British journal of hospital medicine (London, England : 2005) · 2026
A Mixed-Methods Study on the Current Situation and Factors Influencing Nurses' Practice of Palliative Care in Hangzhou, China.
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Yuan Xiao, Ning Li, Wang Li, Wu Qingqing, Li Yimin
Аннотация
AIMS/BACKGROUND: With the growing need for high-quality end-of-life care in China, this study aimed to evaluate the practical palliative care skills of nurses across 17 pilot institutions in Hangzhou, identify the key factors influencing these skills, and explore their interrelationships. The ultimate goal was to inform the development of a targeted training and assessment system that can support and enhance palliative care team development in China.
METHODS: This study used a convergent mixed-methods design integrating quantitative and qualitative approaches. From February to May 2022, 723 nurses from 17 palliative care pilot institutions in Hangzhou, China, were surveyed using structured scales assessing their palliative care knowledge, perceived difficulty, and self-reported practice. Descriptive, univariate, and multivariate analyses were performed. Semi-structured interviews were subsequently conducted with eight nurses to gain deeper insights into their practical experiences and challenges.
RESULTS: Quantitative findings indicated that palliative care practice competency was at an upper-intermediate level (64.17 ± 15.99). Multivariate linear regression identified gender, age, and willingness to volunteer in palliative care as significantly affecting nurses' palliative care practice ability. Qualitative analysis demonstrated three core themes: (1) cognitive understanding present but specialized knowledge lacking; (2) behavioral gaps in technical skills and symptom management; and (3) structural barriers, including absence of guidelines and restrictive policies. Integrated results highlighted that personal willingness, cognitive awareness, social support, and training opportunities were consistent determinants of competency.
CONCLUSION: Nurses in Hangzhou demonstrate moderate levels of palliative care competency; however, notable gaps impede high-quality service delivery. There is an urgent need for systematic training, particularly in symptom management and communication skills. Multilevel efforts involving government, healthcare institutions, and the wider community are essential. Priorities include optimizing resource allocation, refining insurance policies, establishing specialized training systems, and enhancing public education to foster informed and rational understanding of end-of-life care.
METHODS: This study used a convergent mixed-methods design integrating quantitative and qualitative approaches. From February to May 2022, 723 nurses from 17 palliative care pilot institutions in Hangzhou, China, were surveyed using structured scales assessing their palliative care knowledge, perceived difficulty, and self-reported practice. Descriptive, univariate, and multivariate analyses were performed. Semi-structured interviews were subsequently conducted with eight nurses to gain deeper insights into their practical experiences and challenges.
RESULTS: Quantitative findings indicated that palliative care practice competency was at an upper-intermediate level (64.17 ± 15.99). Multivariate linear regression identified gender, age, and willingness to volunteer in palliative care as significantly affecting nurses' palliative care practice ability. Qualitative analysis demonstrated three core themes: (1) cognitive understanding present but specialized knowledge lacking; (2) behavioral gaps in technical skills and symptom management; and (3) structural barriers, including absence of guidelines and restrictive policies. Integrated results highlighted that personal willingness, cognitive awareness, social support, and training opportunities were consistent determinants of competency.
CONCLUSION: Nurses in Hangzhou demonstrate moderate levels of palliative care competency; however, notable gaps impede high-quality service delivery. There is an urgent need for systematic training, particularly in symptom management and communication skills. Multilevel efforts involving government, healthcare institutions, and the wider community are essential. Priorities include optimizing resource allocation, refining insurance policies, establishing specialized training systems, and enhancing public education to foster informed and rational understanding of end-of-life care.