Influencing Factors Of Hospice Care Behavior In Oncology Nurses

ObjectivesTo investigate the current status of hospice care behaviors among oncology nurses,and to explore the factors that affect hospice care behaviors among oncology nurses.Findings of this study will provide scientific basis for developing and adopting targeted strategies to improve the hospice care behavior of oncology nurses.MethodsThis was a cross-sectional study.Based on the self-administered general information questionnaire,the Hospice Care-related Knowledge,Attitude and Practice Questionnaire of clinical nurse,the Hospice Care Self-efficacy Scale on nurses,the Hospital Anxiety and Depression Scale and Nursing Practice Environment Scale,381 oncology nurses from 10 hospitals in Shenzhen were surveyed about hospice care between November 2020 and July 2021.The data were entered into SPSS 23.0 for statistical analysis.Results1.The average score for hospice care behavior in oncology nurses was 3.96±0.67,generally on moderate-to-high level.Among the 381 nurses,72（18.90%）scored at high level,256（67.19%）at moderate level,and 53（13.91%）at low level.2.Comparison of the score for hospice care behavior with different sociodemographic data in oncology nurses.Nurses with a bachelor’s degree or above had a higher score for hospice care behavior than those with three-year college’s or secondary vocational school’s diploma（P<0.001）;nurses with>5 years of oncology nursing experience had a higher score for hospice care behavior than those with ≤5 years of oncology nursing experience（P=0.02）;oncology nurses with the senior title had a higher score for hospice care behavior than junior nurses（P=0.03）;specialist nurses had a higher score for hospice care behavior than non-specialist nurses（P=0.01）;oncology nurses who had attended hospice care training in the past year had a higher score for hospice care behavior than those who hadn’t（P<0.001）;oncology nurses who had experience in caring for end-of-life patients in the past year had a higher score for hospice behavior than those who hadn’t（P<0.001）.3.Correlations of scores for hospice care knowledge,belief,self-efficacy,anxiety,depression,work environment with the score for hospice care behavior in oncology nurses.Pearson correlation analyses showed that scores for hospice care knowledge（r=0.639,P<0.001）,hospice care belief（r=0.821,P<0.001）,hospice care self-efficacy（r=0.762,P<0.001）and work environment（r=0.647,P<0.001）were positively correlated with the score for hospice care behavior in oncology nurses.Scores for anxiety（r=-0.135,P<0.001）and depression（r=-0.204,P<0.001）were negatively correlated with the score for hospice care behavior in oncology nurses.4.Multiple linear regression analysis of hospice care behavior in oncology nurses.Oncology nurses’ hospice care knowledge（β=0.098,P=0.003）,belief（β=0.503,P<0.001）,self-efficacy（β=0.332,P<0.001）and the nurse’s work environment（β=0.113,P<0.001）were independent influencing factors of hospice care behavior in oncology nurses,which could explain 80%of the variance in hospice care behavior（adjusted R2=0.80）.Conclusions1.Hospice care behavior among oncology nurses is generally at a moderateto-high level,while one-seventh of the behavior is at a low level and is in urgent need of improvement.2.Factors influencing hospice behavior in oncology nurses include hospice knowledge,beliefs,self-efficacy and the nursing work environment.3.Nursing managers should adopt targeted and continuous special training program,taking various teaching modes,to improve hospice knowledge,beliefs and self-efficacy of oncology nurses.At the same time,they should also supplement the workforce of oncology nursing,grant permission to participate in hospital affairs,continuously strengthen positive guidance and create a favorable working atmosphere to improve oncology nurses’ level of hospice care behavior and to improve the quality of life of patients with advanced cancer.