The first edition of this book provides a comprehensive text for nurses working within palliative care, although it would also be an interesting addition to the bookshelves of other professionals associated with this speciality. The target readership is palliative nurses working at an advanced practice level and the aim is to provide an intellectual challenge to engender critical thinking regarding clinical care of the dying rather than a ‘how to do' manual. These may be rather grand aspirations, but are ably backed by an international list of contributors. In the main, they have hit their target as the book represents a genuinely fresh approach to writing in this area and has successfully synthesised for the first time disparate information. Overall, this makes for an interesting read and certain chapters, most notably in Part One – Encountering Illness, that document the contemporary history of nursing within this speciality will become increasingly referenced and much valued.

There are four parts to the book: Encountering Illness; Transitions into the Terminal phase; Loss and Bereavement; and Contemporary Issues, each containing an overview from the editors introducing the principles and theoretical issues followed by shorter chapters that concentrate on aspects of the section. The difference is that they have avoided the rather predicable layout of physical, psychological, spiritual and so on, in favour of an integrated approach to the organisation of writing that flows more readily with the actual transitions people experience at the end of life. This approach has much to recommend as it avoids the pitfalls of making the discussions around aspects of care seem dislocated.

Part One – Encountering Illness is the strongest section. It is both illuminating and original and explores what it means for people who become ill and face death to take up the social role of patient and the implications for those that become their carers. This is examined by presenting short chapters including an excellent historical analysis followed by an account of global palliation developments and discussion of how such nurses continue to shape their approach to care. An examination of developments where patients themselves have increasingly become engaged with planning care has much relevance to recent policy imperatives and helps to put this in context, as does a review of the evidence thus far for end of life care for those without cancer and the questions it raises around organisation of the delivery of care and appropriate access. Developing palliative care in hospitals, a unique piece of writing on illness transitions, and robust overview of the communication literature all applied in a relevant way to clinical care. Lastly, there was a weaker overview on assessment in the end of life care, which is more rudimentary and missed the current emphasis that nurses are providing in areas such as pain and extending roles to include physical examination.

Part Two concentrates on the Transitions into the Terminal Phase. Again the editors have the confidence to give adequate exposure to dying, unlike other palliative care textbooks that cover this in a brief single chapter. There is valuable writing here with clinical applicability. Two particularly good examinations of the spiritual dimensions of palliative care on the excluded at the end of life is undertaken. A fundamental weakness of the book is the depth of discourse around the ethical issues at the end of life. The brevity ensured that the chapter on ethical issues was not examined in sufficient depth, leaving the sterile and remote from the clinical reality that is rather more complex. An area of great relevance is the need for palliative nurses to be articulate and fully aware of issues surrounding euthanasia. This book will not help them obtain more than a cursory examination of the argument. Although euthanasia is illegal in the UK, the authors persisted to give a neutral emphasis to the arguments. The argument against it was intellectually weak, missing an adequate exploration around how palliative nurses can engage suffering positively, an issue only partly dealt with, in the section chapters. Nurses increasingly have a major part in determining capacity and discussing issues of futility at the end of life and this omission limits the comprehensiveness of the book. This text never claimed to emphasise aspects of particular symptom control apart from a useful chapter on emotions and cognitions and pain. I suspect this will therefore be more useful for palliative nurses teaching trainees rather than challenging clinical decisions surrounding pain, which advanced practice nurses currently make. Most palliative nurses therefore will still have to use this textbook as a companion to a palliative medicine textbook.

Part Three – Loss and Bereavement will be valuable to palliative nurses and many worry that their actions are self-taught and rarely make reference to theoretical underpinnings. Organ and tissue donation are deservedly dealt with and the chapter on families and children facing loss and bereavement is especially informative and will greatly enhance how nurses approach clinical care. A nurse's role in supporting a person in exploring funeral plans would have been a useful addition here. The last section on Contemporary Issues is well balanced and introduces discourse on professional boundaries and the cost of caring, then moving onto education, research, governance and leadership.

The editors are to be congratulated in presenting a concise corpus of contemporary relevant issues of nurses' roles in palliation. Those in the speciality working at advanced practice level should certainly own a copy. Most of the material presented does indeed raise questions, however, the authors had scope for some truly visionary thinking especially in areas of clinical practice, which they did not quite harness. For this reason, I do not think that in this first edition they have quite managed to reach the claim to test the intellect, which after all was the original premise. I look forward to the second edition.

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Palliative Care Nursing: Principles and Evidence for Practice

Background Nurses have a primary role in providing palliative and end-of-life (EOL) care. Their knowledge of EOL care, attitudes toward care of the dying, and palliative care self-efficacy are important in care delivery. Little is known regarding palliative care preparedness among Mongolian nurses. This study examines palliative care knowledge, attitude towards death and dying, and self-efficacy among Mongolian nurses, and examines predictors of self-efficacy. Methods A cross-sectional descriptive study was conducted. Participants were 141 nurses employed at the National Cancer Center in Mongolia. Data was collected using a self-administered questionnaire. Results The median score for the knowledge of palliative care was 8.0/20. "Psychosocial and spiritual care" was the lowest score on the palliative care knowledge subscale. The mean score for attitude toward care of the dying was 69.1%, indicating positive attitudes. The mean score for the palliative care self-efficacy was 33.8/48. Nurses reported low self-efficacy toward communicating with dying patients and their families, and managing delirium. Palliative care knowledge and duration of experience as an oncology nurse significantly predicted self-efficacy toward palliative care, accounting for 14.0% of the variance. Conclusions Palliative education for nurses should address the knowledge gaps in EOL care and focus in increasing palliative care self-efficacy. Considering palliative care knowledge and nursing experience as an oncology nurse were significant predictors of self-efficacy toward palliative care, more effort is needed to fill the knowledge gaps in EOL care among nurses, especially for less experienced nurses.

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Knowledge, attitude and self-efficacy towards palliative care among nurses in Mongolia: A cross-sectional descriptive study.

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Self Efficacy In Nursing Research And Measurement Perspectives

Background Hospice care is a multidisciplinary approach that focused on patients’ quality of life, and nurses allocate more of their time with patients and patients’ families than those nurses working in other disciplines. Nurses’ knowledge of and attitudes toward hospice care can affect the quality of hospice care. At present, China’s hospice care institutions are suffering from an obvious shortage of nursing staff. Since clinical nurses are the main force behind the future provision of hospice care, their knowledge of, attitudes and willingness to practice can greatly promoted the growth of hospice care, however, available data on clinical nurses’ willingness to practice hospice care are limited. Methods A cross-sectional descriptive study design was employed to collect data from 1833 nurses working in tertiary or secondary general hospitals in Guangxi, China. We examined nurses’ demographic characteristics and scores on the Chinese version of the hospice care knowledge scale, the Chinese version of the Bradley Attitude Assessment Questionnaire, and a brief quiz concerning their willingness to practice hospice care in the future. Descriptive, single factor, multiple regression analyses and logistic regression analyses were used for data analysis. Results Nurses displayed moderate mean scores for both knowledge of and attitudes, and only 505 (27.5%) nurses expressed their willingness to practice hospice care, 1329 (72.5%) of nurses sampled expressed their unwillingness or uncertainty. Multivariate regression analyses showed that education, professional qualification, monthly income, whether they had been trained in hospice care, and willingness to practice hospice care were the main influencing factors of knowledge; education, whether they lived with someone aged >60 years, and whether they had been trained in hospice care were main factors influencing attitudes. Additionally, logistic regression analyses showed that hospice care knowledge, whether they had been trained in hospice care, and whether they had clinical experience affected the nurses’ willingness to practice hospice care. Conclusion This study highlighted a knowledge gap and moderate attitudes toward hospice care among nurses, and most nurses did not prefer to practice hospice care. Having been trained in hospice care was the main common factor of nurses’ knowledge of, attitudes toward, and willingness to practice hospice care in the future, indicating the necessity to provide nurses with more targeted hospice care training.

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Nurses’ knowledge, attitudes, and willingness to practice hospice care: An analysis of influencing factors

BACKGROUND The occurrence of nosocomial infections remains a health threat to patients and hospital staff. This study applied social-cognitive theory for predicting determinants of nosocomial infections control behaviors in hospital nursing Staff. METHODS In this cross-sectional study, 280 nurses and assistant nurses were selected by random sampling from intensive care wards including CCU, ICU, NICU, dialysis of educational hospitals in Mashhad, Iran in 2020. Data were collected using a 5-point Likert scale structural questionnaire based on social cognitive theory constructs. Using the structural equation modeling method, direct and indirect relationships of social cognitive factors on preventive behaviors of nosocomial infections were analyzed via AMOS 23.0. RESULTS Our results showed that self-regulation, outcome expectations, and barrier constructs had a direct effect on behavior and the highest effect was related to self-regulation structure (p < 0.001). The constructs of social support, modeling, perceived environment and Task self-efficacy had an indirect effect on behavior and the most impact was related to the constructs of perceived environment (p < 0.05). CONCLUSION Considering that self-regulation, outcome expectation and barriers have a significant effect on following the preventive behaviors of nosocomial infections in nursing staff. It is suggested that policymakers and planners try to reduce barriers, strengthen behavioral motivation, and empower nursing staff by teaching self-regulatory strategies.

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Predictors of preventive behavior of nosocomial infections in nursing staff: a structural equation model based on the social cognitive theory

Introduction: The increasing need for palliative care (PC) in the intensive care unit (ICU) is characterised by an increasing number of patients with critical and terminals conditions. It requires comprehensive treatment of nurses, through PC. Self-efficacy is a major predictor that affects the application of PC in ICU. Therefore, nurses need to have high self-efficacy to provide quality PC for patients and their families. This study aimed to analyse the factors that dominant relates to nurses' self-efficacy in implementing of providing PC in ICU. Methods: This research was correlational research with cross-sectional survey design. The sampling technique used was total sampling, which involved 127 critical nurses who were actively working at a general hospital in Bandung, Indonesia. Data were collected using questionnaires. Bivariate analysis using Pearson correlation and Rank-Spearman test and multivariate analysis using linear regression. Results: The results showed that the majority of respondents had high self-efficacy, working experience >15 years, enough interest to the nursing profession had less knowledge and negative perception related to the PC in ICU. There was a significant relationship between self-efficacy with work experience, nurses' interest in the nursing profession, knowledge and perception variables. The most dominant factors related to self-efficacy, namely knowledge and perceptions of nurses related to PC. Conclusion: This study indicates that majority of the respondents lacked knowledge and had negative perceptions related to PC in ICU, it is necessary to socialise and training related to it by focusing on self-belief or self-efficacy of nurses on their ability.

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Factors Associated with Nurses’ Self-Efficacy in Applying Palliative Care in Intensive Care Unit

Background : The increasing need for palliative care in intensive care unit (ICU) is indicated by the increasing number of patients with critical and terminal conditions or life-threatening diseases. A comprehensive handling through palliative care by nurses is needed. Self-efficacy is the main predictor that influences the application of palliative care in ICU. Therefore, nurses should have high self-efficacy in order to provide qualified palliative care for patients and their families. Objective : This study aimed to analyze the relationship between perceptions and self-efficacy of nurses in applying palliative care in ICU. Methods: This study was a correlational study with a cross sectional approach. The sampling technique used was total sampling, which involved all nurses who were actively working at the Bandung General Hospital during the study. There were 127 people in total. Data were collected using questionnaires. Descriptive analysis was used for the univariate analysis and Pearson correlation test was used for bivariate analysis. Results: The results of univariate analysis showed that the majority of respondents had high self-efficacy (56.7%) and negative perceptions (52%) related to palliative care in the intensive room. Based on the results of bivariate analysis, there was a significant relationship between perception and self-efficacy variables (p value = 0.000). Conclusion: The results showed that high number of respondents had negative perceptions related to their competences in implementing palliative care in the ICU. Therefore, socializations and trainings related to this are needed, which focus on nurses' beliefs in their abilities.

https://belitungraya.org/BRP/index.php/bnj/article/download/607/253

The relationship between nurses' perceptions and self-efficacy in implementing palliative care in the intensive care unit

Background: nurses' perceptions of risk have an impact on the process of dealing with a pandemic as well as affecting their quality of life in terms of physical health, psychology, social relations, and the environment.Purpose: this study analyzed the relationship between perceptions of the risk of exposure to Covid-19 and the quality of life of nurses in the Emergency Room after booster vaccination.Methods: research using studies cross-sectional by sampling technique total sampling for all emergency room nurses at hospitals in Sukabumi City there were 49 people. The data collection instrument uses a risk perception questionnaire and a questionnaireWorld Health Organization Quality of Life (WHOQOL-BREF).Results: the result revealed that51% had high-risk perception and 51% had poor physical health, 63.3% had bad psychological, 57.1% had a bad environment, and 77.6% with good social relations. After doing the testChi-Square significance (α = 0.05), there is a relationship between perceptions of the risk of exposure to Covid-19 with 3 domains of quality of life including physical health (0.032), psychological (0.029), and the environment (0.029). But there is no relationship with the domain of social relations (0.196).Conclusion: Health workers, especially nurses, always have a good coping mechanism during a pandemic. Apart from that, it is hoped that nurses can improve their quality of life, such as maintaining their physical and psychological health to improve the quality of service.

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Perception of Risk of Exposure to Covid-19 and Quality of Life for Nurses in the Emergency Room after Booster Vaccination

Background: Short stature in toddlers indicates chronic nutritional problems that are influenced by maternal conditions, birth weight, toddler weight, and infant diseases or other problems that indirectly affect health.Purpose: To determine the factors affecting stunting among toddlers in Ende, IndonesiaMethod: Correlational using a cross sectional approach to 155 toddlers. Purposive sampling was used to collect samples from eight sub-districts in Ende Regency. Questionnaires were distributed for data collection. In this study, bivariate analysis used chi-square test, and multivariate analysis used logistic regression.Results: Univariate analysis showed that most of the respondents (mothers of toddlers) had a history of short stature, was not at risk for gestational age, had poor nutrition, had a good level of knowledge about infant food and nutrition, had no history of infection during pregnancy, and always had antenatal care check-ups. Factors under five identified that almost all have a history of infectious diseases, have been sick in the last month, have no history of low birth weight, have complete vaccination, are not premature, and have intrauterine growth, and growth restriction. Environmental factors indicate that some respondents have clean latrines, have a distance to health facilities <1 km, have clean drinking water, and are not pregnant and breastfeeding.Conclusion: Several variables have a significant relationship with stunting in such as exclusive breastfeeding, infectious diseases, drinking water quality, and distance to health facilities. The results of the multivariate analysis showed that the infectious disease variable was the dominant variable causing stunting in Ende Regency.Suggestion: Local health authority to garner cooperation from various regional bureaucracies in Ende Regency to tackle stunting in this area.

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The factors affecting stunting among toddlers in Ende, Indonesia

Background: Longer life expectancy in Indonesia is a sign for the government to intensively improve various programs for the elderly for better welfare and quality of life. Elderly Health Service (or Posyandu Lansia)  that is well-conducted will provide convenience for the elderly in accessing basic health services to maintain and optimize their quality of life.
Objective: This research aimed to analyze the relationship between beliefs on health and family support toward the participation of the elderly in Posyandu Lansia.
Methods: This correlational research was performed using a cross-sectional approach on 30 elderly selected purposively. The Health Belief Model (HBM) was used as a framework in this study. Data were collected using validated questionnaires and analyzed using univariate statistics, Chi-square, and logistic regression.
Results: The results indicated the presence of a correlation between health beliefs, especially perceived vulnerability (p = 0.048) and perceived benefits (p = 0.030), and family support in the elderly’s participation in Posyandu Lansia.
Conclusion: It is essential for the public health centers to monitor and approach the families of elderlies who rarely attend Posyandu Lansia to improve their health and quality of life.

Theresia Avila Kurnia

Papers

Factors Associated with Nurses’ Self-Efficacy in Applying Palliative Care in Intensive Care Unit

The relationship between nurses' perceptions and self-efficacy in implementing palliative care in the intensive care unit

Perception of Risk of Exposure to Covid-19 and Quality of Life for Nurses in the Emergency Room after Booster Vaccination

The factors affecting stunting among toddlers in Ende, Indonesia

The correlation between health beliefs and family support on the elderly’s participation in the Elderly Health Service (Posyandu Lansia)