End-of-Life Care Preparedness, Importance, Performance, and Educational Needs of Care Workers for Integrated Care Support.

Abstract

Purpose: This study examined the levels of end-of-life care preparedness, importance, performance, and educational needs among community-based home care workers and identified factors influencing end-of-life care performance to inform hospice/end-of-life care education programs.

Methods: This study used a descriptive, correlational design. The participants were 152 community-based home care workers with at least 6 months of work experience. Data were collected using structured questionnaires that assessed end-of-life care preparedness, importance, performance, and educational needs. Data were analyzed using descriptive statistics, correlation analysis, importance-performance analysis (IPA), and hierarchical multiple regression analysis using SPSS version 29.0.

Results: Overall, end-of-life care performance was significantly lower than its perceived importance (t=14.41, P< 0.001), with the largest gaps observed in the caregiving support and emotional support domains. In the IPA, multiple items related to death preparation for patients/families, spiritual/emotional support, and care around the time of death fell into the low-importance/low-performance quadrant. Educational needs positively correlated with importance, intention, confidence, preparedness, and performance. In hierarchical regression, preparedness (β=0.21, P=0.03) and importance (β=0.26, P<0.001) significantly predicted performance, explaining 15% of variance.

Conclusion: End-of-life care performance among home care workers was influenced by psychological factors, including preparedness, importance, and confidence in end-of-life care, as well as institutional and environmental factors. Standardized educational programs and organizational support are required to improve the quality of community-based end-of-life care.