Nurses’ toward Palliative Care and its Barriers in Neonatal Intensive Care Units

Palliative care is one of the most important aspects of neonatal intensive care. Providing palliative care for infants faces many obstacles and challenges. The aim of this study was to determine the attitude to palliative care and the barriers for delivering palliative care practices among nurses in the Neonatal Intensive Care Unit (NICU).

In the present descriptive cross-sectional study, 128 nurses working in NICUs of hospitals affiliated to the Shahid Beheshti University of Medical Sciences, Tehran, Iran were selected by census method in 2018. Data were collected with "Fromelt Attitude Towards Caring   for Dying Patient" (FATCOD) and "Neonatal Palliative Care Attitude Scale" (NPCAS). 

Nurseschr('39') attitude toward palliative care was positive (102.17±4.81) and a statistically significant association was observed between shift work and nurseschr('39') attitudes (p<0.001). A strong barrier to providing palliative care was the presence of insufficient resources (10.93±2.66). Improper application of technology (5.90±1.59), organizational culture (18.69±5.25) and professional competence of nurses (18.09±4.82) were classified as intermediate barriers. The weak barrier to the implementation of palliative care was the individual and social attitude of the nurse (18.67±2.60).

Nurses have a positive attitude to providing palliative care, and it is necessary to strengthen their positive attitude by providing clinical and theoretical training. It is also important to pay more attention to eliminating other factors that can affect the implementation of palliative care. Insufficient resources are a strong obstacle to providing palliative care in neonates. So equipping the resources in terms of a suitable physical environment, adequate skilled manpower, providing counseling services and developing guidelines and policies for the nurses,   are important in order to improve the implementation of neonatal palliative care.