Nursing and the future of palliative care

Schroeder, Karla; Lorenz, Karl

doi:10.4103/apjon.apjon_43_17

Cited by 99 publications

(95 citation statements)

References 10 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nurses recognize their role as being witnesses to the patient's experience through their constant presence which is in line with their professional values. In turn, this gives them an "alert role" that can help in anticipating and preparing for a patient centered palliative approach, in accordance with recent results published by Schroeder & Lorenz [22].…”

Section: Discussionsupporting

confidence: 86%

A phenomenological study of nurses experience about their palliative approach and their use of mobile palliative care teams in medical and surgical care units in France

et al. 2020

View full text Add to dashboard Cite

Background: Despite a broad consensus and recommendations, numerous international reports or studies have shown the difficulties of implementing palliative care within healthcare services. The objective of this study was to understand the palliative approach of registered nurses in hospital medical and surgical care units and their use of mobile palliative care teams. Methods: Qualitative study using individual in depth semi-structured interviews and focus group of registered nurses. Data were analyzed using a semiopragmatic phenomenological analysis. Expert nurses of mobile palliative care team carried out this study. 20 registered nurses from three different hospitals in France agreed to participate. Results: Nurses recognize their role as being witnesses to the patient's experience through their constant presence. This is in line with their professional values and gives them an "alert role" that can anticipate a patient-centered palliative approach. The physician's positioning on palliative care plays a key role in its implementation. The lack of recognition of the individual role of the nurse leads to a questioning of her/his professional values, causing inappropriate behavior and distress. According to nurses, "rethinking care within a team environment" allows for the anticipation of a patient-centered palliative approach. Mobile Palliative Care Team highlights the major role of physicians-nurses "balance" while providing personal and professional support.

show abstract

Section: Discussionsupporting

confidence: 86%

A phenomenological study of nurses experience about their palliative approach and their use of mobile palliative care teams in medical and surgical care units in France

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Prognostic uncertainty is made in cases of patients with longstanding chronic disease, for example, with the transition alternating different and difficult levels of care and, given these multiple transitions, the nurse must be able to work in the middle of a infinite range of configurations. 17 It develops the ability to act in different contexts, showing itself as an indispensable protagonist in patient care and considering its particularities. Evidence is based on the variety of roles played by these professionals.…”

Section: Discussionmentioning

confidence: 99%

“…Evidence is based on the variety of roles played by these professionals. 17 The second category emerges in the analysis of the discourses called "Situational Transitions: changes in family reality and redefinition of roles". This category reflects the change in the health condition of the patient in transition from the ICU to the ward and, mainly, the reorganization and adaptations necessary for the patient and his/her family nucleus.…”

Section: Discussionmentioning

confidence: 99%

Transição dos pacientes de unidades de terapia intensiva

Antonio

Bernardino

Tominaga

et al. 2018

Rev enferm UFPE on line.

View full text Add to dashboard Cite

RESUMOObjetivo: compreender, na perspectiva dos acompanhantes, a transição dos pacientes que receberam alta das Unidades de Terapia Intensiva. Método: trata-se de estudo qualitativo, exploratório, realizado por meio de entrevista semiestruturada, com 30 acompanhantes de pacientes identificados como cuidadores principais. Transcreveram-se e analisaram-se os dados pela técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: emergiram-se três categorias: “Continuidade da informação: o cuidado prestado pelos profissionais impactando as percepções dos acompanhantes”; “Transições situacionais: mudanças nas situações de família e a redefinição de papéis” e “Transições no processo de saúde-doença do ser cuidado: os acompanhantes vivenciando a experiência de transição do paciente”. Conclusão: identificaram-se fragilidades, pelos acompanhantes, no processo de transição dos pacientes das Unidades de Terapia Intensiva para as enfermarias, e estas podem ser mitigadas pela atuação do enfermeiro, que deve conhecer o perfil dos pacientes sob a sua responsabilidade e o contexto familiar para aplicar as práticas de cuidado, orientações e medidas de suporte à família. Descritores: Cuidados de Enfermagem; Continuidade da Assistência ao Paciente; Cuidado Transicional; Família; Unidade de Terapia Intensiva; Enfermaria.ABSTRACT Objective: to understand, from the perspective of the companions, the transition of the patients who were discharged from the Intensive Care Units. Method: this is a qualitative, exploratory study, performed through a semi-structured interview, with 30 companions of patients identified as primary caregivers. Data were transcribed and analyzed using the Content Analysis technique in the Thematic Analysis modality. Results: three categories emerged: "Continuity of information: the care provided by professionals impacting the perceptions of the companions"; "Situational transitions: changes in family situations and the redefinition of roles" and "Transitions in the health-illness process of being cared for: the companions experiencing the transition experience of the patient". Conclusion: fragilities were identified by the caregivers in the process of transition of patients from the Intensive Care Units to the infirmary, and these can be mitigated by the nurses' performance, who must know the profile of the patients under their responsibility and the family context to apply care practices, guidelines, and family support measures. Descriptors: Nursing Care; Continuity of Patient Care; Transitional Care; Family; Intensive Care Unit; Patient Rooms.RESUMENObjetivo: comprender, en la perspectiva de los acompañantes, la transición de los pacientes que recibieron alta de las Unidades de Terapia Intensiva. Método: se trata de un estudio cualitativo, exploratorio, realizado por medio de una entrevista semiestructurada, con 30 acompañantes de pacientes identificados como cuidadores principales. Se transcribieron y analizaron los datos por la técnica de Análisis de Contenido en la modalidad Análisis Temático. Resultados: surgieron tres categorías: "Continuidad de la información: el cuidado prestado por los profesionales impactando las percepciones de los acompañantes"; "Transiciones situacionales: cambios en las situaciones de familia y la redefinición de papeles" y "Transiciones en el proceso de salud-enfermedad del ser cuidado: los acompañantes viviendo la experiencia de transición del paciente". Conclusión: se identificaron fragilidades, por los acompañantes, en el proceso de transición de los pacientes de las Unidades de Terapia Intensiva para las enfermerías, y éstas pueden ser mitigadas por la actuación del enfermero, que debe conocer el perfil de los pacientes bajo su responsabilidad y el contexto familiar para aplicar las prácticas de cuidado, orientaciones y medidas de soporte a la familia. Descriptores: Atención de Enfermería; Continuidad de la Atención al Paciente; Cuidado de Transición; Familia; Unidad de Cuidados Intensivos; Habitaciones para Pacientes.

show abstract

“…Therefore, registered nurses [termed nurses from here on] have to assume responsibility for the care of these persons, who often have complex health problems [5]. Nurses also play an active and important part in assessing and relieving pain and suffering [6].…”

Section: Introductionmentioning

confidence: 99%

End-of-life care for people with advanced dementia and pain: A qualitative study in Swedish nursing homes

Lundin¹,

Godskesen

2020

Preprint

View full text Add to dashboard Cite

Background Of the Swedish people with advanced dementia, the majority die in nursing homes. Unresolved pain can occur in people with a terminal illness such as dementia. However, pain management in people with advanced dementia is often suboptimal and inadequate, with fewer palliative care interventions than offered to cancer patients. Although they are largely responsible for the care of these people, few studies have addressed the experiences of registered nurses in this respect. Therefore the aim of this study was to describe the experiences of nurses in caring for people with advanced dementia and pain at the end of life. Methods The study had a descriptive explorative design. Individual qualitative, semi-structured interviews were carried out with thirteen nurses from twelve nursing homes in Sweden. The results were analysed using thematic content analysis. Results The nurses described communicative, relational and organisational challenges. One major issue involved difficulties in communicating with the person with advanced dementia, resulting in uncertain pain assessment. Other difficulties involved the differentiation of pain from anxiety, the balance of benefits and risks with morphine administration, and the creation of good relationships with healthcare personnel and the persons’ relatives. Relatives can greatly affect the assessment and management of pain, both because of their ability to interpret pain behaviour and by questioning the care given. Good pain management was facilitated by good communication and relationships with healthcare staff and relatives, extensive professional nursing experience, and already knowing the person with advanced dementia. Conclusions This study highlights the need for nursing homes to employ specialist nurses who have been trained in the appropriate knowledge and skills to deal with the challenges of end-of-life care for people with advanced dementia and pain. Additionally, there should be resources and strategies available for providing information to family members and for involving them in the decision-making process, as they are often unfamiliar with the multitude of considerations involved in decisions such as whether to administer morphine or not.

show abstract

Nursing and the future of palliative care

Cited by 99 publications

References 10 publications

A phenomenological study of nurses experience about their palliative approach and their use of mobile palliative care teams in medical and surgical care units in France

A phenomenological study of nurses experience about their palliative approach and their use of mobile palliative care teams in medical and surgical care units in France

Transição dos pacientes de unidades de terapia intensiva

End-of-life care for people with advanced dementia and pain: A qualitative study in Swedish nursing homes

Contact Info

Product

Resources

About