Table 1 Factor arrays for the Q-statements

1. I think it is important to provide education for both patients and relevant people around them since the patients may not be able to do things alone in the future.

1**

4

4

-1**

2. I dress patients’ wounds focusing on how they will look when they die, rather than trying to improve the state of the wounds.

2*

3

−2**

3

3. For managing patient wounds, I prioritize my treatment with strategies from guidelines or research that has been proven to be effective, and I believe these methods are effective.

−4**

0**

2**

4**

4. I believe that it is important to seek feedback by patients on the effectiveness of the strategy rather than stopping at the intervention.

4**

−1

0*

−2

5. I believe that no two patients share the same pathological condition, and that it is important to find and apply methods that fit the patient.

4**

−1**

1

1

6. I choose treatment strategies based on the symptom relief strategies that I have used before with other patients.

3**

−1

0**

−2

7. I do not believe that the recommendations concerning the risk and effectiveness of topical drugs are significant in treating pain from wounds, as they change often.

−4**

0

−1

−3**

8. To alleviate pain, I use thicker dressing products that can reduce pressure rather than drugs that can further deteriorate conditions.

0*

−1

−1

2*

9. I recommend using systemic painkillers whose effects are quick and definitive.

−3

1

1

−3

10. I believe the higher priority is to follow the patient’s wishes to extend or shorten dressing changes to manage exudate or pain.

3**

−2

−2

−1

11. I believe that there are limitations for me in controlling pain through dressings or topical measures and recommend visiting the pain clinic.

−2**

1*

2*

0**

12. I have experienced nutritional problems in patients reaching the terminal stage of their lives and therefore consult with the nutritional department to manage their nutrition.

0

1

3**

−2**

13. I recommend connecting with home caregivers to facilitate consistency in care as patients often need to stay home since it is hard for them to come to the hospital frequently.

0

2*

3**

1

14. I believe that recommending and connecting patients with routes of care in advance are important in ensuring they receive care easily rather than connecting them when their situation has worsened.

0**

4

3

2*

15. I believe that care from non-medical professionals, such as physical therapists and social workers, is more important in palliative wound care at the end of the patient’s life.

0

0

0

0

16. I think there are limitations to what I can do for patients as a wound care nurse since there will be more important things than wound.

−1**

2**

−2

−4

17. I ponder on methods that patients or caregiver can use to deal with dressings, as they may ultimately be done at home or in nursing homes.

1

3

4

1

18. I find it very difficult to listen to patients and guardians asking how they can be cured when the patients cannot be cured.

−1

3**

−1

0*

19. I avoid patients and guardians asking about treatment progress because I do not like talking about negative situations to patients.

−1

2

−1

1

20. I believe that dressings are not an important part of the final journey of the patient and make treatment-focused choices by considering the patient’s financial situation.

2**

−1

0*

−2

21. I choose treatment methodologies as long as the patient’s mind is put at ease by choosing what the patients or their caregivers want.

3

−2*

−3*

0*

22. I believe that the patient must know about their situation accurately to be able to mentally prepare themselves.

−2**

−4

1**

3**

23. When my opinions and the patient’s differ, I invite sufficient dialogue before making a decision rather

2**

0

−1

−1

24. If the patients have the wrong information about a treatment, I believe that they should be presented with the correct information.

−3*

−2*

0**

4**

25. I believe that giving false hope to patients and caregivers is not helpful and let them know that what does not work, does not work.

−2

−3

1**

2**

26. Prior to setting objectives, I believe that the patients and caregivers must be provided with detailed explanations and sufficient time rather than scaring them with negative aspects.

1

0*

1

−1*

27. I prioritize the patients’ opinions over the caregivers’, provided that the patient is conscious, as it is a choice that they make for the last part of their lives.

1**

−3

−3

−4*

28. I cannot feel a sense of achievement with patients receiving palliative wound care

−1**

1**

−4

−3

29. Rather than presenting solutions to terminal stage patients, I believe that it is better for the patients’ stability to listen to their stories

2**

0

0

−1

30. I believe that professional treatment is necessary for psychological stability and recommend referral to a psychiatric clinic.

−2**

0*

2*

1*

31. I believe that the patient should regard the disease and wound process directly and accept it for their own psychological stability.

−3**

−4**

2**

3**

32. I try to avoid saying hopeful things, as they may grow more anxious if they develop hope and then are disappointed.

−1**

1**

−3**

0**

33. I try to tell them things that may provide them with positive strength, such as compliments for their current behavior.

1

−3**

0

0

34. I try to do my best in treating patients so that I do not regret it after they die.

0**

2*

−2**

2*

35. I tell the patients that not being cured is not always unfortunate.

0

−2

−4

0