End-of-life care: perceptions and coping with death among healthcare professionals in the Balearic Islands A multicenter study.
Aim: the objective of this study was to explore and compare the perspectives of physicians and nurses about end-of-life care (EOL), palliative care, coping death and determining care practices involved in the EOL decision-making.
Methods: we conducted a descriptive, quantitative and multicentre study with in the Balearic Island (Spain) from different hospitals units and primary care related to patient care at the EOL. It was an anonymous questionnaire and was structured around 3 themes (EOL care, different aspect of attention to terminal patient and coping death).
Results: a total of 422 professionals participated, 292 (66%) are nurses and 150 (34%) are physicians. Differents therapeutic measures like pain relief medication, sedation medication and care of the mouth were classified by a similar percentage of nurses and physicians as basic EOL care. However, body hygiene, positional changes, wound and ulcer care, nasogastric tube, urinary catheterization and fluid therapy were classified by a higher percentage of physicians as basic EOL care. A lower percentage of nurses consider that the care plan is carried out according to the patient and family preferences and that pain is effectively evaluated and treated. A higher percentage of nurses believe that professionals are not familiar with the procedure for accessing the Advance Directives Registry and that the Advance Directives Document is not consulted. A lower percentage of nurse’s report having received the necessary training to support and communicate with the families of dying patients and having had a rewarding experience providing palliative care to terminal patients. To be a physician improves coping with death.
Conclusion: decision and perception about EOL care and attitudes about palliative care are influenced by profession, experiences, environment, values, emotions and beliefs. More emphasis on interprofessional education and collaboration between the two disciplines may enhance future decision making processes and there is a need to improve training in ethics and end-of-life processes.
Keywords: end of life care, nurses, physicians, terminal patient, death.
