Exploring nurses’ end-of-life care for dying patients in the ICU using focus group interviews

2019 ◽  
Vol 52 ◽  
pp. 3-8 ◽  
Author(s):  
Sun Kyeong Jang ◽  
Won Hee Park ◽  
Hyo-In Kim ◽  
Sung Ok Chang
Author(s):  
Mirinae Kim ◽  
Minju Kim

We qualitatively investigated end-of-life care needs. Data were collected via focus-group interviews with three groups: young adults, middle-aged adults, and older adults. The key question was, “What kind of care would you like to receive at the end of life?” Interview data were transcribed and analyzed using content analysis. End-of-life care needs were classified into six categories: life-sustaining treatment needs, physical care needs, emotional care needs, environmental needs, needs for respect, and needs for preparation for death. Because the Korean culture is family-oriented and talking about death is taboo, Korean patients at the end of their life do not make decisions about life-sustaining treatment or actively prepare for death. Therefore, to provide proper end-of-life care, conversations and shared decision-making among patients and their families are crucial. Further, we must respect patients’ dignity and help them achieve a good death by understanding patients’ basic care preferences. Future research should continue examining end-of-life care needs that reflect the social and cultural context of Korea to inform instrument development.


2016 ◽  
Vol 15 (2) ◽  
pp. 158-167 ◽  
Author(s):  
Margareta Karlsson ◽  
Anne Kasén ◽  
Carola Wärnå-Furu

AbstractObjective:When registered nurses care for patients at the end of life, they are often confronted with different issues related to suffering, dying, and death whether working in hospital or community care. Serious existential questions that challenge nurses’ identities as human beings can arise as a result of these situations. The aim of our study was to describe and gain a deeper understanding of nurses’ existential questions when caring for dying patients.Method:Focus-group interviews with registered nurses who shared similar experiences and backgrounds about experiences in end-of-life care were employed to gain a deeper understanding about this sensitive subject. Focus-group interviews were performed in hospice care, in community care, and in a palliative care unit in western Sweden. A qualitative hermeneutic approach was employed to interpret the data.Results:Nurses’ existential questions balanced between responsibility and guilt in relation to their patients, between fear and courage in relation to being professional caregivers and fellow human beings, and between hope and despair in relation to the other's and their own death.Significance of results:Nurses in end-of-life care experience various emotions from patients related to things physical, spatial, and temporal. When nurses encounter these emotions as expressing a patient's suffering, they lead to challenges of balancing between different feelings in relation to patients, as both professional caregivers and fellow human beings. Nurses can experience growth both professionally and as human beings when caring for patients at the end of life.


2000 ◽  
Vol 9 (1) ◽  
pp. 36-42 ◽  
Author(s):  
KT Kirchhoff ◽  
V Spuhler ◽  
L Walker ◽  
A Hutton ◽  
BV Cole ◽  
...  

BACKGROUND: With much attention being focused on how patients die and whether or not they are provided appropriate care, the care of dying patients in intensive care units must be described and improved. OBJECTIVES: To describe end-of-life care in intensive care units as perceived by critical care nurses who have taken care of dying patients. METHODS: A semistructured interview guide was developed and revised after pretesting in a focus group of faculty clinicians with extensive, recent experience in intensive care. Four focus groups were held with randomly selected nurses from 4 intensive care units in 2 hospitals; participants had 2 years or more of experience and were working half-time or more. Tapes from each focus group were transcribed and reviewed by the investigators before the subsequent group met. Category labels were developed, and topics and themes were determined. RESULTS: "Good" end-of-life care in the intensive care unit was described as ensuring that the patient is as pain-free as possible and that the patient's comfort and dignity are maintained. Involvement of the patient's family is crucial. A clear, accurate prognosis and continuity of care also are important. Switching from curative care to comfort care is awkward. CONCLUSIONS: Disagreement among patients' family members or among caregivers, uncertainty about prognosis, and communication problems further complicate end-of-life care in intensive care units. Changes in the physical environment, education about end-of-life care, staff support, and better communication would improve care of dying patients and their families.


2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Lucy Ellen Selman ◽  
Lisa Jane Brighton ◽  
Vicky Robinson ◽  
Rob George ◽  
Shaheen A. Khan ◽  
...  

2017 ◽  
Vol 8 (2) ◽  
pp. 29 ◽  
Author(s):  
Andra L. Davis ◽  
Megan E. Lippe

There is a growing imperative for nurses to be adequately trained to care for patients with serious, life-limiting illness. However, the current nursing education system requires vast content areas be taught, resulting in minimal emphasize on palliative and end-of-life care and inadequate preparation of nurses to care for dying patients upon entering practice. To address the need for enhanced palliative and end-of-life care integration within their respective programs, two universities conducted needs assessments to determine the best next steps in enhancing student preparation to care for patients with serious, life-limiting illness. One university engaged in a three-part needs assessment resulting in the formation of an ad hoc committee to guide discussions for content integration. The second university engaged in a faculty-led survey to identify areas for improvement within the program. The purpose of this paper is to describe the processes and challenges encountered by both schools to aid other programs that may be considering or preparing for a similar endeavor.


2011 ◽  
Vol 26 (4) ◽  
pp. 313-321 ◽  
Author(s):  
Staffan Lundström ◽  
Bertil Axelsson ◽  
Per-Anders Heedman ◽  
Greger Fransson ◽  
Carl Johan Fürst

Background: The complexity of end-of-life care, represented by a large number of units caring for dying patients, different types of organizations and difficulties in identification and prognostication, signifies the importance of finding ways to measure the quality of end-of-life care. Aim: To establish, test and manage a national quality register for end-of-life care. Design: Two questionnaires were developed with an attempt to retrospectively identify important aspects of the care delivered during the last week in life. An internet-based IT platform was created, enabling the physician and/or nurse responsible for the care during the last week in life to register answers online. Setting: Units caring for dying people, such as hospital wards, home care units, palliative in-patient care units and nursing facilities. Results: The register received status as a National Quality Register in 2006. More than 30,000 deaths in nursing facilities, hospital wards, palliative in-patient units and private homes were registered during 2010, representing 34% of all deaths in Sweden and 58% of the cancer deaths. Conclusions: We have shown that it is feasible to establish a national quality register in end-of-life care and collect data through a web-based system. Ongoing data analyses will show in what way this initiative can lead to improved quality of life for patients and their families. There is an ongoing process internationally to define relevant outcome measures for quality of care at the end-of-life in different care settings; the registry has a potentially important role in this development.


2018 ◽  
Vol 6 (4) ◽  
pp. 53
Author(s):  
Maryam Yaqoob ◽  
Husain Nasaif ◽  
Hana Kadhom

Background: Nursing students are frequently exposed to dying patients during their clinical placement. Research studies that examined nursing students’ attitudes toward caring for dying patients were limited in the Gulf Region, including Bahrain.Objective: The purpose of this study is to examine the attitudes of fourth-year baccalaureate nursing students regarding caring for dying patients.Methods: A descriptive cross-sectional design was utilized to recruit a convenience sample of fifty-four nursing students. Frommelt’s Attitudes towards Caring of the Dying (FATCOD) five Likert scale was used.Results: The overall findings revealed that participants had a neutral attitude toward caring for dying patients. The overall attitudes mean score was 3.4 ± 0.3. The majority of participants were female (83%, n = 45). The difference in the mean score in relation to gender was statistically significant (p = .049). Although the majority of all participants (80%) reported having dealt with the terminally ill people in the past, the association between previous experience and reported attitudes was not statistically significant (p = .31).Conclusions and recommendations: Literature revealed that students who received end of life education where found to have positive attitudes. Therefore, it’s crucial to introduce a standalone educational module regarding end of life care early on in the undergraduate curriculum. It is recommended that future studies recruit nursing students from other baccalaureate year levels to reassess the attitudes and level of preparedness following a curriculum reform and implementation of end of life care education. Additionally, a qualitative research method is recommended to explore the lived experience of the nursing students when they are caring for dying patients.


2020 ◽  
pp. 003022282096123
Author(s):  
Deniz Sanli ◽  
Fatma Iltus

Nursing students may feel unprepared to manage the care of dying individuals and may experience anxiety and fear related to death and dying. Preparing nursing students for this situation can help them provide quality care to dying patients. This study aimed to examine the end-of-life care values and behaviors and death attitudes of senior nursing students. In examining these variables, the Values and Behaviors of Intensive Care Nurses for End-of-Life Instrument and the Death Attitude Profile-Revised Scale were used. It was found that the students developed positive attitudes and behavior towards end-of-life care, and that they believed death to be a natural part of life and there is life after death. Students who felt that the information they received during their education was partially sufficient were more likely to have negative death attitudes. It can be recommended that teaching strategies in the education of the nursing students be developed.


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