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The knowledge and attitudes of Flemish geriatric nurses regarding tiredness of life (ToL) and euthanasia: a survey study

Nele Van Den Noortgate (UGent) , Liesbeth Van Humbeeck (UGent) , Let Dillen (UGent) and Ruth Piers (UGent)
(2019)
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Abstract
Background: The prevalence of death wishes increases with age from 6.4% in 80-years old to 13.4% in 90-years old. Nurses frequently encounter euthanasia requests in older persons being tired of life (ToL), although euthanasia is not legalized for this indication in Belgian law. This study aimed to explore the knowledge and attitudes of Flemish nurses regarding euthanasia and tiredness of life. Methods: A survey, consisting of four case vignettes and five multiple choice questions, was send to nurses employed in acute (2 hospital wards) and chronic care setting (1 nursing home and 1 home care organisation). Results: A sample of 151 nurses (92.7% female, median age 42 years) was obtained. Nurses in chronic care were significantly more confronted with tiredness of life (n=76; 32% at least once a week) than nurses in acute care (n=75; 20%) (p=0.02). For the majority the definition of tiredness of life remained unclear. Respondents disagreed on the necessity of having a terminal, life-limiting illness and the absence of depressive symptoms as preconditions of ToL. The mean knowledge score was 62.1% ± 24.4 in chronic care and 73.6% ± 21.6 in acute care (p=0.01). Although 79.5% of the nurses was aware of the fact that euthanasia was legally not an option, 43 % would agree upon the act. No significant differences were noticed between settings and level of education. Discussion: Euthanasia law is rather well known among Flemish nurses. However, a discrepancy is noticed between their actual knowledge of the illegality and their positive attitude to proceed to euthanasia in older people experiencing ToL. Individual and team-based reflexivity on the meaning of good care in case of ToL seems crucial. Conclusion: Physicians should be aware of this attitude of nurses and enhance ongoing interdisciplinary discussion on this topic. More education is needed on this topic.

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Chicago
Van Den Noortgate, Nele, Liesbeth Van Humbeeck, Let Dillen, and Ruth Piers. 2019. “The Knowledge and Attitudes of Flemish Geriatric Nurses Regarding Tiredness of Life (ToL) and Euthanasia: a Survey Study.” In .
APA
Van Den Noortgate, N., Van Humbeeck, L., Dillen, L., & Piers, R. (2019). The knowledge and attitudes of Flemish geriatric nurses regarding tiredness of life (ToL) and euthanasia: a survey study. Presented at the CARE4 International Scientific Nursing and Midwifery Congress, Third Edition.
Vancouver
1.
Van Den Noortgate N, Van Humbeeck L, Dillen L, Piers R. The knowledge and attitudes of Flemish geriatric nurses regarding tiredness of life (ToL) and euthanasia: a survey study. 2019.
MLA
Van Den Noortgate, Nele et al. “The Knowledge and Attitudes of Flemish Geriatric Nurses Regarding Tiredness of Life (ToL) and Euthanasia: a Survey Study.” 2019. Print.
@inproceedings{8599682,
  abstract     = {Background: The prevalence of death wishes increases with age from 6.4\% in 80-years old to 13.4\% in 90-years old. Nurses frequently encounter euthanasia requests in older persons being tired of life (ToL), although euthanasia is not legalized for this indication in Belgian law. This study aimed to explore the knowledge and attitudes of Flemish nurses regarding euthanasia and tiredness of life.
Methods: A survey, consisting of four case vignettes and five multiple choice questions, was send to nurses employed in acute (2 hospital wards) and chronic care setting (1 nursing home and 1 home care organisation).
Results: A sample of 151 nurses (92.7\% female, median age 42 years) was obtained. Nurses in chronic care were significantly more confronted with tiredness of life (n=76; 32\% at least once a week) than nurses in acute care (n=75; 20\%) (p=0.02). For the majority the definition of tiredness of life remained unclear. Respondents disagreed on the necessity of having a terminal, life-limiting illness and the absence of depressive symptoms as preconditions of ToL. The mean knowledge score was 62.1\% {\textpm} 24.4 in chronic care and 73.6\% {\textpm} 21.6 in acute care (p=0.01). Although 79.5\% of the nurses was aware of the fact that euthanasia was legally not an option, 43 \% would agree upon the act. No significant differences were noticed between settings and level of education.
Discussion: Euthanasia law is rather well known among Flemish nurses. However, a discrepancy is noticed between their actual knowledge of the illegality and their positive attitude to proceed to euthanasia in older people experiencing ToL. Individual and team-based reflexivity on the meaning of good care in case of ToL seems crucial.
Conclusion: Physicians should be aware of this attitude of nurses and enhance ongoing interdisciplinary discussion on this topic. More education is needed on this topic.},
  author       = {Van Den Noortgate, Nele and Van Humbeeck, Liesbeth and Dillen, Let and Piers, Ruth},
  language     = {eng},
  location     = {Leuven},
  title        = {The knowledge and attitudes of Flemish geriatric nurses regarding tiredness of life (ToL) and euthanasia: a survey study},
  year         = {2019},
}