Development of Instruments Regarding Knowledge, Practice, and Perceived Barriers for End-of-Life Care among Health Care Professionals caring for Terminal Cancer Patients

다국어 초록 (Multilingual Abstract)

Aim(s): For the quality of care for cancer patients at the end of their lives, the healthcare professional’s competency regarding the end of life care is crucial. By measuring the competency of healthcare providers, an education program relating to a quality end-of-life care should be established. The purpose of this study was to develop instruments for identifying the knowledge, practice, and perceived barriers to end-of-life care among healthcare professionals caring for terminal cancer patients.

Method(s): This study was designed to use methodological research. To measure the knowledge and practice of medical staff in end-of-life care, the first draft of the instrument was developed based on three national and international clinical practice guidelines, including “The end-of-life care clinical practice guidelines”(2020) by the Korean Society of Hospice and Palliative Medicine, the National Cancer Center, and the Ministry of Health and Welfare; “Care of dying adults in the last days of life” (2016) by the National Institute for Excellence in Health and Care; and “Palliative care Version Ⅱ” (2021) by the National Comprehensive Cancer Network. The first draft of the instrument consists of core items that were suggested for at least two of the guidelines. There were 20 initial items of knowledge, 16 items of practice, and 8 items of perceived barriers to end-of-life Care. To validate the developed instrument, 2 oncologists and 4 nurses with master"s degrees or higher and caring for cancer patients were evaluated for validity of content. In addition, the items related to perceived barriers were corrected and supplemented after receiving comments from them.

Result(s): After expert validation, all items met the criteria except 1 with a CVI of less than 0.8. That item was deleted. Finally, 19 items of knowledge, 16 items of practice, and 12 items of perceived barriers regarding end-of-life care were established. The items consist of questions about imminent death, interventions in physical and psychological symptoms, and communication.

Conclusion(s): This survey instrument was reported as applicable to both doctors and nurses, and as relevant to measuring health care providers’ knowledge, practice, and perceived barriers to end-of-life care. This instrument would be helpful in identifying and reducing the gap between the two groups in team nursing that require cooperation for end-of-life care. Ultimately, it provides basic data for research to provide high-quality end-of-life care to terminal cancer patients.