Nurse Comfort With Palliative and End-of-Life Communication: A Rural and Urban Comparison

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Mary J Isaacson1, Mary E Minton, Patricia DaRosa

  • 1Mary 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.

Journal of Hospice and Palliative Nursing : JHPN : the Official Journal of the Hospice and Palliative Nurses Association
|January 5, 2019
PubMed

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.

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