This study aimed to explore the effectiveness of an inpatient hospice palliative care unit (PCU) and palliative consultation service (PCS) on comprehensive quality of life outcome (CoQoLo) among terminally ill cancer patients. This was a prospective longitudinal study. Terminally ill cancer patients who met the inclusion criteria and received PCU or PCS in a northern Taiwanese medical center were recruited. The CoQoLo Inventory was used to measure CoQoLo level pre- and seven days following hospice care between August 2018 and October 2019. A total of 90 patients completed the study. No significant differences were found in CoQoLo levels between the PCU and PCS groups pre- and seven days following care. However, the CoQoLo level of patients significantly improved seven days following care in both PCU and PCS groups, compared with pre-hospice care. Patients’ age, religious belief, marital status, closeness with family, palliative prognostic index (PPI), and symptom severity were significant concerning CoQoLo levels after adjusting for patients’ baseline characteristics. PCU and PCS showed no difference in CoQoLo levels, but both of them can improve CoQoLo among terminally ill cancer patients. These patients could receive PCU or PCS to achieve a good CoQoLo at the end-of-life stage.

This study aimed to expand on previous research elucidating the effects of dispositional resilience and self-efficacy on practice in advanced care planning (ACP) of terminally ill patients among Taiwanese nurses using path modeling. This cross-sectional study was conducted using cluster sampling. Data were collected using demographics, nurses’ knowledge, attitude, and practice of ACP (KAP-ACP) inventory, Dispositional Resilience Scale, and General Self-Efficacy Scale. A total of 266 nurses from a tertiary medical center in northern Taiwan participated in this study in 2019. The results showed that gender and ward were significant K-ACP predictors among nurses. The ACP knowledge, ward, and experience of caring for terminally ill friends or relatives were significant A-ACP predictors, whereas ACP attitudes, dispositional resilience, self-efficacy, ward, and the frequency of caring for terminally ill patients were the key predictors of P-ACP. The path modeling showed that dispositional resilience; self-efficacy; medical, surgical, hematology and oncology wards; previous experience in caring for terminally ill friends or relatives; participating in the do-not-resuscitate signature; and the frequency of caring for terminally ill patients directly influenced ACP practices. We recommend that nurses enhance their dispositional resilience and self-efficacy, which may encourage them to appreciate the value of ACP practice of terminally ill patients and improve the quality of care.

This study aimed to elucidate the predictors and the effects of path modeling on the knowledge, attitude, and practice toward do-not-resuscitate (DNR) among the Taiwanese nursing staff. This study was a cross-sectional, descriptive design using stratified cluster sampling. We collected data on demographics, knowledge, attitude, and practice as measured by the DNR inventory (KAP-DNR), Mindful Attention Awareness Scale, General Self-Efficacy Scale, and Dispositional Resilience Scale. Participants were 194 nursing staff from a medical center in northern Taiwan in 2019. The results showed that participation in DNR signature and education related to palliative care were significant positive predictors of knowledge toward DNR. The DNR predictors toward attitude included DNR knowledge, mindfulness, self-efficacy, dispositional resilience, and religious belief of nurses. Generally, the critical predictors of DNR practice were DNR attitude, dispositional resilience, and male nurses. In path modeling, we identified that self-efficacy, dispositional resilience, master’s degree, and religious belief directly influenced practice constituting DNR. Based on the findings of this study, we propose that nurses should improve their self-efficacy and dispositional resilience through training programs. Encouraging staff to undertake further education and have religious beliefs can enhance the practice of DNR and provide better end-of-life care.