Associations of Life-Sustaining Treatment–Related Knowledge, Role Perception, and Nursing Stress with End-of-Life Nursing Care Performance among Intensive Care Unit Nurses

Background: This study examined the associations of intensive care unit (ICU) nurses’ knowledge of life-sustaining treatment (LST), role perception regarding LST, and nursing stress related to LST with their performance of end-of-life nursing care.Methods: A total of 179 ICU nurses from tertiary general hospitals participated in this descriptive correlational study. Data were collected using structured self-administered questionnaires. The data were analyzed using the independent t-test, one-way ANOVA, Mann–Whitney U-test, Kruskal–Wallis test, Pearson’s correlation coefficient, and multiple regression analysis, employing IBM SPSS version 28.0.Results: The performance of end-of-life nursing care was significantly higher among nurses with 5 to <7 years (β=0.17, P=0.032) and ≥7 years (β=0.20, P=0.011) of total clinical experience, as well as those who had performed end-of-life nursing care 20 times or more (β=0.17, P=0.014). Higher role perception regarding LST (β=0.27, P<0.001) and lower nursing stress related to LST (β=–0.41, P<0.001) were also associated with better performance. These variables explained 31.3% of the variance in end-of-life nursing care performance.Conclusions: These findings suggest that tailored educational and support programs based on clinical experience and care exposure may be helpful for supporting end-of-life nursing care performance among ICU nurses. In particular, role perception regarding LST and nursing stress related to LST may be important considerations when designing strategies to support the quality of end-of-life nursing care. Such strategies may also contribute to patient dignity and family-centered supportive care in ICU end-of-life situations.