"Comparison of Ethical Issues Experienced during Palliative Care Provision in Nursing Homes in the UK and Canada: Findings from a Cross-sectional Survey"

Deborah Muldrew, Sharon Kaasalainen, Dorry McLaughlin, Kevin Brazil

Research output: Contribution to journalConference article

Abstract

Background: Increased dependency on nursing homes to provide palliative care to an ageing population with complex care needs may lead to an increase in ethical issues, which may in turn lead to burnout and moral distress for staff.

Aim: To identify the type of ethical issues and level of associated distress experienced by nurses providing palliative care in nursing homes in the UK and Canada.

Methods: A cross-sectional survey design was utilised. On the day of data collection, all nurses working in 21 nursing homes across the UK and Canada received the “Ethical issues in Palliative Care for Nursing Homes” survey instrument. The EPiCNH instrument consists of 26 items, scored on two subscales; Frequency and Distress. One hundred and twenty three nurses completed the instrument across two days of data collection. Descriptive and inferential statistics were used to compare the frequency and level of distress caused by ethical issues in the UK and Canada.

Results: Frequent ethical issues include upholding resident autonomy, managing family distress, lack of staff communication, and lack of time in both countries. Higher levels of distress resulted from poor communication, insufficient training, lack of time, and family disagreements. Nurses in Canada experienced a greater frequency of ethical issues (p=.022), however, there was no statistical difference in reported distress levels (p=.53).

Conclusions: Nurses’ reported comparable experiences of providing palliative care in UK and Canadian nursing homes. The majority of items overlap between the two countries suggesting pervasiveness of these ethical issues. These findings have implications on the practise of care in nursing homes, including how care is organized as well as capacity of staff to care for residents at the end of life. Training staff to take account of patient and family values during decision-making may address many ethical issues, in line with global policy recommendations.

Funder: Queen’s University Belfast

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Nursing Homes
Palliative Care
Ethics
Canada
Cross-Sectional Studies
Nurses
Hospice and Palliative Care Nursing
Communication
Home Care Services
Decision Making
Population

Cite this

@article{a85b01b114ab4269be7b9c1e2bad9cd2,
title = "{"}Comparison of Ethical Issues Experienced during Palliative Care Provision in Nursing Homes in the UK and Canada: Findings from a Cross-sectional Survey{"}",
abstract = "Background: Increased dependency on nursing homes to provide palliative care to an ageing population with complex care needs may lead to an increase in ethical issues, which may in turn lead to burnout and moral distress for staff.Aim: To identify the type of ethical issues and level of associated distress experienced by nurses providing palliative care in nursing homes in the UK and Canada.Methods: A cross-sectional survey design was utilised. On the day of data collection, all nurses working in 21 nursing homes across the UK and Canada received the “Ethical issues in Palliative Care for Nursing Homes” survey instrument. The EPiCNH instrument consists of 26 items, scored on two subscales; Frequency and Distress. One hundred and twenty three nurses completed the instrument across two days of data collection. Descriptive and inferential statistics were used to compare the frequency and level of distress caused by ethical issues in the UK and Canada.Results: Frequent ethical issues include upholding resident autonomy, managing family distress, lack of staff communication, and lack of time in both countries. Higher levels of distress resulted from poor communication, insufficient training, lack of time, and family disagreements. Nurses in Canada experienced a greater frequency of ethical issues (p=.022), however, there was no statistical difference in reported distress levels (p=.53).Conclusions: Nurses’ reported comparable experiences of providing palliative care in UK and Canadian nursing homes. The majority of items overlap between the two countries suggesting pervasiveness of these ethical issues. These findings have implications on the practise of care in nursing homes, including how care is organized as well as capacity of staff to care for residents at the end of life. Training staff to take account of patient and family values during decision-making may address many ethical issues, in line with global policy recommendations.Funder: Queen’s University Belfast",
author = "Deborah Muldrew and Sharon Kaasalainen and Dorry McLaughlin and Kevin Brazil",
year = "2019",
month = "5",
day = "21",
doi = "https://doi.org/10.1177/0269216319844405",
language = "English",
journal = "Palliative Medicine",
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"Comparison of Ethical Issues Experienced during Palliative Care Provision in Nursing Homes in the UK and Canada: Findings from a Cross-sectional Survey". / Muldrew, Deborah; Kaasalainen, Sharon; McLaughlin, Dorry; Brazil, Kevin.

In: Palliative Medicine, 21.05.2019.

Research output: Contribution to journalConference article

TY - JOUR

T1 - "Comparison of Ethical Issues Experienced during Palliative Care Provision in Nursing Homes in the UK and Canada: Findings from a Cross-sectional Survey"

AU - Muldrew, Deborah

AU - Kaasalainen, Sharon

AU - McLaughlin, Dorry

AU - Brazil, Kevin

PY - 2019/5/21

Y1 - 2019/5/21

N2 - Background: Increased dependency on nursing homes to provide palliative care to an ageing population with complex care needs may lead to an increase in ethical issues, which may in turn lead to burnout and moral distress for staff.Aim: To identify the type of ethical issues and level of associated distress experienced by nurses providing palliative care in nursing homes in the UK and Canada.Methods: A cross-sectional survey design was utilised. On the day of data collection, all nurses working in 21 nursing homes across the UK and Canada received the “Ethical issues in Palliative Care for Nursing Homes” survey instrument. The EPiCNH instrument consists of 26 items, scored on two subscales; Frequency and Distress. One hundred and twenty three nurses completed the instrument across two days of data collection. Descriptive and inferential statistics were used to compare the frequency and level of distress caused by ethical issues in the UK and Canada.Results: Frequent ethical issues include upholding resident autonomy, managing family distress, lack of staff communication, and lack of time in both countries. Higher levels of distress resulted from poor communication, insufficient training, lack of time, and family disagreements. Nurses in Canada experienced a greater frequency of ethical issues (p=.022), however, there was no statistical difference in reported distress levels (p=.53).Conclusions: Nurses’ reported comparable experiences of providing palliative care in UK and Canadian nursing homes. The majority of items overlap between the two countries suggesting pervasiveness of these ethical issues. These findings have implications on the practise of care in nursing homes, including how care is organized as well as capacity of staff to care for residents at the end of life. Training staff to take account of patient and family values during decision-making may address many ethical issues, in line with global policy recommendations.Funder: Queen’s University Belfast

AB - Background: Increased dependency on nursing homes to provide palliative care to an ageing population with complex care needs may lead to an increase in ethical issues, which may in turn lead to burnout and moral distress for staff.Aim: To identify the type of ethical issues and level of associated distress experienced by nurses providing palliative care in nursing homes in the UK and Canada.Methods: A cross-sectional survey design was utilised. On the day of data collection, all nurses working in 21 nursing homes across the UK and Canada received the “Ethical issues in Palliative Care for Nursing Homes” survey instrument. The EPiCNH instrument consists of 26 items, scored on two subscales; Frequency and Distress. One hundred and twenty three nurses completed the instrument across two days of data collection. Descriptive and inferential statistics were used to compare the frequency and level of distress caused by ethical issues in the UK and Canada.Results: Frequent ethical issues include upholding resident autonomy, managing family distress, lack of staff communication, and lack of time in both countries. Higher levels of distress resulted from poor communication, insufficient training, lack of time, and family disagreements. Nurses in Canada experienced a greater frequency of ethical issues (p=.022), however, there was no statistical difference in reported distress levels (p=.53).Conclusions: Nurses’ reported comparable experiences of providing palliative care in UK and Canadian nursing homes. The majority of items overlap between the two countries suggesting pervasiveness of these ethical issues. These findings have implications on the practise of care in nursing homes, including how care is organized as well as capacity of staff to care for residents at the end of life. Training staff to take account of patient and family values during decision-making may address many ethical issues, in line with global policy recommendations.Funder: Queen’s University Belfast

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DO - https://doi.org/10.1177/0269216319844405

M3 - Conference article

JO - Palliative Medicine

T2 - Palliative Medicine

JF - Palliative Medicine

SN - 0269-2163

ER -