nursing ethics; palliative care; hospice care

BACKGROUND: The practice of continuous palliative sedation until death is the subject of much medical and ethical debate, which is reflected in the inconsistency that persists in the literature regarding the definition and indications of palliative sedation. AIM: This study aims to gain a better understanding of palliative care clinicians' experiences with continuous palliative sedation. DESIGN: We conducted a qualitative study based on focus group discussions...

BACKGROUND: The aim of this study was to explore how palliative care staff reason about the autonomy challenge that arises when a patient who has first said he wants full information appears to change his mind and rejects being informed. METHODS: The study had a qualitative and exploratory design. Participants (physicians, registred nurses, social workers, physiotherapists and occupational therapists) were recruited from palliative care teams in southern Sweden...

BACKGROUND: So far, there have been many studies on end-of-life nursing care education around the world, and in many cases, according to the cultural, social, and spiritual contexts of each country, the results have been different. The present study intends to gain general insight into the main components of end-of-life care in nursing education programs by reviewing scientific texts and the results of investigations. METHODS: This study was a scoping review conducted with the Arksey and O'Malley methodology updated by Peters et al...

BACKGROUND: Nurses play a unique and critical role in palliative care, and it is noteworthy that nurses often encounter ethical dilemmas in this field. OBJECTIVE: This review aims to conduct a summarised synthesis of the latest research on the ethical considerations nurses faced in palliative care. METHODS: We conducted a rigorous systematic review of relevant existing studies published in high-quality English peer-reviewed journals from January 2017 to July 2023...

Medical and technological advances have made it possible to keep people alive well beyond what was once possible, leading health care providers to focus on life-sustaining measures rather than questioning the futility of such measures and considering quality of life. In the midst of the struggle to foster dying well in a medicalized environment, acute care nurses may be challenged with shifting the focus to providing optimal end-of-life care because of lack of training, time, and resources. A remedy for the current western societal approach to medicalized dying is to look back in history to a time during the late Middle Ages, when death was an accepted part of medieval life...

INTRODUCTION: Palliative care is an approach that aims to holistically improve the quality of life, care and death of people living with life-limiting conditions as well as their families. In Thailand, palliative care became one of its national strategies as of 2014. However, the access to as well as the quality of palliative care being delivered still varies across the nation, due to multiple factors spanning multiple levels. Consequently, there is a need to comprehensively understand the current palliative care ecosystem in Thailand...

BACKGROUND: The COVID-19 pandemic led to an intensified fear and threat of dying, combined with dying and grieving in isolation, in turn significantly impacting nursing in end-of-life situations. The study aims (1) to understand the lived experiences of nurses who provided care to end-of-life patients during COVID-19; and (2) to explore whether providing care under such circumstances altered the perspectives of these nurses regarding end-of-life care. METHODS: Applying the phenomenological-interpretive qualitative approach, 34 in-depth semi-structured interviews were conducted between March 2020-May 2021 with nurses from eight hospitals in Israel who were recruited through purposive and snowball sampling...

Prison populations are rapidly aging. Persons in prison age quicker and suffer more chronic illness and disability than their nonincarcerated peers, posing challenges to caring for prisoners who are chronically ill and dying. The goal of our study was to describe state prisons' practices and policies addressing persons in prison with advanced chronic and life limiting illness through a national web-based survey of state-level prison health care professionals. In particular, we focused on advanced care planning, use of health care directives, decision-making about goals of care, including life sustaining treatments, The response rate was 22% for a sample size 152 completed surveys...

BACKGROUND: Palliative care involves providing comprehensive physical, psychological, and social care to improve clinical symptoms and quality of life, as well as to ensure patients' dignity at the end of life. Nurses are important members of hospice care teams, and undergraduate nursing students are the hospice care providers of the future. The ability of undergraduate nursing students to provide hospice care will, thus, directly affect service quality. OBJECTIVE: To understand the relationship between hospice competence and the death-coping abilities of nursing students and provide a theoretical basis for promoting the development of hospice education for nursing students...

OBJECTIVES: Pediatric healthcare professionals (HCPs) working in a palliative setting may experience challenges during their clinical practice in addressing the complex end-of-life phase of children and their families. Nurses, especially, have a frontline role in providing assistance, thereby becoming at risk of physical and psychological burden. Pediatric psychologists have an ethical responsibility to help colleagues by proposing self-care interventions that will improve their well-being and, indirectly, the work climate...

Palliative care is traditionally delivered by specialty-trained palliative care teams. Because of a national workforce shortage of palliative care specialists, there is an urgent need to explore alternative models of palliative care delivery to meet the needs of patients living with serious illness. As part of a multisite randomized controlled trial, 2 registered nurses without previous palliative care experience were trained to deliver a primary palliative care intervention to patients with newly diagnosed lung cancer...

BACKGROUND: Healthcare professionals in palliative care are found to be confronted with moral challenges on a frequent basis. CURA is a low-threshold instrument for dialogical ethical reflection that was developed to deal with these challenges. A previous study identified the need of healthcare professionals to be trained to introduce CURA in their organization, initiate and facilitate reflections with CURA, and contribute to the implementation of CURA. The aim of this study was to develop and evaluate a training for professionals to become 'CURA-ambassadors'...

Tele-palliative care enables people with a life-limiting illness to consult with palliative care staff without having to leave their homes but requires commitment from all stakeholders, particularly on ethical challenges and patient safety issues. When using telecommunications and virtual technology, ethical challenges and patient safety aspects must be taken into account. The aim was to describe formal and informal caregivers' opportunities in tele-palliative care and the associated ethical and safety challenges using a Whittemore and Knafl integrative review method...

PURPOSE: This study aimed to investigate the impacts of end-of-life care competency and ethical dilemmas on psychological burnout in nurses who care for terminal cancer patients. METHODS: A cross-sectional study of 160 nurses who cared for terminal cancer patients was conducted. The participants were recruited from the hospice-palliative care wards, hematology or oncology wards, or intensive care units of three general hospitals in a single metropolitan area. Data were collected using a self-administered survey to assess end-of-life care competency, ethical dilemmas, psychological burnout, and general sociodemographic characteristics...

BACKGROUND: In 2016 a French law created a new right for end-of-life patients: deep and continuous sedation maintained until death, with discontinuation of all treatments sustaining life such as artificial nutrition and hydration. It was totally unprecedented that nutrition and hydration were explicitly defined in France as sustaining life treatments, and remains a specificity of this law. End- of-life practices raise ethical and practical issues, especially in Europe actually. We aimed to know how oncology professionals deal with the law, their opinion and experience and their perception...

INTRODUCTION: Despite the increasing importance of palliative care, the implementation of professional and ethical quality standards appears to be challenging for nursing homes, leading to different levels of palliative care between facilities. This study aims to examine the concrete problem areas of palliative care in everyday practice and to discover what is needed to improve health care quality and patient safety of palliative residents in nursing homes from different perspectives...

PURPOSE: This study aimed to develop an instrument to showcase Dignity in Care of Terminally Ill Patients for Nurses and to examine its validity and reliability. METHODS: A total of 58 preliminary items on dignity in care of terminally ill patients for nurses were selected using content validity analysis and expert opinions on 97 candidate items derived through a literature review and qualitative focus group interviews. Questionnaires were administered to 502 nurses caring for terminally ill cancer patients at hospice and palliative care institutions...

BACKGROUND: In order to improve the provision of palliative care by nurses, it is necessary to have a tool that measures different dimensions of palliative care and the knowledge and performance of nurses in this field. The Program in Palliative Care Education and Practice Questionnaire (German Revised) is psychometrically evaluated for the first time in Iran. METHODS: To measure the psychometric properties, 360 nursing students (BSc, MSc, PhD) and clinical nurses completed the questionnaire...

OBJECTIVE: Assess access to, need for, and beliefs surrounding specialized palliative care (PC). DESIGN: Observational, comparative analysis needs assessment survey. SETTING: Four inpatient rehabilitation facilities (IRF) or subacute rehabilitation (SAR) in skilled nursing facilities with long-term care (SNF/LTC) within one tertiary care system. PARTICIPANTS: Allied health professionals, physicians, nursing, case managers, social workers, spiritual care...

OBJECTIVES: There is little research on moral uncertainties and distress of palliative and hospice care providers (PHCPs) working in jurisdictions anticipating legalising voluntary assisted dying (VAD). This study examines the perception and anticipated concerns of PHCPs in providing VAD in the State of Queensland, Australia prior to legalisation of the practice in 2021. The findings help inform strategies to facilitate training and support the health and well-being of healthcare workers involved in VAD...