Hubungan Pengetahuan dan Pelaksanaan End Of Life Care Pada Masa Pandemi Covid-19

Rahmi Muthia, Tiya Rama Fitri, Fitri Mailani, Elvi Oktarina, Emil Huriani


Background: During the Covid 19 pandemic, the need of care and the death rate of patients in the Intensive Care Unit (ICU) increased. So that nurses are required to to integrate the implementation of end of life care (EOLC) in end of life (EOL) patients. However, the implementation of EOLC during the Covid 19 pandemic was vulnerable to obstacles. The implementation of EOLC treatment is influenced by knowledge. The purpose of this study was to see the relationship between knowledge and implementation of EOLC during the COVID-19 pandemic in the Intensive Care Unit room. Methods: This research is a descriptive correlation with a cross sectional approach. The research sample was 91 people, using a convenience sampling technique. This research was conducted in August-October 2022 with research respondents in intensive care nurses at the Hospital in Padang City who worked during the Covid 19 pandemic for at least 1 year. Data collection used Palliative Care Quiz for Nurse Indonesian Version (PCQN-I) and Self Reported Practice Checklist. Data analysis used fisher's exact test. Results: The results showed that nurses' EOLC knowledge was in the moderate category (82.4%) and the implementation of end of life care by nurses during the Covid 19 pandemic was in the high category (85.7%). Conclusion: There was no relationship between EOLC knowledge and EOLC implementation during the Covid 19 pandemic (p = 0.451). Hospital institutions are advised to facilitate the increase of end of life care knowledge in nurses so as to support optimal implementation.


Keywords: End of Life Care, Knowledge, Implementation, Nurse, Intensive Care Unit


End of Life Care, Pengetahuan, Implementasi, Perawat, Intensive Care Unit

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Arabi, Y. M., Azoulay, E., Al-Dorzi, H. M., Phua, J., Salluh, J., Binnie, A., ... & Citerio, G. (2021). How the COVID-19 pandemic will change the future of critical care. Intensive care medicine, 47(3), 282-291.

A’la, M. Z., Farikhah, Z., & Hakam, M. (2020). Nurses’ Attitude Toward End of Life Care in Emergency Departement and Intensive Care Unit In Rural Hospital. IJNP (Indonesian Journal of Nursing Practices), 4(1), 14–20.

Beneria, A., Castell-Panisello, E., Sorribes-Puertas, M., Forner-Puntonet, M., Serrat, L., García-González, S., ... & Ramos-Quiroga, J. A. (2021). End of Life Intervention Program During COVID-19 in Vall d'Hebron University Hospital. Frontiers in Psychiatry, 12.

Ben-Jacob, T. K., & Peterson, L. K. N. (2022). Drastic changes in the practice of end-of-life care during the COVID-19 pandemic. Journal of Critical Care, 67, 195-197.

Berlin, A. (2017). Goals of Care and End of Life in the ICU. Surgical Clinics of North America, 97(6), 1275–1290.

Bloomer, M. J., & Bouchoucha, S. (2020). COVID-19 and what it means for end-of-life care in ICU: Balancing the priorities. Collegian (Royal College of Nursing, Australia), 27(3), 248.

Chalk, D., Robbins, S., Kandasamy, R., Rush, K., Aggarwal, A., Sullivan, R., & Chamberlain, C. (2021). Modelling palliative and end-of-life resource requirements during COVID-19: implications for quality care. BMJ open, 11(5), e043795.

Chisbert-Alapont, E.; García-Salvador, I.; De La Ossa-Sendra, M.J.; García-Navarro, E.B.; De La Rica-Escuín, M. Influence of Palliative Care Training on Nurses’ Attitudes towards End-of-Life Care during the COVID-19 Pandemic in Spain. Int. J. Environ. Res. Public Health 2021, 18, 11249.

Connolly, M., Bell, M., Lawler, F., Timmins, F., & Ryder, M. (2021). Hospital-Based Palliative and End-of-Life Care in the COVID-19 Pandemic: A Scoping Review. American Journal of Hospice and Palliative Medicine®, 10499091211057049.

Crump, S. K., Schaffer, M. A., & Schulte, E. (2010). Critical Care Nurses’ Perceptions of Obstacles, Supports, and Knowledge Needed in Providing Quality End-of-Life Care. Dimensions of Critical Care Nursing, 29(6), 297–306. doi:10.1097/dcc.0b013e3181f0c43c

Dewhurst, F., Billett, H., Simkiss, L., Bryan, C., Barnsley, J., Charles, M., Fleming, E., Grieve, J., Hacking, S., Howorth, K., Huggin, A., Kavanagh, E., Kiltie, R., Lowery, L., Miller, D., Nicholson, A., Nicholson, L., Paxton, A., Porteous, A., … Frew, K. (2021). Multicenter Evaluation of 434 Hospital Deaths From COVID-19: How Can We Improve End-of-Life Care During a Pandemic? Journal of Pain and Symptom Management, 61(5), e7–e12.

Eleke, C., Azuonwu, G., Agu, I. S., Nnorom, R. M., Ogini, A. N., Eleke-Bempong, E., & Uzoma, R. A. (2020). Knowledge of palliative care among professional nurses in south east Nigeria: A needs assessment for continuing education. International Journal of Africa Nursing Sciences, 13(August), 100237.

Ersek, M., Smith, D., Griffin, H., Carpenter, J. G., Feder, S. L., Shreve, S. T., … Kutney-Lee, A. (2021). End-Of-Life Care in the Time of COVID-19: Communication Matters More Than Ever. Journal of Pain and Symptom Management, 62(2), 213–222.e2. doi:10.1016/j.jpainsymman.2020.12.024

Etafa, W., Wakuma, B., Fetensa, G., Tsegaye, R., Abdisa, E., Oluma, A., Tolossa, T., Mulisa, D., & Takele, T. (2020). Nurses’ Knowledge About Palliative Care And Attitude Towards End- of-life Care In Public Hospitals In Wollega Zones: A Multicenter Cross-Sectional Study. PLoS ONE, 15(10 October), 1–14.

Falcó‐Pegueroles, A., Zuriguel‐Pérez, E., Via‐Clavero, G., Bosch‐Alcaraz, A., & Bonetti, L. (2021). Ethical conflict during COVID‐19 pandemic: the case of Spanish and Italian intensive care units. International Nursing Review, 68(2), 181-188.

Fauziningtyas, R., Widowati, D. E. R., Indarwati, R., & Asmoro, C. P. (2020). Determinants of Knowledge and Attitude related to Palliative Care Nurses. International Journal of Psychosocial Rehabilitation, 24(7), 7554–7562.

Fleming, E., Dykes, G., Frew, K., & Snell, D. (2021). 7 Collaboration between palliative and critical care: a review of end of life care for patients with COVID-19 on the critical care unit. BMJ Supportive & Palliative Care, 11(Suppl 1), A10-A10.

Funk, D. C., Moss, A. H., & Speis, A. (2020). How COVID-19 Changed Advance Care Planning: Insights From the West Virginia Center for End-of-Life Care. Journal of Pain and Symptom Management, 60(6), e5–e9. doi:10.1016/j.jpainsymman.2020.09.021

Gaffney, M. K. (2015). Critical care nurses' perceptions of their knowledge and self-efficacy about providing end-of-life care (Doctoral dissertation, Walden University).

Hafifah, I., Isnawati, I., & Agustina, R. (2022). Analysis of Nurses’ Knowledge in the Implementation of End of Life Care in Intensive Care Units in Indonesia. KnE Life Sciences, 254–269.

Hanna, J. R., Rapa, E., Dalton, L. J., Hughes, R., Quarmby, L. M., McGlinchey, T., ... & Mason, S. R. (2021). Health and social care professionals’ experiences of providing end of life care during the COVID-19 pandemic: A qualitative study. Palliative Medicine, 02692163211017808.

Hamsani. (2020). Organizational Citizenship Behaviour di Bank Syariah. PT. Scopindo Media Pustaka.

Hendin, A., La Rivière, C. G., Williscroft, D. M., O’Connor, E., Hughes, J., & Fischer, L. M. (2020). End-of-life care in the Emergency Department for the patient imminently dying of a highly transmissible acute respiratory infection (such as COVID-19). CJEM, 1–5. doi:10.1017/cem.2020.352

Heslam, S. S., & Davies, J. (2021). 66 Assessing the quality of end of life care in patients dying in an acute hospital in London and the impact of the Covid-19 pandemic.

Hirakawa, Y., Saif‐Ur‐Rahman, K. M., Aita, K., Nishikawa, M., Arai, H., & Miura, H. (2021). Implementation of advance care planning amid the COVID‐19 crisis: A narrative review and synthesis. Geriatrics & Gerontology International, 21(9), 779-787.

Ho, M. H., Liu, H. C., Joo, J. Y., Lee, J. J., & Liu, M. F. (2022). Critical care nurses’ knowledge and attitudes and their perspectives toward promoting advance directives and end-of-life care. BMC Nursing, 21(1), 1–9.

Huriani, E., Susanti, M., & Sari, R. D. (2022). Pengetahuan Dan Kepercayaan Diri Tentang Perawatan Paliatif Pada Perawat Icu. Jurnal Endurance: Kajian Ilmiah Problema Kesehatan, 7(1), 74-84.

Janwadkar, A. S., & Bibler, T. M. (2020). Ethical challenges in advance care planning during the COVID-19 pandemic. The American Journal of Bioethics, 20(7), 202-204.

Jeitziner, M. M., Camenisch, S. A., Jenni‐Moser, B., Schefold, J. C., & Zante, B. (2021). End‐of‐life care during the COVID‐19 pandemic—What makes the difference?. Nursing in critical care, 26(3), 212-214.

Karbasi, C., Pacheco, E., Bull, C., Evanson, A., & Chaboyer, W. (2018). Registered nurses’ provision of end-of-life care to hospitalised adults: A mixed studies review. Nurse Education Today, 71(March), 60–74.

Kim, Y., Yoo, S. H., Shin, J. M., Han, H. S., Hong, J., Kim, H. J., ... & Park, H. Y. (2021). Practical Considerations in Providing End-of-Life Care for Dying Patients and Their Family in the Era of COVID-19. The Korean Journal of Hospice and Palliative Care, 24(2), 130-134.

Kim, J. Y., & Choi, E. H. (2022). Predictors of end-of-life care stress, calling, and resilience on end-of-life care performance: a descriptive correlational study. BMC Palliative Care, 21(1), 1–11.

Kurnia, T. A., Trisyani, Y., & Prawesti, A. (2020). The relationship between nurses' knowledge and self-confidence in implementing palliative care in an intensive care unit. International Journal of Palliative Nursing, 26(4), 183-190.

Kurnia, T.A., Trisyani, Y., & Prawesti, A. (2018). Factors Associated with Nurses’ Self-Efficacy in Applying

Palliative Care in Intensive Care Unit. Jurnal Ners, 13(2), 219-226.


Martinsson, L., Strang, P., Bergström, J., & Lundström, S. (2020). Were clinical routines for good end-of-life care maintained in hospitals and nursing homes during the first three months of the outbreak of COVID-19? A national register study. Journal of Pain and Symptom Management. doi:10.1016/j.jpainsymman.2020.09.043

Miziara, I. D., & Miziara, C. S. M. G. (2021). Considerations about ethical and legal aspects at the end of life during the COVID-19 pandemic. Clinics, 76.

Mohammed, N. A. ., Abdelaziz, S. A. ., Hrariedy, N. G. E. ., & Abd Elbaky, M. . (2020). Knowledge, Practices And Nurses´ Attitudes About End-Of-Life Care At Critical Units: Suggested Booklets. International Journal of Advance Research in Nursing, 31(1), 45–53.

Mottiar, M., Hendin, F. A., Fischer, F. L., des Ordons, A. R., & Hartwick, M. (2020). End-of-life care in patients with a highly transmissible respiratory virus: implications for COVID-19 Soins de fin de vie pour les patients atteints d’un virus respiratoire extrêmement transmissible: implications pour la COVID-19.

Mulyatsih, E., Rohani, S., Suyani, A., Aisyiyah, U., & Komariah, S. (2021). Persepsi Perawat tentang Pelayanan Pasien Tahap Terminal. The Journal of Hospital Accreditation, 3(01), 39-45.

Palacios-Ceña, D., Velarde-García, J. F., Espejo, M. M., González-Hervías, R., Álvarez-Embarba, B., Rodríguez-García, M., ... & Cachón-Pérez, J. M. (2021). Ethical challenges during the COVID-19 pandemic: Perspectives of nursing students. Nursing ethics, 09697330211030676.

Pattison, N. (2020). End-of-life decisions and care in the midst of a global coronavirus (COVID-19) pandemic. Intensive & critical care nursing, 58, 102862.

Peter, S., Jonas, B., Lisa, M., & Staffan, L. (2020). Dying from Covid-19: Loneliness, end-of-life discussions and support for patients and their families in nursing homes and hospitals. A national register study. Journal of Pain and Symptom Management. doi:10.1016/j.jpainsymman.2020.07.020

Porter, B., Zile, A., Peryer, G., Farquhar, M., & Sanderson, K. (2021). The impact of providing end-of-life care during a pandemic on the mental health and wellbeing of health and social care staff: Systematic review and meta-synthesis. Social Science & Medicine, 287, 114397.

Rao, S. R., Rao, K. S., Singhai, P., Gupta, M., Rao, S., Shanbhag, V., ... & Salins, N. COVID-19 Palliative and End-of-Life Care Plan: Development and Audit of Outcomes. Indian Journal of Palliative Care, 1-9.

Reja, M., Naik, J., & Parikh, P. (2020). COVID-19: implications for advanced care planning and end-of-life care. Western Journal of Emergency Medicine, 21(5), 1046.

Safrina, N., Hariyati, R. T. S., & Pujasari, H. (2021). Nurses’ experiences in providing spiritual care to end of life patients. Enfermería Clínica, 31, S348–S351.

Soikkeli-Jalonen, A., Stolt, M., Hupli, M., & Lemetti, T. (2020). Istruments for assessing Nurses’ palliative care knowledge and skills in specialised care setting: An integrative review. Clin. Nurs., 29, 736–757.

Subih, M., Al-Amer, R., Malak, M. Z., Randall, D. C., Darwish, R., Alomari, D., & Mosleh, S. (2022). Knowledge Of Critical Care Nurses About End-of-Life Care Towards Terminal Illnesses: Levels and Correlating Factors. Inquiry (United States), 59, 1–9.

Tavabie, S., Bass, S., Stewart, E., Redmore, E., & Minton, O. (2020). Care of the dying person before and during the COVID-19 pandemic: A quality improvement project. Future Healthcare Journal, 7(3), e50.

Theresia Avila Kurnia, Yanny Trisyani, & Ayu Prawesti. (2020). The Relationship Between Nurses’ Knowledge And Self-Confidence In Implementing Palliative Care In An Intensive Care Unit. International Journal of Palliative Nursing, 26(4), 183–190.

Torabi, Mohammad, & IslamPanah. (2021). A Survey of Nurses' Ethical Decision Making and Its Relationship with Their Attitudes Towards End-of-Life Care of Patients with Covid 19. Ethics and Medical History of Iran, 14 (1), 333-347.

Tyler, S., Bourbon, E., Cox, S., Day, N., Fineran, C., Rexford, D., Rinas, J., Shumate, K., & Ward-Smith, P. (2012). Clinical competency, self-efficacy, and job satisfaction: Perceptions of the staff nurse. Journal for Nurses in Staff Development, 28(1), 32–35.

Tyler, S., Bourbon, E., Cox, S., Day, N., Fineran, C., Rexford, D., ... & Ward-Smith, P. (2012). Clinical competency, self-efficacy, and job satisfaction: Perceptions of the staff nurse. Journal for Nurses in Professional Development, 28(1), 32-35.

Vellani, S., Boscart, V., Escrig-Pinol, A., Cumal, A., Krassikova, A., Sidani, S., ... & McGilton, K. S. (2021). Complexity of Nurse Practitioners’ Role in Facilitating a Dignified Death for Long-Term Care Home Residents during the COVID-19 Pandemic. Journal of personalized medicine, 11(5), 433.

White, K. R., & Coyne, P. J. (2011, November). Nurses' perceptions of educational




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