Jinxin Zhang1,2,3, Yingjuan Cao3,4, Mingzhu Su1,2, Joyce Cheng5, Nengliang Yao6,7. 1. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China. 2. NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China. 3. School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China. 4. Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China. 5. Johns Hopkins University School of Medicine, Baltimore, United States. 6. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China. ayao@aging.org.cn. 7. NHC Key Lab of Health Economics and Policy Research, Shandong University, Jinan, China. ayao@aging.org.cn.
Abstract
BACKGROUND: Chinese clinical nurses are increasingly confronting patient death, as the proportion of hospital deaths is growing. Witnessing patient suffering and death is stressful, and failure to cope with this challenge may result in decreased well-being of nurses and impediment of the provision of "good death" care for patients and their families. To our knowledge, few studies have specifically explored clinical nurses' experiences coping with patient death in mainland China. OBJECTIVE: We aimed to explore nurses' experiences coping with patient death in China in order to support frontline clinical nurses effectively and guide the government in improving hospice care policy. METHODS: Clinical nurses were recruited using purposive and snowball sampling between June 2020 and August 2020. We gathered experiences of clinical nurses who have coped with patient death using face-to-face, semi-structured, in-depth interviews. Audio recordings were transcribed verbatim and analyzed using thematic analysis. RESULTS: Three thematic categories were generated from data analysis. The first was "negative emotions from contextual challenges." This category involved grief over deaths of younger persons, pity for deaths without family, and dread related to coping with patient death on night duty. The second category was "awareness of mortality on its own." Subthemes included the ideas that death means that everything stops being and good living is important because we all die and disappear. The third category was "coping style." This category included focusing on treating dying patients, recording the signs and symptoms, and responding to changes in the patient's condition. It also involved subthemes such as avoiding talk about death due to the grief associated with dying and death, and seeking help from colleagues. CONCLUSIONS: Clinical nurses' emotional experiences are shaped by intense Chinese filial love, charity, and cultural attitudes towards death. Reasonable nurse scheduling to ensure patient and staff safety is a major priority. "Good death" decisions based on Chinese ethical and moral beliefs must be embedded throughout hospital care.
BACKGROUND: Chinese clinical nurses are increasingly confronting patient death, as the proportion of hospital deaths is growing. Witnessing patient suffering and death is stressful, and failure to cope with this challenge may result in decreased well-being of nurses and impediment of the provision of "good death" care for patients and their families. To our knowledge, few studies have specifically explored clinical nurses' experiences coping with patient death in mainland China. OBJECTIVE: We aimed to explore nurses' experiences coping with patient death in China in order to support frontline clinical nurses effectively and guide the government in improving hospice care policy. METHODS: Clinical nurses were recruited using purposive and snowball sampling between June 2020 and August 2020. We gathered experiences of clinical nurses who have coped with patient death using face-to-face, semi-structured, in-depth interviews. Audio recordings were transcribed verbatim and analyzed using thematic analysis. RESULTS: Three thematic categories were generated from data analysis. The first was "negative emotions from contextual challenges." This category involved grief over deaths of younger persons, pity for deaths without family, and dread related to coping with patient death on night duty. The second category was "awareness of mortality on its own." Subthemes included the ideas that death means that everything stops being and good living is important because we all die and disappear. The third category was "coping style." This category included focusing on treating dying patients, recording the signs and symptoms, and responding to changes in the patient's condition. It also involved subthemes such as avoiding talk about death due to the grief associated with dying and death, and seeking help from colleagues. CONCLUSIONS: Clinical nurses' emotional experiences are shaped by intense Chinese filial love, charity, and cultural attitudes towards death. Reasonable nurse scheduling to ensure patient and staff safety is a major priority. "Good death" decisions based on Chinese ethical and moral beliefs must be embedded throughout hospital care.
Authors: Lara Pivodic; Koen Pardon; Lucas Morin; Julia Addington-Hall; Guido Miccinesi; Marylou Cardenas-Turanzas; Bregje Onwuteaka-Philipsen; Wayne Naylor; Miguel Ruiz Ramos; Lieve Van den Block; Donna M Wilson; Martin Loucka; Agnes Csikos; Yong Joo Rhee; Joan Teno; Luc Deliens; Dirk Houttekier; Joachim Cohen Journal: J Epidemiol Community Health Date: 2015-07-22 Impact factor: 3.710
Authors: Li Weng; Yizhen Hu; Zhijia Sun; Canqing Yu; Yu Guo; Pei Pei; Ling Yang; Yiping Chen; Huaidong Du; Yuanjie Pang; Yan Lu; Junshi Chen; Zhengming Chen; Bin Du; Jun Lv; Liming Li Journal: Lancet Reg Health West Pac Date: 2021-11-09