Nursing Staff's Perception of Barriers in Providing End-of-Life Care to Terminally Ill Pediatric Patients in Southeast Iran.

To determine pediatric nurses' perceptions of intensity, frequency occurrence, and magnitude score of selected barriers in providing pediatric end-of-life (EOL) care. A translated modified version of National Survey of critical care Nurses' s Regarding End-of-Life Care questionnaire was used to assess 151 nurses' perceptions of intensity and frequency occurrence of barriers in caring for dying children. The highest/lowest perceived barriers magnitude scores were "families not accepting poor child prognosis" (5.04) and "continuing to provide advanced treatment to dying child because of financial benefits to the hospital" (2.19). More high perceived barriers by nurses were family-related issues. One of the possible causes of such deficiencies was lack of palliative care (PC) education/PC units in Iran. Thus, developing EOL/PC education may enhance nurses' knowledge/skill to face EOL care challenges.

Iranmanesh S ，Banazadeh M ，Forozy MA 《-》

Barriers of Palliative Care in Neonatal Intensive Care Units.

Azzizadeh Forouzi M ，Banazadeh M ，Ahmadi JS ，Razban F ... -  《-》

The last frontier: rural emergency nurses' perceptions of end-of-life care obstacles.

Caring for dying patients is part of working in a rural emergency department. Rural emergency nurses are prepared to provide life-saving treatments but find there are barriers or obstacles to providing end-of-life (EOL) care. This study was completed to discover the size, frequency, and magnitude of obstacles in providing EOL care in rural emergency departments as perceived by rural emergency nurses. A 57-item questionnaire was sent to 52 rural hospitals in Idaho, Wyoming, Utah, Nevada, and Alaska. Respondents were asked to rate items on size and frequency of perceived obstacles to providing EOL care in rural emergency departments. Results were compared with results from 2 previous emergency nurses' studies to determine if rural nurses had different obstacles to providing EOL care. The top 3 perceived obstacles by rural emergency nurses were: (1) family and friends who continually call the nurse for an update on the patient's condition rather than calling the designated family member; (2) knowing the patient or family members personally; and (3) the poor design of emergency departments that does not allow for privacy of dying patients or grieving family members. The results of this study differed from the other 2 previous studies of emergency nurses' perceptions of EOL care. Nurses in rural emergency settings often work in an environment without many support personnel. Answering numerous phone calls removes the nurse from the bedside of the dying patient and is seen as a large and frequent obstacle. Personally knowing either the patient or members of the family is a common obstacle to providing EOL care in rural communities. Rural nurses often describe their patients as family members or friends. Caring for a dying friend or family member can be intensely rewarding but also can be very distressing. Rural emergency nurses live and work on the frontier. Little EOL research has been conducted using the perceptions of rural emergency nurses possibly because of the difficulty in accurately accessing this special population of nurses. Rural emergency nurses report experiencing both similar and different obstacles compared with their counterparts working in predominately non-rural emergency departments. By understanding the obstacles faced by emergency nurses in the rural setting, changes can be implemented to help decrease the largest obstacles to EOL care, which will improve care of the dying patient in rural emergency departments. Further research is needed in the area of rural emergency nursing and in EOL care for rural patients.

Beckstrand RL ，Giles VC ，Luthy KE ，Callister LC ，Heaston S ... -  《-》

Meaninglessness in terminally ill cancer patients: a validation study and nurse education intervention trial.

Morita T ，Murata H ，Hirai K ，Tamura K ，Kataoka J ，Ohnishi H ，Akizuki N ，Kurihara Y ，Akechi T ，Uchitomi Y ，Japanese Spiritual Care Task Force ... -  《JOURNAL OF PAIN AND SYMPTOM MANAGEMENT》

Oncology nurses' perceptions of obstacles and supportive behaviors at the end of life.

Beckstrand RL ，Moore J ，Callister L ，Bond AE ... -  《-》