Associations of Surrogate Decision-making Support with the Difficulties and Attitudes of Nurses Providing End-of-life Care in Emergency or Intensive Care Settings

Kazumi Matsuoka, A. Kono
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Abstract

Objective: To clarify the relationship between nurses’ surrogate decision-making support and difficulties faced by and attitudes of end-of-life care in emergency or intensive care area of community medical support hospitals. Method: A survey was conducted using a self-administered questionnaire, and nurses in emergency or intensive care units responded anonymously to the questionnaire. Nursing practice of surrogate decision-making was assessed using a nursing practice scale for measuring support for surrogate decision-makers of terminal care. Difficulties of nurses providing end-of-life-care were measured using the Scale for DFINE, and attitudes of nurses providing end-of life care were measured using The FATCOD-BJ. Results: Of the 120 respondents, 60 nurses practicing surrogate decision-making with more support were more likely to have clinical practice in emergency or intensive care units of over 6 years as compared to the remaining 60 nurses practicing surrogate decision-making with less support . The DFINE scores of nurses practicing surrogate decision-making with more support were significantly lower than those of nurses practicing surrogate decision-making with less support under Student’s t-test as well as under analyses of covariance adjusting. The FATCOD-BJ score of nurses practicing surrogate decision-making with more support was almost the same as the score of those of nurses practicing surrogate decision-making with less support under Student’s t-test as well as under analyses of covariance adjusting. Conclusion: The results suggested that nurses in emergency or intensive care units involved in surrogate decision-making with more support had less difficulty
代理决策支持与护士在紧急或重症监护环境中提供临终关怀的困难和态度的关系
目的:探讨社区医疗保障医院急危重症区护士替代决策支持与临终关怀困难及态度的关系。方法:采用自填问卷进行调查,由急诊或重症监护病房的护士匿名填写问卷。采用护理实践量表对临终关怀替代决策者的支持度进行评估。采用DFINE量表测量护士提供临终关怀的困难程度,采用FATCOD-BJ量表测量护士提供临终关怀的态度。结果:在120名受访者中,与其余60名支持较少的护士相比,60名支持较多的护士更有可能在急诊或重症监护病房进行临床实践。在学生t检验和协方差调整分析中,支持度较高的护士实施替代决策的DFINE得分显著低于支持度较低的护士实施替代决策的DFINE得分。在学生t检验和协方差调整分析中,支持度较高的护士的FATCOD-BJ得分与支持度较低的护士的FATCOD-BJ得分基本相同。结论:结果提示急诊或重症监护室护士参与代理决策时,支持越多,困难程度越低
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