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Stilos K. Promoting Self-Care in Palliative Care: Through the Wisdom of My Grandmother. Creat Nurs 2024; 30:87-90. [PMID: 38291617 DOI: 10.1177/10784535241228527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
In the post COVID-19 pandemic period, targeted efforts are needed more than ever to improve frontline nurses' well-being. In the field of palliative care, there is recognition of the importance of self-care, but the concept itself remains nebulous, and proactive implementation of self-care is lacking. Reflective writing has been noted to have positive impacts on health care providers' well-being. This piece brings to light the author's interest and work in reflective writing, sharing a personal account that provides a source of happiness and an opportunity to better understand her palliative care practice. Beyond the individual level, organizations are also encouraged to invest in their nurses' overall well-being.
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Affiliation(s)
- Kalli Stilos
- Division of Palliative Care, Adjunct Clinical Faculty for Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
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2
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Lundberg E, Öhlén J, Dellenborg L, Ozanne A, Enstedt D. Deconstructing spiritual care: Discursive underpinnings within palliative care research. Nurs Inq 2024:e12622. [PMID: 38178543 DOI: 10.1111/nin.12622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/06/2024]
Abstract
Religion and spirituality are integral to the philosophy of palliative care, shaping its approach to spiritual care. This article aims to examine the discourses within palliative care research to illuminate prevailing assumptions regarding spiritual care. Eighteen original articles were analyzed to examine how spiritual care is understood within palliative care. The analysis, informed by Foucault, aimed to identify recurring discourses. The finding reveals that, in palliative care research, spirituality is viewed as enigmatic yet inherently human and natural, assuming that every individual has a spiritual dimension. The analysis points to healthcare professionals being expected to hold certain qualities to put spiritual care into practice. The analysis also reveals that in the analyzed articles, the concept of spiritual care is rooted in a Christian context, with the belief that all individuals possess inherent spirituality or religiosity, a concept often associated with Christian theology. The included articles often utilize theological terms and emphasize a monotheistic viewpoint. Spirituality is articulated as a complex, distinct concept, challenging clear definitions and professional responsibilities. Further, a moral formation of healthcare professionals is described, interpelling and ascribing qualities that healthcare professionals need to provide spiritual care.
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Affiliation(s)
- Emma Lundberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Palliative Centre, Sahlgrenska University Hospital Region Västra Götaland, Gothenburg, Sweden
| | - Lisen Dellenborg
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anneli Ozanne
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Neurology, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Daniel Enstedt
- Department of Literature, History of Ideas, and Religion, University of Gothenburg, Gothenburg, Sweden
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3
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Bäckersten C, Molander U, Benkel I, Nyblom S. "What it is like to be human": The existential dimension of care as perceived by professionals caring for people approaching death. Palliat Support Care 2023:1-6. [PMID: 37859430 DOI: 10.1017/s1478951523001554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Abstract
OBJECTIVES Existential/spiritual questions often arise when a person suffers from a serious and/or life-threatening illness. "Existential" can be seen as a broad inclusive term for issues surrounding people's experience and way of thinking about life. To be able to meet patients' existential needs, knowledge is needed about what the existential dimension includes. The aim of this study was to investigate how professionals caring for people with life-threatening disease perceive the existential dimension of care. METHODS This study is based on a mixed method design utilizing a digital survey with open- and closed-ended questions. Descriptive statistics were applied to closed-ended questions and a qualitative descriptive approach was used for the responses to the open-ended questions. Healthcare professionals at specialized palliative care units, an oncology clinic and municipal healthcare within home care and a nursing home in Sweden answered the survey. RESULTS Responses from 77 professionals expressed a broad perspective on existential questions such as thoughts about life and death. Identifying existential needs and performing existential care was considered a matter of attitude and responsiveness and thus a possible task for any professional. Existential needs centered around the opportunity to communicate, share thoughts and experiences, and be seen and heard. Existential care was connected to communication, sharing moments in the present without doing anything and was sometimes described as embedded in professionals' ordinary care interventions. The existential dimension was considered important by the majority of respondents. SIGNIFICANCE OF RESULTS This study indicates that with the right attitude and responsiveness, all professionals can potentially contribute to existential care, and that existential care can be embedded in all care. The existential dimension of care can also be considered very important by health professionals in a country that is considered secular.
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Affiliation(s)
- Carl Bäckersten
- Palliative Centre, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ulla Molander
- Palliative Centre, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Inger Benkel
- Palliative Centre, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stina Nyblom
- Palliative Centre, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Gaignard ME, Pautex S, Hurst S. Existential suffering as a motive for assisted suicide: Difficulties, acceptability, management and roles from the perspectives of Swiss professionals. PLoS One 2023; 18:e0284698. [PMID: 37083894 PMCID: PMC10121014 DOI: 10.1371/journal.pone.0284698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/05/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Existential suffering is often a part of the requests for assisted suicide (AS). Its definitions have gained in clarity recently and refer to a distress arising from an inner realization that life has lost its meaning. There is however a lack of consensus on how to manage existential suffering, especially in a country where AS is legal and little is known about the difficulties faced by professionals confronted with these situations. OBJECTIVES To explore the perspectives of Swiss professionals involved in end-of-life care and AS on the management of existential suffering when it is part of AS requests, taking into account the question of roles, as well as on the difficulties they encounter along the way and their views on the acceptability of existential suffering as a motive for AS. METHODS A qualitative study based on face-to-face interviews was performed among twenty-five participants from the fields of palliative and primary care as well as from EXIT right-to-die organization. A semi-structured interview guide exploring four themes was used. Elements from the grounded theory approach were applied. RESULTS Almost all participants reported experiencing difficulties when facing existential suffering. Opinions regarding the acceptability of existential suffering in accessing AS were divided. Concerning its management, participants referred to the notion of being present, showing respect, seeking to understand the causes of suffering, helping give meaning, working together, psychological support, spiritual support, relieving physical symptoms and palliative sedation. CONCLUSION This study offers a unique opportunity to reflect on what are desirable responses to existential suffering when it is part of AS requests. Existential suffering is plural and implies a multiplicity of responses as well. These situations remain however difficult and controversial according to Swiss professionals. Clinicians' education should further address these issues and give professionals the tools to better take care of these people.
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Affiliation(s)
- Marie-Estelle Gaignard
- Institute for Ethics, History and the Humanities, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Oncology, Geneva University Hospitals, Geneva, Switzerland
| | - Sophie Pautex
- Division of Palliative Medicine Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Samia Hurst
- Institute for Ethics, History and the Humanities, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Mascio R, Best M, Lynch S, Phillips J, Jones K. Factors influencing nurse spiritual care practices at the end of life: A systematic review. Palliat Support Care 2022; 20:878-896. [PMID: 34872626 DOI: 10.1017/s1478951521001851] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The aim was to identify determinants of nurse spiritual/existential care practices toward end-of-life patients. Nurses can play a significant role in providing spiritual/existential care, but they actually provide this care less frequently than desired by patients. METHODS A systematic search was performed for peer-reviewed articles that reported factors that influenced nurses' spiritual/existential care practices toward adult end-of-life patients. RESULTS The review identified 42 studies and included the views of 4,712 nurses across a range of hospital and community settings. The most frequently reported factors/domains that influenced nurse practice were patient-related social influence, skills, social/professional role and identity, intentions and goals, and environmental context and resources. SIGNIFICANCE OF RESULTS A range of personal, organizational, and patient-related factors influence nurse provision of spiritual/existential care to end-of-life patients. This complete list of factors can be used to gauge a unit's conduciveness to nurse provision of spiritual/existential care and can be used as inputs to nurse competency frameworks.
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Affiliation(s)
- Rita Mascio
- Institute for Ethics and Society, University of Notre Dame, Broadway, NSW, Australia
| | - Megan Best
- Institute for Ethics and Society, University of Notre Dame, Broadway, NSW, Australia
| | - Sandra Lynch
- Institute for Ethics and Society, University of Notre Dame, Broadway, NSW, Australia
| | - Jane Phillips
- School of Nursing, University of Queensland, Brisbane, Queensland, Australia
| | - Kate Jones
- Institute for Ethics and Society, University of Notre Dame, Broadway, NSW, Australia
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Metselaar S, van Schaik M, Widdershoven G. CURA: A clinical ethics support instrument for caregivers in palliative care. Nurs Ethics 2022; 29:1562-1577. [PMID: 35622018 PMCID: PMC9667086 DOI: 10.1177/09697330221074014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This article presents an ethics support instrument for healthcare professionals
called CURA. It is designed with a focus on and together with nurses and nurse
assistants in palliative care. First, we shortly go into the background and the
development study of the instrument. Next, we describe the four steps CURA
prescribes for ethical reflection: (1) Concentrate, (2) Unrush, (3) Reflect, and
(4) Act. In order to demonstrate how CURA can structure a moral reflection among
caregivers, we discuss how a case was discussed with CURA at a psychogeriatric
ward of an elderly care home. Furthermore, we go into some considerations
regarding the use of the instrument in clinical practice. Finally, we focus on
the need for further research on the effectiveness and implementation of
CURA.
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Affiliation(s)
- Suzanne Metselaar
- Suzanne Metselaar, Department of Ethics,
Law & Humanities, Amsterdam University Medical Centers, De Boelelaan 1089a,
Amsterdam 1081 HV, The Netherlands.
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Fan SY, Lin WC. The relationships between self-efficacy, self-care ability, and burnout and compassion satisfaction among hospice staff in Taiwan. Support Care Cancer 2022; 30:5491-5497. [PMID: 35305163 DOI: 10.1007/s00520-022-06980-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/11/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Professional quality of life involves the negative and positive effects of proving care to terminal patients on health care professionals, including burnout and compassion satisfaction. Around 18% of hospice staff have experienced burnout, and few studies explore the role of an innate ability to cope with burnout. The aim of this study was to explore the significant predictors of burnout and compassion satisfaction as well as the coping strategies among hospice staff in Taiwan. METHODS A cross-sectional study was conducted, and 220 hospice staff were recruited. Standardized questionnaires were used to collect self-rated stress and growth due to hospice care, self-efficacy, self-awareness, and managing emotion. RESULTS Hospice staff who perceived higher stress and lower growth due to hospice care and had lower self-efficacy in providing hospice care experienced higher burnout and lower compassion satisfaction. Those who had a lower level of ability related to self-awareness and managing emotion tended to experience higher burnout. The common coping strategies included seeking social support, taking professional courses for clinical skills, and developing hobbies. CONCLUSION Hospice staff have to develop professional abilities in regard to hospice care as well as an ability to maintain awareness and manage emotions related to work.
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Affiliation(s)
- Sheng-Yu Fan
- Institute of Gerontology, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 701, Taiwan.
| | - Wei-Chun Lin
- Department of Hematology and Oncology, Chi Mei Medical Center, Liouying, Tainan, Taiwan
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Faronbi JO, Akinyoola O, Faronbi GO, Bello CB, Kuteyi F, Olabisi IO. Nurses' Attitude Toward Caring for Dying Patients in a Nigerian Teaching Hospital. SAGE Open Nurs 2021; 7:23779608211005213. [PMID: 33912673 PMCID: PMC8047931 DOI: 10.1177/23779608211005213] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/07/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction Death and the dying experience are common phenomena in all clinical settings. Death and the dying presents physical and emotional strain on the dying patient, his relations and professional caregivers. Objective The study therefore assessed the sociodemographic determinants of nurses’ attitudes towards death and caring for dying patient. Method A cross–sectional design was used to study 213 randomly selected nurses, working in one of the tier one teaching hospital in Nigeria. Attitude towards death and the dying was collected with Frommelt Attitude Care of the Dying and Death Attitude Profit–Revised questionnaire. The data collected was analysed with SPSS version 20 and inferential analyses were considered statistically significant at p < 0.05. Results The study revealed that most of the nurses had negative attitudes toward the concept of death (76.5%) and caring for dying patient (68%). Furthermore, a chi-square test revealed significant associations between the nurses’ years of working experience (χ2 = 24.57, p <.00) and current unit of practice (χ2 = 21.464; p = .002) and their attitude towards caring for the dying patient. Also, nurses’ age (χ2 = 13.77, p = .032), professional qualifications (χ2 = 13.774, p = .008), and current ward of practice (χ2 = 16.505, p = .011) were significantly associated with their attitudes to death. Furthermore, the study observed a significant association between nurses’ attitudes to death and caring for the dying patient (χ2 = 11.26, p < 0.01). Conclusion This study concluded that nurses had negative attitudes towards death and dying and therefore prescribes, as part of continuing professional development strategy, the need for requisite positive value – laden, ethnoreligious specific education regarding end of life care.
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Affiliation(s)
- Joel Olayiwola Faronbi
- Department of Nursing Science, College of Health Science, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - Oladele Akinyoola
- Department of Nursing Science, College of Health Science, Osun State University, Osogbo, Nigeria
| | - Grace Oluwatoyin Faronbi
- Department of Nursing Science, College of Health Science, Obafemi Awolowo University, Ile-Ife, Nigeria
| | | | - Florence Kuteyi
- Department of Nursing Science, College of Health Science, Obafemi Awolowo University, Ile-Ife, Nigeria
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Bengoechea C, Molinero C, Velasco C, López-Ibor B. Análisis del uso y funciones del silencio en la comunicación de los profesionales sanitarios en una unidad de oncología pediátrica. PSICOONCOLOGIA 2021. [DOI: 10.5209/psic.74538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Existen diferentes tipos de silencio, con múltiples funciones, y cada uno puede provocar efectos diversos en la comunicación. En el ámbito sanitario una comunicación eficaz es fundamental para lograr que los pacientes comprendan lo que les sucede y se expresen con claridad y confianza ante los profesionales sanitarios. El silencio juega un papel clave en esta comunicación. Objetivo: Desarrollar un instrumento para conocer la importancia que tiene el silencio para los profesionales sanitarios y analizar de qué manera emplean el silencio en su comunicación con los pacientes. Métodos: En el estudio han participado 43 profesionales del ámbito de la Oncología Pediátrica. Este estudio propone una clasificación de los tipos de silencio en la comunicación sanitaria. Resultados: El silencio es heterogéneo y cumple diferentes funciones. Se comprueba que los profesionales sanitarios emplean distintos tipos de silencio, siendo los Silencios Neutros los más utilizados, a continuación, los Silencios Productivos y los menos empleados los Silencios Obstructivos. Aquel que más se usa es el que favorece la atención, el acompañamiento, la reflexión y la expresión, mientras que el silencio de poder y el de desconexión son los menos empleados. Conclusión: El instrumento de evaluación propuesto (Q-SPS) ha presentado buenos niveles de consistencia interna para esta muestra permitiendo establecer un perfil comparativo entre el uso del silencio por parte de los distintos profesionales del ámbito de la salud por lo que podría valorarse una investigación más exhaustiva con mayor volumen de participantes.
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Kwon S, Kim M, Choi S. Nurses' experiences of providing "sensitive nursing care" for terminally-ill individuals with cancer: A qualitative study. Eur J Oncol Nurs 2020; 46:101773. [PMID: 32504877 DOI: 10.1016/j.ejon.2020.101773] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 04/30/2020] [Accepted: 05/08/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To explore the sensitive nursing care provided by nurses who care for terminally-ill individuals with cancer. METHODS In-depth interviews were conducted using Colaizzi's phenomenological approach. Participants were 16 hospice specialists and four non-specialist nurses with experience in caring for terminal cancer patients in hospice specialized institutions in South Korea. RESULTS Eight theme clusters were drawn from the data and these clusters had two dimensions consisting of sensitive attitudes and sensitive nursing behaviors. The sensitive attitudes included reflecting on past experiences, developing an accepting attitude toward death, using intuition to address critical situations, and having an open mind regarding collaborating with colleagues. The sensitive nursing behaviors contained listening to patients' needs, responding to patients in a manner suitable to their conditions, quickly responding to patients' problem, and providing a moment saying farewell. CONCLUSIONS Teamwork and role models can help hospice specialists and non-specialist nurses caring for terminally-ill individuals with cancer to improve the sensitive nursing care. The sensitive attitudes and behaviors can be used as basic data for training programs designed to enhance nurses' sensitivity.
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Affiliation(s)
- Sinyoung Kwon
- Hospice & Palliative Care Center, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Science, Seoul, South Korea.
| | - Miyoung Kim
- College of Nursing, Ewha Womans University, Seoul, South Korea.
| | - Sujin Choi
- College of Nursing, Woosuk University, Jeonju, South Korea.
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11
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Thompson GN, McClement SE. Critical nursing and health care aide behaviors in care of the nursing home resident dying with dementia. BMC Nurs 2019; 18:59. [PMID: 31798341 PMCID: PMC6884829 DOI: 10.1186/s12912-019-0384-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/15/2019] [Indexed: 11/21/2022] Open
Abstract
Background With the aging of the population, dying with dementia will become one of the most common ways in which older adults will end their final years of life, particularly for those living in a nursing home. Though individuals living with dementia have complex care needs and would benefit from a palliative approach to care, they have traditionally not been recipients of such care. An important aspect of determining quality in end-of-life care is the identification of expert practices, processes or behaviors that may help achieve this care. However, for those living with dementia in nursing homes, we have a limited understanding of how to best support expert end of life care. To redress this gap in knowledge, the purpose of this study was to examine and describe expert care of the individual with dementia approaching death from the perspective of nurses and health care aides (HCAs) identified by their peers as having special expertise in caring for this population. Methods A qualitative research design known as Interpretative Description was used to conduct the study. Expert nurses and HCAs were identified through a two-phase nomination process. Individual semi-structured interviews were conducted with consenting participants. Data were analyzed using constant comparative analysis to determine the key critical behaviors. Results Analysis of data collected from expert nurses (n = 8) and HCAs (n = 7) revealed six critical behaviors when caring for residents dying with dementia. All nurses and HCAs unanimously endorsed that the overarching goal of care is similar for all residents who are actively dying; to achieve comfort. The six critical behaviors in caring for residents dying with dementia included: 1) recognizing and responding to changes in a resident’s pattern of behavior; 2) attending to the person; 3) working with the family; 4) engaging with others; 5) responding after the death has occurred; and 6) having a positive attitude toward care of the dying. Conclusions The critical behaviors described by nurses and HCAs in this study provides emerging evidence of best practices in care of those with dementia and their families, particularly near the end of life within the nursing home setting.
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Affiliation(s)
- Genevieve N Thompson
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2J5 Canada
| | - Susan E McClement
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3T 2J5 Canada
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12
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Norouzadeh R, Anoosheh M, Ahmadi F. Contingency Help: The Main Strategy of Iranian Nurses in Dealing With the Family of the End-of-Life Patients. OMEGA-JOURNAL OF DEATH AND DYING 2019; 83:426-445. [PMID: 31188718 DOI: 10.1177/0030222819854909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Families are struggling with many challenges in the final stages of patient life. It is important to understand what actions nurses do for the family of the end-of-life (EOL) patients. This study aimed to explain the main strategy of nurses' dealing with the family of the EOL patients. Data were analyzed using conventional content analysis. Semistructured interviews were conducted on 32 nurses from hospitals in Tehran. Nurses used six measures of explaining the bitter reality, effective communication, management of violence, referral, consolation, and reinforcement. "Contingency help" was conceptualized as the main strategy. Nurses through "contingency help" were involved in solving the emotional, physical, financial, and spiritual needs of the family. Nurses will be able to apply the results of this study to the development of care policies for the family of the EOL patients.
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Affiliation(s)
- Reza Norouzadeh
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
| | - Monireh Anoosheh
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Islamic Republic of Iran
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13
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Parola V, Coelho A, Romero ÁA, Peiró RP, Blanco-Blanco J, Apóstolo J, Gea-Sánchez M. The construction of the health professional in palliative care contexts: a scoping review on caring for the person at the end of life. Porto Biomed J 2018; 3:e10. [PMID: 31595242 PMCID: PMC6726306 DOI: 10.1016/j.pbj.0000000000000010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 05/04/2018] [Indexed: 11/29/2022] Open
Abstract
Aim The aim of the study was to map of the literature on the elements contributing to the construction of the health care professional in the context of palliative care. Methods Scoping review based on Arksey and O'Malley framework. PubMed, Embase, CINAHL, Scopus databases, and gray literature were the sources searched (2005-2015), completed by reference searching, hand searching, and expert consultations. Primary studies focusing on different professionals working in palliative care units or hospice centers were eligible for inclusion. Results From a total of 3632 articles, 22 met the inclusion criteria. The content of the studies was described and classified in 5 elements: (i) construction and application of the concept of care; (ii) psychosocial effects that the daily care produces; (iii) working conditions that influence the caregiving provided; (iv) knowledge mobilized in the provision of care; and (v) strategies adopted by health care professionals to build relationships. Data about nurses, physicians, and psychologists were found, but no data were found about social workers. Gaps identified in the publications were as follows: relationship competencies and strategies adopted; the real needs from educational programs; and the view of other professionals. Conclusions Key elements identified in the concept of the construction of the health care professional should be addressed in future interventions: prevention of emotional exhaustion, depersonalization, and achievement of a greater personal accomplishment. In addition, none of the articles retrieved offered the different perspectives of all the disciplines in a multidisciplinary team.
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Affiliation(s)
- Vitor Parola
- Abel Salazar Biomedical Sciences Institute, University of Porto, Porto.,Nursing School of Coimbra, Health Sciences Research Unit: Nursing, Portugal Centre for Evidence-Based Practice: A JBI Centre of Excellence, Coimbra, Portugal
| | - Adriana Coelho
- Abel Salazar Biomedical Sciences Institute, University of Porto, Porto.,Nursing School of Coimbra, Health Sciences Research Unit: Nursing, Portugal Centre for Evidence-Based Practice: A JBI Centre of Excellence, Coimbra, Portugal
| | - Álvaro A Romero
- Faculty of Nursing and Physiotherapy, GESEC, Lleida University, Lleida, Spain
| | - Roland P Peiró
- Faculty of Nursing and Physiotherapy, GESEC, Lleida University, Lleida, Spain
| | - Joan Blanco-Blanco
- Faculty of Nursing and Physiotherapy, GESEC, Lleida University, Lleida, Spain
| | - João Apóstolo
- Nursing School of Coimbra, Health Sciences Research Unit: Nursing, Portugal Centre for Evidence-Based Practice: A JBI Centre of Excellence, Coimbra, Portugal
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15
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Bassett L, Bingley AF, Brearley SG. Silence as an element of care: A meta-ethnographic review of professional caregivers' experience in clinical and pastoral settings. Palliat Med 2018; 32:185-194. [PMID: 28786322 DOI: 10.1177/0269216317722444] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In interactions between professional caregivers, patients and family members at the end of life, silence often becomes more prevalent. Silence is acknowledged as integral to interpersonal communication and compassionate care but is also noted as a complex and ambiguous phenomenon. This review seeks interdisciplinary experience to deepen understanding of qualities of silence as an element of care. AIM To search for published papers which describe professional caregivers' experience of silence as an element of care, in palliative and other clinical, spiritual and pastoral care settings and to synthesise their findings. DESIGN Meta-ethnography: employing a systematic search strategy and line-of-argument synthesis. DATA SOURCES PsycINFO and seven other cross-disciplinary databases, supplemented by hand-search, review of reference lists and citation tracking. No date range was imposed. Inclusion criteria focused on reported experience of silence in professional caregiving. Selected papers ( n = 18) were appraised; none were rejected on grounds of quality. RESULTS International, interdisciplinary research and opinion endorses the value of silence in clinical care. As a multi-functional element of interpersonal relationships, silence operates in partnership with speech to support therapeutic communication. As a caregiving practice, silence is perceived as particularly relevant in spiritual and existential dimensions of care when words may fail. CONCLUSION Experience of silence as an element of care was found in palliative and spiritual care, psychotherapy and counselling supporting existing recognition of the value of silence as a skill and practice. Because silence can present challenges for caregivers, greater understanding may offer benefits for clinical practice.
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Affiliation(s)
- Lynn Bassett
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancashire, UK
| | - Amanda F Bingley
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancashire, UK
| | - Sarah G Brearley
- Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancashire, UK
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17
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Holyoke P, Stephenson B. Organization-level principles and practices to support spiritual care at the end of life: a qualitative study. BMC Palliat Care 2017; 16:24. [PMID: 28399827 PMCID: PMC5387203 DOI: 10.1186/s12904-017-0197-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 04/03/2017] [Indexed: 01/22/2023] Open
Abstract
Background Though most models of palliative care specifically include spiritual care as an essential element, secular health care organizations struggle with supporting spiritual care for people who are dying and their families. Organizations often leave responsibility for such care with individual care providers, some of whom are comfortable with this role and well supported, others who are not. This study looked to hospice programs founded and operated on specific spiritual foundations to identify, if possible, organizational-level practices that support high-quality spiritual care that then might be applied in secular healthcare organizations. Methods Forty-six digitally-recorded interviews were conducted with bereaved family members, care providers and administrators associated with four hospice organizations in North America, representing Buddhist, Catholic, Jewish, and Salvation Army faith traditions. The interviews were analyzed iteratively using the constant comparison method within a grounded theory approach. Results Nine Principles for organizational support for spiritual care emerged from the interviews. Three Principles identify where and how spiritual care fits with the other aspects of palliative care; three Principles guide the organizational approach to spiritual care, including considerations of assessment and of sacred places; and three Principles support the spiritual practice of care providers within the organizations. Organizational practices that illustrate each of the principles were provided by interviewees. Conclusions These Principles, and the practices underlying them, could increase the quality of spiritual care offered by secular health care organizations at the end of life. Electronic supplementary material The online version of this article (doi:10.1186/s12904-017-0197-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Paul Holyoke
- Saint Elizabeth Research Centre, Saint Elizabeth Health Care, 90 Allstate Parkway, Suite 300, Markham, ON, Canada, L3R 6H3.
| | - Barry Stephenson
- Department of Religious Studies, Memorial University of Newfoundland, St. John's, NF, Canada, A1A 5S7
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Kisvetrová H, Joanovič E, Vévoda J, Školoudík D. Dying Care Nursing Intervention in the Institutional Care of End-of-Life Patients. Int J Nurs Knowl 2016; 28:131-137. [DOI: 10.1111/2047-3095.12128] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Helena Kisvetrová
- Helena Kisvetrová, PhD, RN, is Assistant Professor in the Department of Nursing
| | - Eva Joanovič
- Eva Joanovič, MSc, RN, is PhD Student in the Department of Nursing
- Authors who are also affiliated to Faculty of Health Sciences; Palacký University; Olomouc Czech Republic
| | - Jiří Vévoda
- Jiří Vévoda, PhD, is Assistant Professor in the Department of Humanities and Social Sciences; Faculty of Health Sciences; Palacký University; Olomouc Czech Republic
- Authors who are also affiliated to Faculty of Health Sciences; Palacký University; Olomouc Czech Republic
| | - David Školoudík
- David Školoudík, MD, PhD, FESO, is Professor in the Department of Nursing
- Authors who are also affiliated to Faculty of Health Sciences; Palacký University; Olomouc Czech Republic
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19
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Kisorio LC, Langley GC. Intensive care nurses' experiences of end-of-life care. Intensive Crit Care Nurs 2016; 33:30-8. [PMID: 26791353 DOI: 10.1016/j.iccn.2015.11.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 09/25/2015] [Accepted: 11/20/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To explore intensive care nurses' experiences of end-of-life care in adult intensive care units. DESIGN AND METHODS An exploratory, descriptive qualitative approach was utilised. Purposive sampling method was used to select nurse participants (n=24) working at the selected intensive care units in the three academic affiliated, tertiary specialist hospitals in the Johannesburg and Pretoria regions, South Africa. Using a focus group guide, three focus group discussions were conducted. Data were analysed using the long-table approach (Krueger and Casey, 2000). Trustworthiness of the study was ensured by following the criteria set out by Lincoln and Guba (1985). FINDINGS Five major themes related to nurses' experiences of end-of-life care emerged. These included: "difficulties we experience", "discussion and decision making", "support for patients", "support for families" and "support for nurses". CONCLUSION End-of-life care can be difficult and a challenging process. Nevertheless, this study has highlighted some of the interventions and support systems that could be incorporated for improved caring process. Whereas the dying patients and their families need to be continuously supported, critical care nurses too need to be taken care of for them to continue providing the best possible end-of-life care.
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Affiliation(s)
- Leah C Kisorio
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Park Town 2193, Johannesburg, South Africa.
| | - Gayle C Langley
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Park Town 2193, Johannesburg, South Africa.
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20
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21
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Tornøe KA, Danbolt LJ, Kvigne K, Sørlie V. The challenge of consolation: nurses' experiences with spiritual and existential care for the dying-a phenomenological hermeneutical study. BMC Nurs 2015; 14:62. [PMID: 26609281 PMCID: PMC4658768 DOI: 10.1186/s12912-015-0114-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 11/19/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A majority of people in Western Europe and the USA die in hospitals. Spiritual and existential care is seen to be an integral component of holistic, compassionate and comprehensive palliative care. Yet, several studies show that many nurses are anxious and uncertain about engaging in spiritual and existential care for the dying. The aim of this study is to describe nurses' experiences with spiritual and existential care for dying patients in a general hospital. METHODS Individual narrative interviews were conducted with nurses in a medical and oncological ward. Data were analyzed using a phenomenological hermeneutical method. RESULTS The nurses felt that it was challenging to uncover dying patients' spiritual and existential suffering, because it usually emerged as elusive entanglements of physical, emotional, relational, spiritual and existential pain. The nurses' spiritual and existential care interventions were aimed at facilitating a peaceful and harmonious death. The nurses strove to help patients accept dying, settle practical affairs and achieve reconciliation with their past, their loved ones and with God. The nurses experienced that they had been able to convey consolation when they had managed to help patients to find peace and reconciliation in the final stages of dying. This was experienced as rewarding and fulfilling. The nurses experienced that it was emotionally challenging to be unable to relieve dying patients' spiritual and existential anguish, because it activated feelings of professional helplessness and shortcomings. CONCLUSIONS Although spiritual and existential suffering at the end of life cannot be totally alleviated, nurses may ease some of the existential and spiritual loneliness of dying by standing with their patients in their suffering. Further research (qualitative as well as quantitative) is needed to uncover how nurses provide spiritual and existential care for dying patients in everyday practice. Such research is an important and valuable knowledge supplement to theoretical studies in this field.
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Affiliation(s)
- Kirsten Anne Tornøe
- Lovisenberg Diaconal University College, Lovisenberg gt. 15B 0456, Oslo, Norway ; MF, Norwegian School of Theology, Gydas vei 4, Majorstuen 0302, P.O. Box 5144, Oslo, Norway ; Religionspsykologisk Senter (Center for the Psychology of Religion) Innlandet Hospital, P.O. Box 68 2312, Ottestad, Norway
| | - Lars Johan Danbolt
- MF, Norwegian School of Theology, Gydas vei 4, Majorstuen 0302, P.O. Box 5144, Oslo, Norway ; Religionspsykologisk Senter (Center for the Psychology of Religion) Innlandet Hospital, P.O. Box 68 2312, Ottestad, Norway
| | - Kari Kvigne
- Department of nursing, Faculty of Public Health, Hedmark University College, P.O. Box 400 2418, Elverum, Norway ; Department of nursing Nesna University College, Nesna, 8700 Norway
| | - Venke Sørlie
- Lovisenberg Diaconal University College, Lovisenberg gt. 15B 0456, Oslo, Norway
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22
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Bradas C, Bowden V, Moldaver B, Mion LC. Implementing the 'No One Dies Alone program': process and lessons learned. Geriatr Nurs 2014; 35:471-3. [PMID: 25457287 DOI: 10.1016/j.gerinurse.2014.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | | | | | - Lorraine C Mion
- MetroHealth Medical Center, USA; Vanderbilt University School of Nursing, USA.
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23
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da Mata AM. Research roundup. Int J Palliat Nurs 2014. [DOI: 10.12968/ijpn.2014.20.10.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Synopses of a selection of recently published research articles of relevance to palliative care.
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