Asian Journal of Nursing Education and Research

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Nursing Staff's Perception of Facilitators in Providing End of Life Care to Terminally Ill Pediatric Patients in South East Iran


Affiliations
1 Kerman University of Medical Science, Kerman, Iran, Islamic Republic of
     

   Subscribe/Renew Journal


Objective: To determine pediatric nurses 'perceptions of intensity, frequency of occurrence and magnitude score of selected facilitators of providing pediatrics EOL care. Method: A sample of 173 nurses working in pediatric units in 2 hospitals supervised by Kerman University of Medical Sciences was surveyed. A translated modified version of the (NSCCNR-EOLC) was used to rate the facilitators' intensity and frequency.

Results: 173 sets of questionnaires were distributed with a drop out of 22. The 3 highest PFM (Perceived facilitator magnitude) score were: 1) providing a peaceful, dignified bedside scene for family members once the Child has died (5.75). 2) Physicians agreeing about direction of child care (5.25), and 3) Nurses offer verbal and behavioral support to each other (5). The 3 lowest PFM score were: 1) Letting the religious leader take primary care of the grieving family (1.08), and 2) Having a unit schedule that allows for continuity of care for the dying child by the same nurses (1.76). 3) Having fellow nurses take care of your other child while you get away from the unit for a few moments after your child's death (2.19).

Conclusion: The result may indicate a long distance between what nurses believe to be facilitating and what actually happens. Therefore some efficient strategies are needed to improve the current situation. The lack of education and experience as well as some cultural and professional limitations may have contributed to this distance. Creating a reflective narrative environment in which nurses can express their feelings about death, dying, and palliative care may be an effective approach. A continuing palliative care education adding to nursing curriculum can improve the EOL care quality in the context. Since EOL care is multidimensional, it is suggested to conduct some appropriate qualitative studies to deeply understand nurses' experiences/perceptions about facilitators of providing EOL care to terminally ill pediatric patients to develop valuable instruments in order to assess most important issues around this topic.


Keywords

Perception, Facilitators, End of Life Care, Terminally Ill Children.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Knapp C, Madden V, Woodworth L, etal. An Overview of Pediatric Palliative Care. In Knapp C, Madden V, Fowler-Kerry S. Pediatric Palliative Care: Global Perspectives, Edited by Knapp C, Madden, Fowler-Kerry S. London. 2012; 1th Ed: PP.3-4.

  • www.who.int/country/irn/en.2012.Retrieved June 2014.

  • Benini F, Spizzichino M, Trapanotto M, etal. Pediatric palliative care.Italian Journal of Pediatrics.34 (4); 2008.

  • Bennett H. A Guide to End of Life Care: Care of children and young people before death, at the time of death and after death.2012: 14.

  • Valentin A, Druml W, Stelzer H, etal. Recommendations on therapy limitation and therapy discontinuation in intensive care units: consensus paper of the Austrian Associations of Intensive Care Medicine. Intensive Care Medicine. 34; 2008: 771-776.

  • Oncology Nursing Society and Association of Oncology Social Work. End-of-life care [Position statement]. 2007. Retrieved June 2014 from http://www.ons.org/Publications/Positions/EndOfLife/.

  • Flood Y. Caring for the child with palliative care needs. InMoyraA.BaldwinandJan Woodhouse. Key concepts in palliative care. London. 2011; 1th Ed: pp22.

  • Morgan D. Caring for Dying Children: Assessing the Needs of the Pediatric Palliative Care Nurse. Journal of Pediatric nursing. 35(2); 2009: 86-90.

  • European Association of Palliative Care (EAPC) .Taskforce: IMPaCCT: standards for pediatric palliative care in Europe. European Journal of Palliative Care. 14; 2008:2-7.

  • Friebert S. National Hospice and Palliative Care Organization facts and figures: Pediatric palliative and hospice care in America. 2009. Retrieved from http://www.nhpco.org/pediatrics.

  • Children's Hospice International Resources: an unmet need. Children's Hospice International. 2008. www.chionline.org. Accessed 2011.

  • Mesukko, J. Critical care nurses' perceptions of quality of dying and death, barriers, and facilitators to providing pediatric end-of-life care in Thailand, Ph.D. thesis, Frances Payne Bolton School of Nursing. 2010:11, 145.

  • Davies B, Sehring S. A, Partridge J. C, et al. Barriers to palliative care for children: Perceptions of pediatric health care providers. Pediatrics. 121(2); 2008: 282-288.

  • Beckstrand R.L, Rawl N.L, Calliste L, et al. Pediatric Nurses' Perceptions of Obstaclesand Supportive Behaviors in End-of- Life.AJCC. 19; 2010: 543-552.

  • Gehan EL Nabawy Ahmed Moawad. Nurses' perception of obstacles and supportive behaviors inproviding end of life care to critically ill pediatricpatients.Journal of Biology, Agriculture and Healthcare. 3(2); 2013: 96-105.

  • IglesiasMEL. Pascual C, Ricardo Becerro de Bengoa Vallejo, etal.Obstacles and Helpful Behaviors in Providing End-of-Life Care to Dying Patients in Intensive Care Units. Dimensions of Critical Care Nursing.32 (2); 2013.

  • Beckstrand R.L and Kirchhoff K.T. Providing end-of-life care to patients: Critical care nurses' perceived obstacles and supportive behaviors. AJCC.14(5); 2005: 395-403.

  • Beckstrand R.L, Smith M.D, Heaston S, etal. Emergency nurses' perceptions of size, frequency, and magnitude of obstacles and supportive behaviors in end-of-life care. Journal of Emergency Nursing. 34(4); 2008: 290-300.

  • Beckstrand,; R.L, Rawle N.L, Callister L, etal. Pediatric nurses' perceptions of obstacles and supportive behaviors in end-of-life care 2009. Retrieved December 21, 2009, from http://ajcc.aacnjournals.org/cgi/content/ abstract/ajcc2009 497v1.

  • Statisticswww.who.int/country/irn/en Retrieved June 2014.

  • kirpalsingh.org/Booklets/Death and Dying revised.pdf. Retrieved June 2014.

  • Abedi M. Palliative Care within the Iranian Context: Re-defining Palliative Care, Deploying Spirituality as a Support Measure and Need for Cultural Sensitivity.2012.www.inter disciplinary.net/wpcontent/.../2012/02/abedisppaper.

  • Zargham-Boroujeni A, Sayed Bagheri SH., Kalantari M, et al. Effect of end-of-life care education on the attitudes of nurses in infants' and children's wards. IJNMR. 16(1); 2011: 93-99.

  • Kirchhoff K.T and Beckstrand R.L. Critical care nurses' perceptions of obstacles and helpful behaviors in providing end-of-life care to dying patients. AJCC. 9; 2000:96-105.

  • Nikbakht Nasrabadi A and Emami A. Perceptions of nursing practice in Iran. Nursing Outlook . 54(6); 2006:320-327.

  • Denisco SM and Barker A.M. advanced practice nursing: Evolving roles for the transformation of the profession, Jones and Bartlett Publishers. 2012.

  • Tulchinsky T.H and Varavikova E.A. New Public Health, Academic Press Incorporated.2013.

  • Iranmanesh S, Razban F, Ghazanfari, et al. Nurses' attitudes toward caring for dying patients and professional autonomy in South-east Iran. International journal of palliative nursing. In press 2014.

  • Amini K, Negarandeh R, Ramezani‐Badr F, etal. Nurses' autonomy level in teaching hospitals and its relationship with the underlying factors. International journal of nursing practice. 2013.

  • Iranmanesh S, Razban F, Tirgary B, etal. Nurses' knowledge about palliative care in Southeast Iran. Palliate and Supportive Care. 2013; 1-8.

  • Crump S.K, Schaffer M.A, Schulte E. Critical Care Nurses 'Perceptions of Obstacles, Supports, and Knowledge Needed in Providing Quality End-of-Life Care. Dimensions of Critical Care Nursing. 29; 2012: 6.

  • Palliative Care Australia. Journeys: palliative care for children and teenagers. Common wealth of Australia, Australia. 2012.

  • Bauer-Wu S, Barrett R, Yeager K, etal. Spiritual perspectives and practices and the end-of life: A review of the major world religions and application to palliative care. Indian Journal of Palliative Care. 13; 2007:53-58.

  • Baggs J. G, Norton S. A, Schmitt M. H, et al. The dying patient in the ICU: Role of the interdisciplinary team. Critical Care Clinics. 20(3); 2004: 525-540.

  • Ciccarello G. P. Strategies to improve end-of-life care in the intensive care unit. Dimensions of Critical Care Nursing. 22(5); 2002: 216-222.

  • Puntillo K. A, Benner P, Drought T., et al. End-of-life issues in intensive care units: A national random survey of nurses' knowledge and beliefs. American Journal of Critical Care. 10(4); 200: 216-229.

  • Puchalski C. M, Lunsford B, Harris M. H, et al. Interdisciplinary spiritual care for seriously ill and dying patients: A collaborative model. Cancer Journal. 12(5); 2006: 398-416.

  • Contro N, Davies B, Larson J, et al. Away from home: experiences of Mexican American families in pediatric palliative care. Journal of Social Work in End-of-Life and Palliative Care.6; 2010:185-204.

  • Wilson K, Mazhar W, Rojas-Cooley T, et al. A glimpse into the lives of 3 children. Journal of Pediatric Oncology Nursing. 28(2); 2012:100-106.

  • Rahbar M, Ahmadi M, Lornejad H, et al. Mortality Causes in Children 1-59 Months in Iran. Iranian Journal of Public Health. 42(Supple1); 2013: 93-97.Pdf. Retrieved June 2014.

  • www.penous.com/News/print/323/ .


Abstract Views: 329

PDF Views: 1




  • Nursing Staff's Perception of Facilitators in Providing End of Life Care to Terminally Ill Pediatric Patients in South East Iran

Abstract Views: 329  |  PDF Views: 1

Authors

Sedigheh Iranmanesh
Kerman University of Medical Science, Kerman, Iran, Islamic Republic of
Marjan Banazadeh
Kerman University of Medical Science, Kerman, Iran, Islamic Republic of

Abstract


Objective: To determine pediatric nurses 'perceptions of intensity, frequency of occurrence and magnitude score of selected facilitators of providing pediatrics EOL care. Method: A sample of 173 nurses working in pediatric units in 2 hospitals supervised by Kerman University of Medical Sciences was surveyed. A translated modified version of the (NSCCNR-EOLC) was used to rate the facilitators' intensity and frequency.

Results: 173 sets of questionnaires were distributed with a drop out of 22. The 3 highest PFM (Perceived facilitator magnitude) score were: 1) providing a peaceful, dignified bedside scene for family members once the Child has died (5.75). 2) Physicians agreeing about direction of child care (5.25), and 3) Nurses offer verbal and behavioral support to each other (5). The 3 lowest PFM score were: 1) Letting the religious leader take primary care of the grieving family (1.08), and 2) Having a unit schedule that allows for continuity of care for the dying child by the same nurses (1.76). 3) Having fellow nurses take care of your other child while you get away from the unit for a few moments after your child's death (2.19).

Conclusion: The result may indicate a long distance between what nurses believe to be facilitating and what actually happens. Therefore some efficient strategies are needed to improve the current situation. The lack of education and experience as well as some cultural and professional limitations may have contributed to this distance. Creating a reflective narrative environment in which nurses can express their feelings about death, dying, and palliative care may be an effective approach. A continuing palliative care education adding to nursing curriculum can improve the EOL care quality in the context. Since EOL care is multidimensional, it is suggested to conduct some appropriate qualitative studies to deeply understand nurses' experiences/perceptions about facilitators of providing EOL care to terminally ill pediatric patients to develop valuable instruments in order to assess most important issues around this topic.


Keywords


Perception, Facilitators, End of Life Care, Terminally Ill Children.

References