Factors Associated with Quality of Dying and Death in Korean Intensive Care Units: Perceptions of Nurses

Exploring good death in China: A qualitative study from the perspectives of family members

China's emerging palliative care services are heavily influenced by Western models of palliative medicine, which emphasize dignity, autonomy and individuality. How palliative care is designed and provided, however, within the distinctively non-Western context of Chinese society has yet to be fully explored. To examine palliative care as a socio-cultural construct, this qualitative study investigates what a good death means in China from the perspective of bereaved family members. Thirty-one semi-structured interviews were conducted, followed by an inductive thematic analysis. Four main themes were identified: (1) Negotiating Autonomy in Family Contexts; (2) Familial Obligations and Cultural Practices; (3) Security and Resource Stability; (4) Meaning and Legacy at the End of Life. We found that, for family members, a good death is primarily mediated by the objectives of family harmony and continuity, often overriding the dying person's individual wishes. This emphasis on the family can act as a double-edged sword, both supporting and complicating the experience of death in China. Based on our findings, we propose a social support system that balances individual and family interests, to inform more culturally informed end-of-life care within practical and policy paradigms.

Nurses' experience of end-of-life care for patients with COVID-19: A descriptive phenomenology study

The mortality rates among critically ill patients with COVID-19 have been high. The national and institutional infection control policies and resource shortages caused by the pandemic led patients to undergo deaths without dignity and inevitably changed intensive care unit (ICU) end-of-life care (EOLC) practices. This study explores ICU nurses' experiences of providing EOLC for patients with COVID-19 who died. Eight nurses participated in a qualitative phenomenological study. Semi-structured interviews were conducted from July to September 2022. Colaizzi's data analysis method was used, and the following four main themes emerged: (i) only companion in the death journey; (ii) helping families prepare for death; (iii) EOLC trapped within a framework; and (iv) EOLC in retrospect. To secure high-quality EOLC in ICU, it is important to promote practical support for nurses and EOLC-related discussions/education. Technical support, such as digital communication technologies, should be reinforced to help patients and their families participate in EOLC.

Factors associated with the quality of dying and death and missed nursing care

BACKGROUND

Patients in intensive care units need full nursing care due to the high mortality rate. However, some aspects of nursing care can be forgotten.

AIMS

To investigate the quality of death and dying and its association with aspects of missed nursing care, alongside the overall perception of nurses in intensive care units about factors associated with missed nursing care.

METHODS

This cross-sectional study used a census sampling method of 105 nurses working in intensive care units. In order to collect data, the Quality of Dying and Death Questionnaire (QODD), missed nursing care (MISSCARE survey) and factors associated with missed nursing care questionnaire were used. Data analysis was performed by using SPSS 16.

FINDINGS

The quality of death and dying, as perceived by nurses, was found to be lower than the average (Range score: 0 to 100). The range of missed nursing care was average (Range of score: 24 to 96) and the most noticeable reason for this missed nursing care was the shortage of nursing staff.

CONCLUSION

Managers should ensure that nurses provide complete nursing care for terminally ill patients in intensive care units and eliminate factors that lead to aspects of nursing care being missed, such as staffing levels, material resources and communication between staff members.

Providing End-of-Life Care to COVID-19 Patients: The Lived Experiences of ICU Nurses in the Philippines

In the midst of COVID-19, radical change in the work environment further exacerbated the detrimental effects of critical illness in the intensive care unit (ICU). This may be heightened if the patient experiences a lamentable end-of-life experience due to inadequate end-of-life care (EoLC). Anchoring on the theory of bureaucratic caring and the peaceful end-of-life theory, insights can be gained into the motivations and behaviors that support the delivery of palliative care during COVID-19. With this having been having said, the objective of this study was to use a narrative approach to examine the lived experience of 12 nurses who provided EoLC in the COVID-19 ward of several hospitals in the Western Philippines. Participants' narratives were transcribed, translated and analyzed. Among the themes that have emerged are: establishing a peaceful journey to death, holistic caring for the end of life, venturing into risky encounters in the call of duty, staying close amidst the reshaped work environment, and preparing the family life after a loved one's departure. The study identified the importance of assisting patients on their journey to a peaceful death, but this journey was also accompanied by a sense of self-preservation and safety for colleagues and families.