Nurses' attitudes and practice related to hospice care

Purpose: To describe characteristics, attitudes, and communications of nurses regarding hospice and caring for terminally ill patients. Design: A cross-sectional study of randomly selected nurses (n=180) from six randomly selected Connecticut community hospitals was conducted in 1998 and 1999. Methods: Hospice-related training, knowledge and attitudes, demographic and practice characteristics, and personal experience with hospice were assessed with a self-administered questionnaire (response rate=82%). Logistic regression was used to model the effects of hospice-related training, knowledge, and attitudes on these outcomes, adjusting for personal experience and other characteristics of nurses. Findings: Characteristics associated with discussion of hospice with both patients and families included greater religiousness, having a close family member or friend who bad used hospice, and reporting satisfaction with hospice caregivers. Greater self-rated knowledge was significantly associated with discussion of hospice with patients. Attitudinal scores indicating greater comfort with initiating discussion and greater perceived added benefit of hospice were significantly associated with discussion with patients' families. Conclusions: Nurses' discussion of hospice with terminally ill patients and their families are related to the Potentially modifiable factors of self-rated knowledge and attitudes revealing comfort with discussion and perceived benefit of hospice care.