Role Adaptation Process of Hospice Nurses

Abstract

Purpose: This study was performed to identify the role adaptation process of hospice nurses and suggest a model for the process. Methods: Grounded theory methodology was used. Twenty nurses participated in individual in-depth interviews. Data were collected until saturated. Questions for the interviews were about phenomenon, conditions, action/interaction strategies, and consequences in the process. Data were analyzed by applying open, axial and selective coding proposed by Strauss and Corbin. Results: Core category of the role adaptation process was 'building up real capabilities'. Phenomenon of the role adaptation was oppressive feelings when caring for dying patients. Contextual conditions were lack of knowledge, experience and belief about hospice and hospice care being regarded as penance. Intervening conditions were expansion of horizons in understanding life and expansion of social comprehension about hospice. Action/interaction strategies included 'reflecting on oneself as a hospice nurse', 'using oneself with feelings of a calling' and 'striving for self-management'. Consequence of the process was being a caring expert for peaceful death. Conclusion: The role adaptation process of hospice nurses for the participants was the process of building up real capabilities leading them to become caring experts for peaceful death through overcoming oppressive feeling when caring for dying patients.

Moderating Effect of Nurse’s Character on the Relationship between Attitudes toward Nursing Care of the Dying and Performance of Terminal Care in South Korea

“…These capabilities make up a nurse’s character [ 11 ]. In a qualitative study on the adaptation of hospice nurses to their roles, nurses assigned to the hospice ward who faced difficulties naturally and positively accepted their perception of death, understood and empathized with the patients and their families, and practiced respectful nursing [ 10 ]. It is said that they adapted to their own roles while playing the role of coordinator in their relationship with medical personnel.…”

“…Furthermore, attitudes toward nursing care for dying patients were found to significantly influence the performance of terminal care by intensive care unit nurses [ 8 ], and it is also an important influencing factor in the performance of terminal care of cancer ward nurses [ 9 ]. However, some of these nurses encounter difficulties in performing terminal care due to the lack of knowledge, experience, or values, a limited understanding of end-of-life patients, or communication problems with other medical personnel [ 10 ]. In addition, nurses said that they found terminal care challenging as they experienced spiritual conflicts caused by anxiety or skepticism about death [ 3 ].…”

Factors Associated with Person-Centered Care among Hospice Nurses

“…The ultimate goal of terminal patient nursing is to provide patients and their families with holistic care in order to maintain their human dignity and quality of life so that they can experience a peaceful death [ 4 ]. The proportion of terminal patients who used inpatient hospices increased from 9.1% in 2009 to 24.3% in 2019 [ 5 ], and this increasing trend is expected to continue.…”

“…Hospice nurses perform various activities such as responding to the personal preferences and demands of terminal patients [ 6 ], caring for patients and their families, managing bereaved families, and administering available community services [ 7 ]. To provide terminal care in response to different demands, careful planning to satisfy individual patients is required [ 4 , 6 ], and person-centered care, which includes the practice of holistic nursing for patients and their families, is necessary.…”

“…Background In 2001, the Institute of Medicine defined patient-centered care as the most fundamental factor for determining the quality of medicine and patient safety [1], and person-centered care is now becoming established as a core component of the provision of medical services [2]. Person-centered care refers to the concept of respecting and responding to the demands and values of individual patients in all clinical decision-making processes to provide comprehensive care that enables therapeutic communication between medical personnel and patients based on mutual trust and information-sharing that satisfies the physical, mental, and social demands of patients [3].The ultimate goal of terminal patient nursing is to provide patients and their families with holistic care in order to maintain their human dignity and quality of life so that they can experience a peaceful death [4]. The proportion of terminal patients who used inpatient hospices increased from 9.1% in…”