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http://dx.doi.org/10.34250/jkccn.2021.14.1.1

A Structural Equation Model of Clinical Nurses' End-of-life Care Performance  

Park, Hyo jin (Department of Nursing, Kyungnam College of Information & Technology)
Lee, Yun Mi (College of Nursing, Institute of Health Science Research.Inje University)
Kim, Min Hye (College of Nursing, Inje University)
Publication Information
Journal of Korean Critical Care Nursing / v.14, no.1, 2021 , pp. 1-13 More about this Journal
Abstract
Purpose : Based on Quint's theory and the relevant literature, this study constructed a structural equation model for explaining and predicting end-of-life care performance in clinical nurses. Methods : A self-administered questionnaire was used to collect data from 265 nurses between September 1 and September 30, 2016. The data were analyzed using SPSS ver. 21 and AMOS ver. 21. Results : The goodness of fit of the modified model was found to be relatively satisfactory (χ2=114.82, Nomed χ2(χ2/df)=2.44, SRMR=.06, GFI=.94, AGFI=.89, CFI=.95, TLI=.91, RMSEA=.07). End-of-life care performance was affected by the attitudes toward nursing care of the dying, working unit, and death anxiety. The attitudes toward such care had the highest effect on end-of-life care performance. Conclusion : The results suggest that end-of-life care performance is directly and indirectly affected by attitudes toward nursing care of the dying, participation in end-of-life care education, working unit, death perception, and death anxiety. To improve clinical nurses' end-of-life care performance, effective programs to promote death anxiety and attitudes toward nursing care of the dying need to be developed. In addition, hospital nursing organizations should attempt to produce concrete measures for death anxiety and terminal care attitudes in clinical nurses.
Keywords
Terminal care; Performance; Attitude; Perception; Anxiety;
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Times Cited By KSCI : 2  (Citation Analysis)
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1 Woo YW, Kim KH, Kim KS. Death anxiety and terminal care stress among nurses and the relationship to terminal care performance. Korean Journal of Hospice and Palliative Care. 2013;16(1):33-41. https://doi.org/10.14475/kjhpc.2013.16.1.033   DOI
2 Statistics Korea. 2019 Population trends survey: provisional results of birth and death statistics [Internet]. Seoul: Statistics Korea; 2020 [cited 2020 October 30]. Available from: http://kostat.go.kr/portal/korea/kor_nw/1/1/index.board?bmode=read&bSeq=&aSeq=380865&pageNo=1&rowNum=10&navCount=10&currPg=&searchInfo=srch&sTarget=title&sTxt=%EC%9E%A0%EC%A0%95+%EA%B2%B0%EA%B3%BC
3 Ko MJ, Moon SH. Factors influencing performance of end-of-life care by ICU nurses. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2016;25(4):327-37. https://doi.org/10.12934/jkpmhn.2016.25.4.327   DOI
4 Martin RS, Hayes B, Gregorevic K, Lim WK. The effects of advance care planning interventions on nursing home residents: a systematic review. Journal of the American Medical Directors Association. 2016;17(4):284-93. https://doi.org/10.1016/j.jamda.2015.12.017   DOI
5 Quint JC. The nurse and the dying patient. New York, NY: Macmillan Publishing Company; 1967.
6 Mallory JL. The impact of a palliative care educational component on attitudes toward care of the dying in undergraduate nursing students. Journal of Professional Nursing. 2003;19(5):305-12. https://doi.org/10.1016/s8755-7223(03)00094-2   DOI
7 Kim S. Factors for end-of-life care performance among home visiting nurses [dissertation]. Seoul: Chung-Ang University; 2020. p. 41-6.
8 Han J, Lee N. Nursing students' attitude toward death and perception on hospice care. Journal of Korean Oncology Nursing. 2009;9(2):95-103.
9 Deffner JM, Bell SK. Nurses' death anxiety, comfort level during communication with patients and families regarding death, and exposure to communication education: a quantitative study. Journal for Nurses in Staff Development. 2005;21(1):19-23.   DOI
10 Kim BH, Chon MY, Kang HJ. A study on the death orientation of hospice care members. Korean Journal of Adult Nursing. 1997;9(3):453-61.
11 Baek SH, Lee M, Kim I. A study on change in death orientation of college student nurses -comparison of pre and post hospice care class-. Journal of Korean Academy of Fundamentals of Nursing. 2001;8(3): 357-65.
12 Park SJ, Choi SH. A study on the degrees of death orientation and terminal care performance of nurses. Journal of Korean Academy of Fundamentals of Nursing. 1996;3(2):285-97.
13 Wessel EM, Rutledge DN. Home care and hospice nurses' attitudes toward death and caring for the dying: effects of palliative care education. Journal of Hospice and Palliative Nursing. 2005;7(4):212-8.
14 Collett L, Lester D. The fear of death and the fear of dying. The Journal of Psychology. 1969;72(2): 179-81.   DOI
15 Kim WS, Cho HH, Kwon S. The influence of terminal care performance, death anxiety and self-esteem on terminal care stress of geriatric hospital nurses. Korean Journal of Hospice and Palliative Care. 2016; 19(2):154-62. https://doi.org/10.14475/kjhpc.2016.19.2.154   DOI
16 Detering KM, Hancock AD, Reade MC, Silvester W. The impact of advance care planning on end of life care in elderly patients: Randomised controlled trial. The British Medical Journal. 2010;340:c1345. https://doi.org/10.1136/bmj.c1345   DOI
17 Noh SS, Lee CK, Sung YH. Predictors of terminal care performance of clinical nurses for cancer patients. Journal of Korean Critical Care Nursing. 2016;9(2): 61-70.
18 Oh YJ. Relationship of perception and anxiety about death between terminal care performance of nurse [master's thesis]. Cheongju: Chungbuk National University; 2017. p. 1-68.
19 Chi KA, Kim EJ. Factors influencing nurse's attitude toward hospice. Journal of Korean Academy of Psychiatric and Mental Health Nursing. 2005;14(3): 285-91.
20 Kim MH, Lee ES. Nurses' stress, attitude, and performance during terminal care towards do-not-resuscitate patients. Chonnam Journal of Nursing Science. 2015;20(1):25-41.
21 Moon SB. Basic concepts and applications of structural equation modeling. Seoul: Hakjisa; 2009.
22 Seo MJ, Kim JY, Kim S, Lee TW. Nurses attitudes toward death, coping with death and understanding and performance regarding EOL care: focus on nurses at ED, ICU and oncology department. Korean Journal of Hospice and Palliative Care. 2013;16(2):108-17. https://doi.org/10.14475/kjhpc.2013.16.2.108   DOI
23 Peters L, Cant R, Payne S, O'Connor M, McDermott F, Hood K, et al. How death anxiety impacts nurses' caring for patients at the end of life: a review of literature. The Open Nursing Journal. 2013;7:14-21. https://doi.org/10.2174/1874434601307010014   DOI
24 Kim GS. AMOS 18.0 structural equation modeling analysis. Seoul: Hannarae Academy; 2010.
25 Inumiya Y. A study on development of a view of life and death scale and relationships among its elements [dissertation]. Seoul: Korea University; 2002. p. 1-97.
26 Suh H. The relationships among life satisfaction, locus of control, and death anxiety as perceived by Korean and American older adults using selected personal demographic variables. Korean Journal of Health Education and Promotion. 1987;4(2):95-135.
27 Cho HJ, Kim ES. The effect of the death education program on the death anxiety and attitudes toward nursing care of the dying patients of nursing student. Korean Journal of Hospice and Palliative Care. 2005; 8(2):163-72.
28 Hong E, Jun M, Park ES, Ryu E. Death perceptions, death anxiety, and attitudes to death in oncology nurses. Journal of Korean Oncology Nursing. 2013; 13(4):265-72. https://doi.org/10.5388/aon.2013.13.4.265   DOI
29 Lee LJ, Park HS. Death anxiety and terminal care performance of nurses at long term care hospitals. Korean Journal of Hospice and Palliative Care. 2017; 20(1):37-45. https://doi.org/10.14475/kjhpc.2017.20.1.37   DOI
30 Frommelt KHM. The effects of death education on nurses' attitudes toward caring for terminally ill persons and their families. American Journal of Hospice & Palliative Medicine. 1991;8(5):37-43. https://doi.org/10.1177/104990919100800509   DOI
31 Park EH, Kim NY. The influence of nursing professionalism, attitudes toward advance directive, and death anxiety on terminal care performance of nurses in long-term care hospitals. Korean Journal of Adult Nursing. 2018;30(2):183-93. https://doi.org/10.7475/kjan.2018.30.2.183   DOI