Journal of Home Health Care Nursing (가정∙방문간호학회지)

Korean Academic Society of Home Health Care Nursing (한국가정∙방문간호학회)
권호 표지
DOI QR코드

DOI QR Code

Experience of Visiting Nurse's End-of-life Care: A Qualitative Contents Analysis

방문간호사의 생애말기 간호에 대한 경험: 질적 내용분석

  • Bang, Misung (Graduate School, Changwon National University) ;
  • Lee, Insook (Department of Nursing, Changwon National University) ;
  • Yang, Juhyeon (Department of Nursing, Changwon Moonsung University) ;
  • Kim, Sohee (Graduate School, Changwon National University)
  • Received : 2022.03.31
  • Accepted : 2022.05.08
  • Published : 2022.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study aims to describe and explore the experiences of visiting nurses so as to providing high-quality end-of-life care at home. Methods: Data was collected and recorded through in-depth interviews with 11 visiting nurses and transcribed verbatim. The data were analyzed with qualitative contents analysis. Data were collected from April 8 to July 30, 2021. Results: The results revealed the following four themes and ten sub-themes: The main themes were 'Dignified end-of-life caring practice at home', 'Providing integrated support of end-of-life family caregivers', 'Confronting the limits of visiting nursing at the end of life' and 'Reflection on life and feeling rewarded'. Visiting nurses have performed dignified end-of-life care at home and integrated support for family caregivers. Although the visiting nurse sometimes faced the limits of visiting nursing during end-of-life care, it was surveyed that they rewarded on their lives and felt rewarding through the end-of-life nursing experience. Conclusion: Practical and systematic training is needed to positively change the end-of-life care of visiting nurses. We propose programs, such as expert counseling, to improve coping skills in end-of-life care practice at home. Additionally, we propose various institutional supports which can support the limitations of end-of-life care provision.

Keywords

References

  1. End of life care [Internet]. National Health Service, england [cited 2021 Oct 25]. Available from: https://www.nhs.uk/conditions/end-of-life-care/
  2. 2018 Community Integrated Health Promotion Project Guide, Visiting health care [Internet]. Seoul: Korea Health Promotion Foundation(KHPF), Ministry of Health and Welfare (MOHW) c2018[cited 2021 May 25]. Available from: https://www.khealth.or.kr/kps/publish/view?menuId=MENU00890&page_no=B2017003&pageNum=3&siteId=&srch_text=&srch_cate=&srch_type=&str_clft_cd_list=&str_clft_cd_type_list=&board_idx=10049
  3. Lee SJ, Kwak CY. Effects of visiting nursing services in long-term care insurance on utilization of health care. Journal of Korean Academy of Community Health Nursing 2016;27(3):272-283. https://doi.org/10.12799/jkachn.2016.27.3.272
  4. Long-term Care Insurace [Internet]. Wonju: National Health Insurance Corporation [cited 2022 Apr 11]. Available from: https://www.longtermcare.or.kr/npbs/e/b/403/npeb403m01.web?menuId=npe0000000290&zoomSize=
  5. Fukui F, Otsuki N, Ikezaki O, Fukahori S, Irie S. Provision and related factors of end-of-life care in elderly housing with care services in collaboration with visiting nurse agencies: a nationwide survey. BMC Palliative Care. 2021;20(1):1-9. https://doi.org/10.1186/s12904-021-00847-7
  6. Costa V, Earle CC, Esplen MJ, Fowler R, Goldman R, Grossman D, et al. The determinants of home and nursing home death: a systematic review and meta-analysis. BMC palliative care. 2016;15(1):1-15. https://doi.org/10.1186/s12904-016-0077-8
  7. Kim SE. The relationship between intensive care unit nurses' death perception and terminal care performance. [master's thesis]. Suwon: Ajou University; 2011. 53p.
  8. Kim SH. Factors for end-of-life care performance among home visiting nurses. [dissertation]. Seoul: Chung-Ang University; 2020. 146p.
  9. Detering KM, Hancock AD, Reade MC, Silvester W. The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMJ. 2010;340. https://doi.org/10.1136/bmj.c1345
  10. Chung SY. A study on terminal care stress and terminal care performance of ICU nurse. [master's thesis]. Seoul: Hanyang University; 2013. 70 p.
  11. Kim SJ. Death anxiety and terminal care attitudes of nurses in hospice palliative units. Nursing Science. 2015; 27(1):23-34.
  12. Jung JS, Lee KS. Investigation of the relationships between death recognition, terminal care stress, and terminal care performance in terminal hospital nurses. Science of Emotion and Sensibility. 2020;23(1):79-88. https://doi.org/10.14695/kjsos.2020.23.1.79
  13. Seol, EM, Koh CK. Experiences of critical care nurses caring for dying patients. Journal of Korean Critical Care Nursing 2018;11(2):1-10.
  14. Kang SY, Koh MH, Choi JS. The experience of hospice nurses on spiritual care: The process of untying a knot of mind. Asian Oncology Nursing. 2008;8(2):111-119.
  15. Korean Statistical Information Service. Aging index [Internet]. Seoul: Statistics Korea; 2021 [cited 2022 February 15]. Available from: https://kosis.kr/visual/nsportalStats/detail.do?menuId=10&NUM=1016&cntUpd ate=Y
  16. Oh JY, Lee DH, LIM JW, Shin YJ, Park DH, Yoo HR, et al. Study on improvement of hospice palliative care service in investigation system-focusing on strengthening linkage between types and promoting patient-centered integrated use. Research report. Wonju: Health Insurance Review & Assessment Service; 2020 February. Report No.: G000F8R-2020-27 https://repository.hira.or.kr/handle/2019.oak/2259
  17. Choi SH, Jung JH, Jung SW. Concept and procedures of qualitative content analysis. Journal of Qualitative Inquiry. 2016;2(1):127-155.
  18. Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qualitative Health Research. 2005;15(9):1277-1288. https://doi.org/10.1177/1049732305276687
  19. Elo S, Kyngas H. The qualitative content analysis process. Journal of advanced nursing. 2008;62(1):107-115. https://doi.org/10.1111/j.1365-2648.2007.04569.x
  20. Guba EG, Lincoln YS. Effective evaluation: Improving the usefulness of evaluation results through responsive and naturalistic approaches. Jossey-Bass, 1981. https://doi.org/10.1016/0738-0593(82)90012-8
  21. Kim HS, Choi EK, Kim TH, Yun HY, Kim EJ, Hong JJ, et al. Difficulties in end-of-life care and educational needs of intensive care unit nurses: a mixed methods study. The Korean Journal of Hospice and Palliative Care. 2019;22(2):87-99. https://doi.org/10.14475/kjhpc.2019.22.2.87
  22. Lee MS, Kim YJ. Good death recognized by the elderly. The Journal of the Korea Contents Association. 2013;13(6):283-299. https://doi.org/10.5392/jkca.2013.13.06.283
  23. Lee GJ, Park YS. Nurses' spirituality and attitude toward terminal care in geriatric hospital. 2015;13(12):347-357. https://doi.org/10.14400/JDC.2015.13.12.347
  24. Hardin M, Anderson D, Rexford T. Evaluation of self-efficacy and confidence levels among newly graduated nurses exposed to an end-of-life simulation: a comparison study. Journal of Hospice & Palliative Nursing. 2020;22(6)504-511. DOI: 10.1097/NJH.0000000000000698
  25. Ono W. Relationships among actions, antecedents, and outcomes of grief care for bereaved caregivers: surveying visiting nurses throughout Japan. Japan Journal of Nursing Science. 2013;10(2):212-222. https://doi.org/10.1111/jjns.12000
  26. Teruya N, Sunagawa Y, Sunagawa H, Toyosato T. Visiting nurses' perspectives on practices to achieve end-of-life cancer patients' wishes for death at home: A qualitative study. Asia-Pacific journal of oncology nursing. 2019;6(4):389-396. https://doi.org/10.4103/apjon.apjon_18_19
  27. Hwang MS, Park HY, Chang SJ. Difficulties and coping experienced by advanced practice nurses in home health nursing field. Journal of Korean Academy of Community Health Nursing. 2020;31(2):143-155. https://doi.org/10.12799/jkachn.2020.31.2.143
  28. Lim, JY, Kim JH. Expansion strategy of home visit nursing services of long-term care insurance. Journal of Korean Academic Society of Home Health Care Nursing. 2020;27(3):241-249. https://doi.org/10.22705/jkashcn.2020.27.3.241
  29. Choi JS, Jin DB, Lee M, Ko JA. Evaluation of the effectiveness of the first pilot project for home-type hospice palliative care and improvement measures. Research report. Wonju: Health Insurance Review & Assessment Service; 2018 March. Report No.: G000K39-2018-25 https://repository.hira.or.kr/handle/2019.oak/1535.
  30. Kim SH, Jang SN. A study on death perception of home visiting nurses. Journal of Qualitative Inquiry 5.2(2019):89-130 https://doi.org/10.30940/jqi.2019.5.2.89