Attitudes Toward Death, Dying, End-of-Life Palliative Care, and Interdisciplinary Practice in Long Term Care Workers

摘要

Background: Besides personal and professional experiences, long term care providers' own attitudes toward death may affect the care given to dying residents. Objectives: To assess beliefs, values, and attitudes toward death, dying, palliative, and interdisciplinary care in long term care workers and identify any differences between different job categories and places of work. Design: Descriptive cross-sectional survey study. Setting: Five public long term care facilities. Participants: One thousand one hundred seventy volunteers, clinical managers, and all categories of residential long term care workers. Measurements and Methods: An anonymous paper or electronic self-administered survey questionnaire consisting of 24 items, answered on a 4-point bipolar Likert scale. Between-group differences were compared with the analysis of variance test after adjustment for the multiple post-hoc comparisons. Results: Healthcare workers had a relatively positive attitude toward more than one-half of the selected aspects of interdisciplinary practice and end-of-life palliative care for long-term residents. However, attitudes were more mixed about 10 other aspects and a higher percentage of respondents indicated negative attitudes toward them. Overall, there are significant differences between upper-level professionals and managers (registered nurses, physicians, rehabilitation staff, and clinical managers) vs the hands-on caregivers (nursing assistants, patient assistants, and volunteers) with regard to some aspects of the care of the dying. Conclusions: The results suggest that healthcare workers' attitudes need to be taken into account in long term care facilities. Patient assistants, volunteers, and nursing assistants seem most likely to above all benefit from training and support programs.