CROSS-SECTIONAL STUDY ON PALLIATIVE CARE KNOWLEDGE AND ATTITUDES TOWARDS END-OF-LIFE CARE AMONG NURSES IN ACUTE MEDICAL AND CRITICAL WARD

Abstract

Background: Palliative care aims to relieve suffering and improve the quality of life for patients with serious illnesses through a holistic, multidisciplinary approach. Nurses play a pivotal role in delivering end-of-life care, yet their knowledge and attitudes significantly impact the effectiveness of these services. Despite the growing need for palliative care worldwide, disparities in training and exposure remain a concern, particularly in acute medical and critical care settings. Understanding nurses' perspectives can help address educational gaps and enhance palliative care delivery.

Objective: This study aimed to assess the knowledge and attitudes of nurses toward palliative care in acute medical and critical care settings and examine the association between demographic characteristics and their perceptions.

Methods: A cross-sectional study was conducted in three major public hospitals in Khyber Pakhtunkhwa, Pakistan, from August 2023 to November 2024. A sample of 236 nurses was selected using Slovin’s formula. Data collection was performed using the Palliative Care Quiz for Nursing (PCQN) to assess knowledge and the Ferrell and McCaffery (2008) scale to evaluate attitudes. The PCQN scores ranged from 0 to 20, categorizing knowledge into low (0-6), moderate (7-13), and high (14-20) levels. Attitudes were classified into negative (32-72) and positive (73-128) perceptions. Descriptive and inferential statistics, including the Chi-Square test, were applied using SPSS to examine associations between demographic variables and study outcomes.

Results: Among nurses, 29.66% (70) had low knowledge, 44.91% (106) demonstrated moderate knowledge, and 25.43% (60) exhibited high knowledge. Attitude analysis showed that 62.9% (141) of nurses had a positive perception, while 37.1% (83) had a negative attitude toward palliative care. The mean perception score was 65.17, placing the majority in the “satisfied” category. Statistically significant associations were found between attitude and marital status (p = 0.027), educational level (p = 0.002), workplace (p < 0.001), and job position (p = 0.002). Knowledge was significantly influenced by educational level (p = 0.005), workplace (p < 0.001), and job position (p = 0.002), whereas gender, prior palliative care experience, and exposure to terminally ill patients showed no significant impact.

Conclusion: Nurses demonstrated a generally positive attitude toward palliative care, yet knowledge gaps persisted, particularly among those with lower education levels and less exposure to structured training. The findings emphasize the need for standardized palliative care education and ongoing professional development to improve competency in end-of-life care. Strengthening institutional policies and integrating palliative care into nursing curricula will enhance patient-centered care and improve overall healthcare delivery.