A Qualitative Descriptive Study of Nurse-Patient Relationships Near End of Life

Abstract

Background The end of life (EOL) period represents a challenging time for patients with cancer as they face disruptions in their relationships with their oncology healthcare providers (HCPs) when moving toward hospice care. Poor communication and severed or altered relationships in physician-patient relationships have been shown to occur near EOL, leading to perceptions of abandonment and other negative consequences for quality EOL care. Little is known, however, about nurse-patient relationships near EOL in the cancer setting. Objective The purpose of this qualitative descriptive study was to describe the relationships between patients with cancer and their cancer nurses near EOL. Methods A qualitative descriptive methodology was used via semistructured interviews. A total of 9 participants with advanced cancer were enrolled in and completed the study. Data analysis occurred through qualitative content analysis. Results The overarching theme woven throughout the narratives was “Good Communication Fosters Nurse-Patient Relationships.” Three additional themes emerged from this main theme: 1) “Valuing Professionalism in the Relationship,” 2) “Embracing Personhood in the Relationship,” and 3) “An Unimaginable Termination.” Conclusion Patients with cancer continued to perceive good communication and strong relationships with their cancer nurses even as EOL approached. Themes consistent with negative alterations in these relationships or perceptions of abandonment were not identified. Implication for Practice Cancer nurses can foster nurse-patient relationships through patient-centered communication techniques. Spending adequate time engaging with patients as individuals is also recommended. Perhaps most importantly, nurse-patient relationships should continue to be supported as EOL approaches.