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Deng C, Li Q, Hu L, Lin J, Wu Y, Zheng R, Guo Q. Nurses' lived experience of providing hospice care in the emergency department in mainland China: A qualitative study. Int Emerg Nurs 2024; 75:101464. [PMID: 38823289 DOI: 10.1016/j.ienj.2024.101464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 03/28/2024] [Accepted: 05/18/2024] [Indexed: 06/03/2024]
Affiliation(s)
- Chanjuan Deng
- School of Nursing, Capital Medical University, Beijing, 100069 China
| | - Qianqian Li
- Department of Emergency, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020 China
| | - Lei Hu
- Department of Outpatient, Peking University Shougang Hospital, Beijing, 100144 China
| | - Junyi Lin
- School of Nursing, Capital Medical University, Beijing, 100069 China
| | - Yanchao Wu
- School of Nursing, Capital Medical University, Beijing, 100069 China
| | - Ruishuang Zheng
- Department of Hepatobiliary Cancer, Tianjin Medical University Cancer Hospital and Institute, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, 300060 China
| | - Qiaohong Guo
- School of Nursing, Capital Medical University, Beijing, 100069 China.
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Dias R, Robinson K, Poirier P. The Effect of Simulation on Nursing Student Perceptions of Readiness to Provide End-of-Life Care. J Hosp Palliat Nurs 2023; 25:E116-E123. [PMID: 37930167 DOI: 10.1097/njh.0000000000000979] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Evidence suggests that nursing students in a prelicensure nursing program lack the required preparation to care for patients at the end of life (EOL), causing feelings of inadequacy and stress. New graduate nurses (years 0-5) struggle to address the needs of this patient population, leading to considering career changes. Nursing simulation has been shown to enhance competency and is gaining increasing favor in prelicensure nursing education. Little research has been conducted on the application of simulation using standardized patients in EOL patient scenarios. This study used live standardized patients who simulated a home health patient encounter with the nursing student acting as a home health hospice nurse. Watson's theory of caring and interpretive phenomenological analysis guided the qualitative research method and analysis. Five students chose to participate in this simulation and completed 6 reflective questions. After simulation, they felt more comfortable having difficult discussions about EOL care, treatment options, and patient fears. Participants noted the importance of communication in a team setting, which included the caregiver as an integral member. The use of standardized patient-simulated experiences increases realism and provides students the opportunity to bridge the gap between didactic education and clinical practice. This will enhance their readiness and confidence in providing EOL care.
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Jones K, Draper J, Bolton N. Nursing students experiences of end-of-life care. Int J Palliat Nurs 2023; 29:466-475. [PMID: 37862156 DOI: 10.12968/ijpn.2023.29.10.466] [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: 10/22/2023]
Abstract
BACKGROUND Undergraduate nursing students spend a significant amount of time in clinical placements where they are involved in care at the end of a person's life and care after death. While their role is to provide compassionate care, some students feel wholly unprepared. AIMS The aim of this qualitative study was to explore student nurses' experiences of care in death, dying and post death care, and to explore how students can be better prepared to provide such care. METHODS This is a qualitative descriptive study that is concerned with the subjective reality of participant's experiences. FINDINGS Six themes were developed from the analysis: first encounters with death and dying; preparedness; mentoring and support received; the caring role; striving to cope; working with families and working through COVID-19. CONCLUSION Students described their experience of placements in end-of-life care as challenging, yet were also able to adopt ways to develop as compassionate practitioners.
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Affiliation(s)
- Kerry Jones
- Senior Lecturer in End-of-Life Care, The Open University, Milton Keynes, Buckinghamshire
| | - Jan Draper
- Emeritus Professor in Nursing, The Open University, Milton Keynes, Buckinghamshire
| | - Nerys Bolton
- Associate Head of School, Curriculum and Innovation, The Open University, Milton Keynes, Buckinghamshire
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Erden Melikoğlu S, Köktürk Dalcalı B, Aydoğan S. The Relationship of Intensive Care Nurses' Attitudes Towards Organ Donation With Their Attitudes Towards Euthanasia and Moral Sensitivity. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231199882. [PMID: 37650678 DOI: 10.1177/00302228231199882] [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: 09/01/2023]
Abstract
Determination of the relationship between nurses' attitudes towards issues, such as end-of-life care that is specific to intensive care, euthanasia, and organ donation and their moral sensitivity levels is one of the important points for working out ethical problems encountered in intensive care units and increasing the quality of care. This study was conducted to determine the relationship between the attitudes of intensive care nurses towards organ donation, euthanasia, and terminal patients and their moral sensitivity. The study was completed with 175 nurses who agreed to participate in the study. Informed consent of the participants was obtained. While nurses' attitudes towards euthanasia, death, and caring for the dying patient did not correlate with their moral sensitivities, their attitudes towards organ donation did.
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Affiliation(s)
- Seçil Erden Melikoğlu
- Department of Fundamentals of Nursing, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | | | - Semine Aydoğan
- Anesthesiology and Resuscitation Department, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Zhu P, Shi G, Wu Q, Ji Q, Liu X, Xu H, Wang W, Qian M, Zhang Q. Ethical challenges of death faced by nursing undergraduates in clinical practice: A qualitative study. NURSE EDUCATION TODAY 2022; 118:105516. [PMID: 36054977 DOI: 10.1016/j.nedt.2022.105516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/24/2022] [Accepted: 08/15/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The characteristics of nursing work determine that nursing practice is inseparable from ethical considerations and decision-making. Nursing students have difficulty in dealing with death and it is necessary to explore the ethical challenges faced by nursing undergraduates in the process of clinical practice of nursing dead or dying patients. OBJECTIVE To explore the ethical challenges faced by undergraduate nursing students in nursing of dead or dying patients. DESIGN This study was conducted with a phenomenological approach in a qualitative design. SETTINGS, PARTICIPANTS, METHODS The purposive sample of the study consisted of 35 nursing undergraduates in their last year of education at the bachelor level in nursing who had experience of clinical practice. They voluntarily participated in the study. Data were collected through semi-structured interviews and analyzed using the Colaizzi analysis method. RESULTS Through analysis of interviews, four themes were identified: (1) Distant death is coming-inadequate preparation; (2) Making decisions between the needs of different positions-difficult balance; (3) Experience a patient's death up close-irresistible resistance; (4) Providing bereavement care after a patient's death-insurmountable obstacle. CONCLUSION This study shows that nursing undergraduates face ethical challenges in the process of caring for dead or dying patients and the early identification of these ethical challenges is of great significance. University and hospital leaders should pay attention to the ethic and death education of nursing undergraduates so as to help nursing students prepare for clinical practice.
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Affiliation(s)
- Pingting Zhu
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China; Jiangsu Key Laboratory of Zoonosis, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China.
| | - Guanghui Shi
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Qiwei Wu
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Qiaoying Ji
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Xinyi Liu
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - HuiWen Xu
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Wen Wang
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Meiyan Qian
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
| | - Qianqian Zhang
- School of Nursing, Yangzhou University, 136 Jiangyang Middle Road, Hanjing County, Yangzhou City 225009, Jiangsu Province, China
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Saifan AR, Al Zoubi AM, Alrimawi I, Al-Yateem N, Abdelkader R, Assaf EA. Occupational stress and turnover intention: A qualitative study reporting the experiences of nurses working in oncology settings in Jordan. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2135069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | | | - Intima Alrimawi
- School of Nursing, Georgetown University, Washington, DC, USA
| | - Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Charles Sturt University, New South Wales, Australia
| | - Raghad Abdelkader
- Nursing Department, Applied Science Private University, Amman, Jordan
| | - Enas A. Assaf
- Nursing Department, Applied Science Private University, Amman, Jordan
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ÇAKMAK B, İNKAYA B, ALTUNSOY A. Investigation of The Relationship Between Nursing Students' Fear of Death and Their Perceptions of Patient Care. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.30934/kusbed.1075019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Amaç: Bu araştırma hemşirelik öğrencilerinin yaşadıkları ölüm korkusu ile hasta bakım algıları arasındaki ilişkinin incelenmesi amacıyla gerçekleştirilmiştir.
Yöntem: Araştırma kesitsel, tanımlayıcı ve ilişki arayıcı tipte olup araştırmanın örneklemini, Ekim-Kasım 2021 tarihleri arasında bir üniversitenin hemşirelik bölümünde öğrenim gören 326 öğrenci oluşturmuştur. Verilerin toplanmasında, ‘Kişisel bilgi formu’, ‘Ölüm korkusu Ölçeği’ ve ‘Bakım Davranışları ölçeği-24’ kullanılmıştır. Veriler yüz yüze toplanmış olup form ve ölçeklerin doldurulması ortalama 15 dakika sürmüştür.
Bulgular: Çalışmaya katılanların çoğunun 280’inin (%85,9) kadın olduğu, 179’unun (%54,9) ölmekte olan hasta bakımı ile ilgili bilgi kaynaklarını okuduğunu, 245 öğrencinin (%75,2) çevresinde ölüm olgusuyla karşılaştığı, 306’sının (%93,9) yaşam sonu dönemde olan hastaya bakım verme deneyiminin olmadığı ve 175’inin (%53,7) ölümden korktuğu belirlenmiştir. Cinsiyete bağlı olarak kadınların hem ölüm korkusunun hem de yaşam sonu hasta bakımı hemşirelik algılarının, BDÖ-24 Ölçeği alt boyutlarından bağlılık ve saygılı olma alanlarında daha yüksek puan aldıkları belirlenmiştir. Yaşam sonu dönemde bir hastaya bakım verme deneyimi olmayan hemşirelik öğrencilerinin, ölüm korkusu ve bakım davranışları arasında anlamlı bir fark olmadığı belirlenmiştir (p>0,05).
Sonuç: Hemşirelik öğrencilerinin hemşirelik bakım algıları yüksektir. Kadın öğrencilerin hem ölüm korkuları hem de hemşirelik bakımı algıları erkeklerden yüksek olarak bulunmuştur. Yaşam sonu dönemde olan hastaya bakım verme deneyimi olmayan hemşirelik öğrencilerinin daha fazla güvence verme algısına sahip oldukları belirlenmiştir. Öğrencilerin yaşam sonu dönemde olan hastaya güvence verme algılarının yüksek olması açık bir şekilde yaşam sonu hemşirelik bakımı konusunda yetersiz bilgiye sahip olduklarını göstermektedir. Bu nedenle lisans eğitimi boyunca yaşam sonu dönem hasta bakımı ve ölüm korkusu konularında müfredatta daha fazla başlığın ve eğitim metodlarının yer almasının gerekli olduğu düşünülmektedir.
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Winger A, Früh EA, Holmen H, Kvarme LG, Lee A, Lorentsen VB, Misvær N, Riiser K, Steindal SA. Making room for life and death at the same time - a qualitative study of health and social care professionals' understanding and use of the concept of paediatric palliative care. BMC Palliat Care 2022; 21:50. [PMID: 35410275 PMCID: PMC9004044 DOI: 10.1186/s12904-022-00933-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The concept of pediatric palliative care (PPC) is applied differently within the healthcare system and among healthcare professionals (HCPs). To our knowledge, no studies have investigated how multidisciplinary HCPs understand the concept of PPC and the aim of this study was to explore the concept of PPC from the view of HCP in a paediatric setting. METHODS We employed an explorative and descriptive design and conducted four focus groups with a total of 21 HCPs working in hospitals with children in palliative care. The data were analysed using qualitative content analysis. RESULTS The data analysis of the concept of pediatric palliative care resulted in two themes. The first theme "A frightening concept that evokes negative emotions," contains categories to explore the meaning, named "An unfamiliar and not meaningful concept, "A concept still associated with death and dying" and "Healthcare professionals' responsibility for introducing and using the concept and, to obtain a common meaning." The second theme was named "A broad and complementary concept," containing the categories "Total care for the child and the family," "Making room for life and death at the same time" and "The meaning of alleviation and palliative care." CONCLUSIONS The included HCPs reflected differently around PPC but most of them highlighted quality of life, total care for the child and the child's family and interdisciplinary collaboration as core elements. Attention to and knowledge among HCPs might change the perception about PPC from a frightening concept to one that is accepted by all parties, implemented in practice and used as intended. However, our study reveals that there is still some work to do before PPC is understood and accepted by all those involved.
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Affiliation(s)
- Anette Winger
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway.
| | - Elena Albertini Früh
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - Heidi Holmen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - Lisbeth Gravdal Kvarme
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - Anja Lee
- Oslo University Hospital, Oslo, Norway
| | | | - Nina Misvær
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - Kirsti Riiser
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway
| | - Simen A Steindal
- VID Specialized University, Oslo, Norway.,Lovisenberg Diaconal University College, Oslo, Norway
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Zhou S, Wei L, Hua W, He X, Chen J. A qualitative study of phenomenology of perspectives of student nurses: experience of death in clinical practice. BMC Nurs 2022; 21:74. [PMID: 35351123 PMCID: PMC8966360 DOI: 10.1186/s12912-022-00846-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 03/14/2022] [Indexed: 11/18/2022] Open
Abstract
Aim To describe the experiences of student nurses in confronting the death of their patients, and to understand how they cope with these events and to what extent there are unmet needs that can be addressed in their trainings. Methods Semi-structured interview method was used to collect data from Chinese nursing students and then Colaizzi’s seven-step analysis method was applied to identify recurrent themes in their responses to patient deaths. We listened the tape repeatedly combined with observations of their non-verbal behaviors, then transcribed them with emotional resonance, and entered them into Nvivo. After that, we extracted repeated and significant statements from the transcriptions, coded, then clustered codes into sub-themes and themes which were identified by the comparation with transcriptions and re-confirmation with our participants. Results After confirmation from the interviewees, five themes emerged: emotional experience, challenge, growth, coping and support. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-022-00846-w.
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Affiliation(s)
- ShiShuang Zhou
- Department of Nursing Aministration, School of Nursing, Army Medical University, Chongqing, China
| | - LiZhen Wei
- XiangYa Nursing School of Central South University, 172 TongZiPou Rd, Yuelu District, Changsha, Hunan, 410000, China
| | - Wei Hua
- JiangNing Hospital, Nanjing, China
| | - XioaChong He
- Department of Nursing Aministration, School of Nursing, Army Medical University, Chongqing, China.
| | - Jia Chen
- XiangYa Nursing School of Central South University, 172 TongZiPou Rd, Yuelu District, Changsha, Hunan, 410000, China.
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Green G, Gendler Y, Sharon C. “Fighting for life and losing”: Intensive Care Unit Nursing Staff’s Experience With COVID-19 Patient Deaths During the First Two Waves: A Qualitative Study. INQUIRY: THE JOURNAL OF HEALTH CARE ORGANIZATION, PROVISION, AND FINANCING 2022; 59:469580221094327. [PMID: 35574939 PMCID: PMC9111020 DOI: 10.1177/00469580221094327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The study explored the experiences of intensive care unit nursing staff caring
for COVID-19 patients who eventually died during the two first pandemic waves.
We used - descriptive-qualitative-phenomenological. The findings included four
main themes—the first vs the second COVID-19 waves, fighting for life and being
unable to win, a chronicle of pre-determined death, and nurse’s emotional coping
with patient death. Based on these findings, we have concluded that in order to
enhance nurses’ mental health, policy makers and governments need to create an
appropriate support system for them.
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Affiliation(s)
- Gizell Green
- Department of Nursing, School of Health Sciences, Ariel University, Ariel, Israel
| | - Yulia Gendler
- Department of Nursing, School of Health Sciences, Ariel University, Ariel, Israel
| | - Cochava Sharon
- Department of Nursing, School of Health Sciences, Ariel University, Ariel, Israel
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Chen Y, Tan X, Xing C, Zheng J. How healthcare workers respond to COVID-19: The role of vulnerability and social support in a close relationships defense mechanism. Acta Psychol (Amst) 2021; 221:103442. [PMID: 34717255 PMCID: PMC8549441 DOI: 10.1016/j.actpsy.2021.103442] [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: 05/27/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 12/25/2022] Open
Abstract
Healthcare workers play a vital role in the fight against COVID-19. Based on Terror Management Theory (TMT), the present research examined whether a close relationships defense mechanism reduces anxiety among healthcare workers (N = 729) in China. Our results suggest that this defense mechanism, as indexed by relationship satisfaction, serves as an effective terror management source after exposure to reminders of death (MS; mortality salience). These findings extend TMT by identifying two moderating variables: vulnerability and social support. In a low objective vulnerability group, healthcare workers who subjectively believed themselves as less vulnerable to COVID-19 showed a stronger defense mechanism after a MS manipulation as compared to those who felt more vulnerable. Further, healthcare workers with higher levels of social support reported more relationship satisfaction. These findings have practical implications for guiding healthcare workers on how to buffer death-related anxiety and maintain their mental health in the fight against COVID-19.
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Affiliation(s)
- Yunjiao Chen
- Department of Psychology, Renmin University of China, Beijing 100872, China
| | - Xuyun Tan
- Institute of Sociology, Chinese Academy of Social Sciences, Beijing 100732, China
| | - Cai Xing
- Department of Psychology, Renmin University of China, Beijing 100872, China,Corresponding author at: Department of Psychology, Renmin University of China, ZhongGuanCun Street No. 59, Beijing 100872, China
| | - Jiaren Zheng
- The Third Hospital of Jinjiang, Fujian 362211, China
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Ma RH, Zhao XP, Ni ZH, Xue XL. Paediatric oncology ward nurses' experiences of patients' deaths in China: A qualitative study. BMC Nurs 2021; 20:197. [PMID: 34649533 PMCID: PMC8518223 DOI: 10.1186/s12912-021-00720-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 09/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Considering cancer death is second only to accidental death in the number of lives claimed each year,nurses in paediatric oncology wards often experience helplessness, sadness, frustration and such other adverse emotions when they witness children's death due to cancer.However,there is a lack of qualitative studies on nurses who witness the death of children in paediatric oncology wards in China. METHOD A qualitative study was conducted using a semi-structured interview guide with 22 paediatric oncology ward nurses. Interviews were recorded and simultaneously translated and transcribed. Thematic analysis was used to analyse the data. RESULTS The analysis resulted in the identification of three main thematic categories: Different emotional expression, Different copingstrategies, A weak support system. Nursing managers should pay attention to problems faced by nurses in paediatric oncology wards, and take targeted measures in terms of continuing training courses, improving the psychological adaptability of oncology professional nurses, and providing them substantive support. CONCLUSION Nurses in paediatric oncology wards have strong stress responses to facing the death of children. They reported experiencing complex psychological feelings and have different coping attitudes. Healthcare authorities should recognise and understand the needs of paediatric oncology ward nurses, who often witness the death of children. Appropriate and effective support measures should be planned and implemented for these nurses to maintain their mental health, thus enabling them to better serve patients.
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Affiliation(s)
- Ruo Han Ma
- Children's Hospital of Soochow University, No.92, Zhongnan St, Suzhou, 215025, China.,Medical College of Soochow University, No.199 Renai Rd, Suzhou, 215123, China
| | - Xue Ping Zhao
- School of Nursing, Medical College of Soochow University, No.1 Shizi St, Suzhou, 215000, China
| | - Zhi Hong Ni
- Children's Hospital of Soochow University, No.92, Zhongnan St, Suzhou, 215025, China.
| | - Xiao Ling Xue
- Global Institute of Software Technology, No.5, Qinshan Rd, Suzhou, 215163, China.
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Morrissey J, Higgins A. "When my worse fear happened": Mental health nurses' responses to the death of a client through suicide. J Psychiatr Ment Health Nurs 2021; 28:804-814. [PMID: 33960590 DOI: 10.1111/jpm.12765] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/04/2021] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The death of a client to suicide evokes a range of grief responses for mental health nurses (MHNs), which vary in intensity according to the nature of the therapeutic relationship with the deceased client. There are limited qualitative studies on the experiences of nurses working in the community and the personal or professional strategies used by nurses to cope with the death of a client by suicide. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Following a client suicide, MHNs were often left to carry the burden of grief alone and to care for themselves with the support of their family and colleagues. While all participants perceived the need for support following the death of a client by suicide, they were offered minimal support beyond the debriefing meetings, with their grief experience being largely unacknowledged and disenfranchised. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: MHNs and services need to establish and promote a culture of openness in which suicide is anticipated as a possible outcome, even with excellent standards of care and wherein all staff are supported and encouraged to discuss and reflect on their concerns and fears during the aftermath of a client suicide. As MHNs are often left to carry the burden of grief alone, services need to recognize the emotional cost of embodied engagement with clients and families and provide the necessary supports. ABSTRACT: Introduction Experiencing a client's death through suicide is complex and challenging, yet limited research exists on how MHNs might deal with its aftermath. Aim This study aimed to explore the impact and responses of MHNs to a client suicide. Method The study design is a secondary analysis of an existing data set involving semi-structured interview with 33 MHNs that were analysed using the principles of grounded theory. To answer the secondary question on the impact and responses of MHNs to the death of a client by suicide a subset of the data from 10 participants who experienced the death of a client by suicide were re-analysed using thematic analysis. Ethical approval was granted by the university ethics committee. Findings The findings identified five themes: "Hearing the news," "Experiencing the impact of grief," "Grieving privately" "Searching for meaning" and "Questioning practice." Discussion Findings highlighted that although participants perceived the need for support, they were offered minimal support beyond the debriefing meetings, with their grief experience being largely unacknowledged and disenfranchised. Implications for practice MHN services need to promote a culture of openness wherein all MHNs are supported and encouraged to discuss their concerns and fears during the aftermath of a client suicide.
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Affiliation(s)
- Jean Morrissey
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Agnes Higgins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
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Oelschlägel L, Dihle A, Christensen VL, Heggdal K, Moen A, Österlind J, Steindal SA. Implementing welfare technology in palliative homecare for patients with cancer: a qualitative study of health-care professionals' experiences. BMC Palliat Care 2021; 20:146. [PMID: 34535125 PMCID: PMC8448170 DOI: 10.1186/s12904-021-00844-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 09/09/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Introducing welfare technology in home-based palliative care has been suggested to be beneficial for improving access to health care at home and enhancing patients' feelings of security and safety. However, little is known about the experiences of municipal health-care professionals using welfare technology in palliative home care. The aim of this study was to explore municipal health-care professionals' experiences regarding the significant challenges, facilitators, and assessments associated with implementing a technological solution named "remote home care" in palliative home care for patients with cancer. METHODS A qualitative, descriptive, exploratory design was used. Data were collected through focus-group interviews and individual semi-structured interviews with interdisciplinary health-care professionals who had experience using remote home care in clinical encounters with cancer patients who were in the palliative phase and living at home. Data were analyzed using qualitative content analysis. RESULTS Three themes were identified: 1) shifting from objective measures to assessing priorities for patients, 2) lack of experience and personal distress regarding cancer inhibits professional care, and 3) prominent organizational challenges undermine the premise of remote home care. CONCLUSION The results showed that shifting from a disease-focused to a person-centered approach enables health-care professionals to assess patients' personal priorities. However, health-care professionals' uncertainty and lack of knowledge and experience, along with organizational issues concerning information-sharing, represent great challenges that have the potential to inhibit professional care. The availability of networks through which difficult issues can be discussed was highlighted as being a fundamental resource for facilitating the provision of care.
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Affiliation(s)
- Lina Oelschlägel
- Lovisenberg Diaconal University College, Lovisenberggata 15B, 0456, Oslo, Norway.
- Department of Nursing, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Alfhild Dihle
- Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Vivi L Christensen
- Lovisenberg Diaconal University College, Lovisenberggata 15B, 0456, Oslo, Norway
- University of South-Eastern Norway, Drammen, Norway
| | - Kristin Heggdal
- Lovisenberg Diaconal University College, Lovisenberggata 15B, 0456, Oslo, Norway
| | - Anne Moen
- Department of Nursing, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jane Österlind
- Department of Healthcare Sciences/Palliative Research Center, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Simen A Steindal
- Lovisenberg Diaconal University College, Lovisenberggata 15B, 0456, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
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15
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Griffith S, Gelling L. How do hospice nurses prepare to give end-of-life care? A grounded theory study of nurses in one UK hospice. Int J Palliat Nurs 2021; 27:334-350. [PMID: 34569281 DOI: 10.12968/ijpn.2021.27.7.334] [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] [Indexed: 11/11/2022]
Abstract
BACKGROUND Literature for preparing hospice nurses to deliver end-of-life care is sparse. AIM To investigate how nurses in one UK hospice prepared to deliver end-of-life care in their role. METHODS A classic grounded theory approach was used to investigate the experiences of 22 registered nurses in one UK hospice, to discover how they prepared for their role. A total of 17 individual interviews and one focus group were conducted. Constant comparison of data and member checking were performed to establish validity. FINDINGS Findings were synthesised into five categories: the 'shared ideal', feeling good at the job, making a difference, experience/exposure to hospice work and the importance of role models. The shared ideal formed the core category, which explained how hospice nurses feel a sense of 'fit' with their work. CONCLUSION The feeling of a nurse feeling well-suited to the work and that there the work was a good 'fit' for them was identified as a core element to nurses' feelings of preparedness to provide end-of-life care.
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Affiliation(s)
- Sue Griffith
- Education Department, Farleigh Hospice, Chelmsford, Essex, UK
| | - Leslie Gelling
- Department of Nursing Science, Bournemouth University, Bournemouth, UK
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Mastroianni C, Marchetti A, D'Angelo D, Artico M, Giannarelli D, Magna E, Motta PC, Piredda M, Casale G, De Marinis MG. Italian nursing students' attitudes towards care of the dying patient: A multi-center descriptive study. NURSE EDUCATION TODAY 2021; 104:104991. [PMID: 34139582 DOI: 10.1016/j.nedt.2021.104991] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 05/01/2021] [Accepted: 05/24/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND International literature reports that nursing students feel unprepared when facing patients and families within dying care. They consider their curricula inadequate in teaching end-of-life care and promoting the attitudes required to care for dying patients. Findings of recent studies exploring nursing students' attitudes towards care of the dying patient are often contradictory. OBJECTIVES To explore Italian nursing students' attitudes towards caring for dying patients. DESIGN A multicenter cross-sectional study was conducted. SETTINGS The Bachelor's Degree in Nursing courses of four Universities of the Lazio Region. PARTICIPANTS The sample included 1193 students. METHODS Data were collected between September 2017 and March 2018 using the Italian version of FATCOD-B-I. The differences between the mean scores were compared through t-test or ANOVA. Associations between scores and participant characteristics were evaluated through generalized linear regression. RESULTS The mean score of FATCOD-B-I was 115.3 (SD = 9.1). Higher scores were significantly associated with training in palliative care (p < 0.0001) and experience with terminally ill patients (p < 0.0001). Students manifested more negative attitudes when they perceived patients losing hope of recovering, and patient's family members interfering with health professionals' work. Uncertainties emerged around knowledge of opioid drugs, decision-making, concepts of death and dying, management of mourning, and relational aspects of patient care. CONCLUSIONS Italian nursing students seem to have more positive attitudes towards care of dying patients than most other countries. They believe that caring for a terminal patient is a formative, useful experience but they do not feel adequately prepared in practice. Deeper palliative care education, integrated with practical training, would prepare students better, enabling them to discover their own human and professional capacity to relieve suffering.
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Affiliation(s)
- Chiara Mastroianni
- Antea Foundation Palliative Care Center, Piazza di Santa Maria della Pietà, 5, 00135 Rome, Italy.
| | - Anna Marchetti
- Research Unit of Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, 00128, Rome, Italy.
| | - Daniela D'Angelo
- Centro Eccellenza Clinica, Qualità e Sicurezza delle Cure, Istituto Superiore di Sanità, Viale Regina Elena, 299, 0016 Rome, Italy.
| | - Marco Artico
- Department of Palliative Care and Pain Therapy Unit, Azienda ULSS n. 4 Veneto Orientale, Piazza Alcide de Gasperi, 5, 30027 San Donà di Piave, Italy
| | - Diana Giannarelli
- Clinical Trial Center, Biostatistics and Bioinformatics Unit, National Cancer Institute Regina Elena IRCCS, Via Elio Chianesi, 53, 00144 Rome, Italy.
| | - Elisa Magna
- Department of Biomedicine and Prevention, Tor Vergata University, Viale Montpellier 1, 00133 Rome, Italy.
| | - Paolo Carlo Motta
- Department of Medical and Surgical Specialties, Radiological Science and Public Health, University of Brescia, Piazza del Mercato, 15, 25121 Brescia, Italy.
| | - Michela Piredda
- Research Unit of Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, Rome, Italy..
| | - Giuseppe Casale
- Antea Foundation Palliative Care Center, Piazza di Santa Maria della Pietà, 5, 00135 Rome, Italy.
| | - Maria Grazia De Marinis
- Research Unit of Nursing Science, Campus Bio-Medico di Roma University, Via Alvaro del Portillo 21, Rome, Italy..
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Undergraduate nursing students' transformative learning through disorientating dilemmas associated with end-of-life care simulation: A narrative inquiry study. Nurse Educ Pract 2021; 55:103174. [PMID: 34428723 DOI: 10.1016/j.nepr.2021.103174] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/20/2021] [Accepted: 08/09/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Despite attempts, there remains a theory practice gap for undergraduate nursing students transitioning to clinical practice on graduation, especially for specialty areas of clinical practice, such as palliative care, where there are limited opportunities to gain specialty knowledge and skills. As a result, undergraduate nursing students largely feel unprepared for end-of-life care in clinical practice. End-of-life care simulation is gaining momentum for helping prepare students to undertake this important care. However, little is known of whether end-of-life care simulation is a transformative learning strategy that can be transferred to clinical practice. AIM The aim of this paper is to report on undergraduate nursing students transformative learning through end-of-life care simulation. DESIGN A qualitative research design using narrative inquiry was used with data collected through semi-structured interviews and analysed using Clandinin and Connelly's three dimensions of narrative inquiry. METHODS Eighteen 3rd year undergraduate nursing students enrolled in a compulsory palliative care unit, at an Australian university participated in an immersive end-of-life care simulation. Data were collected through semi-structured interviews and analysed using Clandinin and Connelly's three dimensions of narrative inquiry. RESULTS This study revealed that transformative learning occurred through three disorientating dilemmas of: caring for a dying patient; approaching difficult conversations; and witnessing death for the first time. Knowledge of palliative care and clinical skills were also found to be transferred to clinical practice. CONCLUSIONS End-of-life care simulation can be an effective method of promoting transformative learning and can help to reduce the gap from nursing theory to clinical practice.
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Gilart E, Lepiani I, Núñez MJC, Roman IC, Bocchino A. When Nurses Become Patients. Validation of the Content of the Diagnostic Label Professional Traumatic Grief. Healthcare (Basel) 2021; 9:1082. [PMID: 34442219 PMCID: PMC8391378 DOI: 10.3390/healthcare9081082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/16/2021] [Accepted: 08/18/2021] [Indexed: 12/22/2022] Open
Abstract
(1) Background: The Covid-19 pandemic has put our healthcare systems to the test, exposing their vulnerability and demanding a high degree of commitment and dedication from healthcare teams to confront and contain the disease. In this sense, nursing professionals have played a prominent role in the treatment of complex cases that have required hospitalisation and have manifested pre-existing health complications or mortality. This unprecedented situation made it difficult to regulate the emotional impact and manage grief, often turning it into a traumatic grief whose psychological and emotional manifestations are increasingly evident but very little researched in the current context. (2) Purpose: Validation of the definition, defining characteristics and related factors for the proposal of the nursing diagnosis of professional traumatic grief. (3) Method: Based on Fehring's content validation model, the label name, defining characteristics and other related factors were agreed upon by Spanish experts. (4) Results: The content validity index was 0.9068. A total of 21 defining characteristics were validated by the experts, as all of them scored above 0.6. With respect to the related factors of the proposed 10, all were validated. (5) Conclusion: The present study supports the proposal to develop a nursing diagnosis for professional traumatic grief. The use of standardised language is only the first step in establishing professional traumatic grief as a diagnostic category.
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Affiliation(s)
- Ester Gilart
- Doctor López Cano Hospital of Cadiz, 11010 Cadiz, Spain;
| | - Isabel Lepiani
- Nursing University Salus Infirmorum of Cadiz, 11001 Cadiz, Spain;
| | | | | | - Anna Bocchino
- Nursing University Salus Infirmorum of Cadiz, 11001 Cadiz, Spain;
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Heath L, Egan R, Ross J, Iosua E, Walker R, MacLeod R. Preparing nurses for palliative and end of life care: A survey of New Zealand nursing schools. NURSE EDUCATION TODAY 2021; 100:104822. [PMID: 33705968 DOI: 10.1016/j.nedt.2021.104822] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 01/31/2021] [Accepted: 02/13/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Nurses play a vital role in the care of people with advanced life-limiting illnesses, so palliative and end of life care is an essential skill nurses need to learn. Despite numerous reports in the international literature about educational developments in this area, there are widespread inconsistencies in undergraduate education, and graduates continue to report feeling unprepared for this part of their work. Little is known about how New Zealand nursing students learn about this important area of clinical practice. OBJECTIVES To obtain information about teaching content, organisation, delivery, assessment and clinical learning opportunities in palliative and end of life care in undergraduate nurse education in New Zealand. DESIGN Quantitative descriptive cross sectional study. SETTINGS Tertiary education institutions that provide the Bachelor of Nursing programme in New Zealand. PARTICIPANTS Academic leads and course coordinators. METHODS National online survey. RESULTS A total of 13/18 (72%) educational institutions completed the survey. All integrate palliative and end of life care in their teaching with an identified coordinator at 12 (92%) institutions. Between 1 and 10 h of formal teaching is provided at 11 (85%) institutions where lectures and tutorials are most comon. Clinical placements with specialist palliative care providers are scarce and limited to senior students as elective placements. Assessment of student learning in palliative and end of life care is carried out at seven (54%) institutions, and formally evaluated at 12 (92%). Lack of teaching time and clinical placements with palliative care providers are barriers to increased learning opportunities in palliative and end of life care. CONCLUSIONS This article provides comprehensive information about palliative and end of life care teaching in undergraduate nurse education in New Zealand. Teaching on this subject is not a mandatory requirement so there are inconsistencies in the teaching provided between educational institutions, and significant barriers to development. Mandatory competencies need to be introduced to ensure graduates have the knowledge, skills and attitudes required to provide optimal care for people near the end of life.
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Affiliation(s)
- Lis Heath
- Department of Medicine, University of Otago, Dunedin, New Zealand.
| | - Richard Egan
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.
| | - Jean Ross
- School of Nursing, Otago Polytechnic, Dunedin, New Zealand.
| | - Ella Iosua
- Centre for Biostatistics, University of Otago, Dunedin, New Zealand.
| | - Robert Walker
- Department of Medicine, University of Otago, Dunedin, New Zealand.
| | - Rod MacLeod
- School of Population Health, University of Auckland, Auckland, New Zealand
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20
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Harder N, Lemoine J, Chernomas W, Osachuk T. Developing a Trauma-Informed Psychologically Safe Debriefing Framework for Emotionally Stressful Simulation Events. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2020.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Zheng ZH, Luo ZC, Zhang Y, Chan WCH, Li JQ, Pang J, Jia YL, Tang J. Hospice care self-efficacy among clinical medical staff working in the coronavirus disease 2019 (COVID-19) isolation wards of designated hospitals: a cross-sectional study. BMC Palliat Care 2020; 19:188. [PMID: 33302944 PMCID: PMC7726609 DOI: 10.1186/s12904-020-00692-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 12/02/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has caused more than 462,417 deaths worldwide. A large number of patients with severe COVID-19 face death in hospital. Hospice care is truly a philosophy of care that delivers patient-centred care to the terminally ill and their families. Hospice care could provide many benefits for patients, families, and for hospice caregivers. The aim of this study is to investigate hospice care self-efficacy and identify its predictors among Chinese clinical medical staff in COVID-19 isolation wards of designated hospitals. METHODS A cross-sectional design was used. The Hospice Care Self-Efficacy, Self-Competence in Death Work Scale, Positive Aspects of Caregiving, and Simplified Coping Style Questionnaires were administered between February and April 2020. A total of 281 eligible medical staff responded to the questionnaires, with a response rate of ≥78.9%. RESULTS The mean score of hospice care self-efficacy was 47.04 (SD = 7.72). Self-efficacy was predicted by self-competence in death work (B = 0.433, P < 0.001), positive aspects of caregiving (B = 0.149, P = 0.027), positive coping (B = 0.219, P < 0.001), giving hospice care to dying or dead patients before fighting against COVID-19 (B = -1.487, P = 0.023), occupational exposure while fighting against COVID-19 (B = -5.244, P = 0.004), holding respect for life and professional sentiment as motivation in fighting against COVID-19 (B = 2.372, P = 0.031), and grade of hospital employment (B = -1.426, P = 0.024). The variables co-explained 58.7% variation of hospice care self-efficacy. CONCLUSION Clinical nurses and physicians fighting COVID-19 reported a moderate level of hospice care self-efficacy during this pandemic. Exploring the traditional Chinese philosophy of life to learn from its strengths and make up for its weaknesses and applying it to hospice care may provide a new framework for facing death and dying during the COVID-19 pandemic. Continuous hospice care education to improve self-competence in death work, taking effective measures to mobilize positive psychological resources, and providing safer practice environments to avoid occupational exposure are also essential for the improvement of the hospice care self-efficacy of clinical nurses and physicians. These measures help caregivers deal effectively with death and dying while fighting against the COVID-19 pandemic.
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Affiliation(s)
| | - Zhong-Chen Luo
- School of Nursing, Guizhou Medical University, Guiyang, China
| | - You Zhang
- School of Foreign Languages, Chongqing Medical University, Chongqing, China
| | - Wallace Chi Ho Chan
- Department of Social Work, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China
| | - Jian-Qiong Li
- School of Nursing, Chongqing Three Gorges Medical College, Tianxing Road, Chongqing, China
| | - Jin Pang
- Nursing Department, Guizhou Provincial People's Hospital, Guiyang, China
| | - Yu-Ling Jia
- School of Nursing, Guizhou Medical University, Guiyang, China
| | - Jiao Tang
- School of Nursing, Chongqing Medical University, 1#, Medical College Road, Chongqing, 400016, China.
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22
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Pan S, Li X, Shen Y, Chen J, Koniak-Griffin D. Reframing the meaning of life and professional values: A theoretical framework of facilitating professional care for terminally ill patients. Nurs Health Sci 2020; 23:167-175. [PMID: 33169901 DOI: 10.1111/nhs.12792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 10/11/2020] [Accepted: 11/07/2020] [Indexed: 11/30/2022]
Abstract
Professional values reflect nurses' understanding of how to deliver professional care, which might influence nurses' attitudes and caring behaviors during end-of-life care. However, limited research has been conducted to explore nurses' experiences of professional development during end-of-life care, and theoretical explanations are scarce about how nurses enact their professional values during the caring process. This study explored the social process of professional values involved in end-of-life care in the Chinese cultural context by adopting a constructivist grounded theory approach. Twenty semi-structured in-depth interviews with 15 nurses from three hospitals in southeastern China were conducted. A theoretical framework emerged when focusing on the social process of "reframing the meaning of life and professional values" to facilitate professional care for terminally ill patients. Three main categories were sequentially identified as "recognizing the dilemmas when caring for terminally ill patients," "applying strategies to deal with values conflict," and "reconstructing values." This theoretical framework may be applied as a practical framework for equipping nurses with effective strategies to cultivate professional values, including the provision of adequate end-of-life knowledge, and a supportive workplace environment.
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Affiliation(s)
- Si Pan
- The Second Xiangya Hospital, Central South University, Changsha, China.,Xiangya Nursing School of Central South University, Changsha, China
| | - Xianhong Li
- Xiangya Nursing School of Central South University, Changsha, China
| | - Yan Shen
- Xiangya Nursing School of Central South University, Changsha, China
| | - Jia Chen
- Xiangya Nursing School of Central South University, Changsha, China
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23
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Anderson NE, Robinson J, Moeke-Maxwell T, Gott M. Paramedic care of the dying, deceased and bereaved in Aotearoa, New Zealand. PROGRESS IN PALLIATIVE CARE 2020. [DOI: 10.1080/09699260.2020.1841877] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Natalie Elizabeth Anderson
- School of Nursing, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
- Auckland District Health Board, Auckland, New Zealand
| | - Jackie Robinson
- School of Nursing, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
- Auckland District Health Board, Auckland, New Zealand
| | - Tess Moeke-Maxwell
- School of Nursing, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
| | - Merryn Gott
- School of Nursing, Faculty of Medical & Health Sciences, University of Auckland, Auckland, New Zealand
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24
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Zheng R, Bloomer MJ, Guo Q, Lee SF. New graduate nurses' coping with death and the relationship with death self-efficacy and death anxiety: A multicentre cross-sectional study. J Adv Nurs 2020; 77:795-804. [PMID: 33145826 DOI: 10.1111/jan.14621] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 06/09/2020] [Accepted: 10/12/2020] [Indexed: 11/30/2022]
Abstract
AIMS To examine new graduate nurses' perceptions of competency on coping with dying and death and the relationship with death self-efficacy and death anxiety. DESIGN A multicentre, cross-sectional study. METHODS Three hundred and forty new graduate nurses from five metropolitan hospitals were recruited between August-November 2018. Participants completed the Coping with Death Scale, Death Self-efficacy Scale, and Death Anxiety Scale. RESULTS Two hundred and ninety-eight new graduate nurses responded to the survey. The mean score of coping with death and death self-efficacy was 120.11 (SD 24.59), 259.11 (SD 57.70) respectively. 88.9% feared a painful death, 81.5% were particularly afraid of getting cancer, and 80.2% were afraid of death. There was a positive relationship between coping with death and death self-efficacy, a negative relationship between coping with death and death anxiety and a negative correlation between death self-efficacy and death anxiety. Five variables, including death self-efficacy, three dimensions of death anxiety including emotion, cognition with life and death and stress and distress and religion in total accounted for 46.9% of the variance of coping with death. CONCLUSION New graduate nurses are at a disadvantage in terms of death self-efficacy, less well prepared in coping with death and are more anxious about death. IMPACT It is imperative for educational institutions to support new graduate nurses with pre-licensure learning related to patient death issues and care. Organizations are also strongly advised to support new graduate nurses to cope with patient death through development of culturally sensitive interventions and guidelines, which may in turn assist with decreasing new graduate nurses' risk of burnout and increasing their longevity in the profession.
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Affiliation(s)
- Ruishuang Zheng
- School of Nursing and Midwifery, Monash University, Frankston, Victoria, Australia.,Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Melissa Jane Bloomer
- School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Centre for Quality and Patient Safety Research, Deakin University, Geelong, Victoria, Australia
| | - Qiaohong Guo
- School of Nursing, Capital Medical University, Beijing, China
| | - Susan Fiona Lee
- School of Nursing and Midwifery, Monash University, Frankston, Victoria, Australia
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25
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Galehdar N, Kamran A, Toulabi T, Heydari H. Exploring nurses' experiences of psychological distress during care of patients with COVID-19: a qualitative study. BMC Psychiatry 2020; 20:489. [PMID: 33023535 PMCID: PMC7538040 DOI: 10.1186/s12888-020-02898-1] [Citation(s) in RCA: 150] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/24/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND COVID-19 infection is a new disease that infects a large number of people, killing a ratio of whom every day in the world. Healthcare staff, especially nurses, experience a great deal of psychological distress during care of COVID-19 patients. Detecting factors that disturb nurses' mental health during care of these patients can help to reduce their psychological distress. Therefore, this study aimed to explore nurses' experiences of psychological distress during care of patients with COVID-19. METHODS The present qualitative research was performed using the conventional content analysis method in Iran from March to May 2020. Participants in this study included the nurses caring for patients with COVID-19, and they were selected based on the purposeful sampling method. The data was collected through 20 phone call interviews and analyzed based on the method proposed by Lundman and Graneheim. RESULTS Qualitative data analysis revealed 11 categories including death anxiety, anxiety due to the nature of the disease, anxiety caused by corpse burial, fear of infecting the family, distress about time wasting, emotional distress of delivering bad news, fear of being contaminated, the emergence of obsessive thoughts, the bad feeling of wearing personal protective equipment, conflict between fear and conscience, and the public ignorance of preventive measures. CONCLUSION The data showed that the nurses experienced a variety of psychological distress during care of patients with COVID-19. Through proper planning by authorities, it is possible to manage the risk factors of mental health distress in nurses and improve their mental health status.
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Affiliation(s)
- Nasrin Galehdar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Aziz Kamran
- School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Tahereh Toulabi
- School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Heshmatolah Heydari
- Social Determinates of health center, Lorestan University of Medical Sciences, Kilomer 4 Khorramabad-Broujerd road Kamalvand, Khorramabad, 6813856967, Iran.
- Department of Home-based palliative care, ALA Cancer Prevention and Control Center (MACSA), Tehran, Iran.
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The Effects of Clinical Experience on Early Career Psychiatrists' Beliefs and Attitudes Towards Older Psychiatric Patients. Community Ment Health J 2020; 56:1344-1353. [PMID: 32026217 DOI: 10.1007/s10597-020-00571-1] [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: 08/06/2019] [Accepted: 01/31/2020] [Indexed: 10/25/2022]
Abstract
Although literature has documented widespread negative and stereotypical attitudes held by healthcare professionals towards the older adults, there is a current paucity of research about the perspective of psychiatrists. We aimed to identify the attitudes of Tunisian early career psychiatrists towards the older adults. This was a cross-sectional study conducted among 71 early career psychiatrists. Data were collected through anonymous online surveys. A series of 4 point Likert-type questions ("strongly agree", "somewhat agree", "somewhat disagree", "strongly disagree") asked participants about their beliefs about older patients, the characteristics of the psychiatric care of an older person and emotions related to caring for older patients. Psychiatrists agreed that the older patient: is frail and vulnerable in 64.8% of cases, does not trust his psychiatrist in 28% of cases, has problems of communication in 36.6% of the cases and shows hostile or aggressive behavior in 5.6% of the cases. A multivariate binary logistic regression analysis found that clinical experience would play an independent role in predicting the following beliefs and attitudes of early career psychiatrists towards older patients: the belief that the older patient often has perceptual disorders that he is fragile and vulnerable, that he often requires polypharmacy, and that his management exposes the psychiatrist to painful emotional experiences. Given the population aging, early career psychiatrists need to be equipped with skills to fulfil significant roles in responding to future health and support needs. Integrating clinical training in psychogeriatrics into the psychiatric curriculum is strongly recommended.
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Gül Ş, Demir Karabulut S, Eren H, Durmuş İskender M, Göçmen Baykara Z, Keles Ş, Yıldız A, Yalim NY. Nursing Students' Experiences With Death and Terminal Patients During Clinical Education. OMEGA-JOURNAL OF DEATH AND DYING 2020; 85:628-649. [PMID: 32838653 DOI: 10.1177/0030222820950510] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The aim of this study is to explore nursing students' experiences with death and terminal patients during clinical education. A secondary analysis of qualitative data that were collected through 11 focus group interviews with nursing students was performed. Data obtained from the interviews were analyzed using thematic analysis. There were a total of 9 themes across 3 contexts. Data were grouped under the following themes: feelings experienced when encountering death for the first time, reactions to the first encounter with death, factors affecting the reactions to death, involvement in terminal patient care, being informed about the physical process that terminal patients are going through, students' approach toward terminal patients and their relatives, health professionals' approach toward terminal/dying patients/their relatives, changes in the ideas about death, and changes in the ideas about terminal/dying patients. The study shows a lack of guidance on the part of teachers who also avoid patients and families who are considered terminally ill.
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Affiliation(s)
- Şenay Gül
- Fundamentals of Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Seyhan Demir Karabulut
- Department of Medical Ethics and History, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Handan Eren
- Department of Nursing, Health Sciences Faculty, Yalova University, Yalova, Turkey
| | | | | | - Şükrü Keles
- Department of Medical Ethics and History, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Abdullah Yıldız
- Department of Medical Ethics and History, Faculty of Medicine, Ankara University, Ankara, Turkey
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Park S, Jang MK, Seo YJ, Doorenbos AZ. Funeral Experience in South Korea: A Phenomenological Study. OMEGA-JOURNAL OF DEATH AND DYING 2020; 84:1025-1044. [PMID: 32397814 DOI: 10.1177/0030222820921586] [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: 11/17/2022]
Abstract
Few studies of death preparation in South Korea are available. This article describes South Koreans' experiences of death and a funeral in a hospital setting to improve health care providers' ability to care for dying patients and their family. Using Colaizzi's phenomenological method, we conducted semistructured interviews with 40 South Koreans who had lost a family member in a hospital setting. Participants' statements were classified into 12 themes, 5 theme clusters, and 3 categories: (a) vagueness of funeral culture, (b) distortion of meaning in funeral culture, and (c) the need to prepare for death and process grief. Our findings are relevant to hospital-based health care providers who care for dying patients and their family. Targeted educational information could help health care providers better serve patients and family. Policy changes could improve quality of care by allowing health care providers to transition with the family from hospital units to a hospital-based funeral setting.
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Affiliation(s)
- Sungwon Park
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, USA
| | - Min Kyeong Jang
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, USA
| | - Yoo-Jin Seo
- Department of Global Cooperation, National Health Insurance Service, Wonju, Republic of Korea
| | - Ardith Z Doorenbos
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, USA.,University of Illinois Cancer Center, Illinois, USA
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Puente‐Fernández D, Lozano‐Romero MM, Montoya‐Juárez R, Martí‐García C, Campos‐Calderón C, Hueso‐Montoro C. Nursing Professionals’ Attitudes, Strategies, and Care Practices Towards Death: A Systematic Review of Qualitative Studies. J Nurs Scholarsh 2020; 52:301-310. [DOI: 10.1111/jnu.12550] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Daniel Puente‐Fernández
- PhD Student, Doctoral Programme in Clinical Medicine and Public Health University of Granada Granada Spain
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Pehlivan S, Lafçı D, Vatansever N, Yıldız E. Relationship Between Death Anxiety of Turkish Nurses and Their Attitudes Toward the Dying Patients. OMEGA-JOURNAL OF DEATH AND DYING 2019; 82:128-140. [PMID: 31856657 DOI: 10.1177/0030222819895122] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aims to investigate the relationship between death anxiety of the Turkish nurses and their attitudes toward the dying patient. This study involved 203 nurses who were working at a university hospital. The data were collected using "Nurse Information Form" (which was prepared by the authors of this research), "Thorson-Powell Death Anxiety Scale," and "Attitude Scale about Euthanasia, Death, and Dying Patient." There was a positive correlation between death anxiety and dying patient avoidance behavior and euthanasia score (p < .05). The findings showed that nurses, death anxiety, and death scores were high in the loss of a close relatives (p < .05). Our findings suggest that the situation of the dying patients and their families and also nurses should be improved. Thus, special psychological education/training should be given to the nurses to deal with death anxiety and their attitude to the dying patient.
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Affiliation(s)
- Seda Pehlivan
- Department of Internal Medicine Nursing, Health Science Faculty, Uludag University, Bursa, Turkey
| | - Diğdem Lafçı
- Department of Fundamentals Nursing, Faculty of Nursing, Mersin University, Turkey
| | - Nursel Vatansever
- Department of Surgery Nursing, Health Science Faculty, Uludag University, Bursa, Turkey
| | - Ebru Yıldız
- Department of Fundamentals Nursing, Faculty of Nursing, Mersin University, Turkey
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31
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Sawin KJ, Montgomery KE, Dupree CY, Haase JE, Phillips CR, Hendricks-Ferguson VL. Oncology Nurse Managers' Perceptions of Palliative Care and End-of-Life Communication. J Pediatr Oncol Nurs 2019; 36:178-190. [PMID: 30939966 DOI: 10.1177/1043454219835448] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
The purpose of this study was to describe pediatric oncology nurse managers' (NMs) perspectives of palliative care/end-of-life (PC/EOL) communication. The study, guided by group-as-a-whole theory and empirical phenomenology, was part of a larger, multisite study aimed at understanding pediatric oncology nurses' experiences of PC/EOL communication. Nurses were assigned to focus groups based on length or type of experience (i.e., nurses with <1, 2-5, or >5 years' work experience and NMs). Eleven NMs from three Midwestern pediatric hospitals with large oncology programs participated in one focus group. The participants' mean years of experience was 15.8 in nursing and 12 in pediatric oncology; 90% had a BSN or higher degree; all had supervisory responsibilities. The authors identified 2,912 meaning statements, which were then analyzed using Colaizzi's method. Findings include NMs' overall experience of "Fostering a Caring Climate," which includes three core themes: (1) Imprint of Initial Grief Experiences and Emotions; (2) Constant Vigilance: Assessing and Optimizing Family-Centered Care; and (3) Promoting a Competent, Thoughtful, and Caring Workforce. Findings indicate that pediatric oncology NMs draw on their own PC/EOL experiences and their nursing management knowledge to address the PC/EOL care learning needs of nursing staff and patient/family needs. NMs need additional resources to support nursing staff's PC/EOL communication training, including specific training in undergraduate and graduate nursing programs and national and hospital-based training programs.
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Affiliation(s)
- Kathleen J Sawin
- 1 Children's Hospital of Wisconsin, Milwaukee, WI, USA.,2 University of Wisconsin-Milwaukee, Milwaukee, WI, USA
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Lian Z, Skytt B, Li C, Engström M. Nursing students’ reflections on caring for end-of-life patients in a youth volunteer association. Nurse Educ Pract 2019; 34:204-209. [DOI: 10.1016/j.nepr.2018.12.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 12/07/2018] [Accepted: 12/28/2018] [Indexed: 11/25/2022]
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Chang WP. How social support affects the ability of clinical nursing personnel to cope with death. Appl Nurs Res 2018; 44:25-32. [DOI: 10.1016/j.apnr.2018.09.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 08/08/2018] [Accepted: 09/16/2018] [Indexed: 11/28/2022]
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Saifan AR, Al Zoubi AM, Alrimawi I, Melhem O. Exploring the psychological status of Jordanian nurses working with cancer patients. J Nurs Manag 2018; 27:215-222. [DOI: 10.1111/jonm.12667] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/13/2018] [Accepted: 05/16/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Ahmad Rajeh Saifan
- Nursing Department; Fatima College of Health Sciences; Abu Dhabi United Arab Emirates
| | | | - Intima Alrimawi
- School of Nursing; Stratford University; Falls Church Virginia
| | - Omar Melhem
- Nursing Department; Fatima College of Health Sciences; Abu Dhabi United Arab Emirates
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Abstract
BACKGROUND Recent international documents have highlighted the importance of preparing the nursing workforce for end of life care. However, these documents do not make clear what prepared in the context of end-of-life care actually means. Searching the literature failed to retrieve any papers defining prepared in this context. AIM A concept analysis, using Walker and Avant's model, was conducted to help address this gap in the knowledge base. RESULTS From this analysis many attributes and antecedents were synthesised. These include that a prepared nurse would be confident to: assess the dying patient, communicate with empathy, identify and manage symptoms, recognise and deal with death and dying, understand the holistic elements of dying, be comfortable with the effects of loss and bereavement on patients and self, and be self-competent. CONCLUSIONS From this analysis, a clearer idea of what is needed to prepare nurses for end-of-life care is offered and suggestions for future research are made.
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Affiliation(s)
- Sue Griffith
- Education Co-ordinator, Farleigh Hospice, Chelmsford, UK
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Ranse K, Ranse J, Pelkowitz M. Third-year nursing students' lived experience of caring for the dying: a hermeneutic phenomenological approach. Contemp Nurse 2018; 54:160-170. [PMID: 29669455 DOI: 10.1080/10376178.2018.1461572] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND In preparation for practice as a Registered Nurse, it is essential that students are equipped to care for the dying patient and their family. AIM To explore nursing students' lived experience of caring for a dying patient and their family. DESIGN Hermeneutic phenomenology. METHODS Students who had cared for a dying patient in their final year of study were invited to participate in an interview. Participants' narratives (n = 6) were thematically analysed. FINDINGS Analysis revealed three themes: being caring, unexpectedness in witnessing an expected death and experiencing loss. Students demonstrated family-centred care but recounted unexpectedness in both the dying trajectory and physical changes in the dying patient. When reflecting on experiencing loss, students questioned their own actions, acknowledged the value of relationships and identified ways to cope. CONCLUSIONS Engaging students in the care of dying patients and providing appropriate preparation/support can influence their experience and the care they provide in the future.
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Affiliation(s)
- Kristen Ranse
- a School of Nursing & Midwifery, Gold Coast Campus , Griffith University , Southport , Queensland , Australia.,b School of Nursing & Midwifery, Faculty of Health , University of Canberra , Canberra , Australia
| | - Jamie Ranse
- a School of Nursing & Midwifery, Gold Coast Campus , Griffith University , Southport , Queensland , Australia.,c Department of Emergency Medicine , Gold Coast Hospital and Health Services , Southport , Queensland , Australia
| | - Mikayla Pelkowitz
- b School of Nursing & Midwifery, Faculty of Health , University of Canberra , Canberra , Australia
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Smith MB, Macieira TGR, Bumbach MD, Garbutt SJ, Citty SW, Stephen A, Ansell M, Glover TL, Keenan G. The Use of Simulation to Teach Nursing Students and Clinicians Palliative Care and End-of-Life Communication: A Systematic Review. Am J Hosp Palliat Care 2018. [PMID: 29514480 PMCID: PMC6039868 DOI: 10.1177/1049909118761386] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives: To present the findings of a systematic review on the use of simulation-based learning experiences (SBLEs) to teach communication skills to nursing students and clinicians who provide palliative and end-of-life care to patients and their families. Background: Palliative care communication skills are fundamental to providing holistic patient care. Since nurses have the greatest amount of direct exposure to patients, building such communication competencies is essential. However, exposure to patients and families receiving palliative and end-of-life care is often limited, resulting in few opportunities to learn these skills in the clinical setting. Simulation-based learning experiences can be used to supplement didactic teaching and clinical experiences to build the requisite communication skills. Methods: Searches of CINAHL, MEDLINE, PsychINFO, ERIC, and Web of Science electronic databases and Grey Literature returned 442 unique records. Thirty articles met the established criteria, including the SBLE must contain a nursing role. Results: Simulation-based learning experience are being used to teach palliative and end-of-life communication skills to nursing students and clinicians. Lack of standardization, poor evaluation methods, and limited exposure to the entire interprofessional team makes it difficult to identify and disseminate validated best practices. Conclusion: While the need for further research is acknowledged, we recommend this evidence be augmented by training programs that utilize SBLEs through (1) applying standards, (2) clearly specifying goals and objectives, (3) integrating externally validated scenarios, and (4) employing rigorous evaluation methods and measures that link the SBLE to the training objectives and desired clinician practice behaviors and patient outcomes.
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Affiliation(s)
- Madison B Smith
- 1 College of Nursing, University of Florida, Gainesville, FL, USA
| | | | - Michael D Bumbach
- 2 College of Nursing, Family, Community, and Health System Science, University of Florida, Gainesville, FL, USA
| | | | - Sandra W Citty
- 2 College of Nursing, Family, Community, and Health System Science, University of Florida, Gainesville, FL, USA
| | - Anita Stephen
- 4 College of Nursing, Biobehavioral Nursing Science, University of Florida, Gainesville, FL, USA
| | - Margaret Ansell
- 5 Health Science Center Libraries, University of Florida, Gainesville, FL, USA
| | - Toni L Glover
- 4 College of Nursing, Biobehavioral Nursing Science, University of Florida, Gainesville, FL, USA
| | - Gail Keenan
- 2 College of Nursing, Family, Community, and Health System Science, University of Florida, Gainesville, FL, USA
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38
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Heise BA, Wing DK, Hullinger AHR. My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death. Nurs Educ Perspect 2018; 39:355-359. [PMID: 29889184 DOI: 10.1097/01.nep.0000000000000335] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM The purpose of this study was to examine, on a national level, nursing students' perceptions after experiencing a patient death. BACKGROUND Death is a highly stressful experience for nursing students. Debriefing, which routinely occurs with a patient's demise in the simulation setting, typically does not happen in actual death situations. METHOD A mixed-methods design using quantitative and qualitative questions as part of an anonymous survey was sent to the membership of the National Student Nurses' Association. Of approximately 55,000 members, 2,480 responded to the survey. RESULTS Experiencing a patient death as a student occurred for 41 percent of participants in the nationally representative sample. Of those who experienced a patient death, 64 percent did not receive any debriefing. CONCLUSION Most nursing students did not feel prepared to care for a dying patient and the patient's family. Students need and want more education on end-of-life nursing care.
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Affiliation(s)
- Barbara A Heise
- About the Authors Barbara A. Heise, PhD, RN, CNE, CQIA, is a retired associate professor, Brigham Young University College of Nursing, Provo, Utah. Debra K. Wing, MSN Ed, RN, CNE, is an assistant professor and lab coordinator, Nursing Learning Center, Brigham Young University College of Nursing. Amy H. R. Hullinger, RN, is a former nursing student, Brigham Young University College of Nursing. For more information, contact
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39
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Zheng R, Lee SF, Bloomer MJ. How nurses cope with patient death: A systematic review and qualitative meta-synthesis. J Clin Nurs 2017; 27:e39-e49. [DOI: 10.1111/jocn.13975] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Ruishuang Zheng
- School of Nursing and Midwifery; Monash University; Melbourne Vic Australia
| | - Susan Fiona Lee
- School of Nursing and Midwifery; Monash University; Melbourne Vic Australia
| | - Melissa Jane Bloomer
- School of Nursing and Midwifery; Faculty of Health; Deakin University; Geelong Vic Australia
- Centre for Quality and Patient Safety Research; Deakin University; Geelong Vic Australia
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40
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Lippe M, Jones T, Becker H, Carter P. Student Preparation to Care for Dying Patients: Assessing Outcomes Across a Curriculum. J Nurs Educ 2017; 56:633-637. [DOI: 10.3928/01484834-20170918-10] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 04/25/2017] [Indexed: 11/20/2022]
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41
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Khalaf IA, Al-Dweik G, Abu-Snieneh H, Al-Daken L, Musallam RM, BaniYounis M, Al-Rimawi R, Khatib AH, Habeeb Allah A, Atoum MH, Masadeh A. Nurses' Experiences of Grief Following Patient Death: A Qualitative Approach. J Holist Nurs 2017; 36:228-240. [PMID: 28845718 DOI: 10.1177/0898010117720341] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore the lived experiences of nurses' feelings, emotions, grief reactions, and coping mechanisms following their patients' death. BACKGROUND On a daily basis, nurses are experiencing patients' death, which exposes them to grief. Nurses' grief has not been sufficiently addressed in practice settings, although it has been a well-known threat to health and work performance. DESIGN A qualitative design guided by a phenomenological approach was adopted. METHOD Data were collected from a purposive sample of 21 Jordanian nurses by conducting three focus groups and analyzed using Colaizzi's framework. FINDINGS Four themes were generated in which participants reported feelings of grief following their patients' death. Their grief emotions were reported as sadness, crying, anger, shock, denial, faith, fear, guilt, fear of the family's reaction, and powerlessness. CONCLUSIONS The study provided evidence that nurses respond emotionally to patients' death and experience grief. Nurses are burdened by recurrent patients' deaths and try to cope and overcome their grief. This study emphasizes the importance of developing strategies to help nurses positively cope with their grief from a holistic perspective. This will reflect positively on the nurses' performance.
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Affiliation(s)
- Inaam A Khalaf
- The University of Jordan.,Princess Nourah bint Abdulrahman University
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43
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Bacon CT. Nurses' Experiences With Patients Who Die From Failure to Rescue After Surgery. J Nurs Scholarsh 2017; 49:303-311. [PMID: 28384381 DOI: 10.1111/jnu.12294] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE To describe the lived experiences of hospital nurses caring for surgical patients who died from failure to rescue (FTR). DESIGN A qualitative phenomenologic approach was used. Methods to ensure rigor and trustworthiness were incorporated into the design. METHODS The investigator conducted one-on-one semistructured interviews with 14 nurses, and data were analyzed using Colaizzi's methods. FINDINGS Six themes were identified: (a) the environment surrounding the FTR was unexpected; (b) FTR was unexpected but not preventable; (c) nurses were emotionally ill-prepared for the FTR; (d) nurse outcomes are different in unexpected versus expected death; (e) nurses' roles as protectors are important; and (f) FTR effects future nursing practice. CONCLUSIONS Nurses' reactions after an FTR surgical death may be different when there is no identified nursing error contributing to the event. There may be key differences between deaths that are simply unexpected and those that involve FTR. The importance of mentoring junior nurses in protective surveillance skills is vital. CLINICAL RELEVANCE Developing an understanding of nurses' experiences with FTR can assist nurse leaders to better support nurses who experience FTR deaths. Insight into the environment surrounding FTR deaths provides a foundation for future research aimed at improving patient safety and quality through an improved working environment for nurses.
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Affiliation(s)
- Cynthia Thornton Bacon
- Assistant Professor, University of North Carolina at Greensboro, School of Nursing, Greensboro, North Carolina
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44
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Ghaljeh M, Iranmanesh S, Nayeri ND, Tirgari B, Kalantarri B. Compassion and care at the end of life: oncology nurses' experiences in South-East Iran. Int J Palliat Nurs 2017; 22:588-597. [PMID: 27992279 DOI: 10.12968/ijpn.2016.22.12.588] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND End of life (EOL) care is newly established in the Iranian context. Context, in this case, refers to the internal and external manifestation of the nurse values, norms and experiences that are learnt throughout life. AIM The aim of this study was to explore nurses' experiences of caring for dying patients in Iran. METHODS A phenomenological hermeneutic approach, influenced by the philosophy of Ricoeur, was used to analyse 10 oncology nurses' experiences of caring for dying persons. FINDINGS Three themes emerged from the analysis: 1) seeing the patient as unique person, 2) being present and open to seeing patients as unique persons and 3) personal and professional development as a result of closeness between nurse and patient. Caring for dying persons means assisting them at the end of their lives. CONCLUSION Caring relationships underlie professional palliative care and are essential in EOL care. Proper palliative education and professionally led supervision should be included in the Iranian nursing curriculum.
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Affiliation(s)
- Mahnaz Ghaljeh
- Phd Nursing Student, Nursing Research center, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Sedigheh Iranmanesh
- Assistant Professor, Kerman Research Centre, Razi School Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Nahid Dehghan Nayeri
- Professor, Tehran, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Batool Tirgari
- Assistant Professor, Kerman Neuroscience Research Center and neuropharmacology institute, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Behjat Kalantarri
- Assistant professor, Department of Medicine at Kerman University of Medical Sciences, Kerman, Iran
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45
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Glover TL, Garvan C, Nealis RM, Citty SW, Derrico DJ. Improving End-of-Life Care Knowledge Among Senior Baccalaureate Nursing Students. Am J Hosp Palliat Care 2017; 34:938-945. [DOI: 10.1177/1049909117693214] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: It is imperative that nurses are proficient and comfortable providing care to patients at the end of life. Recent studies show that nurses’ knowledge of end-of-life care is less than optimal. Effective, evidence-based methods to infuse palliative and end-of-life care education into the undergraduate nursing curriculum are needed. Methods: A descriptive pre- and postassessment evaluating senior nursing students’ acquisition of knowledge on end-of-life care after attending the End-of-Life Nursing Education Consortium (ELNEC) core course was conducted. The course evaluation included qualitative statements. Results: Before the ELNEC course, one-third of the students had cared for a dying patient during clinical rotations, yet 85% reported they had not received adequate training in end-of-life care. Posttest questions related to palliative care, symptom management, communication, and grief indicated that students acquired significant knowledge after participating in the ELNEC course ( P < .05). Conclusion: The ELNEC core course is an effective way to improve nursing students’ knowledge of palliative and end-of-life care.
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Affiliation(s)
- Toni L. Glover
- Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Cynthia Garvan
- Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Rose M. Nealis
- Family, Community and Health System Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | - Sandra W. Citty
- Family, Community and Health System Science, College of Nursing, University of Florida, Gainesville, FL, USA
| | - David J. Derrico
- Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL, USA
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46
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Shaw PA, Abbott MA. High-fidelity simulation: Teaching end-of-life care. NURSE EDUCATION TODAY 2017; 49:8-11. [PMID: 27866111 DOI: 10.1016/j.nedt.2016.10.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 09/07/2016] [Accepted: 10/31/2016] [Indexed: 06/06/2023]
Abstract
The American Nurses Association, American Association of Colleges of Nursing, and the Institute of Medicine of the National Academies are unified in the position that nursing education must prepare students to coordinate and perform end-of-life (EOL) care. Yet, according to literature, undergraduate nursing education in EOL care remains inadequate. Following a review of literature indicating a need for more EOL instruction, a high-fidelity simulation activity is introduced and described. Included are guidelines for preparation, role assignment, integration of other professionals and family, and student reflection after the activity. Student evaluations indicate that the simulation is valuable and improves self-efficacy in caring for the dying. By providing students with the opportunity to experience EOL in a low-risk, learning environment, a high-fidelity EOL simulation activity can help educators bridge the knowledge gap in nursing education.
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Affiliation(s)
- Peggy A Shaw
- Mount Carmel College of Nursing, 127 South Davis Avenue, Columbus, OH 43222, United States.
| | - Miriam A Abbott
- Mount Carmel College of Nursing, 127 South Davis Avenue, Columbus, OH 43222, United States.
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47
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Abstract
The purpose of this study was to describe nurses' needs and how they are being met and not met after caring for surgical patients who died after a failure to rescue (FTR). A qualitative, phenomenologic approach was used for the interview and analysis framework. Methods to ensure rigor and trustworthiness were incorporated into the design. The investigator conducted semistructured 1:1 interviews with 14 nurses. Data were analyzed using Colaizzi's methods. Four themes were identified: (1) coping mechanisms are important; (2) immediate peer and supervisor feedback and support are needed for successful coping; (3) subsequent supervisor support is crucial to moving on; and (4) nurses desire both immediate support and subsequent follow-up from their nurse leaders after every FTR death. Nurses' needs after experiencing an FTR patient death across multiple practice areas and specialties were remarkably similar and clearly identified and articulated. Coping mechanisms vary and are not uniformly effective across different groups. Although most nurses in this study received support from their peers after the FTR event, many nurses did not receive the feedback and support that they needed from their nurse leaders. Immediate nurse leader support and follow-up debriefings should be mandatory after patient FTR deaths. Developing an understanding of nurses' needs after experiencing an FTR event can assist nurse leaders to better support nurses who experience FTR deaths. Insight into the environment surrounding FTR deaths also provides a foundation for future research aimed at improving patient safety and quality through an improved working environment for nurses.
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López-Pérez B, Ambrona T, Hanoch Y. Influence of the type of patient in the emotional response of nurses and nursing students. Nurse Educ Pract 2016; 19:7-11. [DOI: 10.1016/j.nepr.2016.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 02/18/2016] [Accepted: 03/25/2016] [Indexed: 11/28/2022]
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Statton S, Jones R, Thomas M, North T, Endacott R, Frost A, Tighe D, Wilson G. Professional learning needs in using video calls identified through workshops. BMC MEDICAL EDUCATION 2016; 16:140. [PMID: 27165431 PMCID: PMC4863338 DOI: 10.1186/s12909-016-0657-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 04/28/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Most people want to die at home but only half do. Supporting patients in rural locations is challenging. Video calls such as Skype, might help but are not routinely used; we should consider learning needs to increase uptake and ensure effective use. We aimed to identify learning needs of healthcare professionals (HCPs) in using video calls to support patients (and their carers) to die at home. METHODS Face-to-face workshops were held in five Southwest England locations. Participants discussed advantages, disadvantages, scenarios for use, and the learning needs of video call users. Ideas were documented on flipcharts and discussions audio-recorded. The 116 participants included nurses, allied HCPs, doctors and previously bereaved volunteers. Lists of advantages, disadvantages, scenarios and learning needs were compiled and circulated to participants. In a subsequent online workshop, 21 participants ranked seven groups of learning needs in priority order. RESULTS Most participants thought video calls could be used to advantage in many end-of-life scenarios, especially in rural areas. Seven themes, covering 59 learning needs for HCPs, were identified (in priority order): (i) confidence and technical ability in using video calls; (ii) being aware of how video calls fit into clinical practice; (iii) managing video calls; (iv) communication skills on 'camera'; (v) understanding how patients and families may be affected by video call use; (vi) presenting video calls as an option to patients and families to assess their readiness; (vii) normal professional skills that become essential for effective video calls. CONCLUSIONS Although almost ubiquitous, video call software is not routinely and effectively used in British clinical practice. Supporting patients and families at end-of-life is one example where it could be used to advantage, but clinicians need to plan and practise before using it in real situations. Learning needs were identified that could be developed into learning modules and/or courses.
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Affiliation(s)
- Sarah Statton
- School of Nursing and Midwifery, Plymouth University, 3 Portland Villas, Plymouth, PL4 8AA, UK
| | - Ray Jones
- School of Nursing and Midwifery, Plymouth University, 3 Portland Villas, Plymouth, PL4 8AA, UK.
| | | | - Tracie North
- School of Nursing and Midwifery, Plymouth University, 3 Portland Villas, Plymouth, PL4 8AA, UK
| | - Ruth Endacott
- School of Nursing and Midwifery, Plymouth University, 3 Portland Villas, Plymouth, PL4 8AA, UK
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50
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Barriers and facilitators in coping with patient death in clinical oncology. Support Care Cancer 2016; 24:4219-27. [DOI: 10.1007/s00520-016-3249-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
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