The impact of perceptions of a good death, person-centered care, and empathy competency on end-of-life care among long-term care facilities' nursing staff and mediating effects of empathy competency: A descriptive study

Abstract

Purpose The purpose of this study was to explore the perceptions of a good death, person-centered care, and empathy competency among nursing staff in long-term care facilities, examining their influence on end-of-life (EOL) care. Methods A descriptive survey was conducted with 154 nursing staff, including nurses, nursing assistants, and care workers, from three long-term care facilities. Data were collected through structured questionnaires assessing perceptions of a good death, person-centered care, empathy competency, and EOL care. Regression and mediation analysis were performed to identify influential factors and mediation effects using the SPSS 27 program and PROCESS Macro. Results The key factors influencing EOL care were person-centered care (β=.44, p<.001), empathy competency (β=.16, p=.028), age (β=.16, p=.013), and job type (β=-.14, p=.034). The overall explanatory power for EOL care was 41.5% (adjusted R2=.415). The mediating effect of empathy competency was statistically significant between perceptions of a good death and EOL care (β=.24, p=.002, 95% confidence interval 0.09~0.33) and between person-centered care and EOL care (β=.51, p<.001, 95% confidence interval 0.03~0.24). Conclusion Enhancing EOL care in long-term care facilities requires improving empathy competency and person-centered care. Tailored education and interventions to strengthen empathy and professional attitudes among nursing staff are essential. Organizational support and systemic approaches are also needed to improve the quality of EOL care.