International journal of palliative nursing
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In this study the Nurses Stress Scale and Nurses Coping With Stress Questionnaire were used to investigate work-related stress in 18 nurses providing palliative care in a UK NHS community hospital. These instruments were administered twice before and twice after a stress-reduction programme. In depth qualitative interviews were conducted before and after the programme and a 12-item questionnaire was used to assess whether the nurses found the programme useful. ⋯ Likewise, few (only 33%) had found an opportunity to practice the relaxation skills they had learnt during the stress-reduction programme. This might explain why there was no evidence of any general improvement in stress and coping scores following the stress-reduction programme. Although the nurses enjoyed the programme and found it helpful, such programmes need to tackle contextual barriers to coping with stress as well as improving the individual coping skills of staff.
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Comparative Study
Voluntary refusal of food and fluids: attitudes of Oregon hospice nurses and social workers.
As the ethical debate about euthanasia and physician-assisted suicide (PAS) continues, one alternative that has been suggested is for the patient to voluntarily refuse all food and fluids (VRFF). The article describes the results of a study of hospice nurses' and social workers' attitudes towards VRFF and compares them with their attitudes towards PAS. ⋯ The results from this study suggest that perceptions regarding VRFF are significantly different from those regarding PAS. These results may have important clinical implications for nurses and social workers involved in end-of-life care who encounter patients who wish to hasten their deaths.
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Little is known about how American nurses understand and respond to requests made by decisionally capable patients for assistance in dying. This article is based on a broader qualitative study first reported elsewhere (Schwarz, 2003). The study used phenomenological interpretation and analysis of stories told by 10 nurses who worked in home hospice, critical care, and HIV/AIDS care settings. ⋯ Few participants unequivocally agreed or refused to help patients die; most struggled to find morally and legally acceptable ways to help patients die well. Regardless of how they responded, nurses who believed they had hastened death described feelings of guilt and moral distress. Healthcare professionals who provide care for symptomatic dying patients need opportunities to meet with supportive colleagues, to share the experience of troubling cases and of moral conflict, and to be supported and heard in a 'safe' environment.