Knowledge, attitudes, and behavioral intentions of nurses toward providing artificial nutrition and hydration for terminal cancer patients in Taiwan.

The aim of this study was to understand present knowledge, attitudes, and behavioral intentions of clinical nurses providing artificial nutrition and hydration (ANH) for terminal cancer patients. Study subjects were composed of 197 nurses from the gastroenterology, general surgery, and intensive care units of Taipei Veterans General Hospital in Taiwan. Subjects were surveyed between April and June 2005 via self-developed structural questionnaires. Collected data were descriptively analyzed with SPSS 11.0 software. Nurses' knowledge about palliative care was high (accurate-answer rate, 96.75%); knowledge about providing ANH for terminal cancer patients was lower (accurate-answer rate, 53.67%). Although nurses' attitudes about providing ANH for terminal cancer patients viewed ANH as having more burdens (mean [SD], 14.12 [3.62]) than benefits (6.35 [2.19]), nurses' behavioral intentions still favored providing ANH (3.21 [0.95]). In subjective norms, "attending physicians and/or superiors" (45.3%) and, secondarily, "patients" (38.4%) were important influencing persons on nurses' support for ANH. Other influencing factors were communication difficulties with patients and/or family members (3.40 [0.83]), staff disagreements (3.01 [0.78]), and fear of medical dispute (3.42 [0.95]). Study results suggest that reinforcing in-service education to enhance nurses' knowledge of providing ANH for terminal cancer patients and building up positive attitudes and behavioral intentions may strengthen nurses' efforts to actively communicate and cooperate with physicians in assisting patients and families to make the most appropriate medical decisions.