Nurses' and physicians' opinions on end-of-life: a secondary analysis from an Italian cross-sectional study

Ann Ig. 2020 May-Jun;32(3):274-284. doi: 10.7416/ai.2020.2350.

Abstract

Background: In daily clinical practice, healthcare workers face end-of-life issues, such as futility, which is generally defined as the provision of treatments that do not produce any meaningful benefit for patients.

Study design: To investigate the end-of-life issues according to Italian nurses' and physicians' opinions and to detect any differences between them, a secondary analysis of existing data from a cross-sectional study was conducted.

Methods: A validated questionnaire was used involving 351 nurses and 128 physicians from four hospitals in Central Italy.

Results: Regarding the definition of futility, nurses mainly focused on agony, suffering, and risks, while physicians paid more attention to the hope of healing. Nevertheless, both were distressed by different aspects of the treatments; in particular, nurses by the 'invasiveness of the treatments' and physicians by the 'over-medicalization of death'. Instead, nurses and physicians similarly recognized patients' right to seek to anticipate the end of life when they are terminally-ill and to express freely their desire not to be revived.

Conclusions: The description of experiences and opinions of health professionals could represent a valid basis to develop a 'regulatory system' aimed to guide and support daily clinical and nursing activities.

Keywords: End of life care; Ethics; Futility; Nurses; Physicians; Terminal care.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Attitude to Health*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Nurses / psychology*
  • Physicians / psychology*
  • Terminal Care*
  • Young Adult