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Research Article Palliative Medicine & Care: Open Access Open Access

Palliative Care Practice and Associated Factors among

Nurses Working in Jimma University Medical Center
South-West Ethiopia, 2017
Temamen Tesfaye1*, Yeamanuelwork Anbessie2 and Admasu Belay Gizaw3
1
Jimma University, Institute of Health, School of Nursing and Midwifery, Ethiopia.
2
Jimma University Medical Centre, Ethiopia.
3
Jimma University School of Nursing and Midwifery, Ethiopia.

Received: June 20, 2018; Accepted: July 19, 2018; Published: July 27, 2018

*Corresponding author: Temamen Tesfaye Yunka, Jimma University School of Nursing and Midwifery; P.O. Box: 378 Ethiopia. Fax: 0471-
11-14-50; Tel: +251913153299, 2514711112213; Email: tekanetesfu@gmail.com

Abstract and relief of suffering by means of early identification and

impeccable assessment and treatment of pain and other health
Background: Palliative care is an approach that improves the
problems [1]. Evidence shows that palliative care is effective in
quality of life of patients and their families facing problem associated
chronic and with life threatening illness. Since Nurses are pivotal improving the Quality of Life by meeting the needs of people with
role players in providing palliative care, identifying their level of life threatening illness and their families [1, 2].
knowledge, attitude and practice is very crucial. Conversely, there
According to the World health organization estimation, by 2020
is paucity of information on palliative care practice and associated
factors in the study area. non-communicable disease will be prevalent as communicable
diseases in developing countries especially in sub-Saharan Africa.
Objective: This study aimed to assess palliative care practice and This is an indicator for increased need in palliative care service.
associated factors among nurses working in Jimma University Medical
Despite the needs of palliative care and documented evidence of
Center south-west Ethiopia.
palliative care in improving the quality of life, the development
Methods: Institution based cross-sectional study was conducted and access to comprehensive, integrated palliative care service
among 243 nurses. The study participants were selected using simple
remains limited in most developing countries. Consequently, only
random sampling method and data was collected using structured
self-administrated questionnaires. Descriptive, Bivariate and
few countries in SSA have integrated the new concept of palliative
Multivariable logistic regression analyses were performed. Statistical care into their agenda and currently palliative care provision
level of significance was declared at P<0.05. remains inadequate and available to less than 5% [3- 7].
Results: A total of 237 nurses were responded correctly and The implementation of palliative care is a global health
yielding a response rate of 97.5%. Around two third [65.8%] of the challenge especially in developing countries because; the service
study participants had poor palliative care practices. Age, clinical area, is isolated in majorities of African countries, scattered in scope,
years of experience, monthly income and level of knowledge about
not well supported, heavily donor dependent, had unclear policies,
palliative care services significantly associated with overall palliative
care practices. limited healthcare resource, Role unfamiliarity, poor perception,
low level of practice and low knowledge about benefits by service
Conclusion: Almost two third of the nurses had poor palliative users, health care workers and supporting community [8-12].
care practices. Age, clinical area, years of experience, monthly income
and level of knowledge about palliative care services are significantly There are also insufficient government policies recognizing
associated with overall palliative care practice. Thus, efforts should palliative care as an essential component of healthcare, inadequate
be made in designing and providing short and long term training for training for healthcare professionals and limited awareness
nurses on palliative care practices.
among the general public about palliative care. Moreover, there
Keywords: Palliative care; Nurses; End-of life care; Chronic are limited studies in the area of patients palliative care needs
illness; Jimma. which will support to provide appropriate care. Hence, palliative
care needs are often under-assessed and addressed. As a result, up
to 80% of pain is under-treated and about two-thirds of palliative
Background
care needs are missed. Addressing physical, emotional, social and
Palliative care is a holistic approach that improves the quality spiritual needs and supporting people to achieve a sense of peace
of life of patients and their families facing the problem associated and meanings of life and prevention of end-of-life sufferings are
with chronic and life-threatening illness, through the prevention unthinkable without integration of pallative care[13- 17].

Symbiosis Group *Corresponding author email: tekanetesfu@gmail.com

Palliative Care Practice and Associated Factors among Nurses Working in Copyright:
© 2018 Temamen T, et al.
Jimma University Medical Center South-West Ethiopia, 2017

Study conducted in different countries showed that nurses Unfavorable attitude = < 50% of the total score of [FATCOD] Scale.
had poor knowledge and practice towards palliative care
Good practice = ≥75% response of nurses from a total practice
services, while they had favourable attitude [18, 19]. Sex, years of
questions.
experience, working units and training were predicting variables
of practice of palliative care [18, 20, 21]. Poor practice = <75% response of nurses from a total practice
questions.
The most recent information on nursing posts in different
country showed that palliative care & life-threatening illness Data Processing and Analysis
mainly relies on nurses. Knowledge, attitude and practice
The completed questionnaires were checked for
towards palliative care is critical among health care professionals
inconsistencies and missed values before data entry. Data
mainly among nurses. Therefore, this study focuses on assessing
analysis was made using SPSS version 21.0 software. Descriptive
palliative care practice level and associated factors among nurses
statistics, Binary and Multivariable logistic regression analysis
working at Jimma University Medical centre.
were done to describe and identify factors affecting palliative
Methods and Materials care practice among nurses.
Study Area, Period and Design Ethical Consideration
The study was conducted in Jimma University Medical center Ethical clearance letter was obtained from institutional
from April 1-5, 2017 found in Jimma town at South-West of review board [IRB] of Jimma University. Study participants were
Ethiopia. It has a total bed capacity around 555 with nearly 1600 briefed about the study and oral consent were obtained and they
hospital staffs. Institution based cross-sectional study design was are informed that participating in this study was fully voluntary.
employed. In addition, confidentiality of the information was assured.
Sample Size and Sampling Technique Results
A total of 243 nurses were selected from 523 nurses by simple Socio-Demographic Characteristics
random sampling method from different working units.
From total of 243 randomly selected nurses, 237 (97.5%)
Data Collection Tools and Procedure questionnaires were returned. More than half 124 (52.3%) of
respondents were females and 105 (44.3%) were between the
The data collection instrument included four sections. Section
age group of 26-30 years. Almost half 119 (50.2) nurses were
one: A socio demographic variables. Section two comprised
married and 103 (43.5 %) were followers of orthodox religion.
knowledge questions which taken from the Palliative Care
The qualification of respondents showed that 127 (53.6%) had
Knowledge Test [PCKT] using questions with Yes or No answers.
Bachelor of Science (BSc) in nursing and 151 (63.7%) of them
The third section included attitude questions, which adapted
had less than or equal to five years of work experience. About one
from Frommelt Attitude toward Care of the Dying [FATCOD]
fourth 60 (25.3%) of nurses earn monthly salary between 3001-
questionnaire. It has a 5 point Likert scale. The last section had
4000 Ethiopian birr and 41 (17.3%) of nurses working in surgical
8 practical questions which the researchers constructed from
unit. More than half 133 (56.1%) of nurse had no any training
guidelines and various literatures related to palliative care
related to palliative care and 104 (43.9%) of them had less than
practice. [18, 24].
or equal to two years’ experience in caring terminal ill patients
A Pre-test was conducted on 24 nurses at Limmu Genet (Table 1).
district hospital in Jimma Zone to check clarity of data collection
tools. Based on the result of pretest, necessary modification was
Nurses’ Knowledge towards Palliative Care
done [before pretest the attitude part was measured through One hundred thirty eight (58.2%) of nurses were believed
the original FATCOD questionnaire which consists of 30 items. that palliative care should only be provided for patient who has
However, after pretest the questionnaires were reduced to 17 curative treatment available. More than two third 165 (69.6%)
items because some of the questions were difficult to understand of nurses said that getting spiritual support important to
and increase bulkiness of the questioner]. Data was collected by terminally ill patients and 173 (73%) of them believe that family
three trained MSc nursing students and they were facilitated the involvement in any aspect of patient care is part of palliative
data collection procedure. care. More than three fourth 185(78.1%) of nurse thought that
manifestation of chronic pain is different from those of acute pain
Operational Definition [18]
and 125 (52.7%) of them understood that palliative care service
Good knowledge = ≥75% of total score of the Palliative Care extending after mortal care (Table 2). Overall level of knowledge
knowledge test [PCKT] scale showed that majority 127 (53.6%) of nurses working in Jimma
University medical center had Poor knowledge and 110 (46.4%)
Poor knowledge = < 75% of total score of the Palliative Care
had Good knowledge about palliative care services (Figure 1).
knowledge test [PCKT] scale.
Favorable attitude = ≥ 50 of the total score of [FATCOD] Scale.

Citation: Temamen T, Anbessie Y Gizaw AB (2018) Palliative Care Practice and Associated Factors among Nurses Working in Jimma Page 2 of 8
University Medical Center South-West Ethiopia, 2017. Palliat Med Care 5(3): 1-8.
DOI: http://dx.doi.org/10.15226/2374-8362/5/3/00160
Palliative Care Practice and Associated Factors among Nurses Working in Copyright:
© 2018 Temamen T, et al.
Jimma University Medical Center South-West Ethiopia, 2017

Table 1: Socio-demographic characteristics of nurses working at

Others (psychiatry, OR*, ICU*) 33 13.9
Jimma University Medical center, April 2017 (n= 237)
Socio-demographic Characteristics n % Training on palliative care

Sex Yes 104 43.9

Male 113 47.7 No 133 56.1
Female 124 52.3
Experience in caring terminal ill patients
Age in years
20-25 96 40.5 <2 104 43.9
26-30 105 44.3 5-Mar 69 29.1
31-40 27 11.4 >6 26 11
>41 9 3.8 Don’t have 38 16
Marital Status *Eth. Birr: Ethiopian birr, MCH: Maternal and child health, OPD:
Married 119 50.2 Outpatient department, OR:Operation room, ICU: Intensive care Unit.
Single 106 44.7
Divorced 6 2.5 Table 2: Distribution of knowledge variables towards palliative care
Widowed 6 2.5 services among nurses working at Jimma University Medical center,
Religion April 2017 (n= 237)

Orthodox 103 43.5

Variables Response n %
Muslim 68 28.7
Palliative care should only be
Protestant 56 23.6 Yes 138 58.2
provided for patient who has on
Others (Catholic, Wake feta) 10 4.2
curative treatment available No 99 41.8
Qualification
Diploma in Nursing 106 44.7 Long term use of Morphine can Yes 132 55.7
B. Sc in Nursing 127 53.6 induce addiction
MSc in Nursing 4 1.7 No 105 44.3

Work experience Adjuvant therapies are important in

Yes 191 80.6
<5 years 151 63.7 Managing pain

6-10 years 60 25.3   No 46 19.4

11-15 years 10 4.2 Getting Spiritual support is Yes 165 69.6

16 years and above 16 6.8 important to terminally ill patient
No 72 30.4
Monthly salary (Eth. Birr*)
2000-3000 48 20.3 Morphine should be used to relieve Yes 127 53.6

3001-4000 60 25.3 Dyspnea in cancer patient

No 110 46.4
4001-5000 58 24.5
Respiratory desperation will be Yes 129 54.4
5001-6000 21 8.9
common when Opioids are taken No 108 45.6
>6001 50 21.1
Palliative care Service extending Yes 125 52.7
Clinical area/Working units
after mortar care No 112 47.3
Surgical ward 41 17.3
Medical ward 24 10.1 Benzodiazepines should be effective Yes 124 52.3

MCH* 33 13.9 for controlling delirium No 113 47.7

Pediatrics ward 36 15.2 Some dying patient will require Yes 148 62.4
Chronic Illness clinic 15 6.3 continuous sedation to alleviate
Maternity ward 32 13.5 suffering No 89 37.6

OPD* 23 9.7

Citation: Temamen T, Anbessie Y Gizaw AB (2018) Palliative Care Practice and Associated Factors among Nurses Working in Jimma Page 3 of 8
University Medical Center South-West Ethiopia, 2017. Palliat Med Care 5(3): 1-8.
DOI: http://dx.doi.org/10.15226/2374-8362/5/3/00160
Palliative Care Practice and Associated Factors among Nurses Working in Copyright:
© 2018 Temamen T, et al.
Jimma University Medical Center South-West Ethiopia, 2017

Family involvement in patient care Yes 173 73

is part of palliative care No 64 27

Higher calorie intake needed Yes 157 66.2

terminal stage of cancer
No 80 33.8

Manifestation of chronic pain Yes 185 78.1

different from those of acute pain No 52 21.9

Terminally ill patient encourage Yes 146 61.6

having hope against all odd
No 91 38.4
Figure 1: Overall level of knowledge of nurses working at Jimma Uni-
Attitude towards Palliative Care versity Medical center, April 2017 (n= 237)

From the total study participants 96(40.5%) were agreed should be concerned about helping their dying member make
that giving care to the dying person is a worthwhile experience. the best of his/her remaining life and 56 (23.6%) rejected the
One hundred two (43%) of nurses agreed that caring for the dying person should not allowed to make decisions about his/her
patient’s family should continue throughout the period of grief physical care (Table 3).
and bereavement. About 73(30.8%) of the respondents strongly In summary, more than three fourth 188(79.3%) of nurses
disagree with the idea that they wouldn’t want to give care for had favorable attitude towards palliative care services (Figure 2).
the dying person. On another hand 104 (43.9%) agreed families

Table 3: Distribution of Nurses’ attitude towards palliative care at Jimma University medical center, April 2017
Statement SDN (%) D N (%) UN (%) A N (%) SA N (%)
Giving care to the dying person a Worthwhile
60(25.3) 31(13.1) 21(8.9) 96(40.5) 29(12.2)
experience
Death is not the worst thing that can happen
51(21.5) 51(21.5) 26(11.0) 80(33.8) 29(12.2)
to a person
I would be uncomfortable talking about
41(17.3) 44(18.6) 42(17.7) 85(35.9) 25(10.5)
impending death with dying person
Nursing caring for the patient’s family should
continue throughout the period of grief and 33(13.9) 32(13.5) 40(16.9) 102(43.0) 30(12.7)
bereavement

I wouldn’t want to care for dying person 73(30.8) 59(24.9) 32(13.5) 53(22.4) 20(8.4)

The non-family care giver shouldn’t be the one

48(20.3) 39(16.5) 56(23.6) 75(31.6) 19(8.0)
to talk about death with the dying person
I would be upset when the dying person I was
52(21.9) 40(16.9) 44(18.6) 86(36.3) 15(6.3)
caring for gave up hope of getting better
There are time when dying person welcomes
29(12.2) 39(16.5) 60(25.3) 83(35.0) 26(11.0)
death
When a patient asks, “Am I dying?” I think
it is best to change the subject to something 39(16.4) 27(11.4) 54(22.8) 85(35.9) 32(13.5)
cheerful
The family involved in the physical care of the
23(9.7) 36(15.2) 55(23.2) 98(41.4) 25(10.5)
dying person
I would hope the person I ‘am caring for dies
41(17.3) 47(19.8) 58(24.5) 70(29.5) 21(8.9)
when I am not present

Citation: Temamen T, Anbessie Y Gizaw AB (2018) Palliative Care Practice and Associated Factors among Nurses Working in Jimma Page 4 of 8
University Medical Center South-West Ethiopia, 2017. Palliat Med Care 5(3): 1-8.
DOI: http://dx.doi.org/10.15226/2374-8362/5/3/00160
Palliative Care Practice and Associated Factors among Nurses Working in Copyright:
© 2018 Temamen T, et al.
Jimma University Medical Center South-West Ethiopia, 2017

I am afraid to become friends with the dying

62(26.2) 43(18.1) 55(23.2) 71(30.0) 6(2.5)
person
Families need emotional support to accept the
34(14.3) 22(9.3) 43(18.1) 102(43.0) 36(15.2)
behavior changes of the dying person
Families should be concerned about helping
their dying member make the best of his/her 32(13.5) 29(12.2) 32(13.5) 104(43.9) 40(16.9)
remaining life
The dying person should not allowed to make
52(21.9) 56(23.6) 46(19.4) 68(28.7) 15(6.3)
decisions about his/her physical care
It is beneficial for the dying person to verbalize
24(10.1) 42(17.7) 37(15.6) 105(44.3) 29(12.2)
his/ her feeling
Addiction to pain reliving medication should
37(15.6) 36(15.2) 42(17.7) 97(40.9) 25(10.5)
be dealing with patient
N: Number, SD: Strongly disagree, D: Disagree, U: Uncertain, A: Agree & SA: Strongly agree

of them gave great emphasis on psychological aspect and 135

(57%) of the study participants perceived terminally ill patients
concern as their right. Concerning decision making, 136 (57.4%)
of the respondents revealed that they were comprises patients
idea and 47 (19.8%) involves family members in decision making.
Regarding cultural assessment during patient care
203(85.7%) of the participant were included languages and
family communication and 162 (68.4%) of the nurses reported as
they listen patients with empathy when addressing the spiritual
issue. Around half 115 (48.5%) of the respondents used morphine
commonly for treatment of severe pain (Table 4).

Table 4: Palliative care practice among nurses working at Jimma

Figure 2: Overall nurses attitudes towards palliative care at Jimma Uni-
versity Medical center, April 2017. University medical center, 2017.
Variables Response Number Percent
Practices towards Palliative Care
During diagnosis 121 51.1
Almost two third (65.8 %) of the study participants had Time of initiation When the
poor practice towards palliative care (Figure 3). More than half 94 39.7
pallaitive care problem progress
121 (51.1%) of the nurses initiate palliative care discussion
with patients during diagnosis of patients. Regarding factors discussion At the end of the
43 18.1
considered during dealing with terminal ill patients, 208 (87.8%) life
Cultural 176 74.3
Factors considered
Psychological 208 87.8
when dealing with
Medical 171 72.2
terminal ill patients
Social 169 71.3
Listen with
162 68.2
emphathy
Impose owen
134 56.5
Things considered view

before addressing the Understand

151 63.7
spritual issue patients reaction

Connect
with spritual 143 60.3
Figure 3: Overall level of practice towards palliative care among nurses
working at Jimma University Medical center, April 2017 (n= 237). counselor

Citation: Temamen T, Anbessie Y Gizaw AB (2018) Palliative Care Practice and Associated Factors among Nurses Working in Jimma Page 5 of 8
University Medical Center South-West Ethiopia, 2017. Palliat Med Care 5(3): 1-8.
DOI: http://dx.doi.org/10.15226/2374-8362/5/3/00160
Palliative Care Practice and Associated Factors among Nurses Working in Copyright:
© 2018 Temamen T, et al.
Jimma University Medical Center South-West Ethiopia, 2017

Dietary MCH 0.027 0.268 (0.083, 0.864)

196 82.7
preference Pediatrics   0.565(0.174, 1.831)
Chronic illness 0.02 0.166 (0.036, 0.757)
Language, family
Cultural assessment 203 85.7 Maternity   0.527 (0.159, 1.742)
communication
during patient care OPD   0.458 (0.127, 1.659)
Others
Perspective on 0.03 0.276 (0.086, 0.886)
(psychiatry, OR, ICU)
death suffering 174 73.4
Years of experience
and grieving
>15   1
Emotional
179 75.5 <5   1.889 (0.952, 3. 748)
Addressing the support
psychological aspect 5-10 0.013 4.344 (1.367, 13.806)
Counselling the
of the patient during 158 66.7 11-15   4.271 (0.989, 18.806)
patient
giving pallaitive care Monthly salary (Eth. birr)
Hiding the teruth 168 70.9 >6001   1

Patient 136 57.4 2000-3000 0.005 3.633 (1.463, 9.022)

Family 47 19.8 3001-4000 0.023 2.867 (1.157, 7.101)

Whom do you involve
My own 13 5.5 4001-5000   1.375 (0.446, 4.241)
in decission making?
Other 5001-6000   2.564 (0.99, 6.639)
41 17.3
professionals level of Knowledge among nurses
Patient right 135 57 Poor knowledge   1
Needing Good Knowledge 0.005 0.422 (0.233, 0.766)
55 23.1
treatment *AOR: Adjusted Odds Ratio
Percetion for
Doubting your
terminally ill patients 3 1.3 Factors Affecting Palliative Care Practice
professinalism
concern
Findings of this study revealed age, Clinical area/working unit,
Attention seeking years of experience, monthly salary and level of knowledge are
44 18.6
behaviour identified as factors associated with practice towards palliative
care among nurses.
Paracetamol 67 28.3 Those study participants who were age between 26-30 years
Commony used are 5.5 times more likely had poor practice towards palliative
medication for severe Morphine 115 48.5 care with adjusted odds ratio (AOR) of 5.549 at 95%CI (1.323,
pain 23.275) as compared to those age >41 years. Nurses who are
Petidine 28 11.8
working in maternal and child health, chronic illness clinic OR,
Codein 27 11.4 ICU and psychiatry unit were 73.2%, 83.4% and 72.4% less likely
Table 5: Adjusted logistic regression model showing predictors of
had poor practice towards palliative care with AOR of 0.268 at
95%CI (0.083, 0.864), 0.166 at 95%CI (0.036, 0.757) and 0.276
palliative care practice among nurses working in Jimma University
at 95%CI (0.086, 0.886) respectively.
medical center, April 2017.
Nurses with five to ten years experiences were 4.3 times more
Predicting Variable P- Value AOR* (95% CI)
likely had poor palliative care practice with AOR of 4.34 at 95%CI
Age in years (1.37, 13.8) when compare to those greater than fifteen years of
>41   1 experiences. Nurses who earns monthly salary of 2000-3000 and
20-25   0.745(0.383, 1. 452)
3001-4000 were 3.6 and 2.9 times more likely had poor practice
towards palliative care with AOR of 3.633 at 95%CI (1.463, 9.022)
26-30 0.019 5.549 (1.323, 23.275) and 2.867 at 95%CI (1.157, 7.101) respectively. Nurses who had
31-40   0.448 (0.087, 2.296) good knowledge on palliative care services were 57.8% less
Clinical area likely to have poor palliative care practice as compared to good
knowledge with AOR of 0.422 at 95%CI (0.233, 0.766).
Surgical   1
Medical   0.785 (0.213, 2.899)

Citation: Temamen T, Anbessie Y Gizaw AB (2018) Palliative Care Practice and Associated Factors among Nurses Working in Jimma Page 6 of 8
University Medical Center South-West Ethiopia, 2017. Palliat Med Care 5(3): 1-8.
DOI: http://dx.doi.org/10.15226/2374-8362/5/3/00160
Palliative Care Practice and Associated Factors among Nurses Working in Copyright:
© 2018 Temamen T, et al.
Jimma University Medical Center South-West Ethiopia, 2017

Discussion likely had poor practice towards palliative care compared to

surgical ward. The probable reason for this might be due to
Nurses’ level of knowledge, attitude and practice towards nurses working in these units might had frequent contact with
palliative care is cornerstone for better management and care of chronically and terminally patients and they developed better
patient with chronic life-threatening illness. Less involvement of experience in caring these types of cases.
nurses in palliative care practice increases end of life suffering
and despair of patients with chronic life-threatening illness. Nurses who had five to ten years of experiences were four
Hence, this study assessed the level of palliative care practice and times more likely had poor palliative care practice compare to
associated factors among nurses. those greater than fifteen years of experience. This is consistent
with study done in Egypt [20]. The possible justification for this
In overall, 46.4 % of nurses had good knowledge towards might be nurses with extended years of experiences had better
palliative care services. This is indicates more than half of nurses knowledge, confidence and more familiar in caring of terminal ill
are not equipped with adequate knowledge and information patients. Those nurses who earns monthly income of 2000-3000
about palliative care service which will contribute to poor and 3001-4000 were almost four and three times more likely had
practice, assessment and under-addressing of palliative care poor practice towards palliative care as compared to those nurses
needs, increased health care cost and end of life suffering. This who earn greater than or equal to 6001 respectively. This might
finding is higher than the findings of studies conducted in Egypt be related to those nurses who earn better monthly income were
[20] and Addis Ababa [18]. Time difference among studies might more satisfied by their salary and motivated in caring chronically
be contributed for this result. However, it is lower than the finding and terminal ill patients. Nurses who had good knowledge on
of study in Greek [21] where nurses had better knowledge about palliative care were 57.8% less likely to have poor palliative care
palliative care. This might be due to socio-economic status and practice. This might be because of knowledge about palliative
organizational policies and access of training on the palliative. care is basis for practice and those who knows on how to care
The current study revealed that 79.3 % of nurses had these kind of patients had better skill.
favorable attitudes towards palliative care services. This finding As a conclusion, almost two-third of the study participants
is consistent with studies done in Iran [22] and India [19]. had poor practice towards palliative care. Age, working unit,
Conversely, this finding is higher than study conducted in Addis years of experience, monthly salary and level of knowledge about
Ababa [18] which revealed that 76% of respondents had favorable palliative care services had strongly associated with practice
attitude towards palliative care services. This difference might be of palliative care. Knowledge and experience about palliative
due to better awareness about palliative care and end of life care. care play important role for better attitude and practice of
Concerning palliative care practice, 65.8% of nurses had palliative care. Therefore, the study findings recommended
poor practice towards palliative care. It could be related to that efforts should be made in designing and providing short
poor awareness, health care management systems and little and long term training for nurses on palliative care services. It
integration of palliative care services with regular health care also recommended that to include palliative care part in the
services in Ethiopia. This finding is lower than study conducted curriculum of nursing education.
in Egypt [20] and Addis Ababa [18] which is 76.6% and 76.2%
Limitations
respectively. The difference might be due to sample size, study
period, health care policy and awareness level. Nurses who were The study did not include the primary health settings and
participated on this study had better knowledge about palliative private clinics. Due to this reason comparison between public
care services as compared to nurses in Egypt and Addis Ababa. and private clinic was not performed. Scarcity of similar studies
The findings of this study showed that half of respondents conducted in Ethiopia makes the comparison and discussion
initiating palliative care discussion during diagnosis of patients. It challenging.
is almost consistence with study done in Addis Ababa [18]. More
Authors’ Contribution
than two-third of study participants addressed the psychological
issue of patients by hiding the truth. This finding is lower than Yeamanuelwork Anbessie planned the study, involved in
study conducted in Addis Ababa, but higher than study done in data collection, prepared the first draft proposal and paper,
Norway [23], where the nurses believed that lying about patients’
Temamen Tesfaye contributed to the study conception and
diagnosis and treatment is unethical.
design, supervised the study and conducted data analysis.
Age, working unit, years of experience, monthly salary and
Admasu Belay, contributed on data analysis, supervised the
level of knowledge were identified as factors that significantly
study, critically revised the manuscript.
associated with palliative care practice among nurses in this
study. Those study participants who were age between 26-30 Funding/Support
years are 5.5 times more likely had poor practice compared to
Jimma university covered the survey cost and support
those age >41 years. This indicates; as the age of nurse’s increase,
necessary stationary.
the experiences of applying palliative care components might
be enhanced. The study also showed that nurses working in
the chronic illness clinic and ICU were 83.4% and 72.4% less

Citation: Temamen T, Anbessie Y Gizaw AB (2018) Palliative Care Practice and Associated Factors among Nurses Working in Jimma Page 7 of 8
University Medical Center South-West Ethiopia, 2017. Palliat Med Care 5(3): 1-8.
DOI: http://dx.doi.org/10.15226/2374-8362/5/3/00160
Palliative Care Practice and Associated Factors among Nurses Working in Copyright:
© 2018 Temamen T, et al.
Jimma University Medical Center South-West Ethiopia, 2017

Acknowledgement 13. R Harding, D Karus, P Easterbrook, V Raveis, I Higginson, K Marconi.

Does Palliative Care Improve Outcomes for Patients with HIV/AIDS?
The authors are grateful to Jimma University for providing
A Systematic Review of the Evidence. Sex Transm Infect. 2005;
necessary financial and material support for this study. We would
81(1): 5–14. DOI: 10.1136/sti.2004.010132
also like to thank data collectors, supervisors and friends. At
14. Family health International. Palliative care strategy for HIV and
last but not the least, our heartfelt thanks also goes to all study
participants. other disease; 2009.
15. Harding R, Powell RA, Downing J, Connor SR, Mwangi-Powell
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Citation: Temamen T, Anbessie Y Gizaw AB (2018) Palliative Care Practice and Associated Factors among Nurses Working in Jimma Page 8 of 8
University Medical Center South-West Ethiopia, 2017. Palliat Med Care 5(3): 1-8.
DOI: http://dx.doi.org/10.15226/2374-8362/5/3/00160