Nurses' communication difficulties when providing end-of-life care in the oncology setting: a cross-sectional study

Purpose To (1) examine the communication difficulties nurses experience when providing end-of-life (EOL) care, (2) establish the correlation between communication difficulties across various stakeholders and (3) determine the impact sociodemographic factors has on the communication difficulties experienced. Methods 124/178 (69.7%) nurses from oncology wards of a tertiary hospital were recruited. Sociodemographic survey and three validated subscales: Communication with Patient and Family (CPF), Explanation to Family (EF) and Reassessment of Current Treatment and Nursing Care (RCTNC) were used to collect the data. Data were analysed with Independent SamplesTtest, One-Way Analysis of Variance and Pearson's correlation coefficient. Results Mean score was highest for CPF (8.75 +/- 2.24) and lowest for RCTNC (6.32 +/- 2.26). Positive correlations were found between CPF with EF (r= 0.613,p< 0.001), CPF with RCTNC (r= 0.243,p= 0.007) and EF with RCTNC (r= 0.370,p< 0.001). Age (p= 0.048), years of experience (p= 0.001), religion (p= 0.034) and EOL care training received (p= 0.040) were significant factors for CPF subscale while age (p= 0.011), years of experience (p= 0.001), educational qualification (p= 0.003) and EOL care training received (p= 0.026) were the significant factors for EF subscale. Conclusion Nurses experienced more communication difficulties with patients and families than with the healthcare team. When nurses experience communication difficulties with the healthcare team, they also tend to experience communication difficulties with patients and families and when providing explanations to families. Nurses experienced greater communication difficulties when they are younger, are non-graduates, have less years of experience, adopted a religion or did not receive training in EOL care.