Nurses' Experiences of End-of-life Care in Long-term Care Hospitals in Japan: Balancing Improving the Quality of Life and Sustaining the Lives of Patients Dying at Hospitals

Odachi, Ryo; Tamaki, Tomoko; Ito, Mikiko; Okita, TaTaketoshi; Kitamura, Yuri; Sobue, Tomotaka

doi:10.1016/j.anr.2017.08.004

Cited by 12 publications

(9 citation statements)

References 18 publications

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“…Many nurses fail to offer ideal nursing care at end of life because they feel weakness and burnout in the face of caring a terminally ill patient and death. 21 Decision-making particularly in end-of-life care continues to be a controversial issue which differs by the legislation in each country. Most of the time, healthcare personnel involve patients’ relatives who know them well in the decision-making process based on the principle of avoiding damage in critical decisions like withholding or withdrawing treatment.…”

Section: Discussionmentioning

confidence: 99%

Ethical decision-making levels of oncology nurses

2018

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Aim: This study was carried out in order to determine ethical decision-making levels of oncology nurses. Ethical Consideration: Research Ethics Committee's approval was obtained prior to the data collection. Permission to use the Turkish version of the Nursing Dilemma Test was received from Birgül Cerit. Written approval was taken from school administrators to conduct the study confirming that there were no invasive procedures planned for human beings during the study period. The study was conducted in accordance with the Helsinki Declaration. Verbal consent was obtained from each of the nurses who agreed to participate after they were informed about the study content. Method: The population of this study conducted in a descriptive way consisted of a total of 96 nurses working at the oncology units and outpatient chemotherapy units of four different hospitals between September 2017 and March 2018. The study sample included 60 nurses who responded to the question form. The data of the study were collected using “Nurses Information Questionnaire” and “Nursing Dilemma Test” developed by Crisham in 1981. Results: Oncology nurses’ mean scores in Principled Thinking (49.00 ± 6.46) and those in Practical Considerations (18.35 ± 4.47) were found to be above the moderate level. It was determined that the oncology nurses participated in the study were familiar with situations similar to the dilemmas included in the Nursing Dilemma Test (15.00 ± 4.20). Conclusion: It was concluded that oncology nurses try to take ethical principles into consideration but are also affected by environmental factors while making decisions concerning ethical dilemmas. The most frequently encountered ethical dilemmas by oncology nurses include the following: deciding not to perform cardiopulmonary resuscitation, telling the truth to the patient, studies being carried out without the patient’s content, and patient’s refusal of treatment. In order to improve oncology nurses’ critical thinking and ethical decision-making skills, it is important to determine ethical dilemmas encountered by oncology nurses, and nurses should be encouraged to be involved in ethical decision-making process through cooperation with the other healthcare personnel.

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Section: Discussionmentioning

confidence: 99%

Ethical decision-making levels of oncology nurses

2018

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“…When nurses facilitated them while they were in the grieving stage, they could get through it faster and feel comfortable, which is very important for decision making. Then, nurses could facilitate them in the decision-making process by hinting about the patient's final hours to the family and selecting a proper negotiator in the family because delaying in the decision making can increase the problems of the patients' emotional and spiritual status [16], [29].…”

Section: Discussionmentioning

confidence: 99%

Nurse’s Roles in Patient-Family Decision Making for Palliative Patients in Indonesia and Malaysia

Abdullah

Huriah

Arianti

et al. 2021

Open Access Maced J Med Sci

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BACKGROUND: The limited palliative care services can affect the late in palliative care management, such as late in decision making. Decision making is one of the crucial processes that every patient with life-threatening health life-limiting illness needs to overcome. Nurses can be the third party between the patients and physicians in helping them with decision making. AIM: The aim of this study was to explore the differences perspectives of palliative care decision making for palliative patients and families in Indonesia and Malaysia. METHODOLOGY: The study design used qualitative method with the phenomenology approach. The sample size of this study was 12 participants from two different study settings. They were three palliative nurses and three physicians from each country, selected by purposive sampling. The study was carried out at PKU Muhammadiyah Yogyakarta Hospital and Tuanku Fauziah Hospital Kangar, Perlis, Malaysia. Data collection used in-depth interview. The interpretative phenomenology analysis was used to analyze the data. RESULTS: There were differences in the perspectives of palliative care services in Indonesia and Malaysia based on the culture form each of the countries. Nurses played a supportive role in ensuring that the care delivered to the patients and families were effective and efficient. Lack of staff was one of the challenges for Indonesia and Malaysia palliative care services need to face. CONCLUSION: Three themes emerged from the collected data; there were views on palliative care, nurses’ supportive roles, and limited resources. To encounter the challenges and difficulties that interrupt the care delivery to the patients, nurses need to improve knowledge about palliative and their skills.

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“…Each concept is created from several pieces of data known as variations. Variations are collected along the analysis theme" [14]. Moreover, we considered the interrelationships between the concepts and we created categories.…”

Section: Discussionmentioning

confidence: 99%

Sleep Quality for Patients Receiving Noninvasive Positive Pressure Ventilation and Nasal High-Flow Oxygen Therapy in an ICU: Two Case Studies

Murata¹,

Yamaguchi²

2018

OJN

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Aim: The purpose of this case study was to examine the sleep quality of patients receiving noninvasive positive pressure ventilation (NPPV) or nasal high-flow oxygen therapy (NHF) in an intensive care unit and to investigate what types of nursing support are offered to such patients. Methods: We examined one patient each for NPPV and NHF. Polysomnography (PSG), review of the patient charts, and semi-structured interviews were used to collect the data for analysis. Results: Patients treated with NPPV or NHF demonstrated a noticeable reduction in deep sleep, with most of their sleep being shallow. Their sleep patterns varied greatly from those of healthy individuals. These results suggest that, in addition to experiencing extremely fragmented sleep, sleep in these patients was more likely to be interrupted by nursing interventions, such as during auscultation of breath sounds. Furthermore, it was revealed that "anxiety or discomfort that accompanies the mask or air pressure" in patients treated with NPPV and "discomfort that accompanies the nasal cannula or NHF circuit" in patients treated with NHF may be primary causes of disrupted sleep. Our results suggest a need for nursing care aimed at improving sleep quality in patients treated with NPPV or NHF.

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Nurses' Experiences of End-of-life Care in Long-term Care Hospitals in Japan: Balancing Improving the Quality of Life and Sustaining the Lives of Patients Dying at Hospitals

Cited by 12 publications

References 18 publications

Ethical decision-making levels of oncology nurses

Ethical decision-making levels of oncology nurses

Nurse’s Roles in Patient-Family Decision Making for Palliative Patients in Indonesia and Malaysia

Sleep Quality for Patients Receiving Noninvasive Positive Pressure Ventilation and Nasal High-Flow Oxygen Therapy in an ICU: Two Case Studies

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