Assessing Palliative Care Nursing Knowledge In Macau SAR: A Cross-Sectional Study With Implications For The Greater Bay Area During The Covid-19 Pandemic

Abstract

Background: The COVID-19 pandemic exposed critical gaps in palliative care knowledge among nurses globally. In the unique context of the Guangdong-Hong Kong-Macau Greater Bay Area (GBA), where healthcare integration is a key goal, ensuring consistent palliative care standards is essential. This study aimed to assess the prevalence of palliative care knowledge deficits among clinical nurses in Macau SAR during the pandemic and to identify predictors of knowledge to inform regional policy.

Methods: A quantitative, cross-sectional study was conducted with a sample of 282 clinical nurses from the public sector in Macau SAR between June and August 2021. Data were collected using a secure online questionnaire, which included demographic variables and the validated Palliative Care Quiz for Nursing (PCQN). Data were analyzed using descriptive and inferential statistics with SPSS 26.

Results: The overall mean correct answer rate on the PCQN was 65.07%. Knowledge deficits were most significant in the domains of palliative care philosophy (45.21% correct) and psychosocial support (45.15%). In contrast, knowledge was highest in pain and symptom management (75.78%). Bivariate analysis showed that older age, senior professional rank, longer palliative care nursing experience, and prior palliative care training or clinical experience were all significantly associated with higher knowledge scores (p < .05).

Conclusion: Clinical nurses in Macau possess moderate but incomplete knowledge of palliative care, with significant gaps in the philosophical and psychosocial domains. To meet the post-pandemic challenges and the ambitions for regional integration within the GBA, it is necessary to implement standardized, mandatory palliative care education. This training must be holistic, integrating lessons from the COVID-19 pandemic to ensure nurses can provide comprehensive and compassionate end-of-life care across the region.