Conhecimento e atitudes de profissionais de enfermagem frente aos cuidados paliativos e à terminalidade

Abstract

Introduction: Palliative care aims to alleviate the suffering of patients and families facing life-threatening illnesses. Nursing professionals are the team capable of determining the greatest impact on the quality of this care. Since palliative care is not always included in professional nursing training, access to continuing education is essential to improve knowledge and attitudes toward patients and their families/caregivers. The objectives of this study were to assess nursing professionals' knowledge of palliative care and attitudes toward end-of-life patients and their families/caregivers before and after an In-Service Education Program. Materials and methods: A quasi-experimental, before-and-after intervention study was conducted, analytically and quantitatively, according to the TREND checklist standardization. All nursing professionals from the internal medicine and neurology units at HC-UFTM were invited to participate in a two-stage in-service education program, consisting of two theoretical classes spaced six weeks apart and a conversation circle with case discussions, between June and October 2024. Knowledge assessment questionnaires (Palliative Care Quiz for Nurses) and attitudes (Frommelt Attitude Toward and Care of the Dying Scale Form B) were administered before the first class and ten weeks later, in addition to a sociodemographic questionnaire. Results: Sixty- one professionals participated, most of them nursing technicians, women, with a mean age of 41, White, married or in a stable relationship, with higher education and more than 10 years of professional experience. Most had not received palliative care education during their training, had not participated in events on the topic, considered their knowledge in the area insufficient, and had personal experience with terminal illness. Participants initially scored insufficient on the PCQN (9.0 points), rising to 10.6 in the post-test. From the outset, they demonstrated adequate attitudes according to the FATCOD-B (112.2), improving further to 115.2 in the post-test. The improvement in knowledge and attitudes was statistically significant (p 0.000 and p 0.003, respectively) and had a small effect size. Higher knowledge was demonstrated by women, individuals of Christian faith, nursing technicians, professionals with higher education and postgraduate degrees, those who considered themselves unprepared in palliative care but who had taken specific palliative care courses in their training, and those who had participated in courses or events on the topic. More positive attitudes were observed among professionals who had not taken courses addressing palliative care in their training. Conclusions: Nursing professionals presented insufficient knowledge in PC and adequate attitudes towards terminality, which increased significantly after the in-service education program, reaching sufficient knowledge and even more positive attitudes.