Nurses as Human Beings in End-of-Life Care—A Tentative Theory Model

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Abstract

This article presents a tentative theoretical model of nurses' becoming as human beings in end-of-life care. As human beings, nurses are vulnerable. Caring for patients at the end of life can strengthen their own understanding of life and death. In the caring communion, nurses gain contact with life and themselves as human beings. Nurses' becoming as human beings in end-of-life care can be understood as a strength and a willingness to act in love and in compassion as they strive to understand and be reconciled with their own life situations, happiness, and grief.

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The impact of occupational stress on nurses’ caring behaviors and their health related quality of life

Pavlos Sarafis, Eirini Rousaki, Andreas Tsounis … (2016)

Background Nursing is perceived as a strenuous job. Although past research has documented that stress influences nurses’ health in association with quality of life, the relation between stress and caring behaviors remains relatively unexamined, especially in the Greek working environment, where it is the first time that this specific issue is being studied. The aim was to investigate and explore the correlation amidst occupational stress, caring behaviors and their quality of life in association to health. Methods A correlational study of nurses (N = 246) who worked at public and private units was conducted in 2013 in Greece. The variables were operationalized using three research instruments: (1) the Expanded Nursing Stress Scale (ENSS), (2) the Health Survey SF-12 and (3) the Caring Behaviors Inventory (CBI). Univariate and multivariate analyses were performed. Results Contact with death, patients and their families, conflicts with supervisors and uncertainty about the therapeutic effect caused significantly higher stress among participants. A significant negative correlation was observed amidst total stress and the four dimensions of CBI. Certain stress factors were significant and independent predictors of each CBI dimension. Conflicts with co-workers was revealed as an independent predicting factor for affirmation of human presence, professional knowledge and skills and patient respectfulness dimensions, conflicts with doctors for respect for patient, while conflicts with supervisors and uncertainty concerning treatment dimensions were an independent predictor for positive connectedness. Finally, discrimination stress factor was revealed as an independent predictor of quality of life related to physical health, while stress resulting from conflicts with supervisors was independently associated with mental health. Conclusion Occupational stress affects nurses’ health-related quality of life negatively, while it can also be considered as an influence on patient outcomes.

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Palliative Care Professionals' Inner Life: Exploring the Relationships Among Awareness, Self-Care, and Compassion Satisfaction and Fatigue, Burnout, and Coping With Death

Noemí Sansó, Laura Galiana, Amparo Oliver … (2015)

Professionals working in the landscape of death and dying frequently are exposed to existential issues, psychological challenges, and emotional distress associated with care at the end of life. Identifying factors that help professionals cope with frequent exposure to issues related to mortality could enhance palliative care providers' and patients' quality of life.

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Existential suffering in the palliative care setting: an integrated literature review.

Patricia Boston, Anne Bruce, Rita Schreiber (2011)

Existential and spiritual concerns in relation to palliative end-of-life care have received increasing attention over the past decade. To review the literature specifically related to existential suffering in palliative care in terms of the significance of existential suffering in end-of-life care, definitions, conceptual frameworks, and interventions. A systematic approach was undertaken with the aim of identifying emerging themes in the literature. Databases using CINAHL (1980-2009), MEDLINE (1970-2009), and PsychINFO (1980-2009) and the search engine of Google Scholar were searched under the key words existential suffering, existential distress, existential pain, palliative and end of life care. The search yielded a total of 156 articles; 32% were peer-reviewed empirical research articles, 28% were peer-reviewed theoretical articles, and 14% were reviews or opinion-based articles. After manually searching bibliographies and related reference lists, 64 articles were considered relevant and are discussed in this review. Overall analysis identifies knowledge of the following: 1) emerging themes related to existential suffering, 2) critical review of those identified themes, 3) current gaps in the research literature, and 4) recommendations for future research. Findings from this comprehensive review reveal that existential suffering and deep personal anguish at the end of life are some of the most debilitating conditions that occur in patients who are dying, and yet the way such suffering is treated in the last days is not well understood. Given the broad range of definitions attributed to existential suffering, palliative care clinicians may need to be mindful of their own choices and consider treatment options from a critical perspective. Copyright © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.