Lack of Truth-Telling in Palliative Care and Its Effects among Nurses and Nursing Students

Testoni, Ines; Wieser, Michael; Kapelis, Dafni; Pompele, Sara; Bonaventura, Marino; Crupi, Robert

doi:10.3390/bs10050088

Cited by 24 publications

(22 citation statements)

References 28 publications

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“…The thematic analysis method was adopted to analyze the data, because it offers an accessible and theoretically flexible approach, and it is consistent with the framework of the Grounded Theory (24). Indeed, the conversations were recorded and transcribed in preparation for the Thematic Analysis, in which we identified the patterns of themes using a bottom-up approach (8,25). All the texts were processed using Atlas.ti software (26), which allows researchers to work directly on written texts, highlight portions of them, create labels to be inserted in each text that can adequately represent the fundamental themes, and construct larger clusters of meaning by comparing the data obtained from each text (27).…”

Section: Data Collection and Data Analysismentioning

confidence: 99%

“…Under such conditions, these losses can be considered traumatic (6), because they occurred in sudden and tragic circumstances. The lockdown also instituted a prolonged period of restrictions and social distancing (7), which negatively impacted people mental health (8), interfering with work and normal relationships of caring and social support (9), including end-of-life rites and funeral rituals. For this reason, the loss resulted in a traumatic experience, especially because it was impossible to take leave of even the most important attachment figures.…”

Section: Introductionmentioning

confidence: 99%

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The COVID-19 Disappeared: From Traumatic to Ambiguous Loss and the Role of the Internet for the Bereaved in Italy

et al. 2021

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In Italy, in the very first phase of the COVID-19 pandemic there was a dramatic rise in mortality. However, families were forbidden because of lockdown regulations to be with their loved ones at their deathbeds or to hold funerals. This qualitative study examined bereavement experiences among family members, how they processed their grief, and how they used social networks in particular by uploading photographs during the working-through of bereavement. The sample was composed of 40 individuals aged 23–63 (80% women) from different Italian cities severely impacted by the virus, including a subgroup from the province of Bergamo, which was the city with the highest mortality rate during that time. All interviews were conducted by phone, Skype, or Zoom. Then, the transcriptions underwent a thematic analysis using Atlas.ti. The main themes that emerged were: abandonment anger and guilt, dehumanized disappeared, derealization and constant rumination, and social support and the importance of sharing photos on Facebook. Importantly, the use of social networks proved to be a valuable source of support and photographs were a powerful tool in facilitating the process of mourning by encouraging narration and sharing. Grief had a complex profile: on the one hand, it was traumatic and characterized by all the risk factors causing mourners to experience prolonged grief, but on the other, some features were similar to ambiguous loss (that occurs without closure and clear understanding) because of the impossibility to be with their relatives in their final moments. The possible relationships between ambiguous loss, the use of internet, and the risk of prolonged grief are discussed.

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Section: Data Collection and Data Analysismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The COVID-19 Disappeared: From Traumatic to Ambiguous Loss and the Role of the Internet for the Bereaved in Italy

et al. 2021

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“…In particular, this type of intervention could be managed by palliative psychologists, who can prepare their colleagues in palliative teams in the field of doctor–nurse–patient relationships. This kind of intervention may improve relational skills in order to respect the patient-centered approach [ 28 , 29 , 30 , 31 ] promoted by the World Health Organization (WHO), which is necessary for authentic and effective communication [ 32 , 33 , 34 ].…”

Section: Introductionmentioning

confidence: 99%

A Challenge for Palliative Psychology: Freedom of Choice at the End of Life among the Attitudes of Physicians and Nurses

Testoni

Bortolotti

Pompele

et al. 2020

Behavioral Sciences

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This article considers a particular aspect of palliative psychology that is inherent to the needs in the area of attitudes concerning Advance Healthcare Directives (AHDs) among Italian physicians and nurses after the promulgation of Law No. 219/2017 on AHDs and informed consent in 2018. The study utilized a mixed-method approach. The group of participants was composed of 102 healthcare professionals (63 females and 39 males). The quantitative part utilized the following scales: Attitudes toward Euthanasia, the Religious Orientation Scale, the Balanced Inventory of Desirable Responding, and the Testoni Death Representation Scale. The results were mostly in line with the current literature, especially concerning a positive correlation between religiosity and the participants’ rejection of the idea of euthanasia. However, the qualitative results showed both positive and negative attitudes towards AHDs, with four main thematic areas: “Positive aspects of the new law and of AHDs”, “Negative aspects of the new law and of AHDs”, “Changes that occurred in the professional context and critical incidents”, and “Attitudes towards euthanasia requests.” It emerged that there is not any polarization between Catholics or religious people and secularists: Their positions are substantially similar with respect to all aspects, including with regard to euthanasia. The general result is that the law is not sufficiently understood, and so a quarter of the participants associate AHDs with euthanasia. Discussions on the opportunity for palliative psychologists to help health professionals to better manage these issues through death education courses are presented.

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“…Patient-centered palliative care and communication that pays attention to the values and spiritual beliefs of the patient ensures the creation of an empathetic space supporting the patient’s sense of worthiness [ 54 ]. In this aspect cautious disclosure of the diagnosis and prognosis to patients with terminal illnesses though may seem to be a conspiracy of silence, would respond to some patients’ or their families’ preferences of not discussing death or the end of life [ 55 ]. These themes reflect underpinning socioeconomic aspects and cultural values that shape the perception of dignity in illness in middle eastern culture.…”

Section: Discussionmentioning

confidence: 99%

Dignity of patients with palliative needs in the Middle East: an integrative review

et al. 2021

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Background Patients with palliative needs experience high psychological and symptom distress that may lead to hopelessness and impaired sense of dignity. Maintaining patient dignity or the quality of being valued is a core aim in palliative care. The notion of dignity is often explained by functionality, symptom relief and autonomy in decision making. However, this understanding and its implications in Middle Eastern countries is not clear. The aim of this review is to 1) explore the understanding of dignity and how dignity is preserved in adult patients with palliative care needs in the Middle East 2) critically assess the findings against the Dignity Model dominant in western literature. Method Using an integrative review we searched four databases EMBASE, Psych-Info, CINAHL, and PubMed. These databases retrieve a broad literature on palliative care and are often chosen in other palliative care reviews. To enhance the search strategy, three online journals were hand searched, reference lists of review papers scanned, and forward citations sought. No time limits were applied. The retrieved papers were assessed independently by two authors including quality assessment using the Hawker’s appraisal tool. Results Out of the 5113 studies retrieved, 294 full texts were assessed. Sixteen studies were included for synthesis of which fourteen were published in Iran. Seven themes were developed after data analysis: Maintaining Privacy and Secrecy; Gentle communication with a dialogue that preserves hope instead of blunt truth-telling; Abundance characterised by accessibility to medical supplies and financial stability; Family Support where relatives deliver major assistance in care; Physical Fitness; Reliable health care, and Social justice that endorses equal care to all. Conclusion The results are compatible with the existing evidence from the Dignity Model ascertaining that dignity is socially mediated and influenced by interactions and physical fitness. Nevertheless, the findings highlight that patient dignity is also shaped by the socio-political, cultural, and economic conditions of the country, where family support, gentle communication and accessible health care are essential elements.

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Lack of Truth-Telling in Palliative Care and Its Effects among Nurses and Nursing Students

Cited by 24 publications

References 28 publications

The COVID-19 Disappeared: From Traumatic to Ambiguous Loss and the Role of the Internet for the Bereaved in Italy

The COVID-19 Disappeared: From Traumatic to Ambiguous Loss and the Role of the Internet for the Bereaved in Italy

A Challenge for Palliative Psychology: Freedom of Choice at the End of Life among the Attitudes of Physicians and Nurses

Dignity of patients with palliative needs in the Middle East: an integrative review

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