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J Palliat Med. 2010 Jun;13(6):753-9. doi: 10.1089/jpm.2009.0423.

Nurses' identification of important yet under-utilized end-of-life care skills for patients with life-limiting or terminal illnesses.

Author information

  • 1Department of Veterans Affairs, VA Puget Sound Health Care System, Health Services Research and Development, Seattle, Washington 98195, USA. reinkl@u.washington.edu

Abstract

RATIONALE:

This study was designed to identify nurses' perspectives on nursing skills that are important yet under-utilized in end-of-life care.

METHODS:

A 45-item survey was administered to nurses (n = 717) in four U.S. states with a response rate of 79%. We identified skills that were endorsed by more than 60% of nurses as extremely important and also endorsed as not currently practiced by more than 25% of nurses. We used Chi square statistics to examine professional characteristics associated with ratings of end-of-life care skills including practice settings, years of experience, and end-of-life care education. Content analysis was used to examine nurses' responses to open-ended questions.

RESULTS:

Nineteen items were endorsed as extremely important and also ranked as under-utilized. These end-of-life care skills included communication skills, symptom management competencies especially those concerning anxiety and depression, and issues related to patient-centered care systems. Four complementary themes emerged from qualitative analysis of nurses' comments, which supported the quantitative findings.

CONCLUSIONS:

This study provides a summary of skills nurses feel are important and under-utilized in their care of patients with life-limiting illnesses. The findings support the need to target both nursing education and healthcare system interventions to improve the use of practical end-of-life care skills by nurses with a focus on communication and symptom management skills.

PMID:
20597709
PMCID:
PMC2938887
DOI:
10.1089/jpm.2009.0423
[PubMed - indexed for MEDLINE]
Free PMC Article
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