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Nurse Comfort With Palliative and End-of-Life Communication

A Rural and Urban Comparison

Isaacson, Mary J., PhD, RN, CHPN; Minton, Mary E., PhD, RN, CNS, CHPN; DaRosa, Patricia, DDS, MSc; Harming, Shana, BS

Journal of Hospice & Palliative Nursing: February 2019 - Volume 21 - Issue 1 - p 38–45
doi: 10.1097/NJH.0000000000000483
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Communication is a key component of palliative and end-of-life care. Little is known about comfort with palliative and end-of-life communication among nurses working in rural and urban settings. We assessed this comparison using the 28-item (including 2 ranked items) Comfort with Communication in Palliative and End-of-Life Care instrument. Descriptive analyses of the sample (N = 252) identified statistically significant results differences for age and experience; rural nurses were older and more experienced. Urban nurses reported less comfort than did rural nurses based on composite score analysis (P = .03) and reported less comfort than did rural nurses in talking with patients and families about “end-of-life decisions” (P < .05). Overall, years of experience were significant for more comfort with end-of-life communication. Our instrument could be used within academic settings to establish baseline awareness of comfort with palliative and end-of-life communication and in institutional settings to provide a continuing education bridge from prelicensure through licensure. Moreover, experienced nurses are integral in mentoring new graduates in initiating and sustaining difficult conversations.

Mary J. Isaacson, PhD, RN, CHPN, is assistant professor, College of Nursing, South Dakota State University, Rapid City.

Mary E. Minton, PhD, RN, CNS, CHPN, is associate dean, Graduate Nursing, and associate professor, College of Nursing, South Dakota State University, Brookings.

Patricia DaRosa, DDS, MSc, is public health and health outcomes data analyst, College of Nursing, South Dakota State University, Brookings.

Shana Harming, BS, is Wokini director, South Dakota State University, Brookings.

This project was funded by the Hospice and Palliative Nursing Foundation through a restricted gift from the Hospice and Palliative Credentialing Center.

Address correspondence to Mary J. Isaacson, PhD, RN, CHPN, College of Nursing, South Dakota State University, 1011 11th St, Rapid City, SD 57701 (mary.isaacson@sdstate.edu).

The authors have no conflicts of interest to disclose.

© 2019 by The Hospice and Palliative Nurses Association.