title: Barriers of Palliative Care in Neonatal Intensive Care Units.
abstract: OBJECTIVE
  Neonatal nurses face numerous barriers in providing end-of-life (EOL) care for neonates and their families. Addressing neonatal nurses' attitudes could provide insight into barriers that impede neonatal palliative care (NPC). This study thus conducted to examine neonatal nurses' attitude toward barriers in providing NPC in Southeast Iran.
  
  
  METHODS
  In this cross-sectional study, a translated modified version of Neonatal Palliative Care Attitude Scale was used to examine attitudes of 70 nurses toward barriers of palliative care in 3 neonatal intensive care units in Southeast Iran.
  
  
  RESULTS
  Findings indicated that overall 42.63% of nurses were strongly agreed or agreed with the proposed barriers in NPC. Among all categories, the highest and the lowest scores belonged to the categories of "insufficient resources" (3.42 ± 0.65) and "inappropriate personal and social attitudes" (2.33 ± 0.48), respectively. Neonatal nurses who had less education and study regarding NPC reported the presence of more barriers to NPC in the categories of "inappropriate organizational culture" and/or "inadequate nursing proficiency." Also, younger nurses had more positive attitudes toward the category of inappropriate organizational culture as being a barrier to provision of NPC (4.62).
  
  
  CONCLUSIONS
  The findings suggest that developing a context-based instrument is required to represent the barrier more precisely. Neonatal palliative care can be improved by establishing a special environment to focus on infants' EOL care. This establishment requires standard palliative care guidelines and adequate NPC-trained nurses.
authors.affiliation: 1 Neuroscience Research Center, Institute of Neuropharmacology, University of Medical Sciences, Kerman, Iran.
authors.forename: Mansooreh
authors.initials: M
authors.lastname: Azzizadeh Forouzi
authors.affiliation: 2 Razi Faculty of Nursing and Midwifery, Kerman Medical University, Kerman, Iran.
authors.forename: Marjan
authors.initials: M
authors.lastname: Banazadeh
authors.affiliation: 2 Razi Faculty of Nursing and Midwifery, Kerman Medical University, Kerman, Iran.
authors.forename: Jila Soltan
authors.initials: JS
authors.lastname: Ahmadi
authors.affiliation: 2 Razi Faculty of Nursing and Midwifery, Kerman Medical University, Kerman, Iran.
authors.forename: Farideh
authors.initials: F
authors.lastname: Razban
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D007492:Iran; D007514:Islam; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology*; D015279:Organizational Culture; D010166:Palliative Care / Q000523:psychology*; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D013727:Terminal Care / Q000523:psychology*
keywords: Southeast Iran; attitude; barriers; neonatal intensive care units; neonatal nurses; neonatal palliative care