The nursing dimension of providing palliative care to children and adolescents with cancer

Exploration of the Strategies of Iranian Nurses in Providing Palliative Care to Children with Cancer: A Qualitative Study

AIM

This study aimed to explain the strategies of Iranian nurses in providing palliative care to children with cancer.

METHOD

This study is a qualitative research with an approach to the conventional content analysis. The main participants were nine nurses working in ward pediatric oncology. Also based on data analysis, five parents of children, two children, one social worker, one physician, one psychologist, and one nutritionist were also included. Data were collected through semi-structured interviews and observation and were analyzed by the Elo and Kyngäs approach. Lincoln and Guba criteria were used for the trustworthiness of data analysis.

RESULTS

Three conceptual categories were developed with qualitative analysis: "prevention and relief of pain and physical symptoms", "spontaneous compassion", and "strengthen parental resilience"; that were derived from the main categories: "attention to precautionary considerations," "friendly relationship of nurses with parents of children, create enjoyable moments, spontaneous assistance," "facilitate coping with current situation, perceived confrontation with child death."

CONCLUSION

In this study, the results showed that nurses' strategies in providing palliative care to children with cancer were a combination of professional and spontaneous strategies.

Grieving Experiences of Parents with Children in End-of-Life Care—A Qualitative Review Protocol

Parents that accompany their children in end-of-life care until death go through a devastating, complex and vulnerable situation, which is experienced in a unique way and with individual needs, given the specificity of the palliative care setting in which it occurs. This qualitative review aims to identify and synthesize the best evidence available on the grieving experiences of parents with children in end-of-life care in a palliative care setting. This qualitative review protocol is according to the review method proposed by the Joanna Briggs Institute. The results will enable us to identify how parents of children in end-of-life care in a palliative care setting experience their grieving process. This review will broaden the horizon of understanding of the specificities of the grieving experience of parents who have accompanied their children in end-of-life care until their death in a palliative care setting and promote research in this context. The results of the review will also allow the construction of an “end-of-life grieving script”, with the aim of identifying one’s individuality in the grieving process. This protocol is registered at Open Science Framework.

When Nurses Become Patients. Validation of the Content of the Diagnostic Label Professional Traumatic Grief

(1) Background: The Covid-19 pandemic has put our healthcare systems to the test, exposing their vulnerability and demanding a high degree of commitment and dedication from healthcare teams to confront and contain the disease. In this sense, nursing professionals have played a prominent role in the treatment of complex cases that have required hospitalisation and have manifested pre-existing health complications or mortality. This unprecedented situation made it difficult to regulate the emotional impact and manage grief, often turning it into a traumatic grief whose psychological and emotional manifestations are increasingly evident but very little researched in the current context. (2) Purpose: Validation of the definition, defining characteristics and related factors for the proposal of the nursing diagnosis of professional traumatic grief. (3) Method: Based on Fehring's content validation model, the label name, defining characteristics and other related factors were agreed upon by Spanish experts. (4) Results: The content validity index was 0.9068. A total of 21 defining characteristics were validated by the experts, as all of them scored above 0.6. With respect to the related factors of the proposed 10, all were validated. (5) Conclusion: The present study supports the proposal to develop a nursing diagnosis for professional traumatic grief. The use of standardised language is only the first step in establishing professional traumatic grief as a diagnostic category.

The Nurse as an Information Broker for Children with Terminal Illness: A Qualitative Study

Background:

Providing care for children with a terminal illness is a great challenge for nurses and might be very complex. Several roles can be performed while providing nursing care.

Objective:

The aim of this study was to identify the roles of nurses in providing nursing care to children with terminal illness and explore the nurse's perspective on how they perform their role in caring for children with terminal illness.

Methods:

This research was conducted qualitatively with a content analysis approach. In-depth interviews with 8 nurses and focus group discussion with 7 nurses were the data collection methods used in this study. The sampling technique in this research is purposive sampling with inclusion criteria for nurses who were willing to participate in this research with a minimum education of diploma degree in nursing, and having at least 3 years of working experience in the pediatric ward.

Results:

Based on the nurses’ perspectives, their role as a communicator, counselor, collaborator, advocator, educator, and also as care provider make them an information broker for children with terminal illnesses and their families.

Conclusion:

In conclusion, while performing the roles, nurses must have good communication skills and knowledge related to the condition of the child as well as the ability to work with other healthcare teams with the purpose of providing holistic and comprehensive care for children with a terminal illness.

EXPERIENCIAS Y PROCESO DE DUELO ENTRE PROFESIONALES DE ENFERMERÍA ONCOLÓGICA PEDIÁTRICA: EXPERIENCES AND GRIEVING PROCESS AMONG PEDIATRIC CANCER NURSES

Explore how nursing professionals handle the death of a pediatric patient with cancer under their care and identify needs that they face in the workplace. An exploratory qualitative design was used, under the phenomenological framework and the Model of Information, Motivation and Behavioral Skills (IMHB). The data was obtained through semi-structured interviews with a sample of ten pediatric oncology nursing professionals. Each interview was transcribed and analyzed to identify thematic axes in the narrative of the participants. The findings revealed four categories that alluded to professional experiences in the face of the death of a patient and their handling of the grieving process. These were: Perception of nursing professionals about cancer; management of the pediatric patient in the terminal phase, coping strategies and areas of professional need. According to the findings, limitations were identified in knowledge about the subject of death and the grieving process of these health professionals. These limitations reflect being an obstacle in their clinical skills and in their capacity for assertive management. It is essential to educate these professionals about Thanatology and its benefits; as well as, to enable them access to psychological interventions for emotional management.

Competências do enfermeiro para o cuidado paliativo na atenção domiciliar

Resumo Objetivo: Identificar competências do enfermeiro para o cuidado paliativo na atenção domiciliar. Métodos: Estudo exploratório que utilizou o método Delphi para identificar o consenso de enfermeiros que atuam na atenção domiciliar para com 43 competências elencadas em um questionário, com inclusão de escala de Likert de cinco pontos. Resultados: Na amostra de 20 enfermeiros, houve consenso para 18 competências gerais e 25 específicas com percentuais acima de 75% de concordância, e coeficiente alfa de Cronbach de 0,7 para todas as competências elencadas. O consenso favorável às competências propostas indica o reconhecimento do cuidado paliativo como prática assistencial de enfermagem na atenção domiciliar. Conclusão: O elenco de competências apresentou confiabilidade interna e fornece afirmações assertivas sobre a atuação do enfermeiro em cuidado paliativo na atenção domiciliar.