Current status of knowledge, attitudes, and practices among ICU physicians and nurses regarding palliative care in China.

Integrating palliative care (PC) into the intensive care unit (ICU) can enhance patient quality of life. The knowledge, attitudes, and practices of ICU physicians and nurses in palliative care (KAPPC) are essential for its successful implementation in the ICU. There remains insufficient evidence concerning the knowledge, attitudes, and practices of ICU physicians and nurses in palliative care in China. To investigate the current knowledge, attitudes, and practices of ICU medical staff regarding palliative care, we conducted a study utilizing an indigenized knowledge, attitude, and practice of palliative care (KAPPC) scale. This study aimed to assess the baseline KAPPC of ICU medical personnel in Dalian and explore the factors that influence these aspects in depth. The findings will serve as a reference for medical institutions to develop effective training programs for ICU staff in palliative care. This study uses quantitative and qualitative methodologies with a convenience sampling strategy, focusing on adult ICU medical staff at a tertiary hospital in Dalian. A cross-sectional design was utilized to evaluate the KAPPC of the medical personnel through the adapted KAPPC scale. Quantitative data was collected using the KAPPC scale. Descriptive analysis, linear regression, and Pearson's (r) correlation analysis were performed to explore providers' KAPPC, their influencing factors, and their correlations. Qualitative data was collected from participants' textual responses through an open-ended question, and a content analysis method was employed to code, categorize, and extract themes from the collected text-based content. A total of 220 valid questionnaires were collected, resulting in an effective recovery rate of 84.62%. The overall score for knowledge, attitude, and practice among ICU medical staff in palliative care was 184.75 ± 25.74. The individual scores for knowledge, attitude, and practice were 9.59 ± 2.99, 91.59 ± 12.65, and 83.57 ± 15.49, respectively. The correlation analysis revealed a strong relationship between self-reported practice and confidence. The linear regression analysis demonstrated that several factors, including occupation, professional title, gender, ICU working experience, prior experience in palliative care education, and willingness to engage in palliative care training, significantly affected the knowledge, attitudes, and practices of ICU medical staff about palliative care. To address identified gaps in knowledge, attitudes, and practices, we propose a tripartite enhancement framework: (1) Role-specific competency development through differentiated training for physicians (end-of-life decision-making, multidisciplinary collaboration) and nurses (technical care, emotional support), coupled with palliative care certification; (2) Structural optimization via ICU-specific palliative pathways with rapid-response teams; and (3) Technology integration of Traditional Chinese Medicine techniques and electronic assessment systems for real-time monitoring. This integrated approach targets core barriers to palliative care delivery in Chinese ICUs, with future multi-regional studies needed to evaluate long-term efficacy.