Factors influencing self-efficacy of healthcare professionals towards end-of-life care in acute care settings in Palestine: a cross-sectional study.

Abstract

Background: Caring for individuals at the end of life is a profound emotional and complex responsibility, especially within acute care settings where healthcare professionals must navigate the delicate balance between administering life-saving treatments and providing end-of-life care. This dual role can create considerable challenges for healthcare providers, many of whom may feel inadequately prepared or lack the confidence to offer the specialized care required in these situations. This study aimed to examine the factors influencing nurses' self-efficacy in delivering EOLC in Palestinian acute care hospitals, focusing on communication and patient management competencies.

Methods: A cross-sectional study was conducted among 100 nurses from governmental hospitals in Nablus, Salfit, and Ramallah, selected using convenience sampling. Data were collected through a structured questionnaire that included demographic information and the validated Self-Efficacy in Palliative Care Scale (SEPC-S), covering communication and patient management domains. Descriptive statistics summarized participant characteristics. Inferential analyses-including Pearson correlation, one-way ANOVA, and stepwise multiple regression-were performed to identify significant relationships and predictors of self-efficacy in EOLC. All statistical analyses were conducted using IBM SPSS Statistics for Windows, Version 21.0.

Results: Nurses reported moderate self-efficacy in EOLC, with patient management scoring highest (mean = 7.57, SD = 1.49) and communication lowest (mean = 4.84, SD = 2.40). Significant positive correlations were found between self-efficacy and factors such as age (p = 0.212), marital status (p = 0.03), and education level (p = 0.06). Stepwise regression analysis showed that both patient management (β = 0.76, p < 0.001) and communication (β = 0.54, p < 0.001) domains significantly predicted perceived EOLC competence, collectively explaining 85% of the variance (R² = 0.85, p < 0.001).

Conclusions: This study highlights the need for educational and institutional interventions to enhance nurses' self-efficacy in EOLC. Targeted training programs focusing on communication, symptom management, and interdisciplinary teamwork are essential to fill identified gaps. Simulation-based learning and mentorship can help nurses gain the necessary skills. Policymakers and healthcare institutions should integrate comprehensive palliative care training into nursing curricula and practice to ensure high-quality, compassionate EOLC, ultimately improving patient outcomes and care quality.