Correlation of sociodemographic parameters with nurses' attitudes about opiophobia and thanatophobia
Main Article Content
Abstract
Introduction. Pain is one of the most common symptoms encountered by patients with palliative needs, and since it affects the patient's quality of life, it is the most necessary to alleviate or eliminate it in order to improve the quality of the remaining life of the patient and his family. The basis of the treatment of any pain in palliative care is the application of non-pharmacological procedures and appropriate pharmacotherapy. Among a certain number of medical personnel, there is a fear of the consequences when using opioids, which often leads to their reduced use in practice. The term opiophobia is often associated with the term thanatophobia, which also affects the work of medical staff. In order to treat the pain as best as possible, it is necessary to examine the presence of these fears and to educate about them.
Aims. The aim of this research work was to determine the attitudes of nurses in the Department for extended treatment and palliative care Novi Marof towards opiophobia and thanatophobia.
Methods. The conducted research is of cross-sectional type. An anonymous paper-pencil survey was used in the research and was intended exclusively for nurses of the Service for extended treatment and palliative care in Novi Marof/Croatia. A total of 72 nurses participated. In the first part of the survey, the sociodemographic data of the respondents was collected, and in the second part, the expression of opiophobia and tanatophobia was examined using declarative claims to which the participants responded according to the Likert scale. Based on the collected data, appropriate statistical analyses were performed using the IBM SPSS Statistics 25 program (SPSS Inc., Chicago, IL, USA).
Results. Nurses, regardless of their workplace, years of service or level of education, have equally present thanatophobia. There is a difference with opiophobia, for those nurses who working the Department of Palliative Care, they show more affirmative attitudes towards the use opioids compared to other departments. Similarly, nurses with longer working experience show more affirmative attitudes compared to employees with shorter working experience.
Conclusion. The attitudes of nurses towards opiophobia and thanatophobia have a significant impact on patient care. Addressing these attitudes and providing education and support to nursing staff can improve the quality of care provided to patients in pain and those requiring end-of-life care.
Article Details
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References
https://www.who.int/news-room/fact-sheets/detail/palliative-care
2. Demuro M, Bratzu E, Lorrai S, Preti A. Quality of Life in Palliative Care: A Systematic Meta-Review of Reviews and Meta-Analyses . Clin Pract Epidemiol Ment Health, 2024;20:e17450179183857.
doi. http://dx.doi.org/10.2174/0117450179183857240226094258
3. McCaffrey N, Bradley S, Ratcliffe J, Currow DC. What aspects of quality of life are important from palliative care patients’ perspectives? A systematic review of qualitative research. J Pain Symptom Manage. 2016;52(2):318-328.e5.
4. Wang CW, Chow AYM, Chan CLW. The effects of life review interventions on spiritual well-being, psychological distress, and quality of life in patients with terminal or advanced cancer: A systematic review and meta-analysis of randomized controlled trials. Palliat Med. 2017;31(10):883-94.
5. Kassianos AP, Ioannou M, Koutsantoni M, Charalambous H. The impact of specialized palliative care on cancer patients’ health-related quality of life: A systematic review and meta-analysis. Support Care Cancer. 2018;26(1):61-79.
6. Gaertner J, Siemens W, Meerpohl JJ, et al. Effect of specialist palliative care services on quality of life in adults with advanced incurable illness in hospital, hospice, or community settings: systematic review and meta-analysis. BMJ. 2017;357:j2925.
7. Schüchen RH, Mücke M, Marinova M, et al. Systematic review and meta‐analysis on non‐opioid analgesics in palliative medicine. J Cachexia Sarcopenia Muscle. 2018;9(7):1235-54.
8. Jamison RN, Mao J. Opioid Analgesics. Mayo Clin Proc. 2015;90(7):957-68.
9. Cohen B, Ruth LJ, Preuss CV. Opioid Analgesics. [Updated 2023]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. Available: https://www.ncbi.nlm.nih.gov/books/NBK459161/
10. Trujillo KA. Opiophobia and the tragedy of needless pain: A call for education and balance.
Pharmacol Biochem Behav, 2023;230:173616
11. CDC Guideline for Prescribing Opioids for Chronic Pain. MMWR. 2016; 65(1): 1–49.
12. Dowell D, Haegerich T, Chou R. No shortcuts to safer opioid prescribing. N. Engl. J. Med. 2019; 380:2285-2287.
13. Webster F, Bremner S, Oosenbrug E, Durant S, McCartney CJ, Katz J. From Opiophobia to Overprescribing: A Critical Scoping Review of Medical Education Training for Chronic Pain. Pain Med. 2017;18(8):1467-1475. doi: 10.1093/pm/pnw 352. PMID: 28371881; PMCID: PMC5914373.
14. Balasubramanian C, Subramanian M, Balasubramanian S, Agrawal A, Raveendran S, Kaliaperumal C. "Thanatophobia": Physician's perspective of dealing with patients with fear of death. J Nat Sci Biol Med. 2018;9(1):103-104.
15. Fulton JJ, Newins AR, Porter LS, Ramos K. Psychotherapy targeting depression and anxiety for use in palliative care: A meta-analysis. J Palliat Med. 2018;21(7):1024-37.
16. Kavalieratos D, Corbelli J, Zhang D, et al. Association between palliative care and patient and caregiver outcomes. JAMA. 2016;316(20): 2104-14.
17. Guerrero-Torrelles M, Monforte-Royo C, Rodríguez-Prat A, Porta-Sales J, Balaguer A. Understanding meaning in life interventions in patients with advanced disease: A systematic review and realist synthesis. Palliat Med. 2017;31(9):798-813.
18. Lau J, Mazzotta P, Fazelzad R, Ryan S, Tedesco A, Smith AJ, Sud A, Furlan AD, Zimmermann C. Assessment tools for problematic opioid use in palliative care: A scoping review. Palliat Med. 2021;35:1295-1322. doi: 10.1177/0269216321101 5567. Epub 2021 May 17. PMID: 34000897; PMCID: PMC8267087.
19. Guo Q, Zheng R. Assessing oncology nurses' attitudes towards death and the prevalence of burnout: A cross-sectional study. Eur J Oncol Nurs. 2019;42:69-75. doi: 10.1016/j.ejon.2019.08.002. Epub 2019 Aug 5. PMID: 31446266.
20. Yılmaz İ, Akansel N. The Turkish form of psychometric properties of opioids questionnaire. Agri. 2022;34(2):117-130.
21. Barnett M, Mulvenon C, Dalrymple PA. Nurses' knowledge, attitudes, and practice patterns regarding titration of opioid infusions at the end of life. JHPN. 2010;12(2):81-88.
22. Guest C, Sobotka F, Karavasopoulou A, Ward S, Bantel C. Nurses and opioids: results of a bi-national survey on mental models regarding opioid administration in hospitals. J Pain Res. 2017;10: 481-493.
23. Uwera N. Nurses’ barriers and facilitators to management of pain in children in two selected referral hospitals in Rwanda [Doctoral dissertation, University of Rwanda]. 2022. www.ur.ac.rw
24. Baldemir R, Akçaboy EY, Noyan Ö, Çelik Ş, Akçaboy ZN. Nurses Attitudes Toward Opioid Using. Bozok Med J. 2019;9(4):6-14.
25. Theodosopoulou P, Moutafi M, Kalogridaki M, Tsiamis C, Rekatsina M, Pikoulis E. Acute Pain Management and Perceptions among Emergency Healthcare Workers: Feedback from Greece. Rom J Anaesth Intensive Care. 2023;29(1):22-31. doi: 10.2478/rjaic-2022-0004. PMID: 36844961; PMCID: PMC9949016.
26. Nguyen T, et al. Impact of a pharmacist-led palliative care education program focused on the appropriate use of opioids in Vietnam. Pharm Sci Asia. 2024;49(4): 340-348.
27. Salim NA, Joshua R, AbuBaker NA, Chehab F, Jose A. Effect of a nursing in-service education program on nurses’ knowledge and attitudes towards pain management in a governmental hospital in the United Arab Emirates: Experimental random assignment study. Dubai Med J. 2019;2:146–152.
28. Wells G, Llewellyn C, Hiersche A, Minton O, Wright J. Medical student anxiety in caring for dying patients and their family: a cross-sectional study. BMJ Support Palliat Care. 2023;7;13(e2): e278-e281. doi: 10.1136/bmjspcare-2021-003331. PMID: 34518284.
29. Peters L, et al. Emergency and palliative care nurses' levels of anxiety about death and coping with death: a questionnaire survey. Australas Emerg Nurs J. 2013;16(4):152-9. doi: 10.1016/j.aenj.201 3.08.001. Epub 2013 Sep 26. PMID: 24199900.
30. Cooper J, Barnett M. Aspectsofcaring for dyingpatientswhichcauseanxiety to firstyear student nurses. Int J Palliat Nurs. 2005;11(8):423-430.
31. Arbour RB, Wiegand DL. Self-described nursing responses experienced during care of dying patients and their families: A phenomenological study. JHPN. 2023;25(2):E49-E56.
32. Yazkan G, Ugurlu N, Birgili F. Investigation of nomophobia levels of nursing department students. EJONS Journal. 2022;6(21),118–128. doi. https://doi.org/10.38063/ejons.