The trajectory of experience of critical care nurses in providing end‐of‐life care: A qualitative descriptive study

Ong, Keh Kiong; Ting, Kit Cheng; Chow, Yeow Leng

doi:10.1111/jocn.13882

Cited by 26 publications

(34 citation statements)

References 40 publications

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“…The nursing care that was described in this study is still physical and task-oriented, although a certain amount of comfort care is given both physical and psychological. This is similar to the nursing care provided in other settings [ 67 , 68 ]. High-quality end-of-life nursing care in non-palliative care settings is lacking.…”

Section: Discussionsupporting

confidence: 71%

The experience of caring for patients at the end-of-life stage in non-palliative care settings: a qualitative study

2018

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BackgroundMore patients are dying in non-palliative care settings than in palliative care settings. How health care providers care for adult patients at the end-of-life stage in non-palliative care settings has not been adequately explored. The aim of this study was to explore the experiences of health care providers in caring for patients at the end-of-life stage in non-palliative care settings.MethodsThis is a qualitative study. Twenty-six health care providers from eight health care institutions which are based in Shanghai were interviewed individually between August 2016 and February 2017. Three levels of health care, i.e., acute care, sub-acute care, or primary care, was provided in the health care institutions. The interviews were analyzed using qualitative content analysis.ResultsThree themes emerged from the interviews: (i) Definition of the end-of-life stage: This is mainly defined based on a change in treatment. (ii) Health care at the end-of-life stage: Most patients spent their last weeks in tertiary/secondary hospitals, transferring from one location to another and receiving disease- and symptom-focused treatment. Family-dominated decision making was common when discussing treatment options. Nurses instinctively provided extra care attention to patients, but nursing care is still task-oriented. (iii) Challenges, difficulties, and the future. From the interviews, it was found that pressure from families was the main challenge faced by health care providers. Three urgent tasks before the end-of-life care can become widely available in the future were identified from the interviews, including educating the public on death, extending government support, and creating better health care environment.ConclusionThe end-of-life care system of the future should involve health care institutions at all levels, with established mechanisms of collaboration between institutions. Care should be delivered to patients with various life-threatening diseases in both palliative and non-palliative care settings. But first, it is necessary to address the obstacles to the development of end-of-life care, which involve health care providers, patients and their families, and the health care system as a whole.Electronic supplementary materialThe online version of this article (10.1186/s12904-018-0372-7) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 71%

The experience of caring for patients at the end-of-life stage in non-palliative care settings: a qualitative study

2018

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“…They don’t listen. (Nurse) 48 There was a need to acknowledge the contributions of all disciplines as multidisciplinary collaboration within the health-care institutions is essential in delivering dignified care.We work like a team. Everyone has a duty […] This participative approach is essential to work.…”

Section: Resultsmentioning

confidence: 99%

“…The literature search identified 303 articles as potentially relevant, and of these, 120 articles were selected for full-text screening and 48 articles were included in the final analysis. 7,10 -56 The screening process is presented in Figure 1, and the overview of the 48 articles is presented in Table 2.…”

Section: Methodsmentioning

confidence: 99%

Reciprocal Dynamics of Dignity in End-of-Life Care: A Multiperspective Systematic Review of Qualitative and Mixed Methods Research

Choo

Tan-Ho

Dutta

et al. 2019

Am J Hosp Palliat Care

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Background: Preserving terminally ill patients’ dignity and well-being through dignified and holistic care has become the overarching goal in palliative care services. However, dignity is a multifaceted concept with a wide range of interpretations under different cultural contexts. Aim: The aim of this review is to understand the variations in subjective interpretations and constitutions of dignity in palliative or end-of-life care via an integrative worldview. Design: This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline and used SPIDER tool to screen for appropriate and relevant articles for analysis. Data Sources: Four major databases were searched including CINAHL, ERIC, Medline, and PsycARTICLES between 2009 and 2018. Forty-eight qualitative studies that examined dignity from the perspectives of patients, family caregivers, and health-care professionals were selected for full text data analysis using thematic synthesis. Results: Analysis of the various concepts of dignity revealed 18 themes that were further categorized into 7 conceptual categories: (1) self-determination, (2) existential liberty, (3) relational connectedness, (4) caregiving revitalization, (5) mindful humanity, (6) patient–family care, and (7) sustainable culture. These 7 categories span across individual, familial, and institutional dimensions, forming a new Dynamic Reciprocity of Dignity model. Conclusions: The Dynamic Reciprocity of Dignity model highlights the importance of adopting a systemic lens to address dignity-related needs and concerns at the end of life, while providing insights on how compassionate care and self-compassion can serve as the foundation of dignified care, which in turn serve as a buffer against patients’ existential suffering as well as caregivers’ burnout and fatigue. Recommendations for clinical practice and future research directions are discussed.

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“…[6] The National Institute of Health and Care Excellence defined end of life as "a subset of palliative care focusing on expected impending death within 12 months." [7] The World Health Organization defines end of life care as the process that helps in improving the quality of life of dying patients and their family members through pain control and symptom management. [7] Health care providers continually develop end of life care strategies to help advanced, progressive, and terminally ill patients to live their life with quality until they die.…”

Section: Introductionmentioning

confidence: 99%

End of life care: A concept analysis

Ibrahim

Johnson

Khraim

2021

IJH

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Background: End of life care is crucial to preserve a dying patient’s values and dignity. This type of care also works towards fulfilling any last wishes the dying person may have.Aim: The aim of this paper is to analyze the concept of end of life care using Rodgers’ evolutionary method as a guide.Methods: A systematic search of the literature was conducted in CINAHL, PsycINFO, and Medline databases. After reviewing the literature from 2006 to 2019, 14 articles were selected to be included in this analysis.Results: The consequences of this concept include a good death, peaceful death, and dying with dignity.Conclusions: This concept analysis provides attributes that could help to develop a standardized end of life care approach to patients who are dying.

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The trajectory of experience of critical care nurses in providing end‐of‐life care: A qualitative descriptive study

Abstract: Aims and objectives: To understand the perceptions of critical care nurses towards providing end-of-life care.Background: There has been an increasing interest in end-of-life care in the critical

Cited by 26 publications

References 40 publications

The experience of caring for patients at the end-of-life stage in non-palliative care settings: a qualitative study

The experience of caring for patients at the end-of-life stage in non-palliative care settings: a qualitative study

Reciprocal Dynamics of Dignity in End-of-Life Care: A Multiperspective Systematic Review of Qualitative and Mixed Methods Research

End of life care: A concept analysis

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