa/New Zealand. The interviews were recorded and transcribed verbatim and a thematic analysis was carried out by identifying, coding and categorising patterns in the data. Identified themes were then discussed further to determine the relevance of the data grouped by theme.ResultsFive interrelated themes affecting access emerged: perception of hospice (often negative) through lack of accurate information, but changing; families’ role to look after their own and sick elderly; hospice experiences; continuity of care in the community and the need for information and communication.ConclusionHospice and associated palliative care services are under-utilised and commonly misunderstood among Pacific populations in Aotearoa/New Zealand. There is active support following appropriate information received, hence the need for community education and culturally appropriate hospice and palliative services. Inadequate inter-professional communication contributes to polypharmacy and inefficiency in continuity of care across all levels. The Pacific individual is one component of a collective that is critical in major decisions in end-of-life and life changing situations. The findings may guide policies and further research to improve Hospice and Palliative services in Aotearoa/New Zealand.

\u201cThe way I am treated is as if I am under my mother\u2019s care\u201d: qualitative study of patients\u2019 experiences of receiving hospice care services in South Africa

BackgroundResearch on the patient experience of receiving palliative care across a number of settings is increasing, but the majority of these investigations are situated within the context of developed countries. There is limited research from resource-limited countries, especially with regard to patients with cancer who receive hospice care. The present study explored the lived experience of attending hospice care facilities in South Africa to develop a bottom-up understanding from the perspectives of patients themselves.MethodsA qualitative cross-sectional study was designed to examine how patients experienced receiving hospice care We conducted in-depth, semi-structured interviews with thirteen, purposively selected patients living with terminal cancer and receiving in-patient or day care palliative services from a hospice organisation in South Africa. We used inductive thematic analysis to analyse the data.ResultsWe identified three themes that reflected a process of transformation that was experienced by participants during their engagement with the hospice services. The first theme describes participants’ initial reluctance to be linked to the hospice as a result of the stereotypic perceptions of hospice as being associated with death and dying. The second theme presents the perceived positive impact on patients’ physical and psychosocial wellbeing which resulted from the highly valued interactions with staff and other patients as well as patients’ engagement with creative activities. The final theme delineates the transformation of hospice into a second ‘family’ and ‘home’ and the restoration of an identity that expands beyond the ‘sick’ role.ConclusionsReceiving hospice care that sensitively attends to patients’ psychosocial and physical needs helps people to re-create a sense of homeliness within the world, re-orient themselves toward a meaningful life and re-configure their relationship with self. Patient experience of receiving hospice care in South Africa does not appear dissimilar to that reported by patients in resource-rich countries, suggesting underlying commonalities. There is a need for raising awareness and educating the public about what palliative care can offer to those in need. Public health campaigns could help reduce the stigma attached to palliative care, deflect negative perceptions, and communicate the benefits for patients, families and communities in culturally sensitive ways.

African American Faith Leaders' Experience, Knowledge, and Perceptions of Hospice and Palliative Care (RP525)

African American Faith Leaders' Experience, Knowledge, and Perceptions of Hospice and Palliative Care (RP525)

Randomized trial of a hospice video educational tool for patients with advanced cancer and their caregivers.

Patients with advanced cancer and their caregivers have substantial misperceptions regarding hospice, which contributes to its underuse. The authors conducted a single-site randomized trial of a video educational tool versus a verbal description of hospice in 150 hospitalized patients with advanced cancer and their caregivers. Patients without a caregiver were eligible. Intervention participants (75 patients and 18 caregivers) viewed a 6-minute video depicting hospice. Control participants (75 patients and 26 caregivers) received a verbal description identical to the video narrative. The primary outcome was patient preference for hospice. Secondary outcomes included patient and/or caregiver knowledge and perceptions of hospice, and hospice use. Between February 2017 and January 2019, approximately 55.7% of eligible patients (150 of 269 eligible patients) and 44 caregivers were enrolled. After the intervention, there was no difference noted with regard to patients' preferences for hospice (86.7% vs 82.7%; P=.651). Patients in the video group reported greater knowledge regarding hospice (9.0 vs 8.4; P=.049) and were less likely to endorse that hospice is only about death (6.7% vs 21.6%; P=.010). Among deceased patients, those assigned to the intervention were more likely to have used hospice (85.2% vs 63.6%; P=.01) and to have had a longer hospice length of stay (median, 12days vs 3days; P<.001). After the intervention, caregivers assigned to view the video were more likely to prefer hospice for their loved ones (94.4% vs 65.4%; P=.031), reported greater knowledge concerning hospice (9.7% vs 8.0%; P=.001), and were less likely to endorse that hospice is only about death (0.0% vs 23.1%; P=.066). A hospice video did not significantly impact patients' preferences for hospice care. Patients with advanced cancer and their caregivers who were assigned to view the video were more informed regarding hospice and reported more favorable perceptions of hospice. Patients were more likely to use hospice and to have a longer hospice length of stay.

The Relationship of Perceptions of Hospice and Palliative Care With Emotional Intelligence and Cognitive Empathy in Nursing Students

The Relationship of Perceptions of Hospice and Palliative Care With Emotional Intelligence and Cognitive Empathy in Nursing Students

The Relationship of Perceptions of Hospice and Palliative Care With Emotional Intelligence and Cognitive Empathy in Nursing Students.

This study aimed to identify the relationships of perception of hospice and palliative care with emotional intelligence and cognitive empathy in nursing students. The participants were 458 nursing students. Data were collected using structured questionnaires and analyzed with Pearson correlation coefficients, independent-samples t test, and binary logistic regression. Perception of hospice and palliative care was significantly and positively correlated with emotional intelligence (r = 0.224, P < .001) and cognitive empathy (r = 0.311, P < .001). Mean score differences of perception of hospice and palliative care by emotional intelligence and cognitive empathy were statistically significant (t = -3.973, P < .001; t = -4.109, P < .001, respectively). Logistic regression yielded an odds ratio of 1.860 (P < .001; 95% confidence interval, 1.283-2.698) between the perception of hospice and palliative care and emotional intelligence and an odds ratio of 2.028 (P < .001; 95% confidence interval, 1.394-2.951) between the perception of hospice and palliative care and cognitive empathy. Emotional intelligence and cognitive empathy should be cultivated to raise nursing students' perception of hospice and palliative care and must be included when developing related curricula and extracurricular programs.

산재형 호스피스 병동간호사의 호스피스 간호수행 영향요인

Purpose: This is an explanatory study conducted to provide baseline data for the development of hospice nursing through the understanding of factors that affect hospice nursing performance working in scattered hospice patient units among nurses. Methods: Research subjects were 236 nurses working in two hospitals located in two Metropolitan City. Data were collected from August 15 to 31, 2014 and analyzed by frequency and percentage, mean and standard deviation, ANOVA, correlation analysis, and regression analysis using SPSS WIN 23.0. Results: As a result of examining the difference in hospice nursing performance of nurses depending on their general characteristics, significant differences were found for age, education level, position, total career duration, life satisfaction, hospice counseling experience, hospice training experience, and perception of hospice service provider. Spirituality and hospice perception showed significant positive correlations with hospice nursing performance. A multi variate regression analysis performed to identify independent factors influencing hospice nursing performance was significant (F=61.75, p ＜.001), and the explanatory power of the model was 34.1%. Higher spirituality (&amp;#61538;=.121, p =.027) and hospice perception (&amp;#61538;=.549, p ＜.001) were affecting higher hospice nursing performance. Conclusion: Based on these results, policies and educational measures must be established to promote the development and implementation of a program to enhance nurses’ existential well-being and hospice perception and to create a clinical environment led by spiritually healthy older nurses with more experience to ensure high-quality hospice nursing performance.