Lived experiences of end‐of‐life communication among nursing home staff: An interpretive phenomenological study

Abstract

Aims:To explore and understand lived experiences of end-of-life communication among nursing home staff.Design: Interpretive phenomenological study. Methods:In-person, semi-structured, in-depth interviews were conducted from May to August 2021 with 21 nursing home staff members involved in end-of-life communication (four managers, four chief nurses, three chief medical officers, three nurses, three psychologists, two occupational therapists, one chief nurse aide and one nurse aide). Data were analysed by van Manen's hermeneutic approach, which uses the lifeworld existentials of spatiality, corporeality, temporality and relationality to guide reflection on the human experience. Data were reported according to the Consolidated Criteria for Reporting Qualitative Research.Results: Thirteen categories were identified and framed within the four existentials.Regarding spatiality, end-of-life communication took place in a physical, mental, socio-cultural and professional competence space. With regard to corporeality, interviewees reported difficulties in managing their own feelings and those of family caregivers. For temporality, interviewees reported delays in end-of-life communication due to staffing issues and an increase in urgent and temporary relief admissions to nursing homes. To compensate, they tried to assure that all interactions that did take place were of high quality. Finally, with regard to relationality, interviewees lived end-of-life communication through their relationships with family caregivers and colleagues. The supportive role of colleagues was expressed as teamwork, which helped promote reflexivity about how to tailor communication, manage challenging emotions and situations, set aside time for communication, and prepare family caregivers for death. Conclusion:End-of-life communication was an all-encompassing experience for nursing home staff. The supportive role of colleagues was stressed across all existentials, suggesting that teamwork is essential in delivering effective communication at the end-of-life.

Supporting health and social care professionals in serious illness conversations: Development, validation, and preliminary evaluation of an educational booklet

“…However, the involvement of 15 external validators despite the fact that more than ten are probably unnecessary [52] was justified by the need to include professionals with different scope of practice who work in a wide array of clinical settings. This approach wants to sustain the core message that serious illness conversations are ubiquitous across several care settings and require a multidisciplinary team [53][54][55]. Additionally, only two experts deemed some sections not relevant (one 6/17 and one 2/17) (S5 Table ).…”

“…An ever-present barrier to serious illness conversations is the lack of time [34,54,61,62] and professionals need to quickly identify information that answers specific communication challenges. A resource designed to support clinical practice must address this obstacle.…”