Difficulties in End-of-Life Care and Educational Needs of Intensive Care Unit Nurses: A Mixed Methods Study

Yun

et al. 2022

J Hosp Palliat Nurs

Self Cite

Because of the lack of guidelines and standardized protocols for end-of-life nursing care in intensive care units in Korea, many nurses have reported facing difficulties when providing care for patients. This study attempted to develop a standardized end-of-life nursing protocol for use in intensive care units. A draft of the end-of-life nursing care protocol was developed after a literature review. A Delphi survey was carried out twice with 30 experts, and the content validity ratio of the items was investigated. The draft end-of-life nursing care protocol was divided into 3 separate stages with 24 items: 8 initial end-of-life care assessment items, 5 ongoing end-of-life care items, and 11 post-end-of-life care items. The content validity ratios of the first and second rounds were 0. 33 or greater in each category, demonstrating the validity of the proposed draft as a standardized protocol. Furthermore, at the suggestion of the experts, an extra item was added in the last stage, resulting in 25 items. The results of this study are expected to help leading hospitals in South Korea outline the roles and range of tasks for end-of-life care in an intensive care unit and thereby resolve difficulties for nurses. Furthermore, this will improve the medical services that family members receive during end-of-life care.

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Development of an End-of-Life Nursing Care Protocol for Intensive Care Units

Yun

et al. 2022

J Hosp Palliat Nurs

Self Cite

“…This matched the findings of previous studies showing that such disparity stems from the differences in the departments in terms of intensity and medical treatment [ 47 ]. This may be attributable to the fact that hospice ward nurses frequently provide EOLC and experience patient deaths, and ICU nurses provide patient care without the assistance of patients’ caregivers, as opposed to ED nurses who are required to provide emergency and acute care [ 48 ]. Staff nurses lack awareness of palliative care [ 49 ], but nurses from the ICU or hospice ward experience EOLC more often, which might have increased their awareness of palliative care.…”

Section: Discussionmentioning

confidence: 99%

Predictors of end-of-life care stress, calling, and resilience on end-of-life care performance: a descriptive correlational study

Kim¹,

Choi

2022

BMC Palliat Care

Background Prolonging the end-of-life process means that the duration of health care work increases and the management of death is delegated to health care providers by patients’ families. Thus, it is important to explore measures to enhance the quality of end-of-life care by identifying the predictors thereof. End-of-life care should be people-centred, relieving serious health-related suffering, be it physical, psychological, social, or spiritual. Nurses who provide end-of-life care usually spend the most time with dying patients, administering care to help patients who wish to die with dignity; therefore, end-of-life nursing care is highly significant. Methods This study was conducted on nurses of 500-bed or larger university hospitals in city D and province C in South Korea from 20 August to 10 September 2020 using a structured questionnaire. A total of 213 nurses with a minimum clinical career of one year and at least one EOLC experience participated. The final analysis sample consisted of 206 nurses. Descriptive analysis, Pearson’s correlation coefficients, ANOVA, t-test, and multiple-regression analysis were used to analyse the data. Results This study found that end-of-life care performance was significantly positively correlated with end-of-life care stress [r = .253, p < .001], sense of calling [r = .424, p < .001], and resilience [r = .397, p < .001]. End-of-life care stress [β = .185, p = .003], sense of calling [β = .259, p < .001], resilience [β = .252, p < .001], and working in a hospice ward [β = .140, p = .041] or intensive care unit [β = .218, p = .008], as opposed to the emergency department, were identified as predictors of end-of-life care performance. These factors explained 28.3% of the variance in the end-of-life care performance in this study. Conclusions Boosting the sense of calling and resilience among nurses providing palliative care can improve overall end-of-life care performances. Subsequent studies should develop and evaluate interventions and programs that could improve these factors to ensure a positive change in health care and enhance the quality of end-of-life care in hospitals.

How Do Oncology Nurses Cope With the Psychological Burden of Caring for Dying Patients?

et al. 2022

BackgroundCancer is a leading cause of death worldwide, and most patients with cancer in South Korea die in hospitals. Oncology nurses experience physical, emotional, and occupational challenges associated with the psychological burden of caring for dying patients.ObjectiveThis study explored the coping strategies used by oncology nurses to deal with the psychological burden of patient deaths.MethodsIn this descriptive qualitative study, 10 oncology nurses who had recently experienced a patient’s death were recruited via snowball sampling. All were female, with a mean age of 32.9 years (range, 27–44 years), and their mean working duration was 9.9 (range, 3-23) years. Participants were interviewed individually face-to-face 3 times, with each interview lasting 1 to 1.5 hours.ResultsOncology nurses coped with the psychological burden of a patient’s death in the following 4 ways: (a) avoiding patient deaths to the extent possible, (b) reflecting upon the meaning of life and death, (c) suppressing their emotional distress over the patient’s death, and (d) becoming kinder and more caring toward people around them.ConclusionsThe findings suggest that oncology nurses struggle to cope with the psychological burden of patient deaths. Oncology nurses are affected both negatively and positively by experiencing death as they provide end-of-life care.Implications for PracticeOncology nurses need education or counseling to reduce the psychological burden of caring for dying patients with cancer. Hospital administrators need to continuously identify ways to reduce the psychological burden of oncology nurses providing end-of-life care.