The nursing experience and perception for good death services in the intensive care unit

Abstract

Background: If dying patient can make a choice, good-death is the first choice. Objective: The major purpose of this study is to understand nursing experience and perception for good death services in the intensive care unit. Methods: This was a qualitative study with convenient sampling. Eight female intensive care unit (ICU) nurses were invited to participate in this research. Semi-structured interview questions were used as a guide to collect the data. Every interview was tape-recorded and transcribed verbatim. Content analysis was used to analyze the data of patients. Results: The result of the study emerged 5 categories of the nursing experiences about good-death for the end-stage patients. They are (1) Good-death concepts and belief guide the care behaviors. (2) Good-death care behaviors are divided into patient's dimension and families’ dimension. (3) Key moments that ICU nurses offer interventions for good-death. (4) Predicaments encountered by nurses when they offer good-death behaviors to the dying patients and their families. (5) Strategies which can reduce the ICU nurses’ predicaments when they offer good-death nursing care to patients and their families. Discussion: (1) Most of the intensive care nurses have correct concepts about good-death, but most of them neglected the spirituality dimension. (2) There are some conflicts about good-death impression between nurses, families and doctors. Conclusion: In critical care units, nurses, doctors and families are the most important persons to meet peaceful death of end-stage patients, and their good-death concepts and caring behaviors are related to the care quality of terminal illness patients. We have some suggestions that are: (1) Training programs of intensive care should reinforce the issue of spiritual care in order to meet the peaceful death needs for terminal illness patients in the critical care unit. (2) ICU nurses, doctors and families of patients, they need negotiate with each other through meeting when they have different belief about peaceful death services for terminal patients.