Cancer nursing
-
This study aimed to explore the difficulties experienced by primary informal caregivers of Chinese patients with terminal cancer in Hong Kong and the social support available for such caregivers. For this exploratory study, 21 primary informal caregivers of patients with terminal cancer were recruited from a hospice home service to complete a questionnaire. The results show that all but one of the caregivers (95.2%) perceived difficulties in rendering care. ⋯ Of the 21 caregivers, 20 (95.2%) felt that the support received from hospice home care nurses was useful, especially in skill training (n = 16, 76.2%), informational support (n = 20, 95.2%), and emotional support (n = 20, 95.2%). Informal caregivers also indicated that home care nurses provided more useful overall support than family members and friends (chi2 = 11.35; P =.003). With a better understanding of the difficulties experienced by caregivers and the support they receive, hospice home care nurses will be in a better position to identify effective strategies for helping informal caregivers cope with their difficult circumstances.
-
In this study, 24 family caregivers of terminally ill patients participated in in-depth interviews regarding their experiences of giving care. The data were analyzed using grounded theory qualitative method. Commitment emerged as the precondition of the caregiving process. ⋯ The emotional aspect of the caregiving experience can be described as an intense emotional experience filled with feelings of hope and hopelessness, guilt, fear, and regret. As a result of the caregiving experience, most participants found they have had a change of worldviews and treasure their lives. Findings show a significant need for interventions at each phase of the caregiving process designed to provide effective and culturally sensitive support and affirmation to family members as they care for their loved ones with terminal illnesses.
-
End-of-life care strives to honor terminally ill patients' preferences regarding the way of dying. Scholars defined one domain of quality of dying and death as dying at the place of one's choice. Despite efforts over more than two decades and more than 40 studies to investigate the influencing factors associated with the place of death for terminally ill patients with cancer, there is a notable lack of empirical data examining the reasons why terminally ill patients with cancer choose a specific setting as their preferred place of death. ⋯ Quality of life, availability and ability of family caregivers, concerns of being a burden to others, long-standing relationships with healthcare providers, and quality of healthcare were the major considerations in decision making regarding the place of death. Terminally ill patients with cancer acknowledged dying at their preferred place of death as highly important. Effective nursing interventions need developing to facilitate death at a place that is in accord with dying patients' preferences.
-
Comparative Study
Hospice patient and caregiver congruence in reporting patients' symptom intensity.
As healthcare increasingly moves out of hospitals, the care of patients with cancer is provided in the community with the help of family caregivers. In many cases, nurses depend on family caregivers to provide assessment data about patients. This makes the accuracy and dependability of the data given by caregivers particularly important. ⋯ Furthermore, the limited variance accounted for by the two sets of scores for each of the symptoms (R2 =.16-.26) indicated much more error in the scores than agreement between patient and caregiver. It appears that family caregivers cannot reliably report patient symptom intensity. Healthcare providers need to train family caregivers in conducting systematic assessments instead of assuming that they understand patient symptoms.
-
The process of completing and executing advance directives (ADs) is not without problems and issues that need to be studied. Nurses, by the nature of their practice, are in a unique position to help patients complete ADs. The findings reported in this article focus on an open-ended question that was part of a larger quantitative survey. ⋯ Nurses also wrote about philosophical issues related to dying, end-of-life issues, and ADs, as well as institutional issues that have an impact on the assistance they can give patients completing ADs. In addition, the category "communicating" was frequently discussed by nurses. The importance of communication was a thread woven throughout their responses.