Nurses' Advocacy Behaviors in End-of-Life Nursing Care

2008 ◽  
Vol 15 (2) ◽  
pp. 174-185 ◽  
Author(s):  
Karen S Thacker

Nursing professionals are in key positions to support end-of-life decisions and to advocate for patients and families across all health care settings. Advocacy has been identified as the common thread of quality end-of-life nursing care. The purpose of this comparative descriptive study was to reveal acute care nurses' perceptions of advocacy behaviors in end-of-life nursing practice. The 317 participating nurses reported frequent contact with dying patients despite modest exposure to end-of-life education. This study did not confirm an overall difference in advocacy behaviors among novice, experienced and expert nurses; however, it offered insight into the supports and barriers nurses at different skill levels experienced in their practice of advocacy.

2011 ◽  
Vol 18 (3) ◽  
pp. 374-385 ◽  
Author(s):  
Christina Karlsson ◽  
Ingela Berggren

Nowadays it is increasingly common that the patients in the end of life phase choose to be cared for in their own home. Therefore it is vital to identify significant factors in order to prevent unnecessary suffering for dying patients and their families in end-of-life homecare. This study aimed to describe 10 nurses’ perceptions of significant factors that contribute to good end-of-life care in the patients own home. The transcribed texts from the interviews’ were analyzed using phenomenological hermeneutical method, which focuses on the life-world of human beings. The results demonstrate that good end-of-life care presupposes that the aim of the caring staff is to provide safety, autonomy and integrity for the patient and family in order to create the respect required for as good and dignified a death as possible.


2000 ◽  
Vol 9 (2) ◽  
pp. 96-105 ◽  
Author(s):  
KT Kirchhoff ◽  
RL Beckstrand

BACKGROUND: Little is known about nurses' perceptions of obstacles or helpful behaviors ("helps") in providing end-of-life care in the intensive care setting. OBJECTIVE: To determine the importance of various obstacles and helps in providing end-of-life care as perceived by critical care nurses. METHODS: A questionnaire was mailed to 300 members of the American Association of Critical-Care Nurses. Nurses were asked to rate obstacles and helps in giving end-of-life care, and additional obstacles and/or helps, and answer demographic questions. RESULTS: Six of the top 10 obstacles were related to issues with patients' families that make care at the end of life more difficult, such as the family's not fully understanding the meaning of life support, not accepting the patient's poor prognosis, requesting more technical treatment than the patient wished, and being angry. Added obstacles related mostly to problems with physicians' behavior. Most helps were ways to make dying easier for patients and patients' families, such as agreement among physicians about care, dying with dignity, and families' acceptance of the prognosis. Added helps included allowing music, pets, and so forth into the patient's room. CONCLUSIONS: Nurses have difficulties with patients' families and physicians concerning end-of-life issues, especially when the behaviors remove the nurses from caring for a patient or cause the patient pain or prolong suffering. Nurses do not acknowledge having difficulty providing care to dying patients aside from conflicts that arise because of patients' families and physicians.


2008 ◽  
Vol 25 (5) ◽  
pp. 389-397 ◽  
Author(s):  
Barbara G. Kruse ◽  
Lolita W. Melhado ◽  
Linda Convertine ◽  
Jo Stecher

Author(s):  
Danguolė Drungilienė ◽  
Vida Mockienė

Research background. Nursing care for patients with terminal conditions is one of the leading problems in health care. Health care specialists caring for the dying patient are under enormous psychological stress. Before death the patient requires medical and family support because death provokes feelings of fear or anxiety. During nursing care for dying patients the most important issue is to help people to live fully up to the last moment of his life. The aim of the research was to analyse the aspects of care of dying patients. Research methods. The subjects, 250 health care specialists (doctors, nurses), 57 dying patients’ family members and significant others, filled-in a questionnaire consisting of a Frommelt’s approach to nursing care for dying patients, a modified Collet-Lester scale of death fear, and a questionnaire for the dying patients’ family members and significant others. Results and conclusions. The vast majority (92.4%) of respondents were religious, had experienced bereavement, care for person with incurable illnesses and have knowledge about death. The most important concern of respondents related to the process of death of themselves or their close relatives was due to the pain in the process of death. The majority of respondents (93.1%), especially with higher education, had a good attitude towards nursing care for dying patients. Respondents with the experience of bereavement more often noted that families caring for the patient with incurable disease need for emotional support and that close relatives should participate during the patient’s process of death. Respondents who had work experience with the dying patients significantly more often believed that possibility of the dependence on painkillers should not be considered when it comes to the dying person. According to them, the family members who remain with the dying patient disturb the nursing care. Respondents who have had knowledge about death significantly more often noted that the care for patient’s family members should continue throughout the period of mourning and bereavement, and indicated that they were upset when their patient ceased to believe that he would recover. Respondents who felt threatened by the current bereavement and were more worried about their own death significantly more noted that the stress was the most common psychological problem in the end of life. As proved by the survey outcomes, the majority of the patients (75.4%) were frequently visited by family members. During the time of their disease, most of the patients (77.2%) stayed alone just for short periods of time. At the time of death, the majority of the respondents (61.4%) stayed at the bedside of their family member, 38.6% of the respondents indicated that the dying person frequently felt pain, and 19.3% of them stated that the pain was felt for a short or an insignificant period of time. About half of the respondents claimed that their family member could not eat or bree the independently. Over half of the patients who passed away (52.6%) did not discuss their nursing requirements, such as reanimation or intensive care, at the end of their lives, however, 35.1% of the patients did that. Approximately half of the patients discussed their funeral-related wishes and said good-bye to their family members or significant others. The majority of the survey participants-patients’ family members and significant others (82.5%) indicated that the patient in hospital had been properly cared for.Keywords: dying patient, death, nursing care.


2017 ◽  
Vol 21 (4) ◽  
Author(s):  
Isabella Navarro Silva ◽  
Natália Rejane Salim ◽  
Regina Szylit ◽  
Patricia Stella Silva Sampaio ◽  
Carolliny Rossi de Faria Ichikawa ◽  
...  

Abstract Objective: Understand the care practices experiences of nursing staff in relation to providing end-of-life care to newborns and their families in neonatal intensive care units (NICU). Method: Descriptive study with a qualitative approach, involving eight nursing professionals from an NICU. Results: Through the data analysis, it was possible to identify three central themes: the "obscurity of death in neonatal ICUs": coping with death at the onset of a human life; palliative care and end-of-life decisions: the challenges faced by nursing staff in neonatal ICUs; and types of nursing care in the daily activities of neonatal ICUs. Conclusion: It is essential to understand the experiences and needs of nursing staff, so that proposals can be formulated for seeking improvements in the care relationships that take place in this context.


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