Asian Nurs Res.
2017 Sep;11(3):207-215. 10.1016/j.anr.2017.08.004.
Nurses' Experiences of End-of-life Care in Long-term Care Hospitals in Japan: Balancing Improving the Quality of Life and Sustaining the Lives of Patients Dying at Hospitals
- Affiliations
-
- 1Department of Nursing and Laboratory Science, Graduate School of Medicine, Yamaguchi University, Yamaguchi, Japan. odachi@yamaguchi-u.ac.jp
- 2Division of Health Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan.
- 3Department of Nursing, School of Nursing, Mukogawa Women's University, Nishinomiya, Japan.
- 4Department of Nursing, Shiga University of Medical Science, Shiga, Japan.
- 5Department of Medical Ethics, Tohoku University Graduate School of Medicine, Miyagi, Japan.
- 6Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.
- KMID: 2416444
- DOI: http://doi.org/10.1016/j.anr.2017.08.004
Abstract
- PURPOSE
In Japan, about 80% of deaths occur in hospitals, especially long-term care beds. The purpose of this study was to clarify the nursing practices used for such older patients at the end-of-life stage in long-termcare wards via the modified grounded theory approach (M-GTA).
METHODS
Data were obtained through semi-structured interviews of nineteen nurses working in cooperating long-term care wards, acute care wards, or hospice services (to allow for constant comparison between these types of wards) in western Japan in 2014. We analyzed the transcribed data using M-GTA.
RESULTS
The core category that emerged from the analysis was "Balancing enhancement of patients' daily life quality and life-sustaining care in the face of uncertainty about the patients' character." Eleven categories emerged, such as Seeking older patients' character with their family, Supporting families' decision making, Rebuilding patients' daily life in the ward, and Sustaining patients' life span through medical care.
CONCLUSIONS
Nurses experienced uncertainty about the care needs of older patients, the ethical problems of Enhancing the patients' QOL by using risky care, and the evaluation criteria used to judge their own nursing care after the patients' death. All nurses had the goal of ensuring a natural death for all patients. Nurses' acceptance and evaluation of their own care was critically influenced by the patient's family's responses to their care after patients' death. Further research is necessary to develop evaluation criteria and educational programs for end-of-life nursing care of older adults.
Keyword
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Nurses' Experiences of End-of-life Care for Elderly Patients in Long-term Care Hospitals
- Nurses’ Experiences on End-of-Life Care for Older Patients in Long-Term Care Hospitals: Focusing on the Process of Practice and Barriers
- Lived experiences toward moral distress among long-term care hospital nurses: A phenomenological approach
- End of Life Care Competencies and Terminal Care Stress of Nurses in Long Term Care Hospitals
- Effects of Awareness of Good Death and End-of-Life Care Attitudes on End-of-Life Care Performance in Long-Term Care Hospital Nurses
