Knowledge, Attitude, and Practice of Palliative Care Among Physicians and Nurses in Intensive Care Units in Shanghai, China.

Abstract

Purpose: The growing need for palliative care in China's aging population highlights the intensive care unit (ICU) staff's crucial role and need for specialized training and improved knowledge, attitude, and practice (KAP). The study aims to assess the KAP of palliative care ICU physicians and nurses and identify influencing factors.

Patients and methods: A cross-sectional survey was conducted among ICU physicians and nurses at three Shanghai hospitals. A self-developed structured online questionnaire was used to collect participant characteristics and KAP data related to palliative care. Pathway analysis explored associations among knowledge, attitude, and practice.

Results: Among 203 participants, median scores for knowledge, attitude, and practice were 8/18, 39/50, and 35/45, respectively. Multivariable analysis revealed that 10-15 years (OR=0.06) and >15 years (OR=0.19) of experience in the ICU and the lack of palliative care experience (OR=0.29) were associated with poor knowledge. Positive attitudes (OR=1.22) and palliative care training (OR=3.25) were associated with proactive practice. Knowledge directly impacted attitude (β=0.260; P=0.012) and practice (β=0.320, P<0.001), while attitude directly influenced practice (β=0.278, P<0.001).

Conclusion: The study reveals a low KAP level of palliative care among ICU physicians and nurses in Shanghai. Pathway analysis underscores the crucial role of knowledge in shaping attitudes and practices, emphasizing the urgency of improving knowledge and attitudes toward palliative care among physicians and nurses.