Patient, Family Caregiver, and Nurse Involvement in End-of-Life Discussions During Palliative Chemotherapy: A Phenomenological Hermeneutic Study

Tine Ikander*, Karin B. Dieperink, Olfred Hansen, Mette Raunkiær

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Abstrakt

The aim of this study was to investigate current nursing practice related to end-of-life discussions with incurable lung cancer patients and their family caregivers from the perspectives of patients, family caregivers, and nurses in an oncology outpatient clinic. This phenomenological hermeneutic study included nine patients, eight family caregivers, and 11 nurses. Data were collected using participant observation, informal and semi-structured individual or joint interviews with patients and family caregivers, and focus group interviews with nurses. A Ricoeur-inspired approach was used to analyze the data. Three themes were identified: (a) content of end-of-life discussions, (b) timing of end-of-life discussions, and (c) challenges in end-of-life discussions. End-of-life discussions were seldom initiated; when they were, it was often too late. Discussions addressed treatment, place of care, practical/economic concerns, and existential matters. The physical environment at the outpatient clinic, lack of continuity, and nurses’ instrumental task workloads and time pressure posed challenges to initiating end-of-life discussions.

OriginalsprogEngelsk
TidsskriftJournal of Family Nursing
Vol/bind28
Udgave nummer1
Sider (fra-til)31-42
ISSN1074-8407
DOI
StatusUdgivet - feb. 2022

Bibliografisk note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was funded by the Danish Cancer Society (Grant Number R156-A9971-10226982), the Region of Southern Denmark (17/33611), Aage Theodor Larsen Fund of Cancer Research, Academy of Geriatric Cancer Research (Age Care; http://www.agecare.org/ ), and the Department of Oncology, Odense University Hospital, Denmark.

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