Nurses’ knowledge, attitude and practice in end of life care at Muhimbili national hospital, Dar-es-salaam Tanzania

Abstract

Background: It is obvious that human life has an end either by sudden death, diseases, trauma or aging. At the end of life, a dying patient and families need a holistic nursing care to reduce suffering, maintain quality of life and ensure death with dignity. This require comprehensive nursing knowledge related to a dying patient. Experience in clinical settings shows that dying patient and their families receive poor end of life care from nurses as they die without information about their diagnosis, prognosis and they have poor involvement in the plan of care. Aim of the study: To assess nurses’ knowledge, Attitude and practices in end of life at Muhimbili national hospital (MNH). Methods: A cross-sectional descriptive study was conducted among nurses at Muhimbili national hospital. A self-administered questionnaire with knowledge and attitude parts adapted and modified from Palliative care quiz for nurses (PCQN) and Frommelt attitude for caring dying (FATCOD) respectively together with practice part developed after various literature review. These tools were used to grasp information from nurses working at MNH relating to end of life care. A sample of 308 nurses were involved in the study. Simple random sampling method was used to obtain participants during data collection. The collected data was analyzed using SPSS version 23 and was presented using descriptive statistics. Results: The total number of participants were 308 nurses working at Muhimbili national hospital with a response rate of 89.0%. High number of participants 30.7% had 30-35 years of age, 40.9% have 5-10years’of working experience in nursing and 54.9% were female. Majority 68.6% have no training relating to end of life care. More than half 55.6% had poor knowledge of end of life care. Majority 62.5% have poor attitude about end of life care while 72.7% have poor practice about end of life care. Education level with (AOR=2.581, 95%CI: 1.268-5.255, P-value=0.009) has statistically significant association with nurses’ knowledge on dying patient’s rights in end of life stage. Nurses’ attitude and practice in end of life care has no statistical significance with socio-demographic data of the study participants. Conclusion: From this study, nurses have poor knowledge, poor attitude and poor practice regarding end of life care. This could have been subjected the dying patient and their families into suffering and death without dignity