Nurses’ and patients’ perceptions of expert palliative nursing care

Journal of Advanced Nursing - Tập 54 Số 6 - Trang 700-709 - 2006
Bridget Johnston1, Lorraine N. Smith
1Strathcarron Hospice, Stirlingshire, UK.

Tóm tắt

Aim.  This paper reports a study of the perceptions of patients and nurses of palliative care and, in particular, the concept of the expert palliative nurse.

Background.  Palliative care is a growing speciality and is practised globally. There is, however, limited information on patients’ views about palliative care. While the idea of expertise in nursing is not new, few studies have explored the concept of the expert nurse in palliative care. Some evidence exists on palliative nurses’ perceptions of their care, that it is supportive and involves maintaining therapeutic relationships with patients. Facing a terminal illness has been identified as a stressful and fearful experience that affects all aspects of life. It has also been revealed that dying patients may have unmet care needs, mainly in the areas of pain and symptom control, emotional support, and spending time alone.

Methods.  A phenomenological study was carried out, using in‐depth interviews and thematic content analysis. A convenience sample of 22 Registered Nurses and 22 dying patients was interviewed in 1996–1997.

Findings.  Dying patients had a desire to maintain independence and remain in control. Palliative care nurses experienced both effective and ineffective interpersonal communication, the building of therapeutic relationships with dying patients and attempting to control patients’ pain and distressing symptoms. Patients and nurses agreed that the two most important characteristics of an expert palliative nurse were interpersonal skills and qualities such as kindness, warmth, compassion and genuineness.

Conclusion.  Although the study was conducted in the United Kingdom, the findings have relevance for palliative care practice globally in terms of dependence, issues of patient choice, nurses being interpersonally skilled and building therapeutic relationships with patients.

Từ khóa


Tài liệu tham khảo

10.1016/S0738-3991(00)00111-7

Arblaster G., 1990, Terminally ill patients’ expectations of nurses, The Australian Journal of Advanced Nursing, 7, 34

10.12968/ijpn.1998.4.6.9097

10.1097/00000446-198412000-00027

Benner P., 1994, Interpretive Phenomenology Embodiment Caring and Ethics in Health and Illness, 10.4135/9781452204727

10.1046/j.1365-2648.1996.22012.x

10.1089/109662102753641331

10.7748/nr2003.04.10.3.7.c5892

Cartwright A., 1990, The Natural History of a Survey

10.1016/0020-7489(95)00011-3

Colaizzi P.F., 1978, Existential Phenomenological Alternatives for Psychology, 48

Crotty M., 1996, Phenomenology and Nursing Research

10.1111/j.1365-2648.1994.tb01148.x

Davies B., 1990, Dimensions of the supportive role of the nurse in palliative care, Oncology Nurses Forum, 17, 87

Degner L.F., 1991, Critical nursing behaviours in care for the dying, Cancer Nursing, 14, 246, 10.1097/00002820-199110000-00004

Department of Health, 2000, The NHS Cancer Plan

Doyle D., 2005, Oxford Textbook of Palliative Medicine

10.1046/j.1365-2648.1993.18030387.x

10.1046/j.1365-2648.1999.00927.x

Guba E.G., 1988, Effective Evaluation: Improving the Usefulness of Evaluation Results Through Responsive and Naturalistic Approaches

10.1046/j.1365-2648.1993.18091386.x

10.1097/00002820-199602000-00004

10.1111/j.1365-2648.1996.tb02668.x

10.1111/j.1365-2648.1992.tb01851.x

Ingleton C., 2004, Palliative Care Nursing: Principles and Evidence for Practice, 676

Johnston B., 1999, Palliative Care: The Nurses Role, 2

JohnstonB.(2002)Perceptions of Palliative Nursing.Unpublished PhD thesis University of Glasgow Glasgow.

Kellehear A., 1990, Dying of Cancer: The Final Year of Life

10.1111/j.1365-2648.1994.tb01177.x

10.7748/nr1999.04.6.3.20.c6085

10.12968/ijpn.1998.4.3.9114

Macleod M., 1996, Practising Nursing – Becoming Experienced

10.1016/S0147-9563(05)80063-9

10.1177/026921638900300108

10.1016/0277-9536(94)90002-7

Miles M.B., 1994, Qualitative Data Analysis an Expanded Sourcebook

National Cancer Research Initiative, 2004, NCRI Supportive and Palliative Care Research in the UK

NHS Quality Improvement Scotland (NHSQIS), 2002, Specialist Palliatives Care

10.1111/j.1365-2648.1996.tb00035.x

10.1177/026921639601000406

10.1046/j.1365-2648.1998.00718.x

10.1097/00002820-199308000-00007

Saunders C., 1999, Oxford Textbook of Palliative Medicine, v

Scottish Executive, 2001, Cancer in Scotland: Action for Change

10.1016/0277-9536(94)90021-3

10.1177/026921639701100202

Seymour J., 2004, Palliative Care Nursing: Principles and Evidence for Practice, 55

Steeves R., 1994, An analysis of critical incidents describing the essence of oncology nursing, Oncology Nursing Forum, 21, 19

Stephen D.L., 1991, A discussion of Avery Weisman's Notion of appropriate death, Omega, 24, 301, 10.2190/8C1X-PHTD-45ED-KYKX

Webber J., 1993, The evolving role of the Macmillan Nurse

Wilkes L.M., 1993, Nurses descriptions of death scenes, Journal of Cancer Care, 2, 11

10.12968/ijpn.1998.4.3.9115

10.1111/j.1365-2648.1991.tb01726.x

World Health Organization, 2003, WHO Definition of Palliative Care

Zerwekh J.V., 1995, A family caregiving model for hospice nursing, Hospice Journal-Physical Psychosocial and Pastoral Care of the Dying, 10, 27

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Journal of Advanced Nursing

Tập 54 Số 6

700-709

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