Nursing Staff’s Perception of Barriers in Providing End-of-Life Care to Terminally Ill Pediatric Patients in Southeast Iran

Iranmanesh, Sedigheh; Banazadeh, Marjan; Forozy, Mansoure Azizzadeh

doi:10.1177/1049909114556878

Cited by 12 publications

(18 citation statements)

References 28 publications

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“…“Providing a peaceful and dignified bedside scene for family once the patient has died” was the facilitator with the highest mean score. This finding is in line with prior studies (Banazadeh, Iranmanesh, & Forozy, ; Beckstrand et al., ; Crump et al., ; Iranmanesh & Banazadeh, ; Losa Iglesias, Pascual, de Bengoa, & Vallejo, ). The high rate for this item could reflect the nurses’ understanding of the emotional and psychological effects of a patient's death on family members.…”

Section: Discussionsupporting

confidence: 93%

Nurses’ perceptions of barriers and facilitators and their associations with the quality of end‐of‐life care

Hussin

Wong

Chong

et al. 2017

Journal of Clinical Nursing

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Section: Discussionsupporting

confidence: 93%

Nurses’ perceptions of barriers and facilitators and their associations with the quality of end‐of‐life care

Hussin

Wong

Chong

et al. 2017

Journal of Clinical Nursing

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“…Despite this fact that there is widespread agreement that spiritual care is integral to good pediatric EOL care, 25 the Iranian health care system has no access to spiritual care and chaplains in EOL care to provide spiritual support for dying patients and their families. 26 This shortage is especially vital during the vulnerable period of EOL during childhood. 27 Lack of chaplains in EOL, staff shortages, 28 and lack of specific spiritual education in nursing educational curriculum may cause nurses to feel too much burden, especially those who deal with patients at the end.…”

Section: Discussionmentioning

confidence: 99%

Nurses’ Perception of Supportive Behaviors in Providing Pediatric End-of-Life Care and Its Correlation With Their Demographic Factors

Banazadeh

Iranmanesh

Forozy

2015

Journal of Hospice & Palliative Nursing

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The kind of care that nurses provide for dying persons is influenced by their perceptions and attitudes toward death. Gaining an increased understanding of nurses' perceptions of changes that would facilitate appropriate end-of-life care is important to improve quality care. Using a translated modified version of The National Survey of Critical Care Nurses Regarding End-of-Life questionnaire, the correlation between 151 nurses' demographic factors and their perceptions of supportive behaviors' magnitude was assessed. The highest/lowest perceived supportive behavior magnitude scores belonged to items, respectively, ''providing a peaceful, dignified bedside scene for family once the child has died'' (5.75) in health care professionalYrelated category and ''letting the religious leader take primary care of the grieving family'' (1.08) in organizational-related category. Some nurses' demographic factors including family and close friends' death experience, number of dying children who were cared for, and previous education toward death and dying were positively correlated with perceived supportive behavior magnitude scores. This study revealed that nurses' personal and professional experience may affect their perceptions of supportive behaviors in providing end-of-life care. Some educational programs in raising nurses' self-awareness of their perceptions, accompanied by interventions, are required to improve pediatric end-of-life care.A child's death always results in heartache, grief, and suffering for families and communities. 1 In 2012, 6.6 million children died before their fifth birthday. 2 Providing compassionate end-of-life (EOL) care that is appropriate and in accordance with the patient's wishes is an essential component of nursing care. 3 According to Larson and Tobin, 4 supportive behaviors to providing EOL care are defined as any supportive issue that advocates the delivery of optimal EOL care services. A number of investigators have made an effort to contribute their research outcomes regarding supportive behaviors, interventions, programs, and resources that may improve EOL care for dying patients, which may reside in 3 areas: patientfamilyYrelated factors, health care professionalYrelated factors, and organizational-related factors. 5 The kind of care that nurses provide for dying patients is influenced by their perception and attitude toward death. 6 Gaining an increased understanding of the perceptions of critical care nurses of changes that would facilitate appropriate EOL care is important to ultimately improve the EOL care. 7 Some published researches have addressed supportive behaviors in providing EOL care as perceived by nurses in adult settings [8][9][10][11] and less in pediatric settings, 10(p99),12(p543),13(p95) No study was found that specifically assessed correlation between nurses' demographic characteristics and their perceived supportive behaviors in providing EOL care. However, some studies reported factors that contribute to nurses' attitudes toward death and dying including certain ...

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“…Another barriers related to interdisciplinary team was no available support person for the family such as a social worker or religious leader [20,15,19]. Nurses have to concurrently deal with patients whose lives are being maintained and those whose lives are ending, they might feel it is excessively to tolerate these situations alone.…”

Section: Barriers In Interdisciplinary Teammentioning

confidence: 99%

Section: Families Who Cannot Accept the Child's Poor Prognosismentioning

confidence: 99%

“…Pediatric nurses also perceived the barrier when the family is not accepting of a poor prognosis [16,20,19]. Denying the fact that the child had a poor prognosis is a coping strategy for family to tolerate this great grief [20]. Nurses believe that it is difficult when families do not accept the prognosis, hence it is important to help families comprehend the need to respect the wishes of the patient and to understand when it is necessary to change from cure to care [16].…”

Section: Families Who Cannot Accept the Child's Poor Prognosismentioning

confidence: 99%

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A Systematic Review: What Are the Barriers for Nurses in Providing End of Life Care for Pediatric Patients?

Adistie

Rakhmawati

Hendrawati

2019

KLS

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Background: Providing care for children at the end-of-life is challenging and distressing for nurses and healthcare professionals. It is important to identify matters that might be a barrier in providing end-of-life care (EOLC). Objectives: A review of the literature focusing on the barriers in providing EOLC for pediatric patients. Methods: Literature published from 2009 to 2019 was obtained from four databases (Academic Search Complete, CINAHL, MEDLINE, and Science Direct) and critically reviewed using Joanna Briggs Institute (JBI) critical appraisal tools. Primary research studies written in English describing barriers experienced by nurses on EOLC provision which published between 2009-2019 were included. Results: Ten studies met the inclusion criteria. The barriers perceived by nurses in these studies are communication and language barriers; barriers in interdisciplinary team; lack of knowledge; families who cannot accept the child’s poor prognosis; ﬁnancial needs; nurses’ feeling; aggressive intervention received by the patient; and inadequate hospital facilities. Conclusions: Nurses enact a crucial role in caring for dying children and the children’s families. Overcoming barriers in EOLC provision could greatly improve the quality of end-oflife care for dying children. Therefore, it is necessary to develop a conceptual model tosupportnursesandhealthcareprofessionalsinprovidingEOLCforpediatricpatients.

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Nursing Staff’s Perception of Barriers in Providing End-of-Life Care to Terminally Ill Pediatric Patients in Southeast Iran

Abstract: More high perceived barriers by nurses were family-related issues. One of the possible causes of such deficiencies was lack of palliative care (PC) education/PC units in Iran. Thus, developing EOL/PC education may enhance nurses' knowledge/skill to face EOL care challenges.

Cited by 12 publications

References 28 publications

Nurses’ perceptions of barriers and facilitators and their associations with the quality of end‐of‐life care

Nurses’ perceptions of barriers and facilitators and their associations with the quality of end‐of‐life care

Nurses’ Perception of Supportive Behaviors in Providing Pediatric End-of-Life Care and Its Correlation With Their Demographic Factors

A Systematic Review: What Are the Barriers for Nurses in Providing End of Life Care for Pediatric Patients?

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