title: Modelling end-of-life care practices: Factors associated with critical care nurse engagement in care provision.
abstract: OBJECTIVE
  To identify factors associated with critical care nurses' engagement in end-of-life care practices.
  
  
  METHODS
  Multivariable regression modelling was undertaken on 392 responses to an online self-report survey of end-of-life care practices and factors influencing practice by Australian critical care nurses'. Univariate general linear models were built for six end-of-life care practice areas.
  
  
  RESULTS
  Six statistically significant (p<0.001) models were developed: Information sharing F(3, 377)=40.53, adjusted R(2) 23.8%; Environmental modification F(5, 380)=19.55, adjusted R(2) 19.4%; Emotional support F(10, 366)=12.10, adjusted R(2) 22.8%; Patient and family centred decision making F(8, 362)=17.61 adjusted R(2) 26.4%; Symptom management F(8, 376)=7.10, adjusted R(2) 11.3%; and Spiritual support F(9, 367)=14.66, adjusted R(2) 24.6%. Stronger agreement with values consistent with a palliative approach, and greater support for patient and family preferences were associated with higher levels of engagement in end-of-life care practices. Higher levels of preparedness and access to opportunities for knowledge acquisition were associated with engagement in the interpersonal practices of patient and family centred decision making and emotional support.
  
  
  CONCLUSIONS
  This study provides evidence for interventions to address factors associated with nurse engagement to increase participation in all end-of-life care practice areas.
authors: Disciplines of Nursing & Midwifery, Faculty of Health, University of Canberra, Canberra, Australia. Electronic address: Kristen.Ranse@canberra.edu.au.
authors: Kristen
authors: K
authors: Ranse
authors: School of Nursing & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
authors: Patsy
authors: P
authors: Yates
authors: School of Nursing & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
authors: Fiona
authors: F
authors: Coyer
mesh_terms: D001291:Attitude of Health Personnel; D064648:Critical Care Nursing; D006801:Humans; D016294:Models, Nursing; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000379:methods*
keywords: Critical care; End-of-life care; Factors; Intensive care; Nursing; Survey