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Chang SO, Kim D, Cho YS, Oh Y. Care of patients undergoing withdrawal of life-sustaining treatments: an ICU nurse perspective. BMC Nurs 2024; 23:153. [PMID: 38439003 PMCID: PMC10910717 DOI: 10.1186/s12912-024-01801-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 02/15/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Intensive care unit (ICU) nurses working in South Korea report experiencing uncertainty about how to care for patients undergoing withdrawal of life-sustaining treatments (WLT). A lack of consensus on care guidelines for patients with WLT contributes to uncertainty, ambiguity, and confusion on how to act appropriately within current law and social and ethical norms. To date, little has been discussed or described about how ICU nurses construct meaning about their roles in caring for dying patients in the context of wider social issues about end-of-life care and how this meaning interacts with the ICU system structure and national law. We aimed to better understand how ICU nurses view themselves professionally and how their perceived roles are enabled and/or limited by the current healthcare system in South Korea and by social and ethical norms. METHODS This qualitative descriptive study was conducted using in-depth, semi-structured interviews and discourse analysis using Gee's Tools of Inquiry. Purposive sampling was used to recruit ICU nurses (n = 20) who could provide the most insightful information on caring for patients undergoing WLT in the ICU. The interviews were conducted between December 2021 and February 2022 in three university hospitals in South Korea. RESULTS We identified four categories of discourses: (1) both "left hanging" or feeling abandoned ICU nurses and patients undergoing WLT; (2) socially underdeveloped conversations about death and dying management; (3) attitudes of legal guardians and physicians toward the dying process of patients with WLT; and (4) provision of end-of-life care according to individual nurses' beliefs in their nursing values. CONCLUSION ICU nurses reported having feelings of ambiguity and confusion about their professional roles and identities in caring for dying patients undergoing WLT. This uncertainty may limit their positive contributions to a dignified dying process. We suggest that one way to move forward is for ICU administrators and physicians to respond more sensitively to ICU nurses' discourses. Additionally, social policy and healthcare system leaders should focus on issues that enable and limit the dignified end-of-life processes of patients undergoing WLT. Doing so may improve nurses' understanding of their professional roles and identities as caretakers for dying patients.
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Affiliation(s)
- Sung Ok Chang
- College of Nursing and BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea
| | - Dayeong Kim
- College of Nursing and BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Republic of Korea
| | - Yoon Sung Cho
- Korea University Guro Hospital, Seoul, Republic of Korea
| | - Younjae Oh
- College of Nursing and Research Institute of Nursing Science, Hallym University, Hallymdaehakgil 1, 24252, Gangwon-do, Republic of Korea.
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Shahmohammadi S, Mangolian Shahrbabaki P, Radmehr M, Shahraki SK. The effectiveness of aesthetic care training on nurses' perceptions of end-of-life care in patients with cancer: a quasi-experimental study. BMC Palliat Care 2024; 23:34. [PMID: 38326782 PMCID: PMC10851450 DOI: 10.1186/s12904-024-01343-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 01/05/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Supportive end-of-life care plays a significant role for patients with cancer. Significantly, art and aesthetics in nursing are regarded as key components of nursing practice. They may contribute to supportive end-of-life care that nurses provide for patients with cancer. Therefore, this study aimed to examine the effectiveness of aesthetic care training on nurses' perceptions of end-of-life care in patients with cancer. METHODS A quasi-experimental study was conducted with two groups of nurses working in the oncology wards of two hospitals in Kerman, Iran. A sample consisting of 100 nurses was selected by census and randomly assigned to an experimental group (n = 49) and a control group (n = 51). The experimental group received educational workshops on aesthetic care over four weekly-held 90-minute sessions. Both groups completed the Oncology Nurses' Perceptions of End-Of-Life Care (ONPEoLC) Scale before, immediately after, and one month after the intervention. The data were analyzed with SPSS software version 21 using t-test, Chi-square, and repeated measures ANOVA. The significance level was set to p < 0.05. RESULTS The mean baseline scores on the ONPEoLC Scale were 163.08 ± 13.58 in the experimental group and 163.27 ± 14.57 in the control group. There was no statistically significant difference between the two groups (P > 0.05). Post-intervention mean scores in the experimental and control groups were 187.1 ± 18.22 and 159.11 ± 22.11, respectively, indicating a statistically significant difference between the two groups (P < 0.001). One month after the intervention, the experimental and control groups' mean scores were 190.89 ± 11.13 and 165.80 ± 11.69, respectively, with a significant difference between the groups (P = 0.001). CONCLUSION Based on the results of the present study, designing aesthetic care educational programs is an effective way to improve nurses' understanding of end-of-life care. Therefore, it is recommended that nursing faculties and educational policymakers utilize aesthetic care training to improve the nurses' perceptions of end-of-life care.
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Affiliation(s)
- Sina Shahmohammadi
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Maryam Radmehr
- Community Health Research Center, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
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Bigdeli Shamloo MB, Elahi N, Zarea K. Lived Experience of Caring for Dying Muslim Patients in Emergency Room: A Phenomenological Study. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231153254. [PMID: 36775852 DOI: 10.1177/00302228231153254] [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: 02/14/2023]
Abstract
Death is a natural part of life, which mostly occurs in the ER. This study described the meaning of nurses' lived experience of caring for critical and dying patients in the ERs. In this qualitative study, 13 nurses who was purposefully selected. Data were collected using in-depth individual interviews. Data analysis used van Manen's hermeneutic phenomenological approach. The experiences of caring for the dying patient were divided into two parts: experiences in patients with acute and chronic problems. In patients with acute problems, four themes were extracted: fight to the death, no time for palliative and spiritual care, lacking support for the family, no privacy for peaceful death. In patients with acute problems, four themes were extracted: Facilitating a peaceful death, Allocating time for palliative and spiritual care, support for the family, Attention to privacy. Therefore, attention should be paid to the fields of care and its inadequacies.
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Affiliation(s)
- Marzieh Beigom Bigdeli Shamloo
- Clinical Research Development Unit, Ganjavian Hospital, Dezful University Medical Sciences, Dezful, Iran
- Student Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nasrin Elahi
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kourosh Zarea
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Beiranvand S, Rassouli M, Hazrati M, Molavynejad S, Hojjat S, Tuvesson H, Zarea K. Hospice care delivery system requirements. Int J Palliat Nurs 2022; 28:562-574. [PMID: 36520099 DOI: 10.12968/ijpn.2022.28.12.562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Hospice care is a perceived need in the Iranian health system. AIM This qualitative study is explaining the stakeholders' perception of what is required to develop a hospice care system for patients living with cancer in Iran. METHODS A total of 21 participants (specialists, policymakers, healthcare providers, cancer patients and family caregivers) were selected through purposeful sampling and interviewed in-depth in 2020. Interviews were analysed through directed content analysis. FINDINGS A total of 1054 codes, 7 categories and 21 subcategories were extracted. The requirements include the need to provide: multiple settings and diverse services; participatory decision making; integration into the health system; specialised human resources; an organised system of accountability; the preparation of the existing health system; and wider capacity-building in existing Iranian society. CONCLUSION It is essential that Iranian services create a participatory comprehensive care plan, utilise expert manpower, integrate hospice care into the existing health system and organise a system of accountability. Policymakers should focus on the preparation of the health system and capacity building in society.
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Affiliation(s)
- Samira Beiranvand
- Assistant Professor, Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Rassouli
- Professor, Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Hazrati
- Assistant Professor, Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahram Molavynejad
- Assistant Professor, Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Suzanne Hojjat
- Doctor of Medicine, Department of Home-based Palliative Care, ALA Cancer Prevention and Control Center (MACSA), Tehran, Iran; President of French Institute of International Research and High Education, France
| | - Hanna Tuvesson
- Associate Professor, Faculty of Health and Life Sciences, Department of Health and Caring Sciences, Linnaeus University, Sweden
| | - Kourosh Zarea
- Associate Professor, Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Zarei F, Dehghan M, Mongolian Shahrbabaki P. The Relationship Between Perception of Good Death With Clinical Competence of End-Of-Life Care in Critical Care Nurses. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221134721. [PMID: 36252601 DOI: 10.1177/00302228221134721] [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
Providing a good death can be one of the most important goals of end-of-life care. This study aimed to investigate the relationship between the concept of good death with clinical end-of-life care competence among intensive care nurses. The participants were 279 nurses in southeast Iran. The data were collected using the Nurses' Concept of Good Death Questionnaire and the Clinical Competency of End-of-Life Care Questionnaire. There was a positive, moderate, and significant correlation between nurses' concept of good death and their clinical competence in end-of-life care. Nurses who got higher scores on the concept of good death showed higher levels of clinical competence in end-of-life care. It is possible to take steps to improve nurses' concepts and knowledge through specialized educational interventions.
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Affiliation(s)
- Fatemeh Zarei
- Department of Critical Care, Razi Nursing and Midwifery Department, Kerman University of Medical Science, Kerman, Iran
| | - Mahlagha Dehghan
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Parvin Mongolian Shahrbabaki
- Department of Critical Care, Nursing Research Center, Razi Nursing and Midwifery Department, Kerman University of Medical Science, Kerman, Iran
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SHAHOEI R, NEMATI SM, VALIEE S. Exploring the Experience of Nurses in Providing Care to Patients With COVID-19: A Qualitative Study. J Nurs Res 2022; 30:e217. [PMID: 35576060 PMCID: PMC9301688 DOI: 10.1097/jnr.0000000000000498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 05/19/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has caused conflicts in the world health system. The role of nurses is prominent because of their close contact with patients. PURPOSE The aim of this study was to explore the experiences of nurses in providing care to patients with COVID-19. METHODS This phenomenological study was conducted in 2020. Purposive sampling was used and continued until data saturation. Semistructured interviews were conducted with 14 nurses at Tohid Hospital, Sanandaj, Iran, all of whom had experience providing care to patients with COVID-19. Interviews were transcribed verbatim and analyzed using Colaizzi's phenomenological method. RESULTS The participants included four men and 10 women. Data analysis revealed four main themes (14 subthemes) related to the experience of the participants in providing care to patients with COVID-19. These themes included (a) fear (fear of being infected, fear of being a carrier, fear of the disease, and high mortality of patients), (b) compulsion (compulsion to care, being under pressure), (c) distinct experience (need for self-care, working with personal protective equipment, and ambiguity in care/treatment), and (d) sacrifice (altruism, compassion, self-sacrifice, and being proud of yourself). CONCLUSIONS/IMPLICATIONS FOR PRACTICE The experience of participants in caring for patients with COVID-19, in addition to the unique experience of care, was associated with fear, compulsion, and sacrifice. Because of the ongoing COVID-19 pandemic and the unique experience of nurses serving in COVID-19 units, it is necessary to educate and support nurses to deal effectively with this situation.
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Affiliation(s)
- Roonak SHAHOEI
- PhD, Associate Professor, Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Syede Mona NEMATI
- MSN, RN, Instructor, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Sina VALIEE
- PhD, RN, Professor, Clinical Care Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Kovanci MS, Akyar I. Culturally-sensitive moral distress experiences of intensive care nurses: A scoping review. Nurs Ethics 2022; 29:1476-1490. [PMID: 35724332 DOI: 10.1177/09697330221105638] [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
BACKGROUND Moral distress is a phenomenon that all nurses experience at different levels and contexts. The level of moral distress can be affected by individual values and the local culture. The sources of the values shape the level of moral distress experienced and the nurses' decisions. AIM The present scoping review was conducted to examine the situations that cause moral distress in ICU nurses in different countries. RESULTS A scoping review methodology was adopted for the study, in line with the approach of Arksey, and O'Malley Literature was searched within PubMed/Medline, Scopus, Web of Science, and PsycINFO indexed keywords such as "moral distress", "Critical Care Nurse", and "Moral Distress Scale-Revised". Of the 617 identified citations, 12 articles matched the inclusion criteria. CONCLUSION The moral distress experienced in countries and regions with similar cultures and geographies was parallel. The situations that cause the most moral distress are futile-care to prolong death, unnecessary tests and treatments, and working with incompetent healthcare personnel.
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Affiliation(s)
- Mustafa Sabri Kovanci
- Psychiatric Nursing Department, Faculty of Nursing, 37515Hacettepe University, Ankara, Turkey
| | - Imatullah Akyar
- Internal Medicine Nursing Department, Faculty of Nursing, 37515Hacettepe University, Ankara, Turkey
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Beiranvand S, Rassouli M, Hazrati M, Molavynejad S, Hojjat S, Zarea K. Developing a Model for the Establishment of the Hospice Care Delivery System for Iranian Adult Patients With Cancer. Front Psychol 2022; 13:807621. [PMID: 35418901 PMCID: PMC8997285 DOI: 10.3389/fpsyg.2022.807621] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/09/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Making appropriate plans for the provision of hospice care is considered a perceived need in the Iranian health system. The current study aimed to develop a model for establishing hospice care delivery system for the adult patients with cancer. Materials and Methods This study is part (data of the third and fourth phases) of a larger study that has been done in four phases. This Health System Policy Research (HSPR) utilized a mixed qualitative-quantitative approach. At the first phase, a qualitative study was conducted which explained the care needs and the requirements for establishing this system from the stakeholders' perspective (directed content analysis). The second phase aimed to examine the current situation of hospice care delivery in Iran and identify and determine the similarities and differences among them in the selected countries (comparative study). At the third phase, the main areas of the model and the related indicators were extracted and prioritized by consulting with experts (Delphi survey). Then the model was formulated. At the fourth phase, the proposed model was validated and finalized in terms of importance, scientific acceptability, and feasibility. Results Based on the developed model the first and the most important step in establishing the hospice care delivery system is laying the groundwork in the health system which requires focusing on policymaking. It is necessary to establish hospice centers and implement public awareness raising programs, train, and supply expert manpower, strengthen family physician and referral process, formulate clinical guidelines, encourage the private sector and NGOs(Non-Governmental Organizations (NGOs).) to invest, develop end-of-life and hospice care service packages, and create quality care indicators. The proposed model had moderate feasibility. Conclusion This model was developed based on the current Iranian healthcare structure and the needs of terminally ill cancer patients. It can be used as a model tailored to the current state of the health system and community in Iran. It is suggested to use this model as a pilot at the regional level.
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Affiliation(s)
- Samira Beiranvand
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Rassouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Hazrati
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahram Molavynejad
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Suzanne Hojjat
- Department of Home-Based Palliative Care, ALA Cancer Prevention and Control Center (MACSA), Tehran, Iran
- French Institute of International Research and High Education, Paris, France
| | - Kourosh Zarea
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Kmetec S, Fekonja Z, Škrbić S, Mlinar Reljić N. Doživljanje umiranja z vidika medicinskih sester. OBZORNIK ZDRAVSTVENE NEGE 2021. [DOI: 10.14528/snr.2021.55.4.3090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Uvod: V enotah intenzivne terapije se medicinske sestrednevno soočajo z umiranjem. To jim predstavlja velike obremenitve, ki vodijo do stiske. Namen pregleda literature je ugotoviti, kaj doživljajo medicinske sestre ob umirajočih pacientih v enotah intenzivne terapije in kako se soočajo z umiranjem.Metode: Uporabljena je metoda pregleda literature. Iskanje je bilo izvedeno v bazah podatkov: PubMed, ScienceDirect, SAGE, Web of Science in CINAHL na osnovi vključitvenih in izključitvenih kriterijev. Proces iskanja literature je prikazan z diagramom PRISMA. Za analizo in sintezo podatkov je bila uporabljena metoda tematske analize.Rezultati: Od 1.886 zadetkov smo v končno analizo vključili 10 člankov. Na podlagi tematske analize smo oblikovali dve glavni temi: (1) doživljanje medicinskih sester ob hudo bolnih in umirajočih pacientih; (2) profesionalni odnos medicinskih sester.Diskusija in zaključek: Izvajanje zdravstvene nege v enotah intenzivne terapije je za medicinske sestre zelo stresno. Pri zdravstveni negi kritično bolnih pacientov se najpogosteje srečujejo s stalnimi fizičnimi obremenitvami, čustvenimi pretresi, pomanjkanjem čustvene podpore, žalostjo, izgorevanjem, depresijo, težavami v komunikaciji s pacientovimi sorodniki ter pomanjkljivim sodelovanjem in zagotavljanjem podpore v timu. Izpostavljene so številnim dejavnikom, ki prispevajo k doživljanju lastne stiske. Potrebni so ukrepi za zaščito, učinkovitejšo pomoč in podporo medicinskim sestram, ki se dnevno soočajo z umiranjem in zagotavljanjem podpore pacientovi družini oziroma svojcem.
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Uzelli Yilmaz D, Yilmaz D, Duzgun G, Akin E. A Phenomenological Analysis of Experiences and Practices of Nurses Providing Palliative and End of Life Care. OMEGA-JOURNAL OF DEATH AND DYING 2021:302228211037506. [PMID: 34344255 DOI: 10.1177/00302228211037506] [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: 11/15/2022]
Abstract
The aim of this study was to describe the experiences and practices of nurses providing palliative and end of life care. The study was conducted in the palliative care unit of a territory hospital in Turkey. The sample consisted of 11 nurses who had been working as palliative care nurses for at least one year. The face to face interview method was used to collect data, with a semi-structured in-depth individual interview. 5 main themes and 24 sub-themes were emerged in relation to the experiences and practices of the nurses. The majority of participant nurses pointed that inadequacy in the number of nurses, secondary nursing care activities, refusal of treatment, cultural and ethical problems were barriers in the provision of nursing care. They frequently experienced ethical issues when caring for end of life patients, and for this reason they felt the need for ethics counselling which they could consult.
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Affiliation(s)
- Derya Uzelli Yilmaz
- Department of Nursing, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Dilek Yilmaz
- Department of Nursing, Faculty of Health Sciences, Bursa Uludag University, Bursa, Turkey
| | - Gonul Duzgun
- Department of Emergency and First Aid Services, Vocational School of Health Services, Izmir Tinaztepe University, Izmir, Turkey
| | - Esra Akin
- Department of Nursing, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
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Lafci D, Yildiz E, Pehlivan S. Nurses' views and applications on palliative care. Perspect Psychiatr Care 2021; 57:1340-1346. [PMID: 33283277 DOI: 10.1111/ppc.12695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/30/2020] [Accepted: 11/14/2020] [Indexed: 11/26/2022] Open
Abstract
PURPOSE This study was carried out descriptively to determine the view and applications about pallative care of nurses working in a university hospital. DESIGN AND METHODS The data were collected with the questionnaire form: "Individual Information Form" and "Views and Appllications on Palliative Care," created by the researchers in line with the literature. FINDINGS A total of 96.6% of the nurses evaluated the scope of palliative care as pain relief, and the most common difficulties in care were identified as bad news (88.1%). In all, 22.0% of the nurses talked to the patient and their family about death. PRACTICE IMPLICATIONS It is thought that the majority of nurses are not trained in palliative care and their opinions about palliative care are affected by this situation.
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Affiliation(s)
- Diğdem Lafci
- Faculty of Nursing, Mersin University, Mersin, Turkey
| | - Ebru Yildiz
- Faculty of Nursing, Mersin University, Mersin, Turkey
| | - Seda Pehlivan
- Faculty of Health Sciences, Bursa Uludağ University, Bursa, Turkey
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12
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Norouzadeh R, Anoosheh M, Ahmadi F. Nurses' Communication With the Families of Patients at the End-of-Life. OMEGA-JOURNAL OF DEATH AND DYING 2020; 86:119-134. [PMID: 32993419 DOI: 10.1177/0030222820959933] [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: 11/16/2022]
Abstract
BACKGROUND Effective communication is important in providing quality care to families at the end-of-life. In the end-of-life situations, the nurses' views on how to communicate with the family are not well understood. AIM This study was conducted to explore the nurses' experiences of their communication with families of patients at the end-of-life situations. METHODS The authors used standards for reporting qualitative research. The data were analyzed by conventional content analysis. Semi-structured interviews were conducted with 24 Iranian nurses who had the experiences of dealing with patients' families at the end-of-life. RESULTS Nurses' perceptions of communication with families emerged base on the main theme: "Disrupted communication" consisting of two categories: "restricted communication" and "abortive communication." CONCLUSION The results of this study highlight the need to increase the professional and ethical sensitivity of nurses in dealing with patients' families at the end-of-life.
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Affiliation(s)
- Reza Norouzadeh
- Department of Nursing, Nursing and Midwifery Faculty, Shahed University, Tehran, I. R. Iran
| | - Monireh Anoosheh
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, I. R. Iran
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, I. R. Iran
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Comparison of The Hospice Palliative Care Delivery Systems in Iran and Selected Countries. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2020. [DOI: 10.5812/ijcm.101635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: There is an increasing demand for Hospice Palliative Care (HPC) due to the aging population, increased incidence of cancer, and other chronic diseases, as well as recent advances in care and treatment. Objectives: The present study was conducted to examine the nature and structure of HPC services and to describe and compare them in the United Kingdom (UK), Canada, Australia, Japan, India, Jordan, and Iran to extract general conclusions and suggestions for developing HPC systems in Iran. Methods: In the current descriptive-comparative study, from 2018 to 2019, HPC delivery systems in the selected countries and Iran were reviewed based on the World Health Organization (WHO) guideline, and the similarities and differences among them were explained. Results: Developing the National HPC Program and its integration into the health system are important activities. The most common source of financing is donation. The services are mainly provided to patients with cancer. Human resource development includes curriculum reform, creating specialty, subspecialty disciplines, and holding training courses. Other activities include designing national guidelines, the free access to opioids, research development, the establishment of the national information network, and the quality control programs. Iran lacks any formal structure and program of HPC services and they are provided in a scattered and very limited manner as part of general palliative services. Conclusions: HPC services are in a mediate and low level in developed countries and Iran, respectively. Before the establishment of the HPC delivery system, a complicated range of economic, social, cultural, and political factors must be considered.
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Temelli G, Cerit B. Perceptions of Palliative Care Nurses Related to Death and Palliative Care Practices. OMEGA-JOURNAL OF DEATH AND DYING 2019; 84:378-398. [PMID: 31841067 DOI: 10.1177/0030222819890457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This study has been conducted with the purpose of identifying the perceptions of palliative nurses about death and determining palliative care practices. We conducted qualitative interviews with 23 palliative care nurses in Turkey. Content analysis was used in the evaluation of the data. Three themes have been identified about perception of death. Furthermore, three themes have been identified about palliative care practices. It was concluded that the palliative nurses perceive death as a natural and inevitable process and that as long as their working period increases, they become desensitized. It was identified that the participants generally perform the following procedures in palliative care practices.
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Affiliation(s)
- Gülnur Temelli
- Fundamentals of Nursing Department, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Turkey
| | - Birgül Cerit
- Fundamentals of Nursing Department, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Turkey
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Hassani P, Abdi A, Jalali R, Salari N. Development and Psychometric Evaluation of an Instrument to Measure the Use of Intuition in Clinical Practice by Critical Care Nurses. J Nurs Meas 2019; 26:E142-E158. [PMID: 30593583 DOI: 10.1891/1061-3749.26.3.e142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The current study was conducted to develop and validate an instrument to measure the use of intuition in clinical practice by critical care nurses. METHODS Item generation and psychometric evaluation were developed. In the psychometric, content validity index and content validity ratio were calculated to establish initial instrument validity through the use of expert ratings, as well as, construct and criterion validity. RESULTS The original items reduced to 25. Using principal components analysis and orthogonal varimax rotation, three factors had an eigenvalue >1, with 60.05% variance (Factor 1: 47.9%; Factor 2: 7.56%; and Factor 3: 5.05%). The tool had an acceptable correlation to criterion of the instrument (r = .769, p < .001), a Cronbach alpha consistency of 0.953, and a stability level of r = .945 and p < .001. CONCLUSION In this study, a valid and reliable instrument was developed to measure intuition.
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Affiliation(s)
| | - Alireza Abdi
- Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rostam Jalali
- Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Kermanshah University of Medical Sciences, Kermanshah, Iran
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16
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Vargas CP, Vargas MADO, Tomaschewski-Barlem JG, Ramos FRS, Schneider DG, Camponogara S. Patient advocacy actions by intensivist nurses. Rev Esc Enferm USP 2019; 53:e03490. [PMID: 31389487 DOI: 10.1590/s1980-220x2018011703490] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 02/21/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To explore the actions and factors associated to patient advocacy by intensivist nurses using the Protective Nursing Advocacy Scale. METHOD A quantitative, descriptive-exploratory, cross-sectional study. The questionnaire was answered by nurses who worked in Intensive Care Units in the South and Southeast regions of Brazil. A factorial exploratory analysis of the data, T-tests and the chi-square test were used for association between factors. RESULTS 451 nurses participated in the study. A greater number of nurses disagreed with the negative consequences that patient advocacy may have or bring to them. Greater dialogue among nursing staff would enhance teamwork results. Nurses with two or more job relationships need more physical and mental effort, which compromises their quality of life and work, leading to them being those who least practice patient advocacy. CONCLUSION Nurses understand patient advocacy as an important part of their work, as well as factors which may influence their decision to defend their patients, but are still unaware of the benefits of advocacy.
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Affiliation(s)
- Caroline Porcelis Vargas
- Universidade Federal de Santa Catarina , Departamento de Enfermagem , Programa de Pós-Graduação em Enfermagem , Florianópolis , SC , Brasil
| | - Mara Ambrosina de Oliveira Vargas
- Universidade Federal de Santa Catarina , Departamento de Enfermagem , Programa de Pós-Graduação em Enfermagem , Florianópolis , SC , Brasil
| | | | - Flávia Regina Souza Ramos
- Universidade Federal de Santa Catarina , Departamento de Enfermagem , Programa de Pós-Graduação em Enfermagem , Florianópolis , SC , Brasil
| | - Dulcinéia Ghizoni Schneider
- Universidade Federal de Santa Catarina , Departamento de Enfermagem , Programa de Pós-Graduação em Enfermagem , Florianópolis , SC , Brasil
| | - Silviamar Camponogara
- Universidade Federal de Santa Maria , Departamento de Enfermagem , Santa Maria , RS , Brasil
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Norouzadeh R, Anoosheh M, Ahmadi F. Contingency Help: The Main Strategy of Iranian Nurses in Dealing With the Family of the End-of-Life Patients. OMEGA-JOURNAL OF DEATH AND DYING 2019; 83:426-445. [PMID: 31188718 DOI: 10.1177/0030222819854909] [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: 11/15/2022]
Abstract
Families are struggling with many challenges in the final stages of patient life. It is important to understand what actions nurses do for the family of the end-of-life (EOL) patients. This study aimed to explain the main strategy of nurses' dealing with the family of the EOL patients. Data were analyzed using conventional content analysis. Semistructured interviews were conducted on 32 nurses from hospitals in Tehran. Nurses used six measures of explaining the bitter reality, effective communication, management of violence, referral, consolation, and reinforcement. "Contingency help" was conceptualized as the main strategy. Nurses through "contingency help" were involved in solving the emotional, physical, financial, and spiritual needs of the family. Nurses will be able to apply the results of this study to the development of care policies for the family of the EOL patients.
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Affiliation(s)
- Reza Norouzadeh
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
| | - Monireh Anoosheh
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
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18
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Ahmadi M, Bagheri-Saweh MI, Nouri B, Mohamadamini O, Valiee S. Effect of Interventional Educational Programs on Intensive Care Nurses' Perception, Knowledge, Attitude, and Practice About Physical Restraints: A Pre-/Postclinical Trial. Crit Care Nurs Q 2019; 42:106-116. [PMID: 30507671 DOI: 10.1097/cnq.0000000000000244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The article reports results of an educational program designed to modify negative attitudes of intensive care nurses regarding the use of physical restraints. Findings revealed that increased knowledge about appropriate utilization of various types of restraints positively impacted perceptions, attitudes, and patient care practices. Authors also explore restraint use in several countries and identify variations in use of restraining methods.
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Affiliation(s)
- Mohamad Ahmadi
- Student Research Committee (Mr Ahmadi), Clinical Care Research Center (Mr Bagheri-Saweh and Dr Valiee), Social Determinants of Health Research Center, Research Institute for Health Development (Dr Nouri), and Salahuddin Ayyubi Hospital (Mr Mohamadamini), Kurdistan University of Medical Sciences, Sanandaj, Iran
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Karbasi C, Pacheco E, Bull C, Evanson A, Chaboyer W. Registered nurses' provision of end-of-life care to hospitalised adults: A mixed studies review. NURSE EDUCATION TODAY 2018; 71:60-74. [PMID: 30245257 DOI: 10.1016/j.nedt.2018.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 08/04/2018] [Accepted: 09/06/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES To describe, critically appraise and synthesise research regarding nurses' perceptions of their knowledge, skills or experiences in providing end-of-life care to hospitalised adults to help inform both future educational and practice initiatives. DESIGN Mixed studies review. DATA SOURCES MEDLINE, CINAHL, Cochrane Library, Web of Science and SCOPUS databases were searched for the years 2004-June 2018, along with journal hand-searching and reference list searching. REVIEW METHODS Two independent reviewers screened the titles and abstracts of studies. Data extraction and quality assessment using the Mixed Methods Appraisal Tool was conducted independently by two reviewers. Disagreements were adjudicated by a third reviewer. Study findings were synthesised thematically. RESULTS Nineteen studies met the inclusion criteria. Of them, ten were quantitative, eight qualitative and one mixed-method. All but one quantitative study were conducted in the United States and all but one used some form of survey. The qualitative studies were conducted in a variety of countries and all but one used some form of interview for data collection. Five themes were identified including nurse as a protecting provider, nurse as an advocate, nurse as a reflective practitioner, obstacles to providing quality end-of-life care and aids to providing quality end-of-life care. CONCLUSIONS Registered Nurses have aligned their end-of-life care with practice with the profession's expectations and are enacting a patient centred approach to their practice. They rely on reflective practices and on the support of others to overcome organisational, educational and emotional the challenges they to providing quality end-of-life care.
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Affiliation(s)
- C Karbasi
- Nursing, Physiotherapy and Podiatry Faculty of the Complutense University of Madrid, 28040 Madrid, Spain.
| | - E Pacheco
- Nursing, Physiotherapy and Podiatry Faculty of the Complutense University of Madrid, 28040 Madrid, Spain.
| | - C Bull
- Centre for Applied Health Economics (CAHE), Griffith University, Nathan Campus, 4111 QLD, Australia.
| | - A Evanson
- North West Hospital and Health Service, Mount Isa Hospital, 30 Camooweal Street, QLD 4825, Australia.
| | - W Chaboyer
- Menzies Health Institute Queensland, Griffith University, 4215 QLD, Australia.
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20
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Yáñez Dabdoub M, Vargas Celus IE. Cuidado humanizado en pacientes con limitación del esfuerzo terapéutico en cuidados intensivos, desafíos para enfermería. PERSONA Y BIOÉTICA 2018. [DOI: 10.5294/pebi.2018.21.1.5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
En las unidades de cuidados intensivos (UCI) el equipo de salud utiliza todas las medidas posibles para preservar la vida de sus pacientes. No obstante, cuando las terapias son fútiles, se decide limitar el esfuerzo terapéutico (LET). Este artículo tiene como objetivo describir los factores que pueden llevar a enfermería a deshumanizar sus cuidados en pacientes en LET en UCI. Revisión de la literatura en bases de datos, con las palabras clave: critical care, intensive care unit, limitation of therapeutic effort, end of life care, humanized/human care, nursing. Los hallazgos fueron agrupados en seis categorías que pueden influir en la deshumanización del cuidado en UCI. Se concluye que en el cuidado humanizado se destacan los roles de enfermería como defensora de los intereses del paciente y como agente comunicador.
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Mani ZA, Ibrahim MA. Intensive care unit nurses' perceptions of the obstacles to the end of life care in Saudi Arabia. Saudi Med J 2018; 38:715-720. [PMID: 28674716 PMCID: PMC5556278 DOI: 10.15537/smj.2017.7.18454] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objectives: To explore nurses’ perceptions of obstacles to the provision of end of life care (EoLC) in the intensive care unit (ICU) in Saudi Arabia. Methods: A modified version of a questionnaire developed by Beckstrand and Kirchhoff was administered in one setting at Riyadh, Saudi Arabia between March and April 2015. Results: A total of 87 questionnaires were returned from 140 potential respondents, representing a 62% response rate. Findings highlighted concerns associated with patient’s family, physicians who differed in opinions, cultural differences and language barriers. The nurses also noted issues in awareness and involvement in education about EoLC and futile care. Conclusion: Findings highlight a number of key obstacles to the provision of quality EoLC in ICUs for nurses. Further development of both EoLC guidelines and education about EoLC in ICUs is recommended.
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Affiliation(s)
- Zakaria A Mani
- Ministry of Higher Education, Monash University, King Faisal Specialist Hospital & Research Centre, Riyadh, Kingdom of Saudi Arabia. E-mail.
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23
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Status of Violence in a Selected Faculty: The Students’ Experience. Int J Nurs Educ Scholarsh 2018; 15:/j/ijnes.2018.15.issue-1/ijnes-2016-0063/ijnes-2016-0063.xml. [DOI: 10.1515/ijnes-2016-0063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Accepted: 11/28/2017] [Indexed: 11/15/2022]
Abstract
AbstractThe present study is aimed at examining the status of violence among the students of nursing, midwifery, and operating room. A self-reporting questionnaire with two sections of demographic characteristics and experience of violence was used. The data obtained were analyzed, using SPSS software. 58.7 percent of the students had a history of violence in the previous year. The maximum percentage of violence exposure belonged to the students of operating room (76.9%). The highest incidence of violence was verbal (76.4%), happened in patients’ rooms (32.9%) and was in the form of insult (75.1%). Accordingly, preventive actions are required to prevent and control violence and support students. Informing students about violence, communicative skills, reaction, and coping with violence during studying is necessary. Therefore, educational authorities and theoretical and clinical instructors should take appropriate measures in order to prevent violence and create supportive mechanisms for the students.
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Ong KK, Ting KC, Chow YL. The trajectory of experience of critical care nurses in providing end-of-life care: A qualitative descriptive study. J Clin Nurs 2017; 27:257-268. [DOI: 10.1111/jocn.13882] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Keh Kiong Ong
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | | | - Yeow Leng Chow
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
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25
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Velarde-García JF, Luengo-González R, González-Hervías R, Cardenete-Reyes C, Álvarez-Embarba B, Palacios-Ceña D. Limitation of therapeutic effort experienced by intensive care nurses. Nurs Ethics 2016; 25:867-879. [PMID: 28027690 PMCID: PMC6238171 DOI: 10.1177/0969733016679471] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Nurses who practice limitation of therapeutic effort become fully involved in emotionally charged situations, which can affect them significantly on an emotional and professional level. Objectives: To describe the experience of intensive care nurses practicing limitation of therapeutic effort. Method: A qualitative, phenomenological study was performed within the intensive care units of the Madrid Hospitals Health Service. Purposeful and snowball sampling methods were used, and data collection methods included semi-structured and unstructured interviews, researcher field notes, and participants’ personal letters. The Giorgi proposal for data analysis was used on the data. Ethical considerations: This study was approved by the Ethical Research Committee of the relevant hospital and by the Ethics Committee of the Rey Juan Carlos University and was guided by the ethical principles of voluntary enrollment, anonymity, privacy, and confidentiality. Results: In total, 22 nurses participated and 3 themes were identified regarding the nurses’ experiences when faced with limitation of therapeutic effort: (a) experiencing relief, (b) accepting the medical decision, and (c) implementing limitation of therapeutic effort. Conclusion: Nurses felt that, although they were burdened with the responsibility of implementing limitation of therapeutic effort, they were being left out of the final decision-making process regarding the same.
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Affiliation(s)
- Juan Francisco Velarde-García
- Juan Francisco Velarde-García, Red Cross Nursing College, Universidad Autónoma de Madrid, Avenida Reina Victoria 28, 4a planta, 28003 Madrid, Spain
| | - Raquel Luengo-González
- Juan Francisco Velarde-García, Red Cross Nursing College, Universidad Autónoma de Madrid, Avenida Reina Victoria 28, 4a planta, 28003 Madrid, Spain
| | - Raquel González-Hervías
- Escuela de Enfermería de Cruz Roja de Madrid, Spain.,Juan Francisco Velarde-García, Red Cross Nursing College, Universidad Autónoma de Madrid, Avenida Reina Victoria 28, 4a planta, 28003 Madrid, Spain
| | - César Cardenete-Reyes
- Universidad Europea de Madrid, Spain.,Juan Francisco Velarde-García, Red Cross Nursing College, Universidad Autónoma de Madrid, Avenida Reina Victoria 28, 4a planta, 28003 Madrid, Spain
| | - Beatriz Álvarez-Embarba
- Universidad Autónoma de Madrid, Spain.,Juan Francisco Velarde-García, Red Cross Nursing College, Universidad Autónoma de Madrid, Avenida Reina Victoria 28, 4a planta, 28003 Madrid, Spain
| | - Domingo Palacios-Ceña
- Universidad Rey Juan Carlos, Spain.,Juan Francisco Velarde-García, Red Cross Nursing College, Universidad Autónoma de Madrid, Avenida Reina Victoria 28, 4a planta, 28003 Madrid, Spain
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26
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Moridi G, Valiee S, Nasrabadi AN, Nasab GE, Khaledi S. Meanings of Health for Iranian Diabetic Patients: A qualitative study. Electron Physician 2016; 8:2904-2910. [PMID: 27790342 PMCID: PMC5074748 DOI: 10.19082/2904] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 07/15/2016] [Indexed: 01/06/2023] Open
Abstract
INTRODUCTION Health is an exclusive and subjective phenomenon, and one of the most important situations with regard to perception of health, arises when patients suffer from a chronic disease. This study was conducted within the qualitative research framework and aimed to explore the meanings of health as perceived by a group of Iranian diabetic patients. METHODS A descriptive qualitative analysis design was used. Data were collected through semi-structured interviews with 20 participants among diabetic patients, who were admitted to the diabetes care centre of Tohid Hospital of the Kurdistan University of Medical Sciences, Sanandaj, Iran during a ten-month period in 2014. Interviews were transcribed and analysed through conventional content analysis. RESULTS Based on the findings of the study, three major health-related themes emerged: 1) the syndrome of the healthy body and the happy heart (physical well-being vivacity, satisfaction, and calmness of the mind), 2) life without compulsory limitations (lack of dietary limitations, No activity limitations, lack of social limitations), and 3) exalted spirituality (satisfying self and others, trusting God, remembering God). CONCLUSION Health care providers should consider the meaning of health in special groups, chiefly in patients with chronic diseases. It facilitates the development of appropriate programmes to improve desirable health levels among diabetic patients.
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Affiliation(s)
- Golrokh Moridi
- MSN, Lecturer and Faculty Member, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Sina Valiee
- Ph.D., Assistant Professor, Health and Care Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Golnaz Esmaeil Nasab
- Student in Environmental Engineering, Faculty of Natural Resources, University of Kurdistan, Sanandaj, Iran
| | - Shahnaz Khaledi
- MSN, Lecturer and Faculty Member, School of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Rafii F, Nikbakht Nasrabadi A, Karim MA. End-of-life care provision: experiences of intensive care nurses in Iraq. Nurs Crit Care 2015; 21:105-12. [PMID: 26487503 DOI: 10.1111/nicc.12219] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 08/22/2015] [Accepted: 08/25/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nurses play a key role in providing care for the critically ill in the intensive care unit (ICU). The physical, psychological, emotional and spiritual intimate care given by Kurdish nurses allows them to develop a therapeutic relationship with terminally ill patients in the ICU. AIMS This study sought to explore the meaning of caring for terminally ill patients from the perspective of Kurdish ICU nurses. DESIGN Van Manen's (1990) hermeneutic phenomenological design was adopted. METHOD The data were collected through in-depth semi-structured interviews with a purposive sample of 10 nurses working in ICUs. Interviews were transcribed and finally analysed according to Van Manen's method. RESULTS Four major themes including emotional labour, death as a positive dimension, optimistic rather than futile care and working within constraints emerged. CONCLUSIONS Kurdish nurses in their caring encounters with terminally ill patients experienced a range of feelings from emotional strain to being optimistic while working within limited resources in the ICU. Further research is needed to explore the experiences of nurses with other cultures of caring for terminally ill patients in ICUs. RELEVANCE TO PRACTICE End-of-life care in ICU is emotionally challenging, therefore, nurses in this setting require psychological and spiritual support to ensure optimal care provision.
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Affiliation(s)
- Forough Rafii
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, International Campus (IUMS-IC), Tehran, Iran
| | - Alireza Nikbakht Nasrabadi
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran
| | - Muaf Abdulla Karim
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, International Campus (TUMS-IC), Tehran, Iran
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Piedrafita-Susín AB, Yoldi-Arzoz E, Sánchez-Fernández M, Zuazua-Ros E, Vázquez-Calatayud M. [Nurses' perception, experience and knowledge of palliative care in intensive care units]. ENFERMERIA INTENSIVA 2015; 26:153-65. [PMID: 26242205 DOI: 10.1016/j.enfi.2015.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 06/01/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Adequate provision of palliative care by nursing in intensive care units is essential to facilitate a "good death" to critically ill patients. OBJECTIVE To determine the perceptions, experiences and knowledge of intensive care nurses in caring for terminal patients. METHODOLOGY A literature review was conducted on the bases of Pubmed, Cinahl and PsicINFO data using as search terms: cuidados paliativos, UCI, percepciones, experiencias, conocimientos y enfermería and their alternatives in English (palliative care, ICU, perceptions, experiences, knowledge and nursing), and combined with AND and OR Boolean. Also, 3 journals in intensive care were reviewed. RESULTS Twenty seven articles for review were selected, most of them qualitative studies (n=16). After analysis of the literature it has been identified that even though nurses perceive the need to respect the dignity of the patient, to provide care aimed to comfort and to encourage the inclusion of the family in patient care, there is a lack of knowledge of the end of life care in intensive care units' nurses. CONCLUSION This review reveals that to achieve quality care at the end of life, is necessary to encourage the training of nurses in palliative care and foster their emotional support, to conduct an effective multidisciplinary work and the inclusion of nurses in decision making.
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Affiliation(s)
- A B Piedrafita-Susín
- Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, España.
| | - E Yoldi-Arzoz
- Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, España
| | - M Sánchez-Fernández
- Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, España
| | - E Zuazua-Ros
- Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, España
| | - M Vázquez-Calatayud
- Área de Investigación, Formación y Desarrollo en Enfermería, Clínica Universidad de Navarra, Pamplona, España
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Bloomer MJ, Al-Mutair A. Ensuring cultural sensitivity for Muslim patients in the Australian ICU: Considerations for care. Aust Crit Care 2013; 26:193-6. [DOI: 10.1016/j.aucc.2013.04.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 03/11/2013] [Accepted: 04/16/2013] [Indexed: 10/26/2022] Open
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