Factors Associated with Visiting Nurses' Palliative Care Practices for Japanese Patients with Cancer and Noncancer Illnesses: A Cross-Sectional Study.

Objectives: Enhancing home-based palliative care provided by visiting nurses is a strategic priority in Japan. This study aimed to identify factors associated with visiting nurses' palliative care practices that address physical, psychological, social, and spiritual distress in patients with cancer and noncancer illnesses.

Methods: A questionnaire survey was conducted in 2021 among 294 visiting nurses in Mie Prefecture, Japan, to assess their individual and organizational attributes alongside their palliative care practices. The prevalence ratios were estimated using modified Poisson regression models, with palliative care practices targeting the four distress domains in both patient groups as the objective variables.

Results: The palliative care provided by the included nurses primarily addressed physical distress, followed by psychological, social, and spiritual distress in both patient groups. Collaboration with nurse specialists (certified nurse specialists or certified nurses) improved palliative care for physical (cancer, APR 1.21; noncancer, APR 1.23), psychological (cancer, APR 1.23; noncancer, APR 1.25), and social distress (cancer, APR 1.36; noncancer, APR 1.40) in both patient groups. Moreover, a well-defined perception of palliative care was associated with better palliative care for social (cancer, APR 1.68; noncancer, APR 1.49) and spiritual distress (cancer, APR 2.62; noncancer, APR 2.20).

Conclusions: The study suggests the crucial role of collaboration with nurse specialists and need for a better understanding of palliative care to improve the quality of care provided by visiting nurses to patients with cancer and noncancer illnesses.

Implications for nursing practice: Enhancing palliative care quality requires targeted education for visiting nurses on the effective collaboration with nurse specialists and a clear understanding of palliative care. This approach will enable nurses to address the multifaceted needs of patients with cancer and noncancer illnesses, ultimately improving their physical, psychological, social, and spiritual well-being.