Effects of educational intervention on nurses' knowledge, attitudes, and behavioral intentions toward supplying artificial nutrition and hydration to terminal cancer patients

Support Care Cancer. 2008 Nov;16(11):1265-72. doi: 10.1007/s00520-008-0426-0. Epub 2008 Mar 12.


Introduction: This study aimed to investigate the effects of educational intervention on nurses' knowledge, attitudes, and behavioral intentions regarding supplying artificial nutrition and hydration (ANH) to terminal cancer patients.

Materials and methods: A quasi-experimental design was adopted. A structured questionnaire evaluated the effects of educational intervention. From April to June 2005, 88 nurses were enrolled in the gastroenterology, general surgery, and intensive care unit of Taipei Veterans General Hospital in Taiwan. The nurses were randomly assigned into experimental and control groups in equal numbers (44 nurses in each group). After the experimental and control groups completed the pretest, the experimental group participated in a 50-min lecture. Both groups received a post-test 2 weeks after the lecture.

Results: This study showed that prior to educational intervention, nurses have possessed experiences of ANH use in routine caring for terminal cancer patients. However, due to the lack of knowledge about supplying ANH to terminal cancer patients, the nurses trended toward the negative behavioral intention, although they realized the burdens of ANH in these patients. After educational intervention, mean scores of knowledge, attitudes and behavioral intentions of the experimental group increased significantly (z = -5.255, p < 0.001; t = -5.191, p < 0.001; z = -3.274, p <== 0.001). Mean score changes of knowledge and attitude between these two groups reached significant differences (t = -7.306, p < 0.001; t = -4.165, p < 0.001), but no significant difference was observed in the mean score change of behavioral intention (z = -1.943, p > 0.05).

Conclusion: The educational intervention remarkably improved nurses' knowledge and attitudes regarding supplying terminal cancer patients with ANH. As for the changes in the behavioral intentions, it requires long-term moral and ethical training and communication. The results of this research emphasized the importance of educational interventions, which should be considered seriously in future reference nursing education program.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Educational Measurement
  • Educational Status
  • Female
  • Fluid Therapy* / standards
  • Health Behavior
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Neoplasms / nursing*
  • Neoplasms / psychology
  • Nurses / psychology*
  • Nutritional Support* / standards
  • Program Evaluation / statistics & numerical data*
  • Surveys and Questionnaires
  • Terminal Care / methods*
  • Terminal Care / standards