When and how clinical nurses adjust nursing care at the end-of-life among patients with cancer: Findings from multiple focus groups

Role of emotions in the clinical decision-making process of the hospital nurse: A multicentre qualitative study

While for a long-time emotional reaction and moral distress, have been primarily investigated for the possible outcomes of the nursing decision-making process rather than in terms of their role as antecedents of the final decision taken. The primary study's aim is to explore how inpatient nurses' decision-making takes place in different care settings, with a special focus on the role played by emotions during decision-making. The secondary aim is to explore the subjective experience of hospital nurses in relation to successful and unsuccessful decision-making situations. Multicentre qualitative study, consisting of three phases with different designs: participatory study, grounded theory study, and phenomenological study. Participants will be nurses and may be doctors with various levels of professional experience working in hospital, outpatient, or ward settings. Participants will be recruited through different sampling (purposive and convenience). Data will be collected through focus groups and in-depth interviews with nurses working in different hospital care settings. The researchers expect to find themes that will contribute to a better understanding of the role of emotions in decision-making. The results of this study have the potential of providing important implications to support nurses in the recognition and management of their emotions during the decision-making process.

Social and healthcare professionals' experiences of end-of-life care planning and documentation in palliative care

AIM

To explore social and healthcare professionals' experiences of end-of-life (EOL) care planning and documentation in palliative care.

DESIGN

A qualitative study with narrative methodology.

METHODS

A narrative method with interviews was used. Data were collected from purposively selected registered nurses (n = 18), practical nurses (n = 5), social workers (n = 5) and physicians (n = 5) working in palliative care unit in five hospitals in three hospital districts. Content analysis within narrative methodologies was undertaken.

RESULTS

Two main categories - patient-oriented EOL care planning and multi-professional EOL care planning documentation- were formed. Patient-oriented EOL care planning included treatment goals planning, disease treatment planning and EOL care setting planning. Multi-professional EOL care planning documentation included healthcare professionals' and social professionals' perspectives. Healthcare professionals' perspectives on EOL care planning documentation included benefits of structured documentation and poor support of electronic health record (EHR) for documentation. Social professionals' perspective on EOL care planning documentation included usefulness of multi-professional documentation and externality of social professionals in multi-professional documentation.

CONCLUSION

The results of this interdisciplinary study demonstrated a gap between what healthcare professionals consider important in Advance Care Planning (ACP), that is, proactive, patient-oriented and multi-professional EOL care planning and the ability to access and document this in a useful and accessible way in the EHR.

RELEVANCE TO CLINICAL PRACTICE

Knowledge of the patient-centered EOL care planning and multi-professional documentation processes and their challenges are prerequisites for documentation to be supported by technology.

REPORTING METHOD

The Consolidated Criteria for Reporting Qualitative Research checklist was followed.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Clinical Study of Influence of Continuous Nursing Intervention Combined with Comfort Nursing Intervention under Medical-Nursing Combination on Self-Care Ability and Satisfaction of Elderly Patients with Chronic Diseases

Objective

With the constant development of medical technology, the medical-nursing combination mode targeted at elderly chronic diseases has been proposed, and based on this, the study on the nursing mode of elderly chronic diseases under the background of medical-nursing combination was conducted.

Methods

Total of 100 elderly patients with chronic diseases who were admitted to our hospital from April 2019 to April 2020 were selected and divided into a control group and an experimental group by lot drawing, with 50 patients in each group. Continuous nursing was conducted to patients in the control group, and continuous nursing combined with comfort nursing was performed to patients in the experimental group, so as to compare their nursing effective rate, satisfaction with nursing, self-care ability at 6 months after nursing, quality of life (QLI) scores, and blood glucose, pressure, and lipid levels at various periods.

Results

Compared with the control group, the experimental group obtained significantly improved nursing effective rate, satisfaction with nursing, Exercise of Self-Care Agency (ESCA) scale scores, QLI scores, and lower blood glucose, pressure, and lipid levels at various periods 6 months after nursing, with statistical significance (P all < 0.05).

Conclusion

Under the context of medical-nursing combination, the continuous nursing intervention combined with comfort nursing intervention is conductive to promote the self-care ability and nursing effect of elderly patients with chronic diseases and obviously improve their quality of life and psychological state.