When should Home-visit nurses initiate end-of-life discussions for patients with Organ failure and family caregivers? A qualitative study-Reference-Cited by-同舟云学术

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

Published:2023-08-07 Issue:1 Volume:22 Page:
ISSN:1472-6955
Container-title:BMC Nursing
language:en
Short-container-title:BMC Nurs

Author:

Asaumi Kurumi,Oki Masataka,Murakami Yoshie

Abstract

Abstract Background End-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. Methods The 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. Results Three 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. Conclusions It is necessary to develop a tool that will enable home-visit nurses to implement EOL discussions at the appropriate time.

Funder

JSPS KAKENHI

Publisher

Springer Science and Business Media LLC

Subject

General Nursing

Link

https://link.springer.com/content/pdf/10.1186/s12912-023-01401-x.pdf

Reference50 articles.

1. World Health Organization, World report on ageing and health. 2015. https://apps.who.int/iris/bitstream/handle/10665/186463/9789240694811_eng.pdf?sequence=1. Accessed 6 June 2023.

2. National Institute of Populations and Social Security Research. Population Projections for Japan: 2016–2065. Population Research Series No. 336; 2017. https://www.ipss.go.jp/pp-zenkoku/j/zenkoku2017/pp29_ReportALL.pdf. Accessed 6 June 2023.

3. Ministry of Health, Labour and Welfare. Study Group on the Way of Dissemination and Awareness of Medical Care in the Last Stage of Life. 2017. Report on Survey of Attitudes Toward Medical Care in the Final Stage of Life. https://www.mhlw.go.jp/toukei/list/dl/saisyuiryo_a_h29.pdf Accessed 6 June 2023.

4. Portal site of official statistics of Japan, e-stat. 2020. Vital Statistics of Japan. https://www.e-stat.go.jp/. Accessed 6 June 2023.

5. Shepperd S, Gonçalves-Bradley DC, Straus SE, Wee B. Hospital at home: home-based end-of-life care. Cochrane Database Syst Rev. 2021;3. https://doi.org/10.1002/14651858.CD009231.