PALLIATIVE CARE PRACTICE, PERCEIVED BARRIERS, AND ASSOCIATED FACTORS AMONG NURSES WORKING IN SELECTED PUBLIC HOSPITALS IN HAWASSA CITY, SIDAMA ETHIOPIA

Abstract

Background: Palliative care is a comprehensive approach that enhances the quality of life of patients and their families facing problems related to life-threatening illnesses. Since nurses play an active role in managing patients' disease diagnosis and treatment in clinical palliative care practice, identifying their practice level is critical. However, there is a lack of data regarding palliative care practice, barriers, and associated factors among nurses in the study area. Objective: To assess the palliative care practice, perceived barriers, and associated factors among nurses working in selected public hospitals in Hawassa, Sidama, Ethiopia. Methods: An institutional-based cross-sectional study design using quantitative supplemented by qualitative data collection methods was employed among 319 nurses and 8 key informants, respectively, at a selected public hospital in Hawassa City, Sidama, Ethiopia, from March 15 to July 30, 2023.Simple random sampling techniques and purposive sampling techniques were used to collect data. Data were collected using pretested, self-administered questionnaires and an in-depth interview. Epi-Data and Statistical Program for Social Sciences software were used for data entry and analysis. Descriptive, bivariate, and multivariable logistic regression analyses were utilized. A p-value of <0.05 on multivariate logistic regression was declaredfor the associated variable. For qualitative data, thematic analysis was used. Results:The response rate among the 313 nurses who completed the questionnaire was 98%. Around three-fourths,76.6% [95% CI, 72–81] of participants had poor palliative care practices. Type of hospital, age, education level, experiences, and training were significantly associated with overall palliative care practices. This study explored four main themes in qualitative findings: knowledge deficit, negative patient attitudes, spiritual care, and modern medicine clash, issues with healthcare providers, and inadequate hospital facilities. Conclusion and recommendations: Overall, nurses had poor palliative care practices. Type of hospital, age, education level, experiences, and training were factors associated with practice towards palliative care, anda sub-category of themes emerged from a qualitative study. Therefore, it is necessary to provide basic education and continue on-the-job training for nurses to bridge the gap of poor practice.