Spiritual perspectives of emergency medicine doctors and nurses in caring for end-of-life patients: A mixed-method study

Zhang, Yingting; Pal, Rakhee Yash; Tam, Wilson W.S.; Lee, Alice; Ong, Mabel; Tiew, Lay Hwa

doi:10.1016/j.ienj.2017.07.001

Cited by 18 publications

(9 citation statements)

References 43 publications

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“…Studies on emergency nurses' roles in ED EOLC have shown that nurses were significantly responsible for physical comfort, as well as spiritual and emotional care, and for supporting dying patients and their families. 18,19 Similar to the literature, findings in this current study also showed that the role of nurses was believed to be demanding because of the stressful, fast-paced environment, staff shortages, and time constraints, as well as the clinical and bureaucratic tasks. 20 The cost of the emotional care and support carried out by nurses was reported in this study as an "emotional burden."…”

Section: Discussionsupporting

confidence: 84%

Death, Dying, and End-of-Life Care Provision by Doctors and Nurses in the Emergency Department

Omoya

Bellis

Breaden

2022

J Hosp Palliat Nurs

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There have been significant advancements in the fields of medicine, demography, and pathology. These disciplines have contributed to the classification and control of death and dying. People are now living longer with numerous comorbidities, and there is a significant aging population. Consequently, there have been increases in the numbers of people who present to emergency departments across Australia seeking access to care at the end of life. Emergency department staff must have the knowledge and skills required to provide end-of-life care in a setting that traditionally contradicts the goals of comfort care. With the increase in demand for end-of-life care in emergency departments, a gap exists in the experiences of how staff provide such care in this setting. As a result of this gap, it is important to understand the lived experiences of emergency department doctors and nurses who provide end-of-life care. The aim of this research is to understand the lived experiences of emergency department doctors and nurses concerning death, dying, and end-of-life care provision. Data were analyzed using Diekelmann's 7-step analysis to support Gadamer's phenomenological approach. Results indicate that challenges exist in the decision-making process of end-of-life care in emergency departments.

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Section: Discussionsupporting

confidence: 84%

Death, Dying, and End-of-Life Care Provision by Doctors and Nurses in the Emergency Department

Omoya

Bellis

Breaden

2022

J Hosp Palliat Nurs

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“…The literature has also pointed out that most of the nurses are aware of the insufficient education and training in death-related and end-of-life care. Specifically, the new staff in the intensive care unit, who take care of patients with complex diseases, often feel that they are unable to care for patients at the end of their lives, resulting in physical and mental exhaustion, poor working ability and increased staff turnover rate [ 10 , 11 ]. The emergency medical staff generally considers that patients are exposed to the emergency unit for a short period; therefore, there are practical difficulties in providing end-stage care to them [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Death-coping self-efficacy and its influencing factors among Chinese nurses: A cross-sectional study

Lin

Bai

et al. 2022

PLoS ONE

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Background Nurses are the main caregivers of dying patients. Facing or dealing with death-related events is inevitable. Death-coping self-efficacy (DCS) is very important, as it can reduce the risk of nursing staff to adverse emotional distress, help them participate in end-of-life care and improve the quality of care of patients. Methods Using the convenient sampling method, this study included a total of 572 nurses from a tertiary hospital in Hangzhou, China. The status and influencing factors of the DCS of nurses were explored using a general information questionnaire and DCS scale. Results The scores of each parameter, ranging from low to high, were in the order of coping with grief, preparation for death and hospice care. Factors influencing nurses’ DCS included attendance in hospice care education courses within the previous year, experience of accompanying the family members of the deceased and attitude towards death. Conclusions The overall self-efficacy of nurses in palliative care was at a medium level. Moreover, their self-efficacy in coping with grief and preparation for death should be strengthened. Managers of medical institutions can assess the death-coping ability of nurses, which helps provide corresponding support and training for nurses at an early stage. Nurses should receive guidance in grief adjustment and emotion regulation. Medical units should provide nurses with a platform for continuous training and education, use of death-related theoretical models and frameworks to guide nurses in dealing with death-related events, reduce nurses’ negative mood and jointly promote their mental health.

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“…Apart from medical management, communications including addressing emotions and spiritual needs is an important component in end-of-life care. While previous qualitative studies have shown ED personnel to be lacking in such communications (32,33), our assessment tool will quantify the extent of inadequacy from the perspectives of bereaved family members. The CODE-EM questionnaire will allow us to pinpoint shortcomings in various aspects of ED palliative care, especially in terms of care, communications and infrastructure.…”

Section: Discussionmentioning

confidence: 99%

Validation of “Care of the Dying Evaluation” in Emergency Medicine (CODE-EM): pilot phase of end-of-life management protocol offered within emergency room (EMPOWER) study

et al. 2021

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Background: An increasing number of patients who present to emergency departments are at their endof-life phase and have significant palliative care needs such as in symptom control for pain and dyspnoea.Evaluating quality of care provided is imperative, yet there is no suitable tool validated in the emergency and Asian settings. We aim to examine the face and construct validity, and reliability of a newly developed questionnaire, Care of the Dying Evaluation -Emergency Medicine, for measuring the quality of end-of-life care in an Asian emergency context. Methods:A mixed methods pilot study was conducted. Participants composed of the next-of-kin to thirty dying patients who presented to the emergency departments of three public hospitals in Singapore. Qualitative evaluation, using cognitive "think-aloud" interviews, and quantitative analysis were employed.Percentage agreement and κ statistic were measured to evaluate temporal stability of the questionnaire.Cronbach's α and item-total correlations were used to assess internal consistency within the constructs.Confirmatory factor analysis was performed for construct validity.Results: All participants reported clear understanding of the questionnaire with no ambiguity; a minority felt the questions caused emotional distress (7/30, 23.3%). The questions showed moderate to good testretest reliability. Internal consistencies within the constructs were good for "ENVIRONMENT" and "CARE", and moderate for "COMMUNICATION". Factor loadings range from 0.40 to 0.99. Conclusions:The Care of the Dying Evaluation -Emergency Medicine questionnaire may be valid and reliable for use in an Asian emergency setting. Our prospective multicentre study using this evaluation tool may provide more insight on the quality of care rendered to dying patients and identify areas for improvement.

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Spiritual perspectives of emergency medicine doctors and nurses in caring for end-of-life patients: A mixed-method study

Cited by 18 publications

References 43 publications

Death, Dying, and End-of-Life Care Provision by Doctors and Nurses in the Emergency Department

Death, Dying, and End-of-Life Care Provision by Doctors and Nurses in the Emergency Department

Death-coping self-efficacy and its influencing factors among Chinese nurses: A cross-sectional study

Validation of “Care of the Dying Evaluation” in Emergency Medicine (CODE-EM): pilot phase of end-of-life management protocol offered within emergency room (EMPOWER) study

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