Table 2.
Factor structure of the new factor solution
| Main component |
| 1 Preparation to provide palliative care |
| 1. Care for patients at the end of life. |
| 2. Breaking bad news to a patient about his or her illness. |
| 3. Managing patients’ emotional suffering at the end of life. |
| 4. Discussing end-of-life care decisions, such as a DNRb order, with a patient. |
| 5. Managing ethical issues that arise in caring for patients near the end of life. |
| 6. Helping family members during bereavement. |
| 7. Discussing spiritual issues. |
| 8. Discussing patient/ family psychosocial needs and concerns. |
| 9. Addressing cultural differences related to end-of-life care. |
| 10. Addressing age-related developmental differences in end-of-life care. |
| 11. Responding to a patient’s question “Will I suffer much or have pain?”. |
| 12. Your ability to determine patients’ needs. |
| 13. Physicians have an obligation to tell patients when death is imminent. |
| 2 Attitudes towards palliative care |
| 1. There is little that can be done to ease the suffering of grief.c |
| 2. The physician/nurse has a responsibility to provide bereavement care to the patient’s family after death. |
| 3. It is not possible to tell patients the truth about a terminal prognosis and maintain hope.c |
| 4. Psychological suffering can be as severe as physical suffering. |
| 5. At their request, patients with terminal illnesses should be given whatever medications are necessary to relieve pain, even if the medications hasten death. |
| 6. Talking about death tends to make patients with terminal illnesses more discouraged.c |
| 7. Depression is not treatable in patients with terminal illnesses.c |
| 8. The physician’s/nurse’s responsibility is to the patient; other professionals should deal with the needs of the family.c |
| 9. Physicians/nurses have a responsibility to help patients prepare for death. |
| 10. An interdisciplinary team approach to terminal illness treats patients’ medical needs better than conventional care. |
| 3 Self-estimation of competence in communication with dying patients and their relatives |
| 1. Depression is normal in patients with terminal illness. |
| 2. Family members tend to interfere in the care of patients with terminal illnesses.c |
| 3. Discussing possible symptoms of an incurable illness with patients. |
| 4. Discussing possible symptoms of an incurable illness with the family. |
| 5. Discussing death with patients. |
| 6. Discussing the nearby death of patients with the family. |
| 7. Discussing with the family after patients’ death. |
| 8. Responding to a patient’s question “How long do I still have to live?”. |
| 4 Self-estimation of knowledge and skills in palliative care |
| 1. Managing pain in terminal illness. |
| 2. Managing dyspnea or respiratory distress in terminal illness. |
| 3. Your knowledge concerning the aetiology of palliative patients’ frequent symptoms. |
| 4. Your ability to manage palliative patients’ frequent symptoms. |
| 5. Your knowledge concerning the therapeutic and adverse effects of analgetics. |
bDNR =do not resuscitate
creversed item