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Eichorst MK, Fromenthal AL, Harris GM, Reel CD, Allen RS. In the presence of death and dying: death attitudes and compassion fatigue among certified nursing assistants in skilled care. Aging Ment Health 2024:1-10. [PMID: 39244655 DOI: 10.1080/13607863.2024.2399089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 08/23/2024] [Indexed: 09/10/2024]
Abstract
OBJECTIVES Certified Nursing Assistants (CNAs) are responsible for 80-90% of direct-to-resident care in skilled nursing facilities (SNFs), and may develop close, family-like relationships with their residents. With SNFs becoming a common place of death for older adults, CNAs now find themselves engaging in end-of-life caregiving with limited training and institutional support for emotional outcomes. This study aimed to understand and evaluate the relations between bereavement, death exposure, and compassion fatigue among CNAs, hypothesizing that (a) experiential avoidance moderates the relation between death exposure and negative death attitudes and (b) death attitudes moderate the relation between death exposure and compassion fatigue. METHOD One hundred and ten CNAs across all shifts from four skilled nursing facilities in the southeastern United States participated in surveys and, potentially, focus groups. RESULTS Results failed to find support for death exposure being related either to experiential avoidance or negative death attitudes. However, results supported the relation between negative death attitudes and compassion fatigue. CONCLUSION Implications highlight the need to develop interventions focusing on palliative skills-based training and emotional support of CNAs in their role as end-of-life caregivers. By reducing compassion fatigue, it may be possible to decrease job turnover and increase quality-of-care for residents.
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Affiliation(s)
| | - Ashley L Fromenthal
- Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA
- The University of Alabama, Alabama Research Institute on Aging, Tuscaloosa, AL, USA
| | - Grant M Harris
- St. Louis Veterans Affairs Medical Center, St. Louis, MO, USA
| | - Candice D Reel
- Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA
- The University of Alabama, Alabama Research Institute on Aging, Tuscaloosa, AL, USA
| | - Rebecca S Allen
- Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA
- The University of Alabama, Alabama Research Institute on Aging, Tuscaloosa, AL, USA
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Üzar-Özçetin YS, Budak SE. The Relationship Between Attitudes Toward Death, Rumination, and Psychological Resilience of Oncology Nurses. Semin Oncol Nurs 2024; 40:151645. [PMID: 38664076 DOI: 10.1016/j.soncn.2024.151645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/25/2024] [Accepted: 04/09/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVES The study aimed to examine the relationship between attitudes toward death, rumination, and psychological resilience of oncology nurses. METHODS The study design was cross-sectional. Data were collected from 118 oncology nurses using the Demographic Data Form, Work-Related Rumination Scale, Connor-Davidson Resilience Scale Short Form, and Death Attitude Profile-Revised Scale. For data analysis, correlation and regression analyses were performed. RESULTS The study findings showed that oncology nurses` work related rumination score was moderate, while psychological resilience score was severely high. More than two-thirds of the work-related ruminations of oncology nurses were explained by psychological resilience and attitudes toward death. Even though there is a negative correlation between negative attitudes toward death and psychological resilience, the acceptance of death scores showed positive relations with psychological resilience. CONCLUSION Nurses with positive attitudes toward death can also develop psychological resilience and experience fewer work-related ruminations. This result reveals the necessity of determining oncology nurses' attitudes toward death in order to protect their psychological resilience and reduce work-related ruminations. It is also evident that the results are valuable in presenting how nurses' work-related ruminations relate to psychological resilience and attitudes toward death. IMPLICATIONS FOR NURSING PRACTICE Nurses are the main care providers in oncology settings, and they are witnessing the suffering process of their patients and experiencing the loss of their patients. These challenges bring work-related ruminations that lower the psychological resilience of nurses and affect attitudes toward death. Therefore, nurses can build an awareness of their ruminations and develop coping skills with intrusive ruminations.
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Affiliation(s)
- Yeter Sinem Üzar-Özçetin
- Associate Professor, University College Dublin, School of Nursing, Midwifery and Health Systems, UCD Health Sciences Centre, Dublin, Ireland.
| | - Simay Ezgi Budak
- Research Assistant, Psychiatric Nursing Department, Hacettepe University Faculty of Nursing, 06100, Ankara, Türkiye
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Webb B, Carter-Templeton H, Cunningham T. An Integrative Review of "The Pause" After Patient Death. J Holist Nurs 2023:8980101231218366. [PMID: 38056072 DOI: 10.1177/08980101231218366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
Background: Healthcare providers are engrossed in high-stakes, high-stress situations during their daily work with patient death being a potential negative outcome of work-related stress. Many interventions exist to combat work-related stress among nurses. The Pause, an intervention to offer a moment of silence for the healthcare team after a patient death, is one example. Objective: An integrative review of The Pause was conducted to investigate its use and how it impacts healthcare providers and their work environments. Methods: The integrative review methodology by Whittemore and Knafl was used to guide this study. Steps included were problem identification, literature search, data evaluation, data analysis, and presentation. Content analysis was used to identify themes. Results: Seven databases were searched in 2022 and seven studies were identified for inclusion in this review. Two themes were identified: personal benefits and professional benefits. Findings reveal benefits from self-care and grief processing to a better work environment. Conclusions: The Pause is a low-cost, low-risk intervention that can be implemented at an organizational level to help reduce burnout, unresolved grief, increase resilience, increase retention, and improve patient outcomes. Future research should include an examination of how The Pause may affect patient outcomes and workplace culture.
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Dicks SG, Northam HL, van Haren FM, Boer DP. The bereavement experiences of families of potential organ donors: a qualitative longitudinal case study illuminating opportunities for family care. Int J Qual Stud Health Well-being 2023; 18:2149100. [PMID: 36469685 PMCID: PMC9731585 DOI: 10.1080/17482631.2022.2149100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES To illuminate opportunities for care in the context of deceased organ donation by exploring pre-existing family and healthcare professional characteristics, in-hospital experiences, and ongoing adjustment through the lenses of grief theory, systems theory, meaning-making, narrative, and organ donation literature. METHOD Qualitative longitudinal case studies explored individual and family change in five Australian families who had consented to Donation after Circulatory Determination of Death at a single centre. Participants attended semi-structured interviews at four, eight, and twelve months after the death. FINDINGS Family values, pre-existing relationships, and in-hospital experiences influenced first responses to their changed lives, understanding of the patient's death, and ongoing family adjustment. Novel behaviour that was conguent with family values was required at the hospital, especially if the patient had previously played a key role in family decision-making. This behaviour and emerging interactional patterns were drawn into family life over the first year of their bereavement. RECOMMENDATIONS Training that includes lenses introduced in this study will enable healthcare professionals to confidently respond to individual and family psychosocial needs. CONCLUSION The lenses of grief theory and systems thinking highlight opportunities for care tailored to the unique in-hospital context and needs that emerge in the months that follow.
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Affiliation(s)
- Sean G. Dicks
- Department of Psychology, University of Canberra, Canberra, Australia
| | - Holly L. Northam
- Department of Nursing and Midwifery, University of Canberra, Canberra, Australia
| | | | - Douglas P. Boer
- Department of Psychology, University of Canberra, Canberra, Australia
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Roaquin L. Participatory Grieving: A Concept Analysis. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231184744. [PMID: 37338900 DOI: 10.1177/00302228231184744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Grief is a psychobiological response to loss as manifested by intense feeling of sadness, along with thoughts, mental images and memories of the deceased loved one. In order for the patient to attain successful grieving process, it is fundamental among nurses to recognize and understand the loss or impending loss experienced by the patient and/or its significant others. With the use of Walker and Avant's concept analysis, together with thorough literature review pertaining to bereavement and grieving, the defining attributes, antecedents and consequences of participatory grieving were determined. Furthermore, the results of this concept analysis provide a better view on the significant roles and responsibilities of nurses during the grieving process.
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Affiliation(s)
- Lucky Roaquin
- Master of Arts in Nursing spec, Medical-Surgical Nursing, College of Nursing, Saint Tonis College Inc Dean
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Arbour RB, Wiegand DL. Self-described Nursing Responses Experienced During Care of Dying Patients and Their Families: A Phenomenological Study. J Hosp Palliat Nurs 2023; 25:E49-E56. [PMID: 36763060 DOI: 10.1097/njh.0000000000000936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Critical care nurses care for dying patients and their families. Little is known about the feelings and experiences of critical care nurses and how they are affected when they provide end-of-life care. Study purpose was to understand lived experiences, responses, and feelings of critical care nurses providing end-of-life care. A descriptive phenomenological design with purposive sampling was used to recruit 19 critical care nurses who cared for dying patients and their families. Interviews were recorded and transcribed verbatim. Nurses were asked open-ended questions about experiences and responses while providing end-of-life care. Coliazzi's method of data analysis was used to inductively determine themes, clusters, and categories. Data saturation was achieved, and methodological rigor was established. Responses included personalizing the experience, sadness, ageism, anger, frustration, relief, and stress. Factors contributing to clinicians' lived experience included previous experiences with death affecting how the experience was personalized among others. Critical care nurses may be unprepared for feelings and responses encountered during end-of-life care. Preparation for feelings and responses encountered during end-of-life care in nursing education and critical care orientation classes is essential. Future research should study optimal mentoring, teaching, and preparation for providing optimal end-of-life care. Study results have implications for practice, education, and research.
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Jalili M, Rezapour-Mirsaleh Y, Mirhosseini SJ. Investigating Surgeons' Reactions to Patients' Death: A Phenomenological Study. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231162731. [PMID: 36872588 DOI: 10.1177/00302228231162731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
The main purpose of this study was to scrutinize the reaction of surgeons towards patients' death. This study enjoyed a qualitative approach using a phenomenological lived experience. 12 surgeons who had witnessed patients' death were selected through purposive sampling until data saturation was achieved. The data were collected using semi-structured interviews and were analyzed through the Colaizzi's method. The main concepts extracted from the analysis of the participants' experience comprised three main themes, six sub-categories and 19 initial sub-categories. The main themes were (a) emotional-mental reactions including the sub-themes of emotional distress, mood disorder and mental distress, (b) death encounter including the sub-themes of rational encounter and pre-emptive measure and (c) post-traumatic growth covering the concepts of optimism and performance improvement. The obtained findings imply that the patients' death can sometimes make surgeons aware of the post-incident growth although such deaths affect their personal, family, social and professional lives.
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Affiliation(s)
- Maryam Jalili
- Department of Counseling, Faculty of Humanities and Social Sciences, Ardakan University, Ardakan, Iran
| | - Yasser Rezapour-Mirsaleh
- Department of Counseling, Faculty of Humanities and Social Sciences, Ardakan University, Ardakan, Iran
| | - Seyed Jalil Mirhosseini
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Ahn J, Bang YR, Cho E, Ahmed O, Kim JH, Hong Y, Chung S, Anderson KA. Validation of the Grief Support in Healthcare Scale among frontline nursing professionals working in COVID-19 inpatient wards in Korea. Front Psychiatry 2023; 14:1097022. [PMID: 37151977 PMCID: PMC10158932 DOI: 10.3389/fpsyt.2023.1097022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/15/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction During the COVID-19 pandemic, healthcare workers (HCWs) have been exposed to higher levels of anxiety and psychological stress than the general population. Nurses who cared for COVID patients could not avoid repeated mourning as they witnessed the deaths of their patients. Therefore, tools are needed to evaluate whether there is adequate support for the grieving process of HCWs in both qualitative and quantitative manners. Methods Data from 229 nurses who witnessed the deaths of COVID-19 inpatients were analyzed using an online survey of nurses working in three tertiary hospitals. Factor analysis was conducted to validate the 10-item Korean version of Grief Support in Healthcare Scale (GSHCS). Stress and Anxiety to Viral Epidemics-9 was used to measure stress and anxiety caused by coronavirus, Generalized Anxiety Disorder-7 was used to measure overall anxiety, and Patient Health Questionnaire-9 was used for depression. Convergent validity correlation analysis was also performed with GSHCS. Results The two-factor model showed a good fit for the 10-item GSHCS (χ 2 = 35.233, df = 34, p = 0.410, CFI = 0.999, TLI = 0.990, RMSEA = 0.013, SRMR = 0.064). Cronbach's alpha is 0.918 and McDonald's omega is 0.913, suggesting that the 10-item version of the GSHCS is reliable for determining psychometric properties. Conclusion According to this study, the 10-item Korean version of the GSHCS is a reliable and valid measure of psychological support for grief among frontline nursing professionals who have witnessed the deaths of patients they cared for while working in COVID-19 inpatient wards. A two-factor model of the GSHCS has a good model fit and good convergent validity with other rating scales that measure viral anxiety, depression, and general anxiety.
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Affiliation(s)
- Junseok Ahn
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Young Rong Bang
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Eulah Cho
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Oli Ahmed
- Department of Psychology, University of Chittagong, Chattogram, Bangladesh
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Jeong Hye Kim
- Department of Clinical Nursing, University of Ulsan, Seoul, Republic of Korea
| | - Youjin Hong
- Department of Psychiatry, GangNeung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
- *Correspondence: Youjin Hong,
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Seockhoon Chung,
| | - Keith A. Anderson
- Department of Social Work, University of Mississippi, Oxford, MI, United States
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Bender AA, Kemp CL, Vandenberg AE, Burgess EO, Perkins MM. "You gotta have your cry": Administrator and direct care worker experiences of death in assisted living. J Aging Stud 2022; 63:101072. [PMID: 36462917 PMCID: PMC9769282 DOI: 10.1016/j.jaging.2022.101072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 09/12/2022] [Accepted: 09/15/2022] [Indexed: 11/20/2022]
Abstract
Assisted living (AL) is increasingly a site of end-of-life care and a long-term care location where growing numbers of people are aging in place and dying. Despite these trends, limited research focuses on how death and grief impact the work environment in AL. This grounded theory analysis examined qualitative data collected from 27 administrators and 38 direct care workers (DCWs) in 7 diverse settings. As assisted living administrators and DCWs experienced resident death, they engaged in a dynamic and individualized process of "managing the normalization of death," which refers to the balance of self-identity and workplace identity. The process of reconciling these opposing contexts in AL involved several individual- and community-level conditions. Administrators and DCWs would benefit from additional resources and training around death. Increasing collaboration with hospice and clarifying policies about death communication would better prepare the workforce to acknowledge the end of life in assisted living.
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Affiliation(s)
| | | | | | | | - Molly M Perkins
- Emory University, Atlanta, GA, USA; Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, USA
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Power A, Atkinson S, Noonan M. "Stranger in a mask" midwives' experiences of providing perinatal bereavement care to parents during the COVID-19 pandemic in Ireland: A qualitative descriptive study. Midwifery 2022; 111:103356. [PMID: 35576867 PMCID: PMC9046145 DOI: 10.1016/j.midw.2022.103356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 04/16/2022] [Accepted: 04/26/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To explore the experiences and perceptions of midwives providing perinatal bereavement care during the COVID-19 pandemic and to identify the barriers and facilitators to providing compassionate bereavement care. DESIGN A qualitative descriptive design was utilized to address the research question. Following ethical approval, in depth, semi structured interviews were undertaken to explore midwives' experiences of providing care to parents following perinatal bereavement. Narrative data was analyzed using thematic analysis. SETTING A standalone regional maternity hospital located in a large metropolitan center in the Republic of Ireland. PARTICIPANTS A purposeful sample of eleven midwives, who cared for bereaved parents during the COVID-19 pandemic volunteered to participate in the study. FINDINGS Two main themes were identified, each with associated subthemes (1) Challenges of providing compassionate bereavement care during a pandemic (2) Psychological effect and coping strategies utilised by midwives during a pandemic. CONCLUSION The COVID-19 pandemic brought unprecedented challenges when providing perinatal bereavement care. The mandatory infection prevention and control measures significantly disrupted human communication and connections. Participants in the study utilized techniques to optimize care while adhering to COVID-19 guidelines, and simultaneously putting their own fear and anxieties aside.
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Affiliation(s)
- Annmarie Power
- Health Service Executive, University Maternity Hospital, Ennis Road, Limerick, Ireland.
| | - Sandra Atkinson
- Department of Nursing and Midwifery, Health Science Building, North Bank Campus, University of Limerick, Castletroy, Limerick, Ireland
| | - Maria Noonan
- Department of Nursing and Midwifery, Health Science Building, North Bank Campus, University of Limerick, Castletroy, Limerick, Ireland
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Descriptions of Maternal Mortality From Nurses Who Practice in Perinatal Settings. Nurs Womens Health 2022; 26:288-298. [PMID: 35690097 DOI: 10.1016/j.nwh.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/30/2022] [Accepted: 05/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore nurses' descriptions of maternal mortality when caring for women in the perinatal period in Indiana. DESIGN A qualitative descriptive approach was used to produce nurses' descriptions of maternal mortality. SETTING/PARTICIPANTS Convenience sample of 16 nurses recruited from the Indiana Section of the Association of Women's Health, Obstetric and Neonatal Nurses. MEASUREMENTS Semistructured phone interviews were conducted, and participants were asked to explain their experiences related to maternal mortality. This information, which was summarized using content analysis, provided data related to nurses' descriptions of maternal mortality when caring for women in the perinatal period. RESULTS Analysis revealed three main themes that explain nurses' descriptions of maternal mortality: When It Comes to Maternal Mortality: Out of Sight Is Out of Mind, Nurses Express Detachment From Their Role in Preventing Maternal Mortality, and Experience With Maternal Mortality or a Near-Miss Event Is a Turning Point for Nurses. CONCLUSION Nurses who have limited experience with maternal mortality and who approach the issue in a detached manner may miss opportunities to provide health education to women in the perinatal period. Nurses need education on substance use disorders in the perinatal period, guidance on how to support women in the postpartum period, and support for coping with death and dying in the perinatal period.
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Tatterton M, Honour A, Billington D, Kirkby L, Lyon JA, Lyon N, Gaskin J. Care after death in children's hospices: recommendations for moving and handling, and for managing physiological deterioration. Nurs Child Young People 2022; 34:14-21. [PMID: 35187908 DOI: 10.7748/ncyp.2022.e1412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Children's hospices provide a range of services for babies, children and young people who have a life-limiting or life-threatening condition, including care after death in specialist 'cool bedrooms'. Care after death is a challenging but important element of hospice care. AIM The aims of the study were to identify the practices of staff providing care after death in UK children's hospices, notably their moving and handling practices and their management of physiological deterioration, and to produce recommendations that promote safe and consistent practice in moving and handling and in managing physiological deterioration after death in UK children's hospices. METHOD An electronic survey was sent to all 54 UK children's hospices. Free-text responses were analysed using deductive content analysis and used to add depth to the quantitative findings. FINDINGS Out of 54 children's hospices, 33 responded to the survey. There were great variations in the way hospices delivered care after death, notably in length of stay, interventions and equipment. The lack of consistent practice grounded in evidence-based policy and training may mean that some staff experience higher levels of stress and anxiety than others and that some staff take risks when providing care after death, particularly to express empathy towards bereaved families. CONCLUSION Recommendations are made about moving and handling a child's body after death and managing its physiological deterioration. Hospices can use these recommendations to develop policy and training, standardise what is expected of staff and support practitioners in adequately caring for children after death.
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Affiliation(s)
- Michael Tatterton
- University of Bradford, School of Nursing and Healthcare Leadership, Bradford, West Yorkshire, England
| | | | | | - Lorna Kirkby
- Martin House Children's Hospice, Wetherby, England
| | | | - Nigel Lyon
- Martin House Children's Hospice, Wetherby, England
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Shimoinaba K, McKenna L, Copnell B. Nurses' experiences, coping and support in the death of a child in the emergency department: A qualitative descriptive study. Int Emerg Nurs 2021; 59:101102. [PMID: 34823111 DOI: 10.1016/j.ienj.2021.101102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/21/2021] [Accepted: 09/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND A child's death in the Emergency Department (ED) is usually unexpected and traumatic. Understanding nurses' experiences encountering such death is crucial in determining how they cope to provide quality nursing care to dying children and their families. PURPOSE To report ED nurses' experiences with children's death, coping strategies and support needs. PROCEDURES A qualitative descriptive design. Twenty-four registered nurses who had cared for a child who died in the ED took part in semi-structured interviews. Interviews were audiorecorded, and analyzed using thematic analysis. FINDINGS Three themes were generated: 'nature of emergency department work', 'working with families' and 'coping and support'. This paper reports on the theme 'coping and support'. Although children's deaths were traumatizing and affected nurses personally and professionally, constant time pressure allowed limited reflection time. Common individual coping mechanisms used by participants included external strategies through support from other staff members including peer-support and informal supervision, and internal strategies through personal coping strategies. Participants expressed need for greater support and education/training to effectively deal with pediatric death, children's families, and their own grief. CONCLUSIONS Children's deaths and nature of ED care affected nurses. Adequate support and deathrelated education were urged by participants to promote high-quality care provision.
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Affiliation(s)
- Kaori Shimoinaba
- Nursing and Midwifery, Monash University, PO Box 527, Frankston VIC 3199, Australia.
| | - Lisa McKenna
- School of Nursing and Midwifery, La Trobe University, Plenty Rd & Kingsbury Dr, Bundoora VIC 3086, Australia.
| | - Beverly Copnell
- School of Nursing and Midwifery, La Trobe University, 185 Cooper St., Epping VIC 3076, Australia.
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Case RD, Judie E, Kurszewski T, Brodie W, Bethel P. Are we teaching health science students in the United States what they need to know about death and dying coping strategies? JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2021; 18:29. [PMID: 34775695 PMCID: PMC8616726 DOI: 10.3352/jeehp.2021.18.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/02/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE This investigation aimed to answer the following questions: are health science students provided with death and dying education before attending clinical rotations, and if so, do the students receiving this type of education perceive it as effective? METHODS In this descriptive cross-sectional survey, 96 Midwestern State University health science students were surveyed to determine the percentage of students who had received death and dying education before clinical rotations, as well as the students’ perception of educational effectiveness for those who had received end-of-life training. A self-report questionnaire presented nursing, radiologic sciences, and respiratory care students with a series of questions pertaining to the education they had received concerning the death and dying process of patients. RESULTS Of the 93 students who had already started their clinical rotations, 55 stated they had not received death and dying education before starting clinical courses. Of the 38 who had received death and dying education, only 17 students believed the training was effective. CONCLUSION It is imperative that health science educational programs implement death and dying education and training into the curriculum, and that criteria for evaluating effectiveness be an essential part of death and dying education and training in order to ensure effectiveness.
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Affiliation(s)
- Randy D. Case
- Department of Respiratory Care, Midwestern State University, Wichita Falls, TX, USA
| | - Erica Judie
- Department of Respiratory Care, Midwestern State University, Wichita Falls, TX, USA
| | - Tammy Kurszewski
- Department of Respiratory Care, Midwestern State University, Wichita Falls, TX, USA
| | - Wenica Brodie
- Department of Respiratory Therapy, Children’s Medical Center Dallas, Dallas, TX, USA
| | - Pollyann Bethel
- Department of Respiratory Therapy, Tallahassee Memorial Healthcare, Tallahassee, FL, USA
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15
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Walker W, Efstathiou N. Support after patient death in the intensive care unit: Why 'I' is an important letter in grief. Nurs Crit Care 2021; 25:266-268. [PMID: 32815295 DOI: 10.1111/nicc.12534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Wendy Walker
- The Royal Wolverhampton NHS Trust, Wolverhampton, UK
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16
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Lee E, Kim Y. Caregivers' psychological suffering and posttraumatic growth after patient death. Perspect Psychiatr Care 2021; 57:1323-1330. [PMID: 33230822 DOI: 10.1111/ppc.12693] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 11/06/2020] [Accepted: 11/10/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study aimed to identify the association between caregivers' psychological suffering and posttraumatic growth (PTG) after patient death. DESIGN AND METHODS Participants were a total of 254 caregivers, including nurses, nursing assistants, social workers, and care workers. FINDINGS Higher psychological suffering, in terms of expanding self-consciousness, change of values, and spiritual sublimation, had a positive correlation with PTG. For nurses and nursing assistants, the change of values and spiritual sublimation had a positive correlation with PTG. For social workers, the higher self-consciousness was associated with greater PTG. For care workers, the expanded self-consciousness and lower helplessness had a positive correlation with PTG. PRACTICE IMPLICATIONS These findings will serve as a basis for the development of supportive programs to assist caregivers in improving PTG after patient death.
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Affiliation(s)
- Eunmi Lee
- Department of Nursing, Hoseo University, Asan-si, Chungcheongnam-do, Republic of Korea
| | - Yujeong Kim
- College of Nursing, Kyungpook National University, Daegu, Republic of Korea
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Abstract
Critical care nurses frequently provide end-of-life and bereavement care. This type of care is rewarding, but can put nurses at risk for moral distress, compassion fatigue, and burnout. By incorporating self-care into their routine, critical care nurses minimize this risk and maintain their own health and well-being. This article provides suggestions for promoting physical, emotional, and spiritual self-care for nurses caring for dying intensive care unit patients and their families. A case scenario illustrates the importance of this concept. Practical examples of self-care are highlighted along with discussion on how leadership can support self-care and maintain a healthy work environment.
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Dicks SG, Burkolter N, Jackson LC, Northam HL, Boer DP, van Haren FM. Grief, Stress, Trauma, and Support During the Organ Donation Process. Transplant Direct 2020; 6:e512. [PMID: 32047840 PMCID: PMC6964929 DOI: 10.1097/txd.0000000000000957] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 11/26/2022] Open
Abstract
The organ donation process is complex and stressful for the family of the potential donor and members of the multidisciplinary team who may experience grief, ethical dilemmas, vicarious trauma, or compassion fatigue. Several studies each explore the role of a specific healthcare group and the impact of inhospital processes on group members. We conducted a systematic literature search to identify such studies and a qualitative synthesis to consolidate findings and highlight features of the interaction and relationships between role players. Our results suggest that, while healthcare professionals have different roles, attitudes, and views, the experience of stressors and interdisciplinary tension is common. Nevertheless, staff are united by the goal of caring for the patient and family. We therefore propose that, while focusing on bereavement care and other aspects of the family's experience, staff can find other shared goals and develop understanding, trust, empathy, and respect for each other's positions, thereby improving functioning in the complex adaptive system that forms at this time. Education and training can equip staff to facilitate anticipatory mourning, family-led activities, and a meaningful parting from their relative, assisting families with their grief and increasing staff members' efficacy, confidence, and interdisciplinary teamwork. Knowledge of systems thinking and opportunities to share ideas and experiences will enable staff to appreciate each other's roles, while supportive mentors, self-care strategies, and meaningful feedback between role players will foster healthy adjustment and shared learning. A focus on psychosocial outcomes such as family satisfaction with the process, collaboration within the multidisciplinary team, and reduction in the role stress of healthcare professionals will contribute to family well-being as well as personal and professional growth for staff.
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Affiliation(s)
- Sean G. Dicks
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
- Canberra Health Services, Canberra, ACT, Australia
| | | | | | - Holly L. Northam
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Douglas P. Boer
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Frank M.P. van Haren
- Faculty of Health, University of Canberra, Canberra, ACT, Australia
- Canberra Health Services, Canberra, ACT, Australia
- School of Medicine, Australian National University, Canberra, ACT, Australia
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