| ObjectiveChinese neonatal nurses’s attitudes towards palliative care are unclear.The study adopted the traditional Chinese version of Neonatal Palliative Care Attitude Scale(NiPCAS)to apply in neonatal units to realize nurses’ attitudes.Interviewing neonatal nurses to understand the current status and research progress,basic situation of development,attitudes and beliefs of neonatal palliative care(NPC),to assess impact of nurse’ s personal and professional characteristics on palliative care of newborns,find out obstacles and facilitators.Methods1.After obtaining consent of the original author and traditional Chinese translator,the traditional Chinese version of NiPCAS was subjected to cross-cultural adjustments.We used scale content validity indes(S-CVI)and item content validity index(I-CVI)to measure,the simplified Chinese version of NiPCAS was initially formed.Fifteen nurses were included,we tested Cronbach’s α and test-retest reliability,5 nurses were interviewed to realize the feasibility and understandability.We further modified the questionnaire according to pilot test results and expert opinions to form the simplified Chinese draft of NiPCAS.2.Neonatal nurses from 40 different level of hospitals were selected as participants by means of convenient sampling,550 valid questionnaires were collected.We conducted item analysis and exploratory factor analysis on collected data,and further revised the questionnaire.Exploratory factor analysis was used to test structural validity,final ly a simplified Chinese version of NiPCAS was formed.3.We analyzed nurses’ attitudes through questionnaire and relevant statistical methods,quantified barriers and facilitators,analyzed demographic characteristics and influencing factors.4.A total of 10 neonatal nurses were interviewed.By means of simple sampling,we used generic analysis to analyze transcription data,to manage and analyze recording data,to gain a deeper understanding of nurse’s attitude towards NPC.Results1.We carried out cultural adjustment and semantic analysis on the scale.Eight experts were invited to evaluate content validity,the S-CVI was 0.98,I-CVI was 0.83-1.00.After discussion by experts,a first draft of the simplified Chinese version of NiPCAS was formed.Fifteen questionnaires were distributed in the pilot test,questionnaires were refilled by these 15 nurses 4 weeks later.The internal consistency of the simplified Chinese version of NiPCAS was Cronbach’s a of 0.87 and 0.88.The Pearson r correlation between two Cronbach’s a was 0.89.(P<0.000).It showed that the scale content validity,internal consistency and test-retest reliability were good.2.1)We distributed 595 questionnaires on spot or via Internet link,of which 550 were valid,with an effective rate of 92.44%.2)We conducted exploratory factor analysis and extracted 5 factors with a cumulative contribution rate of 45.83%,indicating the simplified Chinese version of NiPCAS had good structural validity.3)Neonatal nurse’s attitude towards NPC:NiPCAS mean score 3.09±0.38,Organization subscale 3.34±0.72,Resource subscale 2.95±0.62,Barriers subscale 2.89±0.59,Belief subscale 3.67±0.65,Work experience subscale 2.78±0.71,the highest score was 112,the lowest score was 40.4)The difference of having children or not,age,and work years among neonatal nurses’ attitudes to NPC was statistically significant(P<0.05).3.After analyzing data obtained from interviews,results showed that policy management,social environment,medical institutions,laws,patients and their families,and nurses themselves might influence nurses’attitudes towards NPC.The specific points were:inadequate publicity and acceptance of NPC;lack of policies and work guidelines for NPC;lack of legal protection for medical staffs;lack of NPC implementation in medical institutions;lack of NPC experience;inadequate allocation of nursing resources;lack of systematic NPC education or training courses;inadequate knowledge and experience of NPC;attention to nurses’ mental health and recognition of NPC;opinions of neonates’ families.ConclusionThe simplified Chinese version of NiPCAS scale is suitable for assessing neonatal nurses’ attitudes towards NPC in mainland,which can work as an effective tool.The overall attitudes of neonatal nurses to implementation of NPC is positive.Nurses have children or not,with different age and working years have different attitudes;neonatal nurses have insufficient knowledge and practical experience in NPC.It is suggested that the government should publish relevant policies and working guidelines,publish laws to protect nurses’ rights and interests,improve allocation of nursing resources;increase publicity of NPC;set up college NPC courses and training courses;concern about nurses’psychological health,promot nurses’ recognition and development of NPC in China. |
