Nurses’ Knowledge of Hospice Palliative Care Act and Attitude Toward Do Not Resuscitate in the Neonatal Intensive Care Unit

Background and objective: Nurses’ knowledge of Hospice Palliative Care Act and attitude toward “Do Not Resuscitation (DNR)” will affect patients and their families in decision-making and hospice care. As most of the studies focued on adults, few studies explored the issues of neonatal do not resuscitation. The purpose of this study was: (1) to investigate nurses’ knowledge of Hospice Palliative Care Act in the neonatal intensive care unit (NICU), (2) to investigate nurses’ attitude toward caring DNR infants in the NICU, (3) to analysis related factors that affect nurses’ knowledge of Hospice and Palliative Care Act in the NICU, (4) to analysis related factors that affect nurses’ attitude toward DNR in the NICU. Methods: A cross-sectional descriptive correlational design of purposive sampling approach was conducted. A total of 43 subjects were recruited, 30 from a medical center and and 13 from a regional teaching hospital in northern Taiwan. during May to June, 2015. A structured questionnaire was used, including basic data, Hospice Palliative Care Act knowledge (Newborn), the attitude toward caring DNR infants in the NICU. The questionnaire was modified and consulted 5 reference experts to develop and establish reliability and validity. The CVI of Hospice Palliative Care Act knowledge (Newborn) was 0.93 and the attitude toward caring DNR infants in the NICU was 0.92. The Cronbach’s α value of Hospice Palliative Care Act knowledge (Newborn) was 0.547 and the attitude toward caring DNR infants in the NICU was 0.96.The collected data were analyzed in SPSS for windows 22 software. Result: The mean score of Hospice Palliative Care Act knowledge (Newborn version) was 11.74, results showed both nurses in medical center and regional teaching hospital had correct knowledge. Almost 88.4% and 62.8% nurses had wrong answer at distinguishing suitable cases and implementing DNR policies that means nurses had difficulty in these parts. Nurses who thought their religious beliefs were helpful at caring DNR infants, had more correct knowledge about Hospice Palliative Care Act, the p-value was 0.011. The attitude toward caring DNR infants, compared the mean score to physiological, psychological, social and spiritual attitude, physiological attitude (mean = 4.7) was the highest. Age was significantly positive correlation to psychological attitude (p = 0.05), nursing experience of caring DNR patients was significantly positive correlation to the attitude toward caring DNR infants (p = 0.005). In this study, Hospice Palliative Care Act knowledge (Newborn version) and the attitude toward caring DNR infants in the NICU were not correlated (p = 0.187), maybe caused by insufficient subjects . This research can provide a valuable reference for clinical nurses and nursing educators, decision-makers for establishing the DNR guidelines, policies and training programs for ill infants. Also, it is hoped to develop an interface of clinical counseling services for nurses to have experience sharing of caring DNR infants.