Hospice Palliative Nurses' Experience of Caring for Terminal Cancer Patients

Suhye Kwon; Young Sook Tae; Minjoo Hong; Gum Hee Choi

doi:10.5388/aon.2015.15.4.264

Journal List > Asian Oncol Nurs > v.15(4) > 1081852

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Kwon, Tae, Hong, and Choi: Hospice Palliative Nurses' Experience of Caring for Terminal Cancer Patients

Original Article

Asian Oncology Nursing 2015; 15(4): 264-275.

Published online: 31 December 2015

DOI: https://doi.org/10.5388/aon.2015.15.4.264

Hospice Palliative Nurses' Experience of Caring for Terminal Cancer Patients

Suhye Kwon¹, Young Sook Tae¹, Minjoo Hong², Gum Hee Choi³

¹College of Nursing, Kosin University, Busan, Korea.

²Department of Nursing, Changshin University, Changwon, Korea.

³Department of Nursing, Choonhae College of Health Sciences, Ulsan, Korea.

Address reprint requests to: Choi, Gum Hee. Department of Nursing, Choonhae College of Health Sciences, 9 Daehag-gil, Ungchon-myeon, Ulju-gun, Ulsan 44965, Korea. Tel: +82-52-270-0215, Fax: +82-52-225-9889, imgumhee@hanmail.net

Received 28 September 2015 Revised 5 November 2015 Accepted 18 December 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of the study was to explore and describe hospice palliative nurses' experience of caring for terminal cancer patients.

Methods

Eleven hospice palliative nurses participated in the study. Data were collected through individual in-depth unstructured interviews with participants from November, 2012 to October, 2013. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using Corbin and Strauss' 'Grounded Theory Method.'

Results

From open coding, 25 sub-categories and 12 categories were identified. Analysis revealed that the core category was 'becoming stepping-stones between life and death enduring burdens', consisting of three phases: the phase of withdrawal, the phase of exertion, and the phase of maturity. Through this process, participants utilized various action/interactional strategies such as 'maintaining a distance', 'sharing intimate daily life', 'being a mediator for a peaceful death', 'grieving and remembering'. The consequences of these strategies were a transcendental perspective towards life and ambivalent feelings toward hospice nursing.

Conclusion

In-depth understanding of the hospice palliative nurses' experience of caring for terminal cancer patients will guide nurse managers and policy makers to promote effective nursing strategies to better support hospice palliative nurses.

Keywords: Hospice and Palliative Care Nursing, Terminal Care, Neoplasms, Patient Care, Qualitative Research

Figures and Tables

Fig. 1

The Process of Becoming Stepping-Stones between Life and Death Enduring Burdens.

Table 1

Relationships among Categories using Paradigm Model

Subcategory	Category	Paradigm element
Hospice work which was started unprepared	Vaguely started hospice nursing	Causal condition
Repeated dying situations	Gushing situations of dying patients
Unexpected dying situations	Gushing situations of dying patients
Too much burden of physical care	Heavy burden of helping the completion of life	Central phenomenon
Difficulties for caring according to the types of cancer
Emotional distress
Conflicts in relationships
Handling in a businesslike way	Maintaining a distance	Action/interactional strategy
Drawing a line of emotion	Maintaining a distance
Going nearer	Sharing intimate daily life
Sharing daily life like family
Granting wishes
Hanging on to symptom management	Being a mediator for a peaceful death
Providing spiritual care
Mediating relationships
Grieving and missing	Grieving and remembering
Supporting Bereaved family	Grieving and remembering
Positive perspective change regarding death	Transcendental perspective towards life	Consequence
Growing self as different than before	Transcendental perspective towards life
Rewarded feeling from true nursing practice	Ambivalent feelings towards hospice nursing
Feeling skeptical about work world	Ambivalent feelings towards hospice nursing
Strength from faith	Inner strength	Contextual condition
Personal character	Inner strength	Contextual condition
Supportive colleagues	Supporting system	Intervening condition
Building rapport with patients	Relationship with patients	Intervening condition

Notes

This study was supported by the research fund of Kosin University in 2014.

References

1. Statistics Korea. http://www.index.go.kr/potal/main/EachDtlPageDetail.do?idx_cd=27705. Accessed September 1, 2015.

2. National Cancer Center. http://hospice.cancer.go.kr/home/contentsInfo.do?menu_no=443&brd_mgrno. Accessed September 8, 2015.

3. Leou CS, Kim KG, Kim JH. Factors associated with burnout of nurses working for cancer patients. Korean J Hosp Palliat Care. 2005; 8(1):45–51.

4. Kwon IG, Hwang MS, Kwon KM. Quality of life of the terminal cancer patients receiving home care nursing. J Korean Clin Nurs Res. 2008; 14(2):103–114.

5. Lee JH, Park JI, Kang JH, Youm JH, Koh DH, Dwon KS. Needs assessment for the beneficiaries of home-based cancer patients management project. J Agric Med Community Health. 2011; 36(4):238–250.

6. Kim DS, Park HS, Kim JA, Choi JH, Park MJ. A study on nurses, doctors and hospice volunteers's perception of the hospice care and advanced directives about the terminal cancer patients. Glob Health Nurs. 2012; 2:82–93.

7. Lambert VA, Lambert CE. Nurses' workplace stressors and coping strategies. Indian J Palliat Care. 2008; 14(1):38.

8. Schaffer M, Norlander L. Being present: a nurse's resource for end-oflife communication. Indianapolis: Sigma Theta Tau;2009.

9. Sobo EJ, Bowman C, Gifford AL. Behind the scenes in health care improvement: the complex structures and emergent strategies of implementation science. Soc Sci Med. 2008; 67(10):1530–1540.

10. Choi AS. The experience of nursing care for dying patients in new nurses [Master's thesis]. Seoul: Kwandong Univ.;2002.

11. Kim YH. A study of nurses burden and attitude on terminal cancer patients. J Korean Oncol Nurs. 2001; 1(1):65–74.

12. Jo KH, Kim MJ. The perception of suffering by hospice nurses. J Korean Acad Fundam Nurs. 2001; 8(1):35–50.

13. Kang SY, Lee BS. The lived experience of nursing care for the dying patients in clinical nurses. J Korean Acad Nurs Adm. 2001; 7(2):237–251.

14. Yi M. Nurses' experience of caring for dying patients in hospitals. J Korean Acad Nurs. 2003; 33(5):553–561.

15. Corbin J, Strauss A. Basics of qualitative research 3e. London: Sage;2008.

16. Lincoln YS, Guba EG. Naturalistic Inquiry. London: Sage Publications;1985.

17. Kim HJ, Gu JI, Byun JH, Kim SM, Choi HS. Nurse's experience of changing role in the hospice unit of medical ward. Korean J Hosp Palliat Care. 2008; 11(1):30–41.

18. Lazarus RS, Folkman S. Stress appraisal and coping. New York: Springer Publishers;1984.

19. Noh JH, Eom JY, Yang KS, Park HS. New nurses' experience on care of dying patients. Qual Res. 2009; 10(1):51–62.

20. Kang HJ, Bang KS. Neonatal intensive care unit nurses' experience in caring for infants who are dying. Child Health Nurs Res. 2013; 19(4):252–261.

21. Shin MH, Shin SR. Predictors of burnout among oncology nurses. Asian Oncol Nurs. 2003; 3(1):75–84.

22. Kim JH, Lee HK. Cancer unit nurses' end-of-life care-related stress, understanding and training needs. Korean J Hosp Palliat Care. 2012; 15(4):205–211.

23. Kang SY, Koh MH, Choi JS. The experience of hospice nurses on spiritual care: the process of untying a knot of mind. J Korean Oncol Nurs. 2008; 8(2):111–119.

24. Wu HL, Volker DL, editors. Living with death and dying: the experience of Taiwanese hospice nurses. Oncol Nurs Forum. 2009; 36(5):578–584.

25. Jo KH, Kim YK. The influencing factors on the degree of nurse's suffering experience caring for terminal cancer patient. Korean J Adult Nurs. 2004; 16(3):378–387.

26. Lee HR, Lee YO, Choi EO, Park YM. A comparison on stress and coping of bereavement care between nurses in the cancer unit and nurses in the general unit. J Korean Oncol Nurs. 2007; 7:26–35.

27. Jo KH, Park AR, Lee JJ, Choi SJ. The influence of humanistic knowledge, hospice perception and spirituality on terminal care performance of clinical nurses. Korean J Med Ethics. 2015; 18(2):103–116.

28. Mok E, Chiu PC. Nurse-patient relationships in palliative care. J Adv Nurs. 2004; 48(5):475–483.

TOOLS

Similar articles