[Care to the end-stage patient: help and obstacles perceived by Intensive Care nurses]

Enferm Intensiva. 2007 Jan-Mar;18(1):3-14. doi: 10.1016/s1130-2399(07)74384-5.
[Article in Spanish]

Abstract

Background: The Intensive Care Unit (UCI) environment is not the most appropriate for the development of the end-of-life process, due to the fact that ICU is a hi-tech setting and its focus is on curing and giving life support, rather than delivering palliative care to patients.

Aims: To investigate supportive behaviours and obstacles, and the nurses' demographic characteristics.

Method: A descriptive correlational design was used in five tertiary Spanish hospitals. A convenience sample included 151 critical care nurses. A self-administered anonymous questionnaire (Beckstrand and Kirchhoff, 2005) was used to investigate supportive behaviours and obstacles perceived by nurses providing end-of-life care, in a scale from 0 to 5 (O = not help/obstacle; 5 = main help/obstacle). Some demographic data of the sample were also collected.

Findings: Nurses mean age was 35 (min. 22-max. 57; SD = 7,6) and had an average of 9,2 (min. 1-max. 30; SD = 6,9) years of experience working in ICU. Physicians agreeing on direction of patient care was perceived as the most supportive item (x = 4.46); whereas ethics committee constantly involved in the unit as the least supportive one (x = 2.93). The main obstacle for nurses was patient having pain that is difficult to control or alleviate (x = 4.38), and nurses knowing poor prognosis before family was seen as the less important obstacle (x = 1.37) Statistically significant correlations were found between nurses age and years of experience in ICU and their perception of some helps/obstacles. Statistically significant differences were found between nurses with postgraduate education in intensive care and those without it and their perception of some helps/obstacles.

Conclusions: Intensive care nurses perceive adequate patients' pain management, agreement between health professionals on decision-making, and facilitating a comfortable environment for patients and families, during the whole end-of-life process as a priority.

Publication types

  • Comparative Study
  • English Abstract

MeSH terms

  • Adult
  • Analysis of Variance
  • Attitude of Health Personnel*
  • Data Interpretation, Statistical
  • Ethics Committees, Clinical
  • Female
  • Humans
  • Intensive Care Units*
  • Male
  • Middle Aged
  • Nurse's Role*
  • Nursing Staff, Hospital* / psychology
  • Physician-Nurse Relations
  • Spain
  • Surveys and Questionnaires
  • Terminal Care*