2021 Volume 35 Article ID: 35_330_sakai
Purpose: This study examined the current status of and factors associated with clinical competence in specialized palliative care among nurses in palliative care units from the critical thinking and resilience aspects.
Methods: A questionnaire survey was administered to nurses in palliative care units. Clinical competence in specialized palliative care was measured by the core competence required of nurses in charge of specialized palliative care. The questionnaire consisted of clinical competence in specialized palliative care, scales to assess the critical thinking of clinical nurses, the Adolescent Resilience Scale and attributes. Multiple regression analysis was performed with clinical competence in specialized palliative care as a dependent variable.
Results: In all, 1,392 valid responses were obtained (valid response rate: 71%). In terms of the current status of clinical competence in specialized palliative care, nurses scored highly for the items “understand and respect cancer patients and their families just as they are” and “face and support spiritual distress in cancer patients and their families”, but scored low for the items “actively fulfill their roles and responsibilities as a nurse in charge of specialized palliative care”. Six factors were found to be associated with practical competence: “creative thinking”, “logical thinking”, “intuition”, “emotional regulation”, “years of experience in palliative care units”, and “experience of learning palliative care” (adjusted R2 = 0.37).
Discussion: The results regarding the current status of practical competence suggest that nurses respect the values of the patients and their families while showing a high level of awareness of spiritual care, but that there are issues with active engagement in quality improvement. The characteristics of the factors associated with practical competence indicate the importance of: (1) being able to identify the essence of and changes in the palliative care nursing to provide individualized care; (2) being able to reflect and regulate emotions; and (3) repeated practice and learning.
