Staff perception of obstacles and facilitators when providing end of life care in critical care units of two teaching hospitals: A survey design

• Published in: Intensive & critical care nursing 2019-08, Vol.53, p.8-14
• Main Authors: Almansour, I., Seymour, J.E., Aubeeluck, A.
• Format: Article
• Language: English
• Subjects: Academic Medical Centers - organization & administration; Academic Medical Centers - statistics & numerical data; Adult; Attitude of Health Personnel; Clinical decision making; Communication; Critical care; Decision making; Design; End of life decisions; End-of-life care; Facilitators; Female; Health Personnel - psychology; Health Personnel - statistics & numerical data; Humans; Intensive Care Units - organization & administration; Intensive Care Units - statistics & numerical data; Interprofessional Relations; Islam; Islamic culture; Jordan; Likert scale; Male; Medical ethics; Middle Aged; Nurses; Nursing; Nursing care; Obstacles; Palliative care; Patients; Perception; Perceptions; Physicians; Polls & surveys; Professional attitudes; Relatives; Response rates; Surveys and Questionnaires; Teaching hospitals; Terminal Care - methods; Terminal Care - standards; Terminal Care - statistics & numerical data; Western culture
• ISSN: 0964-3397; 1532-4036
• DOI: 10.1016/j.iccn.2019.04.003

To determine perceptions of Jordanian critical care staff about obstacles and facilitators to end-of-life care. The “National Survey of Critical Care Nurses’ Perceptions of End-of-Life Care” was adapted and distributed to 143 critical care nurses (n = 110) and physicians (n = 33) in two Jordanian hospitals. Nurses and physicians completed items about perceived obstacles to end-of-life care. Nurses only completed items about facilitators to end-of-life care. The overall response rate was 72.7% (n = 104/143). Seventy–six nurses (69.1%) and 28 physicians (84.5%) responded. Nurses and physicians agreed that the highest scoring obstacles were: ‘family members who do not understand what life-saving measures mean’ and the ‘poor design of critical care units’. Other highly scoring obstacles related to clinicians’ behaviours, characteristics and attitudes. Nurses perceived the highest scoring facilitator was ‘family members who accepted that the patient was dying’. There is a need to further explore the issues underlying perceptions about clinicians’ behaviours, which were perceived to be key barriers to quality end-of-life care and to find acceptable solutions that fit with Islamic culture. It is the first time that the survey has been used to gather perceptions of doctors and nurses in a non-western culture.