Critical Care Nurses’ Experiences of End-of-Life Care: A Qualitative Study

Motivations behind end-of-life care: a qualitative study of Iranian nurses' experiences

BACKGROUND

Providing high-quality end-of-life care is currently a paramount health priority. Given that the standard of care is intrinsically linked to nurses' motivations, it is becoming too imperative to explore the contributing factors Consequently, this study was undertaken to elucidate the experiences of Iranian nurses regarding their motivation for delivering end-of-life care.

METHODS

This research is a qualitative, descriptive inquiry employing conventional content analysis, carried out at two governmental hospitals in Gorgan, northern Iran, from February to July 2023. 12 nurses were purposefully selected to participate in the study, ensuring maximal diversity. The data were collected through semi structured interviews and analyzed using Graneheim and Lundman's five-step method. The coding process was facilitated by the useof MAXQDA version 10 software. To establish rigor, the four criteria outlined by Guba and Lincoln were applied.

RESULTS

the participants included eight women and four men with an average age of 39.6 ± 6.31 years. The data analysis yielded five main categories and fifteen subcategories. The main categories were: "The Foundations of professional care in nursing", "Core Drivers in Optimal End-of-Life Care", "Family Involvement in End-of-Life Care", "Incorporating Spiritualism in Care" and "Dominant motivational Issues Within the Caregiving Atmosphere".

CONCLUSIONS

This study delineates the experiences that influence the provision of end-of-life care from the perspective of Iranian nurses. Innate traits such as empathy and a passion for nursing, in addition to nurses' moral compass and spiritual beliefs, serve as pivotal motivational stimuli. Leveraging these findings can be instrumental in shaping healthcare practices and policies to enhance the quality of end-of-life care.

The effect of end-of-life care awareness education on the knowledge, attitudes and behaviours of intensive care nurses: A randomized controlled trial

BACKGROUND

Education in end-of-life care (EoLC) is essential for improving the knowledge, attitudes and behaviours of intensive care nurses.

AIM

This study aimed to evaluate the effect of online awareness education, based on the End-of-Life Nursing Education Consortium, on the knowledge levels, attitudes and behaviours of intensive care nurses.

STUDY DESIGN

This single-centre randomized controlled study. This study was performed in a tertiary intensive care unit in a university-affiliated hospital. Seventy-six intensive care nurses were selected and equally randomized. In the education, the group was given an EoLC awareness education programme on an online platform as 40-60-min sessions once a week for 4 weeks. The descriptive Information Form, EoLC Knowledge Test and the Nurses' Attitudes and Behaviours towards the EoLC Scale were used. In the study, intensive care nurses' knowledge, attitude and behaviour levels towards EoLC were evaluated before and after 4 weeks (±3 days) following the education.

RESULTS

When the mean post-education scores of the nurses in the education group were compared with the control group, it was found that their mean scores on the EoLC Knowledge Test (p = .001, Cohen's d = 1.354, 95% CI = 3.240-6.549), the attitude sub-dimension (p = .001, Cohen's d = 1.520, 95% CI = 4.510-7.858), the behaviour sub-dimension (p = .001, Cohen's d = 1.425, 95% CI = 3.206-6.214) and the total attitude and behaviour (p = .001, Cohen's d = 1.927, 95% CI = 8.408-13.643) were statistically significantly higher than those of the control group.

CONCLUSION

This study showed that EoLC awareness education positively affected nurses' knowledge, attitudes and behaviours. Accordingly, planning EoLC awareness education online at regular intervals may be recommended for intensive care nurses.

RELEVANCE TO CLINICAL PRACTICE

Intensive care nurses may be given online EoLC awareness education to positively affect their knowledge, attitudes and behaviours about EoLC. Online EoLC education can be effective in terms of reaching a large number of nurses, time and cost.

Exploring nurses' experiences of recommended patient care: a descriptive phenomenological study

BACKGROUND

Caring for recommended patients creates work and emotional challenges for nurses. Nurses are obligated to provide care regardless of the patient's situation. Therefore, knowing the experiences of nurses in dealing with recommended patients in order to provide quality and effective care can be the basis for increasing patient satisfaction. The present study was conducted aimed to explain nurses' experiences of caring for recommended patients.

METHODS

This was a qualitative study with descriptive phenomenological approach. Participants were 12 nurses working in different wards of hospitals affiliated to Kermanshah University of Medical Sciences, selected by purposive sampling method with maximum diversity. The data collected using semi-structured interviews in face-to-face and audio-recorded methods. MAXQDA 2020 software was used for data management. The analysis of the data was done using the Colaizzi's 7-step method. In order to verify the trustworthiness of the data, Lincoln and Guba criteria were used.

RESULTS

After continuous data analysis, 110 initial codes were extracted. These codes emerged in 18 sub-themes and 6 main themes including: catastrophe, be in decline, be in progress, discrimination, work overload, and poor prognosis.

CONCLUSIONS

The results showed information about the presence of recommended patients in the hospital, which can have consequences for patients and nurses. Therefore, it is advised that nurses provide standard care and avoid any kind of discrimination against all patients regardless of whether the patient is recommended or not.

Nursing Students’ Perception of the Educational Environment in a Public University in Ahvaz, Iran: A Study Based on DREEM Questionnaire

Background: Students’ perception of educational environment is an important factor in evaluating the quality of education as it provides invaluable resources to identify the strengths and weaknesses of educational environment. However, there is a paucity of information regarding the educational environment from the perceptions of nursing students in Iran.Purpose: This study aimed to investigate nursing students’ perception of the educational environment and compare the male and female students’ perceptions of the educational environment in a public university in Ahvaz, Iran.Methods: A cross-sectional study was conducted among 130 nursing students in a public university in Ahvaz, Iran, using the Dundee Ready Educational Environment Measure (DREEM) questionnaire. Convenient sampling was used to recruit the samples. Descriptive statistics and independent t-test were used for data analysis.Results: The overall mean (SD) DREEM score in this study was 105.01(22.00), indicating a more positive educational environment than negative. The highest mean (SD) DREEM score was related to Students’ Perceptions of Learning domain 24.03(6.01), while the lowest one was related to Students’ Social Self-Perceptions domain 14.01(4.00). The female students showed significantly better mean score in the domains of Students’ Academic Self-Perception and Students’ Social Self-Perception than males (p<0.05).Conclusion: The students’ perception of their educational environment is a positive and optimistic one. Therefore, it is suggested that students’ perceptions of the educational environment be measured regularly, for instance, at the end of each academic year, to create a healthy and effective environment for learning in the educational environment.