Factors influencing Intensive Care Units nurses in end-of-life decisions

Baliza, Michelle Freire; Bousso, Regina Szylit; Poles, Kátia; Santos, Maiara Rodrigues dos; Silva, Lucía; Paganini, Maria Cristina

doi:10.1590/s0080-623420150000400006

Cited by 16 publications

(33 citation statements)

References 13 publications

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“…This shows the characteristics of the care and the relationships among team members in PC. This study also affirms that the power of decision regarding the PC appears centered on the medical staff (5) .…”

Section: Discussionsupporting

confidence: 83%

“…However, this same study points out that there is no effort from the team in order to seek transparent discussions to implement the palliative care philosophy to care in the context of ICU, emphasizing the absence of discussion as a factor that hinders the participation of nurses in this process (5) . The ability to communicate is essential to the multidisciplinary work, and can be a tool to overcome the difficulties encountered by the team during the performance in PC.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the same study discusses that nurses, especially the younger ones, feel unprepared and unable to deal with end-of-life processes, including the comfort to the family. They believe that the development of this skill will require adequation of the professional training process (5) . Therefore, this training process can be considered an intervening factor in the care provided to patient under PC, generating the abandonment and undignified death in hospital institutions, in addition to the anguish experienced by family members.…”

Section: Discussionmentioning

confidence: 99%

“…In end-of-life situations, especially those in which the patient is considered out of scope for cure, the role of ICU professionals is to engage in changing this purely technical scenario. Therefore, the objective is to implement less aggressive care, in seeking quality of life or of death, if it were to occur (5) . Palliative care (PC) in Brazil is still an emerging mode of care in terminality of life (6) .…”

Section: Introductionmentioning

confidence: 99%

“…Changing the paradigm between cure and palliative care is a process that depends on the professionals working in the area and on academic institutions, as well as on professional knowledge geared towards this care interface. Therefore, it needs to be a practice based on professional training and guided by established scientific principles (5) . The working environment of nursing professionals subjects them to many stressful situations that may be related to labor activity, as well as to psychological and physical processes of the individual.…”

Section: Introductionmentioning

confidence: 99%

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Cuidado paliativo e enfermeiros de terapia intensiva: sentimentos que ficam

et al. 2016

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Objective: to know the feelings of nurses regarding palliative care in adult intensive care units. Method: qualitative study, which adopted the theoretical framework of Social Representations, carried out with 30 nurses of the state of Santa Catarina included by Snowball sampling. Data were collected through semi-structured interviews conducted from April to August 2015, organized and analyzed through the Collective Subject Discourse. Results: the results showed how central ideas are related to feelings of comfort, frustration, insecurity and anguish, in addition to the feeling that the professional training and performance are focused on the cure. Conclusion: the social representations of nurses regarding the feelings related to palliative care are represented mainly by negative feelings, probably as consequence of the context in which care is provided. Descriptors: Palliative Care; Nursing Care; Nursing; Social Perception; Intensive Care Units. RESUMO Objetivo: conhecer os sentimentos dos enfermeiros acerca dos cuidados paliativos em unidades de terapia intensiva de adultos. Método: estudo qualitativo, cujo referencial teórico adotado foi o das Representações Sociais, realizado com 30 enfermeiros do estado de Santa Catarina incluídos por amostragem Bola de Neve. Os dados foram coletados por meio de entrevistas semiestruturadas realizadas de abril a agosto de 2015, organizados e analisados por meio do Discurso do Sujeito Coletivo. Resultados: os resultados apontaram como ideias centrais estão relacionadas aos sentimentos de conforto, frustração, insegurança e angústia, além do sentimento de que a formação e atuação profi ssional estão voltados para o curativo. Conclusão: as representações sociais dos enfermeiros acerca dos sentimentos relacionados aos cuidados paliativos estão representadas principalmente por sentimentos negativos, provavelmente consequentes ao contexto em que se dá o cuidado. Descritores: Cuidados Paliativos; Cuidados de Enfermagem; Enfermagem; Percepção Social; Unidades de Terapia Intensiva. RESUMENObjetivo: conocer los sentimientos de los enfermeros sobre los cuidados paliativos en unidades de cuidados intensivos para adultos. Método: estudio cualitativo que adoptó el marco teórico de las representaciones sociales, y se llevó a cabo con 30 enfermeros en el estado de Santa Catarina que fueron incluidos por muestreo tipo bola de nieve. Los datos fueron recolectados a través de entrevistas semiestructuradas realizadas entre abril y agosto de 2015, organizados y analizados utilizando el Discurso del Sujeto Colectivo. Resultados: los resultados mostraron que las ideas centrales están relacionadas con sentimientos de comodidad, frustración, inseguridad y angustia, y la sensación de que la actividad profesional y la formación se centran en la curación. Conclusión: las representaciones sociales de los enfermeros sobre los sentimientos relacionados con los cuidados Palliative care and the intensive care nurses: feelings that endure Natyele Rippel Silveira

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Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cuidado paliativo e enfermeiros de terapia intensiva: sentimentos que ficam

et al. 2016

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Meaningful experiences and end-of-life care in the intensive care unit: A qualitative study

Stokes

Vanderspank‐Wright

Bourbonnais

et al. 2019

Intensive and Critical Care Nursing

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Critical care nurses' role in the decision‐making process of withdrawal of life‐sustaining treatment: A qualitative systematic review

Heradstveit

Larsen

Solberg

et al. 2023

Journal of Clinical Nursing

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AimTo synthesise the qualitative evidence regarding the role of critical care nurses in the decision‐making process of withdrawing life‐sustaining treatment in critically ill adults.DesignQualitative systematic review.Review MethodsThis qualitative systematic review employed the guidelines of Bettany‐Saltikov and McSherry. The review was reported according to the ENTREQ checklist. Pairs of authors independently assessed eligibility, appraised methodological quality and extracted data. Data were synthesised using thematic synthesis.Data SourcesCINAHL, MEDLINE and EMBASE were searched for studies published between January 2001 and November 2021.ResultsTwenty‐three studies were included. Three analytical themes were synthesised: performing ethical decision‐making to safeguard patients' needs rights, and wishes; tailoring a supporting role to guide the family's decision‐making process; and taking on the role of the middleman by performing coordination.ConclusionThe role of the critical care nurses in the decision‐making process in withdrawal of life‐sustaining treatment requires experience and the development of the clinical perspective of critical care nurses.Implications for the profession and/or patient careEnhanced knowledge of the decision‐making process of withdrawing life‐sustaining treatment can prepare critical care nurses to be more equipped to master this role and enhance their ability to handle the emotional and moral stress associated with this part of the critical care unit.ImpactThe literature reveals the complex and challenging role of critical care nurses during the decision‐making process of withdrawing life‐sustaining treatment. Critical care nurses perform ethical decision‐making to safeguard patients' concerns, guide the family's decision‐making process and take on the role of the middleman. The findings have implications for critical nurses working in critical care units in hospitals and for educators and students in training in critical care nursing.Patient or Public ContributionNo patient or public contribution was included.

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Factors influencing Intensive Care Units nurses in end-of-life decisions

Abstract: Conclusion:Professional maturity, the ability to transmit information and the ability to negotiate are directly related to the inclusion of nurses in the decision-making process.

Cited by 16 publications

References 13 publications

Cuidado paliativo e enfermeiros de terapia intensiva: sentimentos que ficam

Cuidado paliativo e enfermeiros de terapia intensiva: sentimentos que ficam

Meaningful experiences and end-of-life care in the intensive care unit: A qualitative study

Critical care nurses' role in the decision‐making process of withdrawal of life‐sustaining treatment: A qualitative systematic review

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