The Korean Journal of Hospice and Palliative Care

Comparison of Quantitative and Qualitative Studies on the Difficulties Experienced by ICU Nurses Providing End-of-Life Care.

DomainQuantitativeQualitative quotesInference
1. Limitation of ICU as a dying place1. When death is unavoidable, the patient had better leave the ICU quickly (M±D=3.93±0.81) 2. Patients do not want to die in the ICU, I suppose (M±D=3.84±0.81)1. There should be a room for patients to comfortably prepare for death (Group 3) 2. I want to create an atmosphere where dying patents, families, and health professionals gather together and have warm conversations (Group 3) 3. Because patients’ beds are usually in an open space, surrounding patients can also get agitated. I hope this can improve (Group 1)Expansion They said that in an environment where isolation rooms are not common, emotional aspects of surrounding patients should also be considered
2. Lack of resources for end-of-life care1. There are no role-model nurses in providing for end-of-life care (M±D=3.80±0.75) 2. No time to care for dying patient (M±D=3.25±0.97)1. I do not have enough time to provide appropriate end - of - life care because I spend too much time finding out what documents are required in such situations (Group 2) 2. It is simply difficult to care patients in end-of-life phase, because the severity is too high compared to general ICU patients (Group 2) 3. The disadvantage is that insufficient time is given to families. We are also so busy getting a new patient as soon as a patient passes away, so we cannot care for the deceased. I think we do not even have time to mourn (Group 1)Expansion Many nurses in the ICU felt that time for end-of-life care was insufficient due to high severity of the patient in the end- of-life phase and increased administrative duties required to care for them
3. Psychological burden on the providing of end-of-life care1. I am frightened to tell the family that a patient’s condition is worsening (M±D=3.59±0.95) 2. I often feel a pang of guilt when I face patient death (M±D=3.06±0.98) 3. I would like to avoid care for dying patients, if possible (M±D=3.12±1.00)1. It’s just an ordinary act, but what if it goes wrong all of a sudden? (Group 1) 2. Dying seems to be always hard. I don’t think that experience makes you feel dull about death (Group 4) 3. I wanted to send condolences even though it would not be of any comfort for the families (Group 1) 4. I feel too much empathy for the deceased, so I keep thinking what if he or she was my parents (Group 2)Expansion In quantitative studies, psychological burden was measured the lowest score, but qualitative studies showed that psychological burden accounted 37.1 percent of the content analysis data
4. The difficulties of end-of-life care for patients and their families1. It is difficult to fulfill patients’ wishes (M±D=3.78±0.69) 2. It is difficult to provide care for families in the ICU (M±D=3.72±0.81)1. I know it’s necessary to empathize with families of the deceased patients, but when there are patients on their deathbeds and their families, I don’t know how to treat them and how to nurse them. I just go blank (Group 3) 2. I get cautious especially when facing unprepared deaths (Group 1) 3. There are people who get angry. It is difficult to deal with a guardian. I think the guardian becomes extremely sensitive (Group 1)Expansion Qualitative research shows that end- of-life care for families is more difficult than caring for the patient. They said it was difficult to provide the end-of-life care especially for families whose family member suddenly passed away or those who were dissatisfied and uncooperative with the care
5. Conflict on excessive treatment when a patient is in the end-of-life phase1. Life-sustaining treatment is often given excessively. (M±D=3.90±0.82) 2. Even in the end-of-life phase, limits on visiting hours and people are unavoidable (M±D=3.43±1.03)1. When you’re over the therapeutic limit, you feel it’s right to give up (Group 1) 2. There is a belief that the patient does not want to experience the moment of dying alone. But it’s hard because I can’t keep letting a patient’s family in (Group 1)Confirmation They said that they felt conflicts over providing the excessive treatment and restricting family visits even during the dying phase
Korean J Hosp Palliat Care 2019;22:87~99
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