Siang, TehTian
(2018)
A cross sectional study on perception of doctors and nurses towards end of life care in intensive care unit.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction: End of life (EOL) care is an important goal in intensive care medicine.
There is limited data available in Malaysia.
Objective: To evaluate the perception of doctors and nurses towards EOL care and to
evaluate the factors associated with observed attitudes.
Methods: A cross sectional study with self-administered questionnaires conducted among
65 doctors and 123 nurses from intensive care unit (ICU) of Hospital Universiti Sains
Malaysia and Hospital Raja Perempuan Zainab II (May-December 2016).
Results: Nurses (44%) were more likely than doctors (17%) to agree with the statement
that withholding life support is more ethical than withdrawing life support. There were
58% of doctors and 10% of nurses viewed withholding and withdrawing ethically the
same. Over 65% of doctors and nurses considered patient centered factors and religious
view were important determinants in EOL decision.
When life support discontinued, more doctors would continue sedative and analgesic drugs
than nurses. (P<0.05) About 50% of nurses and doctors would continue nutritional support
when life support discontinued. Over 85% of doctors and nurses agreed majority of ICU
doctors initiated end of life discussion but nurses played minority role.(<5%).
On multivariable analysis, nurses with no experience in end of life were 62% less
reluctant to support EOL care. [ORa: 0.376 (95% CI: 0.168, 0.837), P=0.02] Interpretation
of this result needs to consider subordinate position of nurses in our setting. There was no
association between the care team‟s professions, gender, working setting on particular
attitudes about EOL care.
Conclusion: Patient and family centered factor and religious view are important
determinants in EOL decision. A highlight on similarities and differences on perception in
EOL care between doctors and nurses will help improve EOL care and reduce
miscommunications.
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