Neurological ICU nurses’ experience of palliative care about end-of-life patients and families

Abstract

Background: There were limited studies on the nature of palliative care in neurological ICU. Patients who experienced cerebrovascular accident or sudden trauma and admitted to neurological intensive care unit suffered severe brain damage towards the end-of-life. At the moment of life and death situation, patients and their families are faced with a palliative care decision. The making of pallative decision has great impact on the families and health professionals. It is vital to understand the nature of caring and experience of palliative care in the neurological ICU. Objective: The aim of the study was to investigate the neurological intensive care unit nurses’ experience of palliative care in caring end-of-life patients and their families. Methods: The study was conducted using a focus group study method. Five focus groups were interviewed with semi-structured questions. Each group comprised 12 to 16 participants and they were asked to share their palliative care experiences of caring patients at the end-of-life phase and their families. Results: Four themes emerged from the study: (1) providing a patient-centered care and help families face the impact of changes in illness, (2) improving communication and establishing trust relationship of patient-nurse, (3) helping families in end-of-life decision-making towards comfort, (4) maintaining the patient's dignity and promoting peaceful death. Discussion: The study revealed the nature of the neurological ICU nurses caring of patients throughout the palliative care process. The findings present the natural emotions of patients and families stressful experience when faced with palliative care decision, and to provide patient-centered care to maintain patient's dignity and promoting peaceful death. Conclusion: When patients's condition deteriorates towards the end-of-life situation, patients and families were usually indecisive in making decision for patient to receive palliative care. From the results of the focus groups interviews, ICU nurses interpersonal and intrapersonal relationship, and communication process for palliative care decision and caring of patients dignity were discussed.