Paediatric nurses' perceptions of obstacles and supportive behaviours in end of life care in paediatric intensive care units

Show simple item record Louw, Natwin 2016-10-14T13:12:03Z 2016-10-14T13:12:03Z 2016-10-14
dc.description A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg In partial fulfilment of the requirements for the degree of Master of Science in Nursing Johannesburg, 2016 en_ZA
dc.description.abstract The untimely death of a child in a highly technological intensive care unit evokes exaggerated feelings of devastation, stress, anger, helplessness and hopelessness in the child’s family. The reasons are that death occurs suddenly and at times following a decision to withhold or withdraw life sustaining treatment. As a result; end-of-life care which incorporates principles of family-centred care is an important aspect of paediatric nursing. Empowering family members to participate in care plans in providing the child with a dignified death is a crucially important service that paediatric intensive care nurses can render. Though nurses yearn to nurture and provide the best care possible in end-oflife there are challenges that hinder this desire. The purpose of the study was to identify and describe nurses’ perceptions of behaviours which are obstacles to or support the provision of effective end-of-life care in paediatric intensive care units (PICU) at two public urban academic hospitals in Johannesburg. The study utilised a quantitative approach with a descriptive survey design to collect data means of the self-administered Paediatric Nurses Perceptions of End-of-Life Care (PEDS) questionnaire developed by Beckstrand et al. (2010). The total population of eighty seven (87) paediatric nurses working in paediatric and neonatal intensive care units who met the inclusion criteria were recruited to respond to the PEDS questionnaire. Sixty two (62) questionnaires were returned, a seventy two percent (72%) response rate. Descriptive statistics using SPSS’ version 22 was used to analyse, describe, and summarise data in consultation with a statistician. All the nurses (62; 100%) reported delivering direct end-of-life care to paediatric and neonatal patients during their short (less than 5 years; n=31) to long (6 to more than 30 years; n=31) PICU work experience. Most (48; 77 %) of the nurses were qualified with a vi Diploma in Nursing, twelve (21%) were Bachelor’s degree graduates and one (2%) Doctoral degree prepared nurse, had not participated in a specialised end-of-life care program (53; 85.5%). Nurses identified and ranked; “poor design of units which do not allow for either privacy of dying patients and their family members”, “the nurses workload being too heavy to adequately care for the dying child and grieving family” and “dealing with anxious families” items, as the major and most frequently occurring obstacles to delivering optimal end-of-life care. Amongst supportive behaviours items the cohort ranked “allowing family members adequate time to be alone with the child after he/she dies”, “providing a peaceful, dignified bedside scene for family members once the child has died” the highest. The most frequently occurring supportive behaviours identified were all attributes of a good death. Open ended questionnaire responses identified more helpful behaviours to end-of-life care relating to physician-nurse interactions. Though nurses in this study were faced with obstacles perceived to hinder their ability to provide optimal care to the dying child and family members they reported care demonstrating behaviours which support the provision of optimal end-of-life care and most valued by family members. Whilst increasing awareness of end-of-life-care in PICU the findings of the study have contribute positively in decreasing the dearth of South African literature on the topic. en_ZA
dc.language.iso en en_ZA
dc.title Paediatric nurses' perceptions of obstacles and supportive behaviours in end of life care in paediatric intensive care units en_ZA
dc.type Thesis en_ZA
dc.description.librarian MT2016 en_ZA

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