Long-Term Care Nurses and Their Experiences With Patients' and Families' End-of-Life Preferences: A Focus Group Study

Being Here and Now: An Evolutionary Concept Analysis of Nursing Presence in End-of-Life Care

Nursing presence is an important therapeutic and diagnostic modality in patient-centered care and decision-making during end-of-life (EOL) care. Nurses cultivate presence through intentional awareness and actions to support patients, yet there is a paucity of relevant literature regarding nursing presence in EOL care. An evolutionary concept analysis employing Rodger's techniques was conducted with 20 international research studies and nine analyses of nursing presence between 1992 and 2023. The attributes, antecedents, and consequences of nursing presence in EOL care were described, a theoretical definition was proffered, and suggestions for its clinical application and future research directions were offered. As evidenced by this concept analysis, nursing presence in EOL care is an intentional, temporal, spatial, and intrapersonal relationship. More research and analysis of this concept are needed, especially in long-term care settings given continued growth in the long-term care patient population and the prevalence of nurses leading EOL care in that setting.

End-Of-Life Care Communication in Long-Term Care Among Nurses, Residents, and Families: A Critical Review of Qualitative Research

RNs in long-term care (LTC) are a critical nexus for end-of-life (EOL) care communication with older adult residents and their families. A critical review of 17 qualitative research studies examined nurses' experience with EOL care in LTC. Findings indicate that time, preparation, advocacy, organizational resources, and a continuous, relational approach support EOL care communication. Regulatory burdens, understaffing, workflow demands, family and organizational dysfunction, anxiety, and depression impede EOL care communication. The current review revealed a gap in the literature describing LTC RNs' unique perspectives and knowledge regarding EOL care communication with residents and families. There is a current, pressing need to understand the facilitators LTC RNs use to overcome obstacles to effective EOL care communication. Future research could inform clinical practice guidelines and EOL care nursing education, enhancing LTC nurses' capacity to develop trust-based relationships and improving the efficacy of current EOL care communication interventions in LTC. [Journal of Gerontological Nursing, 47(7), 43-49.].