Table 1.
Factor arrays for the Q-statements
| Q-statements | Factor arrays | |||
|---|---|---|---|---|
| I | II | III | IV | |
| 1. I think it is important to provide education for both patients and relevant people around them since the patients may not be able to do things alone in the future. | 1** | 4 | 4 | -1** |
| 2. I dress patients’ wounds focusing on how they will look when they die, rather than trying to improve the state of the wounds. | 2* | 3 | −2** | 3 |
| 3. For managing patient wounds, I prioritize my treatment with strategies from guidelines or research that has been proven to be effective, and I believe these methods are effective. | −4** | 0** | 2** | 4** |
| 4. I believe that it is important to seek feedback by patients on the effectiveness of the strategy rather than stopping at the intervention. | 4** | −1 | 0* | −2 |
| 5. I believe that no two patients share the same pathological condition, and that it is important to find and apply methods that fit the patient. | 4** | −1** | 1 | 1 |
| 6. I choose treatment strategies based on the symptom relief strategies that I have used before with other patients. | 3** | −1 | 0** | −2 |
| 7. I do not believe that the recommendations concerning the risk and effectiveness of topical drugs are significant in treating pain from wounds, as they change often. | −4** | 0 | −1 | −3** |
| 8. To alleviate pain, I use thicker dressing products that can reduce pressure rather than drugs that can further deteriorate conditions. | 0* | −1 | −1 | 2* |
| 9. I recommend using systemic painkillers whose effects are quick and definitive. | −3 | 1 | 1 | −3 |
| 10. I believe the higher priority is to follow the patient’s wishes to extend or shorten dressing changes to manage exudate or pain. | 3** | −2 | −2 | −1 |
| 11. I believe that there are limitations for me in controlling pain through dressings or topical measures and recommend visiting the pain clinic. | −2** | 1* | 2* | 0** |
| 12. I have experienced nutritional problems in patients reaching the terminal stage of their lives and therefore consult with the nutritional department to manage their nutrition. | 0 | 1 | 3** | −2** |
| 13. I recommend connecting with home caregivers to facilitate consistency in care as patients often need to stay home since it is hard for them to come to the hospital frequently. | 0 | 2* | 3** | 1 |
| 14. I believe that recommending and connecting patients with routes of care in advance are important in ensuring they receive care easily rather than connecting them when their situation has worsened. | 0** | 4 | 3 | 2* |
| 15. I believe that care from non-medical professionals, such as physical therapists and social workers, is more important in palliative wound care at the end of the patient’s life. | 0 | 0 | 0 | 0 |
| 16. I think there are limitations to what I can do for patients as a wound care nurse since there will be more important things than wound. | −1** | 2** | −2 | −4 |
| 17. I ponder on methods that patients or caregiver can use to deal with dressings, as they may ultimately be done at home or in nursing homes. | 1 | 3 | 4 | 1 |
| 18. I find it very difficult to listen to patients and guardians asking how they can be cured when the patients cannot be cured. | −1 | 3** | −1 | 0* |
| 19. I avoid patients and guardians asking about treatment progress because I do not like talking about negative situations to patients. | −1 | 2 | −1 | 1 |
| 20. I believe that dressings are not an important part of the final journey of the patient and make treatment-focused choices by considering the patient’s financial situation. | 2** | −1 | 0* | −2 |
| 21. I choose treatment methodologies as long as the patient’s mind is put at ease by choosing what the patients or their caregivers want. | 3 | −2* | −3* | 0* |
| 22. I believe that the patient must know about their situation accurately to be able to mentally prepare themselves. | −2** | −4 | 1** | 3** |
| 23. When my opinions and the patient’s differ, I invite sufficient dialogue before making a decision rather | 2** | 0 | −1 | −1 |
| 24. If the patients have the wrong information about a treatment, I believe that they should be presented with the correct information. | −3* | −2* | 0** | 4** |
| 25. I believe that giving false hope to patients and caregivers is not helpful and let them know that what does not work, does not work. | −2 | −3 | 1** | 2** |
| 26. Prior to setting objectives, I believe that the patients and caregivers must be provided with detailed explanations and sufficient time rather than scaring them with negative aspects. | 1 | 0* | 1 | −1* |
| 27. I prioritize the patients’ opinions over the caregivers’, provided that the patient is conscious, as it is a choice that they make for the last part of their lives. | 1** | −3 | −3 | −4* |
| 28. I cannot feel a sense of achievement with patients receiving palliative wound care | −1** | 1** | −4 | −3 |
| 29. Rather than presenting solutions to terminal stage patients, I believe that it is better for the patients’ stability to listen to their stories | 2** | 0 | 0 | −1 |
| 30. I believe that professional treatment is necessary for psychological stability and recommend referral to a psychiatric clinic. | −2** | 0* | 2* | 1* |
| 31. I believe that the patient should regard the disease and wound process directly and accept it for their own psychological stability. | −3** | −4** | 2** | 3** |
| 32. I try to avoid saying hopeful things, as they may grow more anxious if they develop hope and then are disappointed. | −1** | 1** | −3** | 0** |
| 33. I try to tell them things that may provide them with positive strength, such as compliments for their current behavior. | 1 | −3** | 0 | 0 |
| 34. I try to do my best in treating patients so that I do not regret it after they die. | 0** | 2* | −2** | 2* |
| 35. I tell the patients that not being cured is not always unfortunate. | 0 | −2 | −4 | 0 |
* P < 0.05, ** P < 0.01