1
|
Uslu-Sahan F, Terzioglu F, Dizdar EA, Kayademir N, Mutlu DK, Adıguzel G, Tozlu G, Baykal T. The Effect of Neonatal Intensive Care Nurses' Attitudes Towards Palliative Care on Death Anxiety and Burnout: An Analytic Cross-Sectional Study. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241252866. [PMID: 38758172 DOI: 10.1177/00302228241252866] [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: 05/18/2024]
Abstract
This study aimed to determined the effect of neonatal intensive care nurses' attitudes towards palliative care on death anxiety and burnout. This was an analytic cross-sectional study conducted with 215 neonatal intensive care nurses working a children's hospital with Turkey's largest NICU bed capacity. The mean Neonatal Palliative Care Attitude Scale total score was 3.04 ± 0.78, and the mean scores of the organization, resources, and clinician subscales were 3.16 ± 0.86, 2.87 ± 0.80, and 3.10 ± 0.97, respectively. The participants' mean Death Anxiety Scale score was 57.65 ± 21.46, and the mean Burnout Inventory score was 39.21 ± 17.61. The organization subscale explained 17% of the variance in death anxiety, and the organization and resources subscales explained 31% of the variance in burnout. Neonatal intensive care nurses' palliative care attitudes are moderate; they face obstacles in providing and improving their attitudes in this field. The high level of obstacles increases nurses' death anxiety and burnout.
Collapse
Affiliation(s)
- Fatma Uslu-Sahan
- Department of Obstetrics and Gynecologic Nursing, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Fusun Terzioglu
- Faculty of Health Sciences, Avrasya University, Trabzon, Turkey
| | - Evrim A Dizdar
- Neonatal Intensive Care Unit, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Neslihan Kayademir
- Children's Hospital, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Derya K Mutlu
- Neonatal Intensive Care Unit, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Garibe Adıguzel
- Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Gönül Tozlu
- Maternity Hospital Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| | - Tugce Baykal
- Neonatal Intensive Care Unit, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey
| |
Collapse
|
2
|
Özsavran M, Kurt A, Ayyıldız TK, Gül Z. "A Life Slips Through Our Fingers" Experiences of Nurses Working in Pediatric Intensive Care Units About Children's Death: A Qualitative Study. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228231225885. [PMID: 38166543 DOI: 10.1177/00302228231225885] [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: 01/04/2024]
Abstract
Caring for a dying child can be an experience full of all kinds of negative emotions, pain and stress for the pediatric nurse. In this study, which was carried out in Turkey, we aimed to determine how nurses working in a pediatric intensive care unit remembered and made sense of their experiences regarding children's deaths. In-depth interviews were held with 13 nurses. The data were analyzed using the content analysis method. Three themes were identified. These were (1) Personal effects of death, (2) Difficulties in care, and (3) Coping with death. It was clear that the nurses were traumatised by their exposure to infant deaths. The findings showed that nurses experienced regret, fatigue and posttraumatic stress disorder. In addition, it was determined that nurses should be supported to cope with child deaths, which is a complicated process involving the child and the family, especially emotionally. Moreover, providing institutional support to nurses and referring them to cognitive-behavioral therapies may make it easier for them to cope with the emotional burden they carry, as well as the burnout they experience.
Collapse
Affiliation(s)
- Musa Özsavran
- Ahmet Erdogan Vocational School of Health Services, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Aylin Kurt
- Faculty of Health Sciences, Bartın University, Bartın, Turkey
| | - Tülay Kuzlu Ayyıldız
- Faculty of Health Sciences, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Zeynep Gül
- Institute of Health Sciences, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| |
Collapse
|
3
|
Wong JQH, Charles JS, Mok HT, Tan TSZ, Amin Z, Ng YPM. Experiences of healthcare personnel with death in the neonatal intensive care unit: a systematic review of qualitative studies. Arch Dis Child Fetal Neonatal Ed 2023; 108:617-622. [PMID: 37197908 DOI: 10.1136/archdischild-2023-325566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/11/2023] [Indexed: 05/19/2023]
Abstract
OBJECTIVE To synthesise evidence from qualitative studies on the experiences of healthcare personnel (HCP) in the neonatal intensive care unit (NICU) caring for dying neonates. METHODS We conducted a systematic search, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO: CRD42021250015), of four databases (PubMed, Embase, PsycINFO and CINAHL) from date of inception of the databases to 31 December 2021 using MeSH terms and related keywords. Data were analysed using three-step inductive thematic synthesis. Quality assessment of included studies was performed. RESULTS Thirty-two articles were included. There were 775 participants, majority (92.6%) of whom were nurses and doctors. Quality of studies was variable. The narratives of HCP coalesced into three themes: sources of distress, coping methods and the way forward. Sources of distress encompassed HCP's discomfort with neonatal deaths; poor communication among HCP and with patient's family; lack of support (from organisations, peers and HCP's family) and emotional responses (guilt, helplessness and compassion fatigue). Methods of coping included setting emotional boundaries, support from colleagues, clear communication and compassionate care and well-designed end-of-life workflows. Steps taken by HCP to move forward and overcome the emotionally turbulent effects of NICU deaths included finding meaning in death, building deeper relationship with patients' families and the NICU team and embracing purpose and pride in work. CONCLUSION HCP face several challenges when a death occurs in the NICU. HCP can provide better end-of-life care if their undesirable experiences with death are mitigated by better understanding and overcoming factors causing distress.
Collapse
Affiliation(s)
| | | | - Hao Ting Mok
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Teresa Shu Zhen Tan
- Paediatrics, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
| | - Zubair Amin
- Neonatology, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
- Paediatrics, Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Yvonne Peng Mei Ng
- Neonatology, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
- Paediatrics, Yong Loo Lin School of Medicine, National University Singapore, Singapore
| |
Collapse
|
4
|
Ravaldi C, Mosconi L, Mannetti L, Checconi M, Bonaiuti R, Ricca V, Mosca F, Dani C, Vannacci A. Post-traumatic stress symptoms and burnout in healthcare professionals working in neonatal intensive care units: Results from the STRONG study. Front Psychiatry 2023; 14:1050236. [PMID: 36816403 PMCID: PMC9935564 DOI: 10.3389/fpsyt.2023.1050236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/13/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Newborns' deaths and life-threatening conditions represent extremely stressful events for parents and professionals working in NICUs, facilitating the onset of secondary traumatic stress symptoms. The STRONG study aims to better understand the psychological impact on Italian NICUs staff of bereavement care. METHODS The STRONG (STress afteR lOss in NeonatoloGy) study is a cross-sectional study based on a web survey consisted of four sections: sociodemographic, CommuniCARE-Newborn questionnaire, the Maslach Burnout Inventory and the Impact of Event Scale-Revised. RESULTS 227 NICU workers (42.7% nurses, 23.3% midwives, 22.2% physicians, 11.8% other HCPs) answered the survey. The hardest tasks were "communicating baby's death" and "informing on autopsy results"; 44.7% of HCPs did not receive formal training in communicating bad news, 44.2% 'learned from the field' by watching other colleagues; 41.2% declared that they do not have any communication strategy. More than 90% of professionals thought that training on bereavement care is necessary. The majority of HCPs showed some degree of post-traumatic stress symptoms: 34% medium and 35.3% severe. Professionals with training in bereavement care and/or in communication had less probability to develop stress symptoms. A multivariate analysis showed that higher levels of burnout were associated with 4 or more monthly losses and medium or severe stress symptoms. Having a well-defined communication strategy for breaking bad news was independently associated with a better personal accomplishment. CONCLUSION Dealing with newborns' deaths is a highly stressful task; professionals should receive proper support such as debriefing, psychological support and training in order to prevent post-traumatic stress symptoms and reduce professional burnout.
Collapse
Affiliation(s)
- C Ravaldi
- CiaoLapo Foundation for Perinatal Health, Prato, Italy.,PeaRL - Perinatal Research Laboratory, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - L Mosconi
- CiaoLapo Foundation for Perinatal Health, Prato, Italy
| | - L Mannetti
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - M Checconi
- Department of Experimental Medicine, University of Perugia, Perugia, Italy
| | - R Bonaiuti
- CiaoLapo Foundation for Perinatal Health, Prato, Italy.,PeaRL - Perinatal Research Laboratory, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - V Ricca
- Department of Health Sciences, Psychiatry Unit, Careggi General Hospital, University of Florence, Florence, Italy
| | - F Mosca
- Department of Pediatrics, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.,Italian Society of Neonatology (SIN), Milan, Italy
| | - C Dani
- PeaRL - Perinatal Research Laboratory, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - A Vannacci
- CiaoLapo Foundation for Perinatal Health, Prato, Italy.,PeaRL - Perinatal Research Laboratory, Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| |
Collapse
|
5
|
Köktürk Dalcali B, Taş AS. What Intern Nursing Students in Turkey Think About Death and End-of-Life Care? A Qualitative Exploration. JOURNAL OF RELIGION AND HEALTH 2021; 60:4417-4434. [PMID: 34282510 PMCID: PMC8288065 DOI: 10.1007/s10943-021-01330-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/28/2021] [Indexed: 06/12/2023]
Abstract
This descriptive qualitative study was planned to determine the views of intern nursing students about death and end-of-life care. The study was completed with 12 intern students based on the criterion of data saturation. As a result of the study, the categories of 'end,' 'uncertainty,' 'fear,' 'beginning,' 'helplessness' under the theme of death, 'ensuring peace,' 'continuing communication' 'providing psychosocial/spiritual support,' 'acting in conformity with principles of ethics/morality,' 'continuing to provide physical care,' 'supporting the family,' 'making the best use of the limited remaining time or helping the patient's last wishes come true' under the theme of end-of-life care emerged.
Collapse
Affiliation(s)
- Berna Köktürk Dalcali
- Department of Nursing Fundamentals, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Bandırma, Balıkesir Turkey
| | - Ayşe Sinem Taş
- Department of Nursing Fundamentals, Faculty of Health Sciences, Bandırma Onyedi Eylül University, Bandırma, Balıkesir Turkey
| |
Collapse
|