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Mediani HS, Sada FR, Nuraeni A, Subu MA. Healthcare Professionals' Experiences in Providing Palliative Care in an Intensive Care Unit in Indonesia: A Phenomenological Study. J Multidiscip Healthc 2024; 17:4427-4439. [PMID: 39281300 PMCID: PMC11397250 DOI: 10.2147/jmdh.s486021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2024] [Accepted: 09/05/2024] [Indexed: 09/18/2024] Open
Abstract
Background In the Intensive Care Unit (ICU), it is vital to meticulously monitor symptoms and thoroughly understand the treatment objectives for critically ill patients. This highlights the necessity of integrating palliative care in this environment. Despite the potential advantages, several barriers impede the effective integration of palliative care in the ICU. Notably, many healthcare professionals (HCPs) in Indonesian ICUs have not fully leveraged the incorporation of palliative care. Purpose This study aimed to investigate and clarify the experiences of healthcare providers (HCPs) involved in administering palliative care to ICU patients in Indonesia. Methods This research employed a qualitative descriptive phenomenological approach. Semi-structured, in-depth individual interviews were conducted with four nurses and three doctors working in an Indonesian hospital. Colaizzi's method was used for data analysis. Results The analysis identified six themes from the interviews, reflecting the experiences of healthcare professionals in delivering palliative care in the ICU. These themes are: 1) Provide Professional Caring, 2) Caring and curing collaboration, 3) Quality Intensive Communication, 4) End-of-Life Care, 5) Controlling Feelings, and 6) Provide Holistic Caring. Conclusion Providing care for ICU patients demands not only the expertise of HCPs but also compassion, communication skills, and a holistic approach to patient care. By offering comprehensive palliative care in the ICU, healthcare professionals can address the diverse needs of patients and their families, promoting comfort, respect, and an improved quality of life throughout the illness. This inclusive approach enhances the experience for both patients and their families while supporting healthcare providers in delivering empathetic and patient-centered care. It is recommended that hospitals develop policies to enhance palliative care services in Indonesia.
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Affiliation(s)
- Henny Suzana Mediani
- Department of Pediatric Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Fidy Randy Sada
- Faculty of Nursing, Universitas Katolik De La Salle Manado, Manado, Indonesia
| | - Aan Nuraeni
- Department of Critical Care of Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Muhammad Arsyad Subu
- Nursing Program, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Alanazi NH. Intensive Care Unit Nurses' Experiences in Caring for End-of-Life Patients in Saudi Arabia: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:931. [PMID: 39063507 PMCID: PMC11277339 DOI: 10.3390/ijerph21070931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 07/12/2024] [Accepted: 07/16/2024] [Indexed: 07/28/2024]
Abstract
Background: Although extensive research on appropriate treatments has been conducted, how nurses provide care to patients at the end-of-life (EOL) is unclear, particularly among intensive care unit (ICU) nurses in Saudi Arabia. Purpose: To explore intensive care unit nurses' experiences in providing end-of-life care in Saudi Arabia. Methods: This study utilized an exploratory, descriptive, qualitative approach. A purposive sampling technique was used to recruit ICU nurses (n = 10) working in ICUs at a tertiary teaching hospital in Riyadh, Saudi Arabia. Using a semi-structured interview guide, ten individual interviews were conducted. Data were analyzed using thematic analysis. The trustworthiness of this study was ensured by following Lincoln and Guba's (1985) criteria. Findings: Four major themes related to ICU nurses' experiences of providing EOL care emerged, including: "feeling challenged but driven", "holistic caring", "collaborative working ethics", and "caring for the undying and dying". Conclusions: This study adds to the body of knowledge about the experience of ICU nurses caring for EOL patients. It offers valuable insights into challenges, coping strategies, holistic caring, collaboration, and the management of critical or dying patients at EOL in the ICUs.
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Affiliation(s)
- Naif H Alanazi
- Medical-Surgical Department, College of Nursing, King Saud University, Riyadh 12372, Saudi Arabia
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Xie P, Liu Z, Chen H, Wu Y, Xie P, Liu H, Ying W. Exploring the barriers and facilitators of palliative care in the adult intensive care unit from nurses' perspectives in China: A qualitative study. Nurs Crit Care 2024; 29:756-764. [PMID: 38311989 DOI: 10.1111/nicc.13035] [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: 08/27/2023] [Revised: 12/11/2023] [Accepted: 01/08/2024] [Indexed: 02/06/2024]
Abstract
BACKGROUND Intensive care units (ICUs) in China primarily focus on active rescue efforts, and it is not common to provide palliative care services within the ICU. As nurses play a primary role as caregivers for end-of-life patients in the ICU, it is necessary to explore the factors that impede or facilitate palliative care from their perspective. AIM To explore the barriers and facilitators associated with implementing palliative care in Chinese adult ICUs from nurses' perspectives. STUDY DESIGN This study utilized a descriptive phenomenological research approach and purposive sampling to conduct face-to-face semi-structured interviews with nurses working in adult ICUs from three comprehensive hospitals in China during the period between February and May 2023. A total of 17 nurses were interviewed, and the collected data were transcribed, coded, and synthesized thematically. RESULTS Two themes of barriers and facilitators of palliative care in the Chinese adult ICU were extracted. The three sub-themes of hindering factors are as follows: (1) The influence of Chinese traditional culture. (2) The specificity of the ICU context. (3) Lacking sufficient attention in the ICU. The three sub-themes of the promoting factors are as follows: (1) Government and society value palliative care. (2) Patients and their families have palliative care needs. (3) Nurses view palliative care positively. CONCLUSION Currently, integrating palliative care into the ICU may face challenges such as cultural factors, the specificity of the ICU context, and insufficient attention. However, it is worth noting that as the government and society place more emphasis on palliative care, more and more people are gradually paying attention to the palliative care needs of critically ill patients and their families. RELEVANCE TO CLINICAL PRACTICE This study serves as a reference for exploring an ICU palliative care service model that is suitable for China's national conditions, such as education and training, resource allocation, service processes, and the palliative care environment, among others.
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Affiliation(s)
- Peiying Xie
- School of Nursing, Shantou University Medical College, Shantou, People's Republic of China
| | - Zhili Liu
- Department of Nursing Research, The First Affiliated Hospital of Shantou University Medical College, Shantou, People's Republic of China
| | - Huiyao Chen
- Intensive Care Unit, The First Peoples Hospital of Foshan, Foshan, People's Republic of China
| | - Yanchun Wu
- Department of Nursing Research, The First Affiliated Hospital of Shantou University Medical College, Shantou, People's Republic of China
| | - Peijie Xie
- Urology Surgery, The Second Affiliated Hospital of Shantou University Medical College, Shantou, People's Republic of China
| | - Hui Liu
- Orthopaedic Surgery, Cancer Hospital of Shantou University Medical College, Shantou, People's Republic of China
| | - Wenjuan Ying
- Department of Nursing Research, The First Affiliated Hospital of Shantou University Medical College, Shantou, People's Republic of China
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Yildiz Çifçioğlu Z, Harmanci Seren AK. The Validity and Reliability of the Thanatophobia Scale-Turkish Form: A Psychometric Study Among Nurses. OMEGA-JOURNAL OF DEATH AND DYING 2024; 89:718-728. [PMID: 35343307 DOI: 10.1177/00302228221082755] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: To examine the validity and reliability of the Thanatophobia Scale-Turkish Form among nurses. Design and methods: This methodological study included 154 nurses. Content and construct validity, item analysis, confirmatory factor analysis, and internal consistency were used to evaluate the data. Findings: The content validity index of the scale was 0.91. Item-total score correlation values varied between 0.453 and 0.718. As a result of the confirmatory factor analyses, one factor was confirmed. Cronbach's alpha internal consistency coefficient was 0.854. Practice Implications: Thanatophobia Scale-Turkish Form is a valid and reliable tool used to evaluate the fear of death among nurses.
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Ayran G, Çevik Özdemir HN. Psychometric properties of the Turkish version of the Stress Scale for Nurses Providing End-of-Life Care for Children. Palliat Support Care 2024; 22:128-136. [PMID: 36727293 DOI: 10.1017/s147895152200181x] [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] [Indexed: 02/03/2023]
Abstract
OBJECTIVES This study was carried out to evaluate the validity and reliability of the Stress Scale for Pediatric Nurses Performing End-of-Life Care for Children in Turkey. METHODS This was a methodological study conducted with 222 pediatric nurses. Data were collected using the information form for pediatric nurses and the "stress scale for nurses performing end-of-life care for children." Content and construct validity, item analysis, confirmatory factor analysis and internal consistency were used to evaluate the data. The Global Pharmaceutical Regulatory Affairs Summit checklist was followed in this study. RESULTS The content validity index of the scale was 0.93. Item-total score correlation values ranged from 0.594 to 0.885. The 5-factor structure of the scale was confirmed as a result of confirmatory factor analysis. Factor loads were greater than 0.30, and fit indices were greater than 0.80. The Cronbach's alpha coefficient of the Turkish version of the scale was 0.97. SIGNIFICANCE OF RESULTS The stress scale for nurses performing end-of-life care for children is a valid and reliable measurement tool for the Turkish sample. This scale facilitates the assessment of the stress levels of pediatric nurses who provide end-of-life care to children. Also, this scale can be used in interventional studies to improve the well-being of pediatric nurses.
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Affiliation(s)
- Gülsün Ayran
- Faculty of Health Sciences, Erzincan Binali Yıldırım University, Erzincan, Turkey
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Karkhah S, Jafari A, Paryad E, Kazemnejad Leyli E, Ghazanfari MJ, Osuji J, Javadi-Pashaki N. Death Anxiety and Related Factors Among Iranian Critical Care Nurses: A Multicenter Cross-Sectional Study. OMEGA-JOURNAL OF DEATH AND DYING 2024; 88:1153-1167. [PMID: 34911401 DOI: 10.1177/00302228211062368] [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] [Indexed: 11/16/2022]
Abstract
The aim of this study is to investigate death anxiety (DA) and related factors among critical care nurses. Using a cross-sectional research design, 325 critical care nurses in eight hospitals in Iran enrolled in the study. Multiple logistic regression analysis showed that deputy head nurse (OR = 18.299; CI: 1.764-189.817; p = .015), shift morning fixed (OR = 8.061; CI: 1.503-43.243; p = .015), surviving parents (OR = 3.281; CI: 1.072-10.037; p = .037), number of children (OR = 1.866; CI: 1.157-3.010; p = .011), years of working experience (OR = 1.143; CI: 1.048-1.246; p = .003), number of end-of-life patient care in the last 3 months (OR = .900; CI: .828-0.977; p = .012), age (OR = .809; CI: .732-.893; p < .001), CCU nurses (OR = .250; CI: .100-.628; p = .003), and mild stressful life events (SLEs) (OR = .167; CI: .046-.611; p = .007) were significantly related to high DA. Therefore, nurse managers and policymakers should pay special attention to these related factors in developing programs to maintain and promote the health of critical care nurses to improve the quality of nursing care.
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Affiliation(s)
- Samad Karkhah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
- Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ali Jafari
- Student Research Committee, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Ezzat Paryad
- Department of Nursing (Medical-Surgical), GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Ehsan Kazemnejad Leyli
- Department of Bio‑statistics, Social Determinants of Health Research Center (SDHRC), School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Javad Ghazanfari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
| | - Joseph Osuji
- School of Nursing and Midwifery, Faculty of Health, Community, and Education, Mount Royal University, Calgary, Ab, Canada
| | - Nazila Javadi-Pashaki
- Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran
- Department of Nursing, Cardiovascular Diseases Research Center, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
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Ma JH, Bai Y, Xie DS, Yang GF. Factors Influencing the Interruption of Nursing Document Writing in the Intensive Care Unit: A Cross-Sectional Survey. J Multidiscip Healthc 2023; 16:419-427. [PMID: 36820218 PMCID: PMC9938661 DOI: 10.2147/jmdh.s394817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 01/23/2023] [Indexed: 02/16/2023] Open
Abstract
Objective To explore the current status of interruption events in nursing document writing in the intensive care unit (ICU) using a cross-sectional survey. Methods Between May and October 2021, the convenience sampling method was used to observe the interruption events in nursing document writing in the ICU. A total of 54 nurses and 7 indicators were observed: the start time, end time, interruption period, source, type, duration and outcome of interruption events. Results A total of 438 interruption events in nursing document writing occurred in 85.955 hours, with a frequency of 5.093 times/hour and a duration of 4787.00 (1152.00, 13,109.00) seconds. The frequency of interruption events in nursing document writing was the highest (11 times/hour) and the duration was the longest (9581.50 seconds) from 08:00 to 12:00. The main sources of interruptions for nurses with 10 or more years of service or with the professional title of nurse are nurses themselves and their colleagues. The main sources of interruptions for nurses who have been in charge for 10 years or over are the working environment and doctors. This intervention in work continuity occurs unexpectedly; however, if adjustments are made to nursing procedures, the interruption can be terminated rapidly or adverse consequences can be avoided. Years of working experience, seniority level, interruption time periods and professional titles were independent factors influencing the number of interruption events, and they were all positively correlated. The results of this study show that there were statistically significant differences in the incidence of negative outcomes among ICU nurses with varying years of working experience and professional titles. Conclusion Interruptions in nursing document writing have high frequency, complex sources and multiple types. For senior nurses, the outcome was predominantly positive, while for junior nurses, it was predominantly negative.
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Affiliation(s)
- Jun-Hong Ma
- Neurology Department, Heze Municipal Hospital, Heze, Shandong Province, 274000, People’s Republic of China
| | - Yuan Bai
- Vascular Surgery Department, Shanxi Bethune Hospital, Taiyuan, People’s Republic of China,Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China,Correspondence: Yuan Bai, Vascular Surgery Department, Shanxi Bethune Hospital, No. 99, Longcheng Street, Xiaodian District, Taiyuan, 030032, People’s Republic of China, Tel +86 13934660965, Email
| | - De-Shun Xie
- CT Department, Heze Municipal Hospital, Heze, Shandong Province, People’s Republic of China
| | - Gui-Fang Yang
- Neurology Department, Heze Municipal Hospital, Heze, Shandong Province, 274000, People’s Republic of China
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Rahmani F, Hosseinzadeh M, Gholizadeh L. Complicated grief and related factors among nursing staff during the Covid-19 pandemic: a cross-sectional study. BMC Psychiatry 2023; 23:73. [PMID: 36703151 PMCID: PMC9879561 DOI: 10.1186/s12888-023-04562-w] [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: 10/13/2022] [Accepted: 01/23/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The challenging working conditions during the Covid-19 pandemic created a perfect storm that can seriously impact nurses' physical and psychological well-being. Our study aimed to investigate complicated grief and its related factors among nursing staff during the Covid-19 pandemic. METHODS This is a cross-sectional study. The participants comprised 375 nurses selected by the convenience sampling method from designated wards for patients with Covid-19 in 3 hospitals in Tabriz, Iran. Participants completed a survey containing demographic and clinical questions, the Inventory of Complicated Grief, and the Multidimensional Scale of Perceived Social Support. Multiple regression analysis was used to identify the associates of nurses' grief. The STROBE guidelines were followed in reporting the study's findings. RESULTS A significant proportion of participants (57.6%) were found to be suffering from complicated grief. Gender, educational background, type of ward, type of nursing role, type of working shift, years of nursing work experience, and experience working in the Covid-19 settings remained the significant associates of nurses' grief in the regression analysis. CONCLUSION Due to frequent exposure to patients' deaths, healthcare providers are at increased risk of suffering from complicated grief during the Covid-19 and post-pandemic. If it remains unresolved, complicated grief can result in significant health problems and the experience of burnout among nurses. Governments, health authorities, and nursing managers should support nurses who work in Covid-19 settings to reduce the adverse impact of the pandemic on nurses' health and well-being.
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Affiliation(s)
- Farnaz Rahmani
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mina Hosseinzadeh
- grid.412888.f0000 0001 2174 8913Department of Community Health Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Gholizadeh
- grid.117476.20000 0004 1936 7611Faculty of Health, University of Technology, Sydney, NSW Australia
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Erikson AE, Puntillo KA, McAdam JL. Bereavement Experiences of Families in the Cardiac Intensive Care Unit. Am J Crit Care 2022; 31:13-23. [PMID: 34972855 DOI: 10.4037/ajcc2022859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Losing a loved one in the intensive care unit is associated with complicated grief and increased psychologic distress for families. Providing bereavement support may help families during this time. However, little is known about the bereavement experiences of families of patients in the cardiac intensive care unit. OBJECTIVE To describe the bereavement experiences of families of patients in the cardiac intensive care unit. METHODS In this secondary analysis, an exploratory, descriptive design was used to understand the families' bereavement experiences. Families from 1 cardiac intensive care unit in a tertiary medical center in the western United States participated. Audiotaped telephone interviews were conducted by using a semistructured interview guide 13 to 15 months after the patient's death. A qualitative, descriptive technique was used for data analysis. Two independent researchers coded the interview transcripts and identified themes. RESULTS Twelve family members were interviewed. The majority were female (n = 8, 67%), spouses (n = 10, 83%), and White (n = 10, 83%); the mean age (SD) was 58.4 (16.7) years. Five main themes emerged: (1) families' bereavement work included both practical tasks and emotional processing; (2) families' bereavement experiences were individual; (3) these families were resilient and found their own resources and coping mechanisms; (4) the suddenness of a patient's death influenced families' bereavement experiences; and (5) families' experiences in the intensive care unit affected their bereavement. CONCLUSIONS This study provided insight into the bereavement experiences of families of patients in the cardiac intensive care unit. These findings may be useful for professionals working with bereaved families and for cardiac intensive care units considering adding bereavement support.
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Affiliation(s)
- Alyssa E. Erikson
- Alyssa E. Erikson is an associate professor, California State University, Monterey Bay, California
| | - Kathleen A. Puntillo
- Kathleen A. Puntillo is a professor emeritus, University of California, San Francisco, California
| | - Jennifer L. McAdam
- Jennifer L. McAdam is a professor, Samuel Merritt University, San Mateo, California
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Baudoin CD, McCauley AJ, Davis AH. New Graduate Nurses in the Intensive Care Setting. Crit Care Nurs Clin North Am 2022; 34:91-101. [PMID: 35210028 PMCID: PMC8782740 DOI: 10.1016/j.cnc.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Colette D Baudoin
- School of Nursing, Louisiana State University Health Sciences Center New Orleans, 1900 Gravier Street, #417, New Orleans, LA 70112, USA.
| | - Aimme Jo McCauley
- School of Nursing, Louisiana State University Health Sciences Center New Orleans, 1900 Gravier Street, #5B7, New Orleans, LA 70112, USA
| | - Alison H Davis
- School of Nursing, Louisiana State University Health Sciences Center New Orleans, 1900 Gravier Street, #509, New Orleans, LA 70112, USA
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Köktürk Dalcali B, Taş AS. What Intern Nursing Students in Turkey Think About Death and End-of-Life Care? A Qualitative Exploration. JOURNAL OF RELIGION AND HEALTH 2021; 60:4417-4434. [PMID: 34282510 PMCID: PMC8288065 DOI: 10.1007/s10943-021-01330-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 06/12/2023]
Abstract
This descriptive qualitative study was planned to determine the views of intern nursing students about death and end-of-life care. The study was completed with 12 intern students based on the criterion of data saturation. As a result of the study, the categories of 'end,' 'uncertainty,' 'fear,' 'beginning,' 'helplessness' under the theme of death, 'ensuring peace,' 'continuing communication' 'providing psychosocial/spiritual support,' 'acting in conformity with principles of ethics/morality,' 'continuing to provide physical care,' 'supporting the family,' 'making the best use of the limited remaining time or helping the patient's last wishes come true' under the theme of end-of-life care emerged.
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Affiliation(s)
- Berna Köktürk Dalcali
- Department of Nursing Fundamentals, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Bandırma, Balıkesir Turkey
| | - Ayşe Sinem Taş
- Department of Nursing Fundamentals, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Bandırma, Balıkesir Turkey
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Benbenishty J, Ganz FD, Anstey MH, Barbosa-Camacho FJ, Bocci MG, Çizmeci EA, Dybwik K, Ingels C, Lautrette A, Miranda-Ackerman RC, Estebanez-Montiel B, Plowright C, Ricou B, Robertsen A, Sprung CL. Changes in intensive care unit nurse involvement in end of life decision making between 1999 and 2016: Descriptive comparative study. Intensive Crit Care Nurs 2021; 68:103138. [PMID: 34750044 DOI: 10.1016/j.iccn.2021.103138] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 08/12/2021] [Accepted: 08/30/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Comparison of nurse involvement in end of life decision making in European countries participating in ETHICUS I- 1999 and ETHICUS II- 2015. METHODOLOGY This was a prospective observational study of 22 European ICUs included in the ETHICUS-II and I. Data were collected as per the ETHICUS-I and ETHICUS-II protocols. Four questions within the ETHICUS protocols related to nurse involvement in end of life decision making were analyzed. This is a comparison of changes in nurse involvement in end of life decisions from 1999 to 2015. SETTING International e-based questionnaire completed by an intensive care clinician when an end of life decision was performed on any patient. SUBJECTS Intensive care physicians and nurses, no interventions were performed. MEASUREMENTS A 20 question survey was used to describe the decision making process, on what basis was the decision made, who was involved in the decision making process, and what precise decisions were made. RESULTS A total of 4592 cases from 22 centres are included. While there was more agreement between nurses and physicians in ETHICUS-I compared to ETHICUS-I, fewer discussions with nurses occurred in ETHICUS-II. The frequency of end of life decisions that were discussed with nurses decreased in all three regions between ETHICUS-I and ETHICUS-II. CONCLUSION Based on the results of the current study, nurses should be further encouraged to increase their involvement in end of life decision-making, especially those in southern Europe.
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Affiliation(s)
- Julie Benbenishty
- Hadassah Hebrew University Medical Center and School of Nursing, Israel.
| | - Freda DeKeyser Ganz
- Hadassah Hebrew University School of Nursing and Jerusalem College of Technology, Israel.
| | - Matthew H Anstey
- Sir Charles Gairdner Hospital, Perth, Australia; School of Public Health, Curtin University, Perth, Australia; School of Medicine, University of Western Australia, Australia.
| | | | - Maria Grazia Bocci
- Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Elif Ayşe Çizmeci
- University of Toronto, Faculty of Medicine, Interdepartmental Division of Critical Care, Sunnybrook Health Sciences Centre, Toronto, Canada; Uludağ University, Faculty of Medicine, Department of Anesthesiology and Intensive Care, Bursa, Turkey
| | - Knut Dybwik
- Intensive Care Unit, Nordland Hospital, Bodø, Nord University, Bodø, Norway
| | - Catherine Ingels
- University Hospital Gasthuisberg Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, Herestraat 49, B-3000 Leuven, Belgium.
| | - Alexandre Lautrette
- Intensive Care Medicine, Gabriel-Montpied University Hospital, Clermont-Ferrand, France.
| | | | | | | | - Bara Ricou
- Intensive Care of Geneva, Department of Anesthesiology, Pharmacology and Intensive Care, Geneva Hospital and University of Geneva, Switzerland.
| | - Annette Robertsen
- Department of Anesthesiology and Critical Care, Oslo University Hospital, Oslo, Norway.
| | - Charles L Sprung
- Department of Intensive Care, Hadassah Hebrew University Medical Center, Israel.
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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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Sandoval SÁ, Vargas MADO, Zilli F. STRENGTHS AND WEAKNESSES TO FACE THE DYING AND DEATH PROCESS: STUDENTS' REFLECTIONS. TEXTO & CONTEXTO ENFERMAGEM 2020. [DOI: 10.1590/1980-265x-tce-2019-0257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to identify the strengths and weaknesses recognized by the students to face the dying process and death in the hospital setting. Method: a qualitative and descriptive approach. The sample was made up of 19 students of the fifth-year of the Nursing course, complying with the in-hospital professional practice, and the study was carried out at a university in the Magallanes and Chilean Antarctic Region, Chile, between September and October 2018. The collected data were submitted to the precepts of Content Analysis. Results: among the identified strengths, the following are to be mentioned: previous experience with death, the support provided by the guiding nurse during hospital stay, the student's mental maturity, soft skills, and sensitivity. In its turn, the limitations identified include lack of experience, psychological immaturity, the few tools they possess, factors associated with the patient such as age, and the affective bonds created with the patient that may end up causing suffering to the student. Conclusion: both the strengths and weaknesses recognized by the students must be worked on in the academy throughout the training, in such a way that the students may acquire the necessary tools to face the process of death and dying. Death must be discussed as an integral phenomenon in order to achieve a better understanding of this topic by the students, so that they can act in the best possible way in front of terminal patients, providing quality and humanized care for the patients and/or families.
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‘I cried too’ – Allowing ICU nurses to grieve when patients die. Intensive Crit Care Nurs 2019; 52:1-2. [DOI: 10.1016/j.iccn.2019.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2019] [Indexed: 12/30/2022]
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