When should Home-visit nurses initiate end-of-life discussions for patients with Organ failure and family caregivers? A qualitative study

BMC Nursing

Research

Masataka Oki¹  Kurumi Asaumi¹  Yoshie Murakami² 

[1] Department of Nursing, School of Health Sciences, Tokyo University of Technology, 5-23-22 Nishikamata, Ota-ku, 144-8535, Tokyo, Japan;Faculty of Nursing, Toho University, 4-16-20 Omorinishi, Ota-ku, 143-0015, Tokyo, Japan;

关键词: End-of-life discussions;    Home-visit nurses;    Patients with organ failure;    Timely identification;    Qualitative descriptive study;    Japan;   

DOI  :  10.1186/s12912-023-01401-x

 received in 2023-02-22, accepted in 2023-07-19,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundEnd-of-life (EOL) discussions for organ-failure patients with family caregivers are important factors for successful EOL care. However, identifying the appropriate time to initiate these discussions is difficult owing to the unpredictability of the disease trajectory. No practical tools or clinical indicators currently exist that can help identify non-cancer patients receiving home care who need EOL discussions.MethodsThe survey was conducted from February 2020 to June 2021. To identify the appropriate time at which to initiate EOL discussions for patients with organ failure and their caregivers, we determined the time when home-visit nurses initiated EOL discussions. We interviewed 19 home-visit nurses (mean total home-visit nursing experience: 6.7 ± 5.9 years) and analyzed the data using Hsieh and Shannon’s qualitative content approach.ResultsThree themes related to home-visit nurses’ experiences of identifying the appropriate time to start EOL discussions were identified: symptomatic worsening, lack of patients’ and family caregivers’ EOL awareness, and decline in activities of daily living.ConclusionsIt is necessary to develop a tool that will enable home-visit nurses to implement EOL discussions at the appropriate time.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023