Date of Award

2-2025

Degree Type

Thesis

Degree Name

Master of Science in Advanced Practice Nurs​ing (MSc-APN)​

First Advisor

Prof. Wesley Too

Second Advisor

Festus Mulakoli

Third Advisor

Doris Machaki

Department

School of Nursing and Midwifery, East Africa

Abstract

Introduction: End-of-life care is an essential aspect of healthcare, and nurses play a vital role in its provision. Due to the growing population, there has been an increase in the number of people in need of End-of-life care, and nurses must be adequately prepared to meet the complex and diverse needs of patients and their families. However, many studies suggest that many nurses feel unprepared to provide quality end-of-life care, and there is a need for further investigation of the factors that contribute to their preparedness.

Methods:The study was conducted at a level 6 teaching and referral hospital, in Nairobi County. A cross-sectional descriptive design was adopted utilizing a quantitative survey method. A multistage sampling method was employed to recruit a sample of 262 participants from the target population which included nurses working in medical-surgical units, Paediatric, accident and emergency, oncology, and critical care units. Data collection was conducted using a self-administered questionnaire which comprised several sections, including demographic characteristics, knowledge of end-of-life care, nurses’ competence, and attitudes toward caring for end-of-life patients. Ethical approval was obtained from the Institutional Scientific and Ethics Review Committee and the National Commission of Science and Technology and Innovation (NACOSTI). The collected data was analyzed using SPSS version 28. Descriptive statistics including frequencies and percentages were used to summarize the numeric data while the bivariate analysis method including chi-square and Fisher exact was used to establish relationships between key variables in this study.

Results: The findings revealed that there were knowledge gaps, with many nurses holding misconceptions regarding the appropriateness and philosophy of end-of-life care. Nurses who had adequate knowledge were 118(45%) while 142(55%) had inadequate knowledge. The study indicated varying attitudes toward EOLC, with an overall score was 186(71.5%) for the positive attitude and 74(28.5%) for the negative attitude. With regards to practice, 225(86.5%) of the nurses indicated competency in EOLC provision while 35(13.5%) were not competent. Further analysis revealed a significant independent association between departments (p= 0.021), years of experience (p= 0.050), age (p= 0.016), attended lectures/training on end-oflife care provision (p= 0.048), and participants' knowledge level. Similarly, nurses' practice and attitude indicated a significant independent association with gender (p=0.02), departments (P= 0.05, .010), end-of-life care service (p= 0.001), years of experience (p= 0.050), age (p= 0.032), and attending any lectures/training on end-of-life care provision (p= .001).

Conclusions and Recommendations: The findings underscore the complex interplay between nurses' knowledge, attitudes, and practices in end-of-life care. Despite their generally high competency in symptom management, there is a knowledge gap with some nurses having a positive attitude Retraining nurses is important and ensuring continuous professional development in end-of-life care.

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1

Last Page

140

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