Oncology nurses' knowledge, attitudes, and experiences regarding advance directives
Oncology nurses' knowledge, attitudes, and experiences regarding advance directives
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DOI：
10.1188/05.onf.319-327
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发表时间：
2005-03-01
影响因子：
1.9
通讯作者：
Bu, XY
中科院分区：
文献类型：
--
作者：
Jezewski, MA;Brown, JK;Bu, XY
目的/目标：确定肿瘤科护士对预先指示 (AD) 的了解、态度和经验。设计：描述性、相关性调查。样本：从肿瘤科护理协会随机选出的 3,840 名成员中，794 名（回报率 21%）的可用回答。典型的受访者是女性、白人、已婚或已婚人士、中年人和基督徒。方法：使用预先指示工具的知识、态度和经验调查工具进行邮寄调查。主要研究变量：知识、态度、经验、信心和 AD。调查结果：总体而言，肿瘤科护士对一般 AD 的了解最多（正确 70%），而对患者自决法案了解较少（51%）正确）及其州法律（正确 53%）。基于三个子量表的平均总知识得分为 17.4（满分 30 分），即 58% 正确。护士对 AD 的体验采用平均分为 4 分的五项分量表进行衡量（SD = 1.11）。他们对帮助患者完成 AD 的能力缺乏信心。受访者的态度反映了临终决策中的倡导作用。态度项目被单独审查。受访者强烈同意（97%）的说法，即患者应该接受足够的药物来缓解疼痛，即使这可能会加速死亡，这反映了肿瘤学对临终时充分疼痛管理的重视。结论：护士的知识得分较低。研究中的护士对自己帮助 AD 患者的能力并不很有信心。人口统计变量通常不会影响知识、信心或经验分数。对护理的影响：需要更多与 AD 相关的教育，并且可以通过在职课程或继续教育进行管理。护士的反应表明他们需要更多时间来帮助患者完成 AD。这在当前的实践环境中很困难，但必须认识到至关重要。
Purpose/Objectives: To determine oncology nurses' knowledge of, attitudes toward, and experiences with advance directives (ADs).Design: Descriptive, correlation survey.Sample: Usable responses from 794 (21% return) of 3,840 randomly selected members of the Oncology Nursing Society. The typical respondent was female, Caucasian, married or living as married, middle-aged, and Christian.Methods: A mailed survey using the Knowledge, Attitudinal, and Experiential Survey on Advance Directives instrument.Main Research Variables: Knowledge, attitudes, experiences, confidence, and ADs.Findings: Overall, oncology nurses were most knowledgeable about ADs in general (70% correct) and less knowledgeable about the Patient Self-Determination Act (51% correct) and their state laws (53% correct). The mean total knowledge score based on the three subscales was 17.4 out of a possible 30, or 58% correct. The nurses' experience with ADs was measured using a five-item subscale with a mean score of 4 (SD = 1.11). They were less confident in their ability to assist patients with completing ADs. Respondent attitudes reflected an advocacy role in end-of-life decisions. Attitude items were reviewed individually. Respondents strongly agreed (97%) with the statement that patients should receive sufficient medication to relieve pain even though it may hasten death, which reflects the emphasis in oncology on adequate pain management at the end of life.Conclusions: Nurses' knowledge scores were low. Nurses in the study were not highly confident in their ability to assist patients with ADs. Demographic variables generally did not influence knowledge, confidence, or experience scores.Implications for Nursing: More education related to ADs is needed and could be administered through in-service classes or continuing education. Nurses' responses indicated that they need more time to assist patients with completing ADs. This is difficult in the current practice environment but must be recognized as critically important.