Conceptual Framework Bloom’s Taxonomy (1964) was used as a guideline to this study. Bloom (1964) identified three domains of educational activities, which are cognitive, affective, and psychomotor. The cognitive domain related to mental skill (Knowledge), the affective domain was defined as growth in feelings or emotional areas (Attitude), and the psychomotor domain related to manual or physical skills (Skills or Doing). Researchers often refer to these domains as KAS, SKA, or KSA, where ‘K’ being Knowledge, ‘A’ being Attitude, and ‘S’ being Skills. Bloom’s taxonomy of learning behaviors can be applied as “the goals of the training process.” That is, after the training session, the learner should gain these new skills, knowledge, or attitudes. Knowledge and attitude of the individuals usually differ according to age, training experience, and caring experience. These factors lead the person’s difference in knowledge background, limitation of knowledge, and accuracy of knowledge. Hence, the individuals interpreted the values and meanings of things differently, and for this reason, the individuals think, feel and make decisions in a unique way. The Copyright by Mahidol University attitude and caring behavior of a person also differ as a result of individual differences related to these factors. Therefore, the researcher eventually generates the conceptual model using in this study as shown in Figure 1.
Knowledge of end of life care
Demographic variables
- Age
- Year of nursing experience Caring behavior
- The training experience of end of life care
- Experience in taking care of their own EOL family members
- The number of end of life patients
Attitude toward end of life care
Purposes of the Study The purposes of this research study are as follows: 1. To explore the knowledge, attitude, and caring behavior of professional nurses related to end of life care. 2. To examine the relationships among the knowledge, attitude, and caring behavior of professional nurses related to end of life care. 3. To examine the relationships of age, year of nursing experience, the number of end of life patients with knowledge, attitude, and caring behavior of professional nurses related to end of life care. 4. To compare the differences in knowledge, attitude, and caring behavior of professional nurses related to end of life care based on the training experience and experience in taking care of their own EOL family members. Copyright by Mahidol University
Research Questions 1. What are the level of knowledge, attitude, and caring behavior of professional nurses related to end of life care in governmental hospitals, Bangkok? 2. Are there any relationships among knowledge, attitude, and caring behavior of professional nurses related to end of life care in governmental hospitals, Bangkok? 3. Are there any relationships among ages, year of nursing experience, and the number of end of life patients with knowledge, attitude, and caring behavior of professional nurses related to end of life care in governmental hospitals, Bangkok? 4. Are there any differences in knowledge, attitude, and caring behavior of professional nurses related to end of life care in governmental hospitals, Bangkok based on the training experience and experience in taking care of their own EOL family members?
Research Hypotheses 1. There is a relationship between knowledge and attitude of professional nurses related to end of life care in governmental hospitals, Bangkok. 2. There is a relationship between knowledge and caring behavior of professional nurses related to end of life care in governmental hospitals, Bangkok. 3. There is a relationship between attitude and caring behavior of professional nurses related to end of life care in governmental hospitals, Bangkok. 4. There are relationships among ages, year of nursing experience, and the number of end of life patients with knowledge, attitude, and caring behavior of professional nurses related to end of life care in governmental hospitals, Bangkok. 5. There are differences in knowledge, attitude, and caring behavior related to end of life care of professional nurses having different training experience and experience in taking care of their own EOL family members.
Scope of the Study This is a descriptive correlation study research. The aims of this study are to determine the relationships among knowledge, attitude and caring behavior of professional nurses related to end of life care. The target group is professional nurses having caring experience for end of life patients of at least one patient with a minimum of one year nursing experience in governmental hospitals, Bangkok who have been working in the medical, surgical or pediatric ward, including intensive care units and general wards at Ramathibodi Hospital, Ratchavithi Hospital and BMA Medical College & Vajira Hospital. Self-administered questionnaires were used to conduct the research wherein the data were collected during March - April 2005.
Benefits of the Study The research results shall provide information related to recent knowledge, attitude, and caring behavior of professional nurses for EOLC which is useful for appropriate planning and essential training program for professional nurses in providing effective EOLC to patients and their families. Moreover, the results of this research serve as a preliminary step for further study in the area of EOLC.
Definition of Terms For the purposes of this study, the following terms were defined: 1. End of life patient refers to the hospitalized persons who are diagnosed with advanced disease or terminally ill or no curative treatments. The patients with seriously illness, multiple organs failure and severe risk to die at all times were included. 2. Professional nurse refers to the registered nurse having a bachelor’s degree in nursing who has worked as a professional nurse at least one year in medical, surgical, or pediatric ward in governmental hospitals, Bangkok. 3. Caring for end of life patient refers to the nursing activities provided to the end of life patients and their families; including medical and other supportive care (such as observe, care, consult, advise, teach, relieve suffering or pain, and provide psychological support), to promote the quality of life until death and help the EOL patients to cope and die in peace. 4. Knowledge of end of life care refers to memory, recall, and understanding about fact, rule, and theory in nursing for end of life care including physical, psychological, emotional, social, and spiritual aspects. 5. Attitude toward end of life care refers to feeling or belief of professional nurse in providing end of life care to patients. 6. Caring behavior of end of life care refers to action or performance of professional nurse in providing end of life care to patients. 7. Age refers to the number of full years of professional nurse. 8. Year of nursing experience refers to the number of full years in nursing practice from the commencement of the professional nurse career until present. 9. The training experience refers to the continuing studies to maintain or improve the knowledge and understanding in providing end of life care to patients. 10. The number of end of life patients refers to end of life patients whom professional nurses provided care within the last year. 11. Experience in taking care of their own EOL family members refers to nurses’ knowledge and skills gain from taking care of their EOL family members