Perinatal palliative care (PPC) is an emerging model of care that provides supportive services to families anticipating fetal or neonatal demise. Clinician reported practice barriers, their perspectives of PPC and confidence in caring for patients requiring PPC are unknown. The aim of this research is to fill a gap in understanding clinician perspectives, perceived practice barriers and reported confidence to providing PPC. A cross sectional survey design using the Perinatal Palliative Care Perceptions and Barriers Scale© was administered using a Web-based tool. Recruitment was completed via email invitation and list serves. Participants included physicians (n = 66) and advance practice nurses (n = 146). T-test and Mann-Whitney U were used to examine differences in perceived practice barriers, clinician perspectives, comfort and confidence in delivering PPC. Hierarchical multiple regression was used to test the hypothesis that clinician perceptions, barriers to PPC, years in clinician practice, referral comfort and personal comfort and case history explain variation in confidence. Physicians and nurses have fundamentally similar perspectives but report significant differences in perceived practice barriers, their comfort with providing and referring patients to PPC and their confidence in delivering such care. A significant regression equation with an overall R2 of .56 explained variation in confidence. Palliative care involves physicians and nurses making synergistic contributions to the care of families expecting a baby with a life-limiting diagnosis. Clinicians are positioned to collaboratively develop PPC programs and can benefit from interventions aimed at modifying practice environments. Supportive interventions and educational initiatives may increase clinician comfort and confidence with palliative care delivery.
Date of publication
Wool, Charlotte, "Perinatal Palliative Care: Assessment of Practice Barriers, Clinician Perspectives and Confidence" (2011). Nursing Theses and Dissertations. Paper 23.