Nursing practices in palliative sedation across respiratory medicine wards and palliative care units in Japan: A cross-sectional study

IF 2.4 3区医学 Q1 NURSING

Asia-Pacific Journal of Oncology Nursing Pub Date : 2025-02-21 DOI:10.1016/j.apjon.2025.100675

Chihiro Yamashita , Shoko Ando , Ayumi Sugimura

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Abstract

Objective

This study aimed to quantitatively assess nursing practices related to palliative sedation (PS) among nurses in respiratory medicine wards (RMWs) and palliative care units (PCUs) and to identify factors influencing these practices.

Methods

A nationwide cross-sectional survey was conducted among nurses in 25 RMWs and 35 PCUs in Japan. A total of 430 nurses (171 from RMWs and 259 from PCUs) completed self-administered questionnaires. Exploratory factor analysis identified key components of PS-related nursing practices, and multiple regression analysis examined influencing factors.

Results

Five key components of PS-related nursing practices were identified: collaboration with experts, assessment and alleviation of suffering, decision-making support, psychological support for families, and evaluation of PS appropriateness and effectiveness. The total PS nursing practice score was significantly lower in RMW nurses (60.6 ± 11.2) than in PCU nurses (68.3 ± 10.6, P < 0.0001). Multiple regression analysis showed that opportunities to discuss bioethics (β = –0.22, P < 0.001), attitudes toward caring for dying patients (FATCOD-B-J, β = 0.22, P < 0.05), collaborative practice with physicians (CPS, β = 0.39, P < 0.001), and opportunities for joint conferences with palliative care teams (β = –0.23, P < 0.001) were significant influencing factors.

Conclusions

To enhance PS-related nursing practices in RMWs, efforts should focus on improving nurses' ethical decision-making abilities, fostering interdisciplinary collaboration, and reducing the psychological burden associated with end-of-life care.

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日本呼吸内科病房和姑息治疗单位的姑息镇静护理实践：一项横断面研究

目的本研究旨在定量评估呼吸内科病房（RMWs）和姑息治疗病房（PCUs）护士对姑息镇静（PS）的护理实践，并确定影响这些实践的因素。方法采用横断面调查方法，对日本25家rmw和35家pcu的护士进行调查。共有430名护士（RMWs 171名，PCUs 259名）完成了自填问卷。探索性因素分析确定了ps相关护理实践的关键组成部分，多元回归分析了影响因素。结果确定了与专家合作、评估和减轻痛苦、决策支持、对家庭的心理支持以及评估PS的适宜性和有效性五个关键组成部分。RMW护士PS护理实践总分（60.6±11.2）明显低于PCU护士（68.3±10.6），P <；0.0001)。多元回归分析显示，讨论生物伦理学的机会(β = -0.22, P <；0.001)、临终病人护理态度(FATCOD-B-J, β = 0.22, P <；0.05)，与医生合作实践(CPS, β = 0.39, P <；0.001)，以及与姑息治疗团队举行联合会议的机会(β = -0.23, P <；0.001)是显著的影响因素。结论要加强临终关怀护理工作，应注重提高护士的道德决策能力，促进跨学科合作，减轻临终关怀的心理负担。

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