PART A: Questionnaire on Attitudes
Directions: Tick the box under the opinion that most closely represents your own.
1. Nurses are capable of identifying that patient is dying.
Slightly Slightly Strongly
Strongly Disagree Agree
Disagree Agree Agree
Disagree
2. I would not like the responsibility of identifying a patient is dying.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
3. Nurses cannot cease routine care for the dying patient without permission from a doctor.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
4. The length of time taken to care for a dying patient is vitally important.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
5. Nurses should not give dying patient honest answers about their condition.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
6. End stage palliative care does not do anything for the patient.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
7. The focus of care should be adopted when death becomes imminent.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
8. When a patient has been identified as dying a ‘do not resuscitate order’ should be placed on
his/her chart.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
9. Nurses play a key role in helping patients die in comfort.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
10. Comfort care for the dying patient should not replace routine nursing practice.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
11. I would not like to care for a dying patient.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
12. Comfort care will enhance the dying patient’s quality.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
13. Specialist palliative care teams are never necessary to deal with a dying patient.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
14. Symptom control for the dying patient is not the nurse’s responsibility.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
15. When nursing a dying patient, it is a good practice, when possible, to frequently ask them
about symptom control
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
16. Symptom control guidelines are necessary for delivering optimal end-of-life care.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
17. Nurses cannot manage symptom control in during phase.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
18. The dying patient’s physical needs should be decided by them when possible.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
19. Dignity of a patient is not more important that effective care.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
20. Administration of opioids by means of a syringe driver is often essential measure n
symptom control.
Strongly Slightly Slightly Strongly
Disagree Agree
Disagree Disagree Agree Agree
SCORING KEY:
All scores will be added together. The following marks are given for each item:
Value
Strongly Disagree 1
Disagree 2
Slightly Disagree 3
Slightly Agree 4
Agree 5
Strongly Agree 6
INTERPRETATION OF SCORE:
Score of 20-40 Nurse’s attitude towards patient’s comfort in the dying phase is very poor.
Score of 41-60 Nurse’s attitude towards patient’s comfort in the dying phase is poor.
Score of 61-80 Nurse’s attitude towards patient’s comfort in the dying phase is fair.
Score of 81-100 Nurse’s attitude towards patient’s comfort in the dying phase is good.
Score of 101-120 Nurse’s attitude towards patient’s comfort in the dying phase is excellent.
Part B: Knowledge Questionnaire
Directions: Please answer all the following questions by ticking the appropriate box to indicate
the answer you consider to be correct. Tick one box only.
1. The decision that a patient is dying should be made by a multidisciplinary team.
Correct Incorrect
2. There is a need for specialist palliative care teams to be involved with every dying patient.
Correct Incorrect
3. The dying person should not be allowed to make decisions about his/her physical care.
Correct Incorrect
4. Treatment procedures should be continued even when the patient is dying.
Correct Incorrect
5. Routine nursing practice should not take precedence over a patient’s comfort.
Correct Incorrect
6. Dehydration is a normal part of the dying process.
Correct Incorrect
7. Frequent repositioning of a dying patient is not always desirable.
Correct Incorrect
8. When a patient is diagnosed as dying current medication should be reassessed and non-
essentials discontinued.
Correct Incorrect
9. Use of opioids is appropriate to control pain for the dying patient.
Correct Incorrect
10. Symptoms of increased chest secretions and terminal agitation are unavoidable in dying
patients.
Correct Incorrect
11. Regulation of bowel movements is often a problem for a dying patient.
Correct Incorrect
12. Retention of urine is more likely than urine incontinence in the dying patient.
Correct Incorrect
13. All dying patients will be at high risk of skin breakdown.
Correct Incorrect
14. Breathless is a common symptom in the dying phase.
Correct Incorrect
15. General comfort care should not take precedence over skin care.
Correct Incorrect
16. Maintaining a fluid balance record for the dying patient is important.
Correct Incorrect
17. The dying patient should not be coaxed to eat.
Correct Incorrect
18. It is appropriate to control pain in the dying phase by use of both analgesia and sedation.
Correct Incorrect
19. An acute episode in a chronically ill patient may represent a terminal event.
Correct Incorrect
20. Reducing the respiratory rate can relieve breathlessness for the dying patient by reducing
anxiety.
Correct Incorrect
INTERPRETATION OF RESULT:
The frequency of a particular response to a question will be calculated as a percentage
and the data will be illustrated using tables and bar charts. Tables facilitate presentation of large
amounts of data and bar charts give a clear picture of results with a sense of proportion. For part
B, central tendency of the data will be calculated using the mean response and the normal
distribution around the mean.
The number of “Correct” responses implies how knowledgeable and experienced the
nurses are in the comfort care of the dying respectively.
On the other hand, the number of “incorrect” responses implies that respondents are
uncertain, not fully knowledgeable, and not completely experienced in the comfort care of the
patients.
Part C: Experience survey
Section 1
Please answer each question by ticking the appropriate box.
1. Please indicate your number of years nursing experience.
1-5 years 5-10 years 10-15 years 15-20 years >20 years
2. Have you received pre-registration education in end-of-life care?
Yes No
3. Have you received post-registration education in end-of-life care?
Yes No
Section 2
The following section concerns your experience in delivering comfort care to dying patients.
Please indicate your answer to the question by placing a number in the box which corresponds to
your experience (see answer guide).
Answer guide
0 never
1 1– 5 times
2 5–10 times
3 10–15 times
4 15– 20 times
5 > 20 times
Score
I have been present as a nurse when a patient has died.
I have been in charge of nursing care for a dying patient.
I have used an integrated care pathway for end-of-life care.
I have been part of an interdisciplinary team that identified a patient as dying.
I have collaborated with an interdisciplinary team in delivering end-of-life care for
a dying patient.
I have nursed a dying patient with a do not resuscitate order.
I have set up a syringe driver for subcutaneous administration of anticipatory
prescribed medications to a dying patient.
I have administered prescribed opiate drugs to a dying patient to control pain.
I have administered prescribed drugs to a dying patient to control respiratory
secretions.
I have administered prescribed drugs to a dying patient to control breathlessness.
I have been involved in cessation of artificial hydration for a dying patient.
I have been involved in cessation of artificial feeding for a dying patient
I have dealt with nausea and vomiting episodes for a dying patient.
I have managed constipation problems for a dying patient.
I have inserted a urinary catheter to manage urine retention for a dying patient.
When caring for a dying patient I have been involved making the decision to cease
routine care and focus on comfort care.
I have managed physical comfort measures for a dying patient with the provision
of an air mattress.
I have discussed the prognosis of dying with a patient in the dying phase
I have acted as advocate for a dying patient when he/she needed their wishes to be
heard regarding treatment.
I have negotiated a cessation of diagnostic interventions for a dying patient
TOTAL
TOTAL IMPLICATIONS
80-100 The nurse has a very high experience in delivering comfort care to dying patients
60-80 The nurse has a high experience in delivering comfort care to dying patients
40-60 The nurse has a moderate experience in delivering comfort care to dying patients
20-40 The nurse has a low experience in delivering comfort care to dying patients
0-20 The nurse has a very low experience in delivering comfort care to dying patients
Section 2: INTERPRETATION OF TOTAL SCORE:
