Dignified end-of-life care in the patients’ own homes

2011 ◽  
Vol 18 (3) ◽  
pp. 374-385 ◽  
Author(s):  
Christina Karlsson ◽  
Ingela Berggren
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Life Care ◽  
Human Beings ◽  
Life World ◽  
Life Phase ◽  
Dying Patients ◽  
Nurses Perceptions ◽  
Significant Factors

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.

Critical care nurses' perceptions of obstacles and helpful behaviors in providing end-of-life care to dying patients

2000 ◽  
Vol 9 (2) ◽  
pp. 96-105 ◽  
Author(s):  
KT Kirchhoff ◽  
RL Beckstrand
Keyword(s):  
Critical Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Life Support ◽  
Critical Care Nurses ◽  
Life Care ◽  
Dying Patients ◽  
Life Issues ◽  
End Of Life Issues ◽  
Nurses Perceptions

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.

Neonatal Staff and Advanced Practice Nurses’ Perceptions of Bereavement/End-of-Life Care of Families of Critically Ill and/or Dying Infants

2004 ◽  
Vol 13 (6) ◽  
pp. 489-498 ◽  
Author(s):  
Arthur J. Engler ◽  
Regina M. Cusson ◽  
Renee T. Brockett ◽  
Charlene Cannon-Heinrich ◽  
Michelle A. Goldberg ◽  
...  
Keyword(s):  
End Of Life ◽  
Critically Ill ◽  
End Of Life Care ◽  
Survey Design ◽  
The United States ◽  
Influential Factors ◽  
Life Care ◽  
Cross Sectional ◽  
Neonatal Nurses ◽  
Nurses Perceptions

• Background Parents need compassionate care when an infant dies. Nurses can provide such care and possibly facilitate grieving, yet often have inadequate preparation in bereavement/end-of-life care. • Objective To describe neonatal nurses’ perceptions of bereavement/end-of-life care of families of critically ill and/or dying infants. • Methods A cross-sectional, descriptive, correlational mailed survey design was used. The 55-item Bereavement End-of-Life Attitudes About Care: Neonatal Nurses Scale containing 4 sections (comfort, roles, involvement, and demographics) was mailed to 240 hospitals in the United States. • Results The final response rate was 52% (190 completed data sets from 125 hospitals). Respondents were comfortable with many aspects of bereavement/end-of-life care. Comfort and roles scores correlated significantly with number of years as a neonatal intensive care nurse. Respondents agreed about many important aspects of their roles with patients’ families, especially the importance of providing daily support to the families. Most respondents identified caring for a dying infant, the actual death of an infant, and language or cultural differences as influential factors in the level of their involvement with families. • Conclusions Education on bereavement/end-of-life care could affect nurses’ comfort with caring for families of critically ill and/or dying infants. Additional education on cultural competence would be helpful. Educators must promote the inclusion of content on bereavement/end-of-life care in nursing curricula. Finally, researchers must focus more attention on factors that promote and inhibit bereavement/end-of-life care of families of critically ill and/or dying infants.

scholarly journals Two prelicensure nursing programs assess readiness to standardize palliative and end of life care curriculum

2017 ◽  
Vol 8 (2) ◽  
pp. 29 ◽  
Author(s):  
Andra L. Davis ◽  
Megan E. Lippe
Keyword(s):  
Nursing Education ◽  
End Of Life ◽  
End Of Life Care ◽  
Ad Hoc ◽  
Life Care ◽  
Student Preparation ◽  
Needs Assessments ◽  
Care Integration ◽  
Dying Patients ◽  
Prelicensure Nursing

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.

Developing a national quality register in end-of-life care: The Swedish experience

2011 ◽  
Vol 26 (4) ◽  
pp. 313-321 ◽  
Author(s):  
Staffan Lundström ◽  
Bertil Axelsson ◽  
Per-Anders Heedman ◽  
Greger Fransson ◽  
Carl Johan Fürst
Keyword(s):  
End Of Life ◽  
End Of Life Care ◽  
Nursing Facilities ◽  
Life Care ◽  
Quality Register ◽  
Dying Patients ◽  
National Quality ◽  
Hospital Wards ◽  
National Quality Register

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.

scholarly journals Undergraduate final year nursing students’ attitudes toward caring for dying patients: Bahrain’s experience

2018 ◽  
Vol 6 (4) ◽  
pp. 53
Author(s):  
Maryam Yaqoob ◽  
Husain Nasaif ◽  
Hana Kadhom
Keyword(s):  
Nursing Students ◽  
End Of Life ◽  
Curriculum Reform ◽  
End Of Life Care ◽  
Life Care ◽  
Gulf Region ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Dying Patients ◽  
Students Attitudes

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.

Experiences of a Group of Senior Nursing Students with End of Life Care and Death in Turkey

2020 ◽  
pp. 003022282096123
Author(s):  
Deniz Sanli ◽  
Fatma Iltus
Keyword(s):  
Nursing Students ◽  
End Of Life ◽  
End Of Life Care ◽  
Quality Care ◽  
Death And Dying ◽  
Life Care ◽  
Death Attitudes ◽  
Positive Attitudes ◽  
Dying Patients ◽  
And Behaviors

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.

Reflecting on one's own death: The existential questions that nurses face during end-of-life care

2016 ◽  
Vol 15 (2) ◽  
pp. 158-167 ◽  
Author(s):  
Margareta Karlsson ◽  
Anne Kasén ◽  
Carola Wärnå-Furu
Keyword(s):  
Focus Group ◽  
Registered Nurses ◽  
End Of Life ◽  
End Of Life Care ◽  
Community Care ◽  
Life Care ◽  
Human Beings ◽  
Focus Group Interviews ◽  
Care Experience ◽  
Group Interviews

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.

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