Journal of palliative medicine
-
Background: Pediatric nurses are particularly vulnerable to moral distress and turnover due to frequent experiences with patient death combined with limited pediatric palliative resources and related support. Objective: This study examined pediatric nurses' experiences of pediatric patient death, moral distress, and turnover intention and identified the correlations between them as well as the mediating role of moral distress. Methods: This cross-sectional study conducted an online survey with 161 pediatric nurses working in a tertiary hospital in Seoul, South Korea. ⋯ Moral distress fully mediated the relationship between the experience of pediatric patient death and turnover intention. Conclusion: Pediatric patient death had an indirect effect on turnover intention through moral distress among pediatric nurses. Reducing pediatric nurses' moral distress caused from experiencing patient death may help minimize their turnover intention.
-
Background: The process of forgiveness is proposed to reduce patient and family conflict and suffering in the face of life-limiting illness. However, it is unclear which theoretical perspectives underpin the concept of forgiveness in palliative care, and how culture may influence it. Objectives: To identify and synthesize primary evidence that underpins the concept of forgiveness within palliative care, and identify theoretical perspectives, including cultural assumptions. ⋯ Conclusion: The synthesized model is based on primary evidence of mixed quality. Future research needs better theoretical conceptualization utilizing cultural perspectives. Forgiveness interventions with consideration of cultural influences are encouraged.
-
Background: Episodic dyspnea (ED) is a common problem in patients with advanced lung cancer (LC). However, the prevalence of ED and other related aspects in this patient population is not known. Objectives: To assess and describe the prevalence, clinical features, treatment, and risk factors for ED in outpatients with advanced LC. ⋯ Conclusions: ED is highly prevalent and severe in outpatients with advanced LC experiencing BD. The association between intrathoracic comorbidities and oxygen therapy points to alveolar oxygen exchange failure having a potential etiopathogenic role in ED in this population. Further studies are needed to better characterize ED in LC to better inform treatments and trial protocols.