The experiences of clinical nurses coping with patient death in the context of rising hospital deaths in China: a qualitative study

Views of health care professionals on the implementation of preoperative advance care planning in older patients with head and neck cancer: Q methodology

Objective

To investigate the views of health care professionals in a head and neck surgical department toward the implementation of advance care planning prior to surgery for older patients with head and neck cancer.

Method

Q methodology was used to explore and analyze participants' views by combining quantitative and qualitative methods. Participants were asked to rank 35 Q statements generated via semi-structured interviews and a literature review and to explain the reasons for their ranking in subsequent interviews. The data was then analyzed and used to develop a factor series to illustrate participants' views.

Results

This study surveyed 15 health care professionals, including eight doctors and seven nurses. The views of health care professionals toward preoperative implementation of advance care planning discussions were varied and could be categorized into three types: defending the autonomy of patients, patients' knowledge and the Chinese traditional cultural context hinder the implementation of preoperative advance care planning, and lack of confidence in performing preoperative advance care planning.

Conclusions

Although the health care professionals in the head and neck surgical department in this study recognized the benefits of preoperative discussions regarding advance care planning, patients' knowledge level, traditional Chinese values, inadequate capacity among health care professionals, and unsound legal policies have caused these professionals to have misgivings about preoperative counseling and discussing advance care planning with patients. Further studies should be conducted, and strategies to overcome barriers to discussions of preoperative advance care planning should be developed.

"It was the first time someone had died before my eyes…": A qualitative study on the first death experiences of nursing students

BACKGROUND

Accompanying a person at their death is a common experience in nurse education. In addition to all death experiences that are a meaningful part of the nursing profession, the first death experience is very important. However, there is limited understanding of nursing students' first death experiences.

OBJECTIVES

This study aimed to explore nursing students' experiences of the death of a person for the first time during clinical practice.

DESIGN

This study was conducted as a qualitative study using a phenomenological design.

PARTICIPANTS

A total of 17 nursing students participated in this study.

METHODS

Data were collected through online individual in-depth interviews and were analyzed using content analysis.

RESULTS

Four main themes and eleven sub-themes emerged. The themes were meaning of death (first death, a part of life), process management (death information, physical environment, bad news), after death (empty bed, questioning, death with dignity) and education (curriculum, support, professional perception).

CONCLUSIONS

While the first experience of death provides an opportunity for students to learn, this experience reveals various negative emotions and the need for support.

Subjective rather than objective patient death experiences link with physicians' and nurses' professional quality of life

BACKGROUND

Patient deaths are impactful events for professional caregivers in both their professional and personal lives. The present study aims to explore how both subjective and objective patient death experiences are related to various aspects of professional quality of life (ProQOL) among physicians and nurses.

METHODS

Secondary analyses of cross-sectional data were conducted, and 306 Chinese physicians and nurses whose most recent patient death experience was more than one month prior were included. Objective and subjective patient death experiences were measured based on the number of past patient deaths and the Accumulated Global Changes (AGC) subscale of the Professional Bereavement Scale, respectively. ProQOL was measured with the Professional Quality of Life Scale. Regressions were run following bivariate analyses.

RESULTS

The number of past patient deaths was not significantly linked with any of the three ProQOL scores in either the bivariate analyses or regressions. Meanwhile, higher AGC scores were associated with higher burnout, secondary traumatic stress, and compassion satisfaction scores after participants' age, occupation (physician/nurse), department, work experience, job commitment, and sense of mission were controlled.

CONCLUSION

Subjective rather than objective past patient death experiences link significantly with all three aspects of physicians' and nurses' ProQOL. The more professional caregivers think that they have been changed by all past patient deaths in their career, the more they experience burnout and secondary traumatic stress, but, the more satisfied they are with their job and the helping itself.

Spiritual care from the perspective of family caregivers and nurses in palliative care: a qualitative study

BACKGROUND

The palliative care period not only affects patients but also family caregivers in many ways. Palliative care units are places where the spiritual needs of family caregivers become important. According to a holistic care approach, palliative care nurses should determine the spiritual needs of family caregivers and help meet these needs.

OBJECTIVE

This study aims at exploring nurses' and family caregivers' experiences of spiritual care.

METHODS

A phenomenological study was designed in this qualitative research. A total of 10 nurses working in palliative care and 11 family caregivers participated in the study. Nurses' experiences of delivering spiritual care and family caregivers' experiences of receiving spiritual care were examined through the in-depth interviewing method on a one-to-one basis. The data were examined using thematic analysis.

RESULTS

Four main themes were obtained by the data analysis: (I) Impacts of being in a palliative care unit; (II) Coping methods; (III) Importance of spirituality and spiritual care; (IV) Spiritual care. The results were presented according to the COREQ criteria.

CONCLUSION

Although spiritual care is very necessary for family caregivers, it is not offered sufficiently due to nurse-and institution-related reasons. Palliative care nurses should determine the spiritual needs of family caregivers in line with the holistic care approach. Nurse managers should determine factors preventing nurses from offering spiritual care and create solutions for these factors. The lack of nurses' knowledge about spiritual care should be resolved by providing continuous training and therefore, nurses' competencies in spiritual care should be improved.

Nurses' Caring Experiences for Dying Patients: A Meta-Synthesis Review

Nurses play an important role in caring for dying patients. The ability to face a dying patient is a vital necessity and skill for nurses. Nurses' experiences in dealing with dying patients help to identify the factors affecting nursing care. Therefore, this meta-synthesis explains nurses caring experiences for dying patients. In this meta-synthesis review, English qualitative articles related to nurses' caring experiences with dying patients that were published in Google Scholar, PubMed, Web of Science, Scopus, and CINAHL databases were selected. The results presented in 4 themes and 4 sub-themes, including (i) dual parallel nursing care (patient care and family care), (ii) conflict between nurses' beliefs and care duties, (iii) care reflections on the nurse (positive and negative care reflection, and (iv) coping strategies of nurses. This study shows that nurses provide diverse care to dying patients and their families, which has had positive and negative reflections on their personal and professional lives. Nurses sometimes had a conflict with their beliefs and treatment protocols, which hesitate to perform the treatment. Although nurses use various coping strategies when caring for dying patients and their families, they need more strategies to cope with multi-faceted physical, mental, spiritual, educational, and management issues.

The mediating effects of attitude toward death and meaning of life on the relationship between perception of death and coping with death competence among Chinese nurses: a cross-sectional study

Background

It is important to understand how the perception of death affects the competence to cope with death.

Objectives

To explore whether the perception of death has an indirect effect on competence to cope with death through the mediation of attitude toward death and meaning of life.

Methods

A total of 786 nurses from Hunan Province, China, selected by random sampling method and asked to complete an online electronic questionnaire between October and November 2021 were included in the study.

Results

The nurses’ scored 125.39 ± 23.88 on the competence to cope with death. There was a positive correlation among perception of death, competence to cope with death, the meaning of life, and attitude toward death. There were three mediating pathways: the separate mediating effect of natural acceptance and meaning of life, and the chain mediating effect of natural acceptance and meaning of life.

Conclusion

The nurses’ competence to cope with death was moderate. Perception of death could indirectly and positively predict nurses’ competence to cope with death by enhancing natural acceptance or sense of meaning in life. In addition, perception of death could improve natural acceptance and then enhance the sense of meaning in life to positively predict nurses’ competence to cope with death.