Palliative and End of Life Care Competencies Among Nurses in Surgical Transplant Units
Keywords:
assessment tool, end-of-life care, competency, nursing, palliative care surgical transplant unitsAbstract
Background: Palliative care is an essential part of modern healthcare. As communicable and non-communicable diseases increase and the population ages, the need for palliative care continues to grow. Nurses must therefore have strong competencies in providing this type of care. While palliative care is commonly associated with cancer patients, little research has examined the palliative care skills of nurses working in surgical transplant units. Purpose: This study aims to determine the palliative and end-of-life care competencies among nurses in surgical transplant units. Methods: A quantitative cross-sectional research design is employed. The data is collected from surgical transplant nurses using Microsoft Forms, specifically those related to Health and Social Care, Living Matters, Dying Matters, and the Palliative and End-of-life competency assessment tool, and distributed through the participants’ personal email. Health and Social Care, Living Matters, Dying Matters, and Palliative and End-of-life competency tool. The t-test, ANOVA, Mann-Whitney U test, and Games-Howell post hoc test are utilized to analyze the results. Results: A total of 188 nurses in the surgical transplant unit participated in this study. Most of the participants were female (84.04%), aged 30 to 39 years (68.62 %), held a bachelor’s degree (85.11%), and had over 11 years of experience (77.13%). Notably, 67.02% lacked formal training in palliative and end-of-life care. Competency scores were generally strong, with communication skills (mean=2.65) and symptom management (mean=2.58) rated highest. Competency varied significantly based on age, education, position, and training. The primary challenges include managing family dynamics (72.34 %) and lack of training 14.89%). Conclusion: The participants’ palliative and end-of-life care competency across all measured domains is highly developed. Age, educational attainment, position, and training have a significant impact on nurses’ competence. Family dynamics is identified as the primary challenge in dealing with palliative and end-of-life patients. Training and education are needed to improve staff competence and ensure high-quality palliative care.
References
Adams, L. Y. (2016). The conundrum of caring in nursing. International Journal of Caring Sciences, 9(1), 1.
Aldridge, M. D., Hasselaar, J., Garralda, E., van der Eerden, M., Stevenson, D., McKendrick, K., Centeno, C., & Meier, D. E. (2016). Education, implementation, and policy barriers to greater integration of palliative care: a literature review. Palliative medicine, 30(3), 224-239.
Anderson, R. J., Bloch, S., Armstrong, M., Stone, P. C., & Low, J. T. (2019). Communication between healthcare professionals and relatives of patients approaching the end-of-life: A systematic review of qualitative evidence. Palliative medicine, 33(8), 926-941.
Atreya, S., Jeba, J., Pease, N., Thyle, A., Murray, S., Barnard, A., Munday, D., Mathews, L., Leng, M., & Palat, G. (2019). Primary palliative care competency framework for primary care and family physicians in India-Collaborative work by Indian Association of Palliative Care and Academy of Family Physicians of India. Journal of family medicine and primary care, 8(8), 2563-2567.
Beauchamp, T., & Childress, J. (2019). Principles of biomedical ethics: marking its fortieth anniversary. The American Journal of Bioethics, 19(11), 9-12.
Brighton, L. J., & Bristowe, K. (2016). Communication in palliative care: talking about the end of life, before the end of life. Postgraduate medical journal, 92(1090), 466-470.
Brohard, C. (2022). What's Your Level of Palliative Care Competency?(GP702). Journal of Pain and Symptom Management, 63(6), 1112-1113.
Connolly, M., Ryan, K., & Charnley, K. (2016). Developing a palliative care competence framework for health and social care professionals: the experience in the Republic of Ireland. BMJ Supportive & Palliative Care, 6(2), 237-242.
Connor, S. (2020). WHCPA Global Atlas of Palliative Care (2nd ed.). ccp-portal.org/system/files/resources/WHPCA_Global_Atlas_FINAL_DIGITAL.pdf
de Campos, A. P., Levoy, K., Pandey, S., Wisniewski, R., DiMauro, P., Ferrell, B. R., & Rosa, W. E. (2022). Integrating palliative care into nursing care. AJN The American Journal of Nursing, 122(11), 40-45.
Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American journal of theoretical and applied statistics, 5(1), 1-4.
Gustafson, C., & Song, M.-K. (2020). State of the Science of Palliative Care in Solid Organ Transplantation. Progress in Transplantation, 30(4), 382-395.
Hagan, T. L., Xu, J., Lopez, R. P., & Bressler, T. (2018). Nursing's role in leading palliative care: A call to action. Nurse Education Today, 61, 216-219.
Hao, Y., Zhan, L., Huang, M., Cui, X., Zhou, Y., & Xu, E. (2021). Nurses’ knowledge and attitudes towards palliative care and death: a learning intervention. BMC palliative care, 20(1), 50. https://doi.org/10.1186/s12904-021-00738-x
Health Service Excecutive. (2014). Palliative Care Competency Framework. In Palliative Care Competency Framework Steering Group. Dublin.
Hendricks-Ferguson, V. L., Sawin, K. J., Montgomery, K., Dupree, C., Phillips-Salimi, C. R., Carr, B., & Haase, J. E. (2015). Novice nurses’ experiences with palliative and end-of-life communication. Journal of pediatric oncology nursing, 32(4), 240-252.
HSC. (2016). Palliative and End-of life Competency Assessment tool. In: HSC Living Matters Dying Matters.
International Council of Nurses. (2022). The International Council of Nurses welcomes WHO’s new Competency Framework in World Health Worker Week
Kavalieratos, D., Gelfman, L. P., Tycon, L. E., Riegel, B., Bekelman, D. B., Ikejiani, D. Z., Goldstein, N., Kimmel, S. E., Bakitas, M. A., & Arnold, R. M. (2017). Palliative care in heart failure: rationale, evidence, and future priorities. Journal of the American College of Cardiology, 70(15), 1919-1930.
Kirkpatrick, A. J., Cantrell, M. A., & Smeltzer, S. C. (2017). A concept analysis of palliative care nursing: Advancing nursing theory. Advances in Nursing Science, 40(4), 356-369.
Nie, X., Lv, F., Li, L., & Jia, J. (2025). Current situation and influencing factors of palliative care practice ability among oncology nurses: A multicenter cross-sectional study. International Journal of Nursing Sciences, 12(1), 35-41. https://doi.org/https://doi.org/10.1016/j.ijnss.2024.12.006
NIPEC. (2020). Competence Assessment Tools and Competency Frameworks. In: Northern Ireland Practice & Education Council for Nursing and Midwifert.
Özmen, S. Ö., & Keskin, A. Y. (2024). Challenges Faced by Nurses Working in Palliative Care Centers. Sürekli T?p E?itimi Dergisi, 33(1), 42-56.
Polit, D., & Beck, C. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Wolters Kluwer.
Price, D. M., Strodtman, L., Montagnini, M., Smith, H. M., Miller, J., Zybert, J., Oldfield, J., Policht, T., & Ghosh, B. (2017). Palliative and end-of-life care education needs of nurses across inpatient care settings. The Journal of Continuing Education in Nursing, 48(7), 329-336.
Rubbai, Y. S., Chong, M. C., Tang, L. Y., Abdullah, K. L., Mohammad, W. T., Mohajer, S., & Namazinia, M. (2024). Barriers in providing quality end-of-life care as perceived by nurses working in critical care units: an integrative review. BMC palliative care, 23(1), 217. https://doi.org/10.1186/s12904-024-01543-y
Shingala, M. C., & Rajyaguru, A. (2015). Comparison of post hoc tests for unequal variance. International Journal of New Technologies in Science and Engineering, 2(5), 22-33.
Singh, A. S., & Masuku, M. B. (2014). Sampling techniques & determination of sample size in applied statistics research: An overview. International Journal of economics, commerce and management, 2(11), 1-22.
Teresa-Morales, C., Rodríguez-Pérez, M., Araujo-Hernández, M., & Feria-Ramírez, C. (2022). Current stereotypes associated with nursing and nursing professionals: An integrative review. International Journal of Environmental Research and Public Health, 19(13), 7640.
Utami, R. S., & Putri, A. K. (2022). Nurse's Obstacles in Delivering End of Life Care. JKG (JURNAL KEPERAWATAN GLOBAL), 95-107.
Wentlandt, K., Weiss, A., O’Connor, E., & Kaya, E. (2017). Palliative and end of life care in solid organ transplantation. American Journal of Transplantation, 17(12), 3008-3019.
WHO. (2020). Palliative Care The Essential Facts. In: World Health Organization.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Proceedings Series on Health & Medical Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
