Child/Adolescent Health

Hope, experience, and education help nurses feel more comfortable and competent in providing palliative care to children

Nurses with more years in nursing, more palliative care education, and a more hopeful attitude feel more comfortable and competent providing palliative (comfort) care to dying children than other nurses. These nurses also find it less difficult to talk about dying or death with children and their families, according to a new study. Chris Feudtner, Ph.D., M.P.H., of Children's Hospital of Philadelphia, and colleagues surveyed nurses employed at the hospital in 2005; 410 responded.

Nurses were asked whether they agreed (+2 for strongly agree to -2 for strongly disagree) with the statement that they were "comfortable working with dying children and their families" and had a mean score of 0.5. When asked if they "find it very difficult to talk about death and dying with children and their families," nurses had a mean score of -.01.

Nurses felt most competent in their ability to manage children's pain and least competent to talk with children and their families about dying. After adjusting for several factors, greater number of years in nursing practice, more hours of palliative care education, and higher scores on the Hope Scale were each significantly associated with more comfort working with dying children and their families, less difficulty talking about death and dying, and feeling more competent in providing palliative care.

Improving hopeful patterns of thoughts and feelings about the challenges confronted during end-of-life care for children might result in improved quality of pediatric palliative care, note the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS00002).

See "Hopeful thinking and level of comfort regarding providing pediatric palliative care: A survey of hospital nurses," by Dr. Feudtner, Gina Santucci, M.S.N., James A. Feinstein, B.A., and others, in the January 2007 Pediatrics 119, pp. 186-192.

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