The process of dying/death: intervening conditions to the nursing care management

Abstract

Subjective, educational, sociocultural and institutional conditions influence the nurse interactions, causing order/disorder on care management.

Perception of Dignity of Patients in Palliative Care

“…The role of the health care team in assisting the patient in decisionmaking is challenging, as well as providing them with information to express their preferences, thus ensuring that autonomy is preserved and, hence, dignity too. 20,[22][23] When autonomy was related to a decreased sense of dignity, it was associated with independence to perform daily basic activities and with the ability to self-care. This concept was also observed in the canadian study 6 and in a systematic review work in which the author analyzed the publications on dignity at the end of life.…”

“…and interaction with the health team also emerged as relevant, which may influence the increase or decrease of patients' perception of dignity. 23,28 Team attitudes contribute to the varying sense of dignity of these patients, and teams with greater knowledge of the later stages of life are able to provide greater comfort to these individuals. 7.23 Behaviors such as eye contact, smiling, empathy and sensitivity to patient values, as well as maintaining privacy, are actions that contribute to patient satisfaction, as well as to greater bonding and trust, 7,19,29 fundamental characteristics for patient care, with a positive impact on their sense of dignity.…”

“…24,31 In addition, facts such as the workload of the nursing staff, gaps in difficult news reporting, as well as lack of material resources and inadequate physical structure also impact negatively on patient assistance in palliative care. 23 Lack of continuing education in communication strategies for patients in palliative care 30 and non-professional involvement with death-related issues interfere with the patients' sense of dignity, as dignity "can come and go" according to the actions of other subjects. [31][32] Therefore, it is necessary to insert a discussion on the process of death and dying in the training courses of the health team.…”

“…[31][32] Therefore, it is necessary to insert a discussion on the process of death and dying in the training courses of the health team. 23,31,[33][34][35][36] Violence is also present in this portion of the population, whether related to family members or to people outside the scope of the elderly. It can be in the way of theft, neglect and financial abuse.…”

Educar para la vida y la muerte a los estudiantes de Enfermería: “del miedo al amor”

“…Cuando los recursos terapéuticos se agotan para estos pacientes, son muchas las enfermeras/os que creen, "que ya no se puede hacer nada más por estos pacientes" (15) El problema que he percibido en estos profesionales es que no saben qué hacer o decir, en esos momentos, les falta formación e instrumentos para enfrentarse al proceso de la muerte y el duelo. (15,16,17).…”