Investigation On Current Status Of Community Nurses' Cognition On Palliative Care In Changchun

Objectives:It can be clear that the current status of palliative care cognition can be identified among the community nurses and their attitude to learn palliative care can be exposed through this investigation. Meanwhile, there are some factors related to the status and attitude, which can be explained and analyzed. In addition, the suggestions and recommendations will be offered about developing palliative care education and training for community nurses. All of these will provide a theoretical basis for development of palliative care education and training and palliative practice.Methods:There was a survey that was completed by using random cluster sampling method, covering 193 community nurses in 24 community health service centers of five Districts in Changchun City in August-September 2011. The questionnaire covered four parts, such as socio-demographical characteristics of community nurses, the status of palliative care education and training, palliative care knowledge questionnaire and attitudes towards palliative care of community nurses when they learned the knowledge and skills and its related factors. A database was established by using Epidata3.0 software, and statistical analysis was done by using the statistical package of social science, i.e. SPSS13.0 software. There were several Statistical methods used to analyzing the data, such as Descriptive statistics, Kruskal-Wallis H, Chi-square and Logistic regression. A solution will be proposed to palliative care education and training for community nurses on the base of the relevant foreign and domestic publications as references.Results:1. In the investigation, 20.9% of respondents had heard of "palliative care", and 15.3% understand "palliative care" knowledge, 2.5% participated in training on palliative care education and training.2. The scores in the questionnaires were as follows: the total Palliative care knowledge score of community nurses (20.6±3.14), and the three dimensions, such as philosophy and principles (3.8±1.5), the control of pain and other symptoms (14.6±2.9), psychological spirit of social support (2.06±1.6). Average accuracy was 40.3%, 31.3%, 45.8%, 28.4%.3. There was significant difference among participants'scores towards palliative care knowledge and its three dimensions, such as education levels, professional titles, work experience, community work experience, whether there are family members with advanced disease and the number of patients with advanced disease who have been cared for.4. There were 94(57.7%) cases among the community nurses surveyed expressed interest in learning the knowledge of palliative care, no interest in 25(15.3%) cases, indeterminate in 44(27.0%) cases. Respondents expressed willingness to participate in palliative care education and training 110(67.5%) cases, do not want to participate in the 28(17.2%) cases, indeterminate in 25(15.3%) cases. Percentages of the nurses who did not want to participate in palliative care education and uncertainty to attend the training under different reasons, such as 35.8% of them said they had'No time', 28.3% said'Not interested', 22.6% said'Not be applied in works'.5. There was significant difference among seven factors that affected community nurses'willingness to learn Palliative care knowledge and skills. The seven factors included the income of nurses, nurses'sense of necessity about developing palliative care in community, nurses'sense of necessity about developing education and training of palliative care, willingness about implementation of palliative care, the confidence on the implementation of palliative care, the effects of discussion about death and taking care of seriously ill patients. After logistic regression test, two factors like sense of necessity about developing education and training of palliative care and willingness about implementation of palliative care came into the regression model.Conclusion:1.The ratio of community nurses who attended palliative care education and training is very low in Changchun. Therefore they were lack of palliative care knowledge.2. The nurses had a quite high willingness to learn palliative care knowledge in communities of Changchun.3. The main factors that affected the nurses on palliative care knowledge included education levels, professional titles, work experience, community work experience, whether there are family members with advanced disease and the number of patients with advanced disease who have been cared for.4. The main factors that affected their attitude to learn palliative care knowledge were the nurses'sense of necessity about developing education and training of palliative care and willingness about implementation of palliative care.