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