Chiara Mastroianni1, Anna Marchetti2, Daniela D'Angelo3, Marco Artico4, Diana Giannarelli5, Elisa Magna6, Paolo Carlo Motta7, Michela Piredda8, Giuseppe Casale9, Maria Grazia De Marinis10. 1. Antea Foundation Palliative Care Center, Piazza di Santa Maria della Pietà, 5, 00135 Rome, Italy. Electronic address: c.mastroianni@antea.net. 2. Research Unit of Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, 00128, Rome, Italy. Electronic address: a.marchetti@unicampus.it. 3. Centro Eccellenza Clinica, Qualità e Sicurezza delle Cure, Istituto Superiore di Sanità, Viale Regina Elena, 299, 0016 Rome, Italy. Electronic address: daniela.dangelo@iss.it. 4. Department of Palliative Care and Pain Therapy Unit, Azienda ULSS n. 4 Veneto Orientale, Piazza Alcide de Gasperi, 5, 30027 San Donà di Piave, Italy. 5. Clinical Trial Center, Biostatistics and Bioinformatics Unit, National Cancer Institute Regina Elena IRCCS, Via Elio Chianesi, 53, 00144 Rome, Italy. Electronic address: diana.giannarelli@ifo.gov.it. 6. Department of Biomedicine and Prevention, Tor Vergata University, Viale Montpellier 1, 00133 Rome, Italy. Electronic address: elisa.magna@unibs.it. 7. Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Piazza del Mercato, 15, 25121 Brescia, Italy. Electronic address: paolo.motta@unibs.it. 8. Research Unit of Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, Rome, Italy.. Electronic address: m.piredda@unicampus.it. 9. Antea Foundation Palliative Care Center, Piazza di Santa Maria della Pietà, 5, 00135 Rome, Italy. Electronic address: g.casale@antea.net. 10. Research Unit of Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, Rome, Italy.. Electronic address: m.demarinis@unicampus.it.
Abstract
BACKGROUND: International literature reports that nursing students feel unprepared when facing patients and families within dying care. They consider their curricula inadequate in teaching end-of-life care and promoting the attitudes required to care for dying patients. Findings of recent studies exploring nursing students' attitudes towards care of the dying patient are often contradictory. OBJECTIVES: To explore Italian nursing students' attitudes towards caring for dying patients. DESIGN: A multicenter cross-sectional study was conducted. SETTINGS: The Bachelor's Degree in Nursing courses of four Universities of the Lazio Region. PARTICIPANTS: The sample included 1193 students. METHODS: Data were collected between September 2017 and March 2018 using the Italian version of FATCOD-B-I. The differences between the mean scores were compared through t-test or ANOVA. Associations between scores and participant characteristics were evaluated through generalized linear regression. RESULTS: The mean score of FATCOD-B-I was 115.3 (SD = 9.1). Higher scores were significantly associated with training in palliative care (p < 0.0001) and experience with terminally ill patients (p < 0.0001). Students manifested more negative attitudes when they perceived patients losing hope of recovering, and patient's family members interfering with health professionals' work. Uncertainties emerged around knowledge of opioid drugs, decision-making, concepts of death and dying, management of mourning, and relational aspects of patient care. CONCLUSIONS: Italian nursing students seem to have more positive attitudes towards care of dying patients than most other countries. They believe that caring for a terminal patient is a formative, useful experience but they do not feel adequately prepared in practice. Deeper palliative care education, integrated with practical training, would prepare students better, enabling them to discover their own human and professional capacity to relieve suffering.
BACKGROUND: International literature reports that nursing students feel unprepared when facing patients and families within dying care. They consider their curricula inadequate in teaching end-of-life care and promoting the attitudes required to care for dying patients. Findings of recent studies exploring nursing students' attitudes towards care of the dying patient are often contradictory. OBJECTIVES: To explore Italian nursing students' attitudes towards caring for dying patients. DESIGN: A multicenter cross-sectional study was conducted. SETTINGS: The Bachelor's Degree in Nursing courses of four Universities of the Lazio Region. PARTICIPANTS: The sample included 1193 students. METHODS: Data were collected between September 2017 and March 2018 using the Italian version of FATCOD-B-I. The differences between the mean scores were compared through t-test or ANOVA. Associations between scores and participant characteristics were evaluated through generalized linear regression. RESULTS: The mean score of FATCOD-B-I was 115.3 (SD = 9.1). Higher scores were significantly associated with training in palliative care (p < 0.0001) and experience with terminally ill patients (p < 0.0001). Students manifested more negative attitudes when they perceived patients losing hope of recovering, and patient's family members interfering with health professionals' work. Uncertainties emerged around knowledge of opioid drugs, decision-making, concepts of death and dying, management of mourning, and relational aspects of patient care. CONCLUSIONS: Italian nursing students seem to have more positive attitudes towards care of dying patients than most other countries. They believe that caring for a terminal patient is a formative, useful experience but they do not feel adequately prepared in practice. Deeper palliative care education, integrated with practical training, would prepare students better, enabling them to discover their own human and professional capacity to relieve suffering.