Ethical issues experienced during palliative care provision in nursing homes

Deborah Muldrew, Dorry Mclaughlin, Kevin Brazil

Research output: Contribution to journalArticle

Abstract

Background: Palliative care is acknowledged as an appropriate approach to support older people in nursing homes. Ethical issues arise from many aspects of palliative care provision in nursing homes; however, they have not been investigated in this context.
Aim: To explore the ethical issues associated with palliative care in nursing homes in the United Kingdom.
Design: Exploratory, sequential, mixed-methods design.
Methods: Semi-structured interviews with 13 registered nurses and 10 healthcare assistants (HCAs) working in 13 nursing homes in the United Kingdom were used to explore ethical issues in palliative care. The ‘Ethical Issues in Palliative Care for Nursing Homes’ instrument was used to measure the frequency and level of distress of ethical issues through a cross-sectional survey with 69 registered nurses and 129 healthcare assistants. Data collection occurred between December 2014 and November 2015.
Ethics: Ethical approval was granted by Queen’s University’s School of Nursing and Midwifery Research Ethics Committee and governance sought from each nursing home’s manager.
Findings: The interviews revealed three themes: ethical issues in practice; relational issues; and organisational issues. No significant differences between registered nurses and healthcare assistants were evident, confirming the patterns emerging from the interviews. Relational issues, primarily issues with residents and families, occurred most frequently and caused greater distress.
Conclusion: The shared environment is key in the experience of ethical issues; therefore, multidisciplinary education is needed for ethical decision making in palliative care. Addressing staff knowledge and service organisation may reduce ethical issues locally and provide a benchmark for
global change.
LanguageEnglish
JournalNursing Ethics
Early online date26 Jun 2018
DOIs
Publication statusE-pub ahead of print - 26 Jun 2018

Fingerprint

Nursing Homes
Palliative Care
Ethics
Allied Health Personnel
Hospice and Palliative Care Nursing
Nurses
Interviews
School Nursing
Benchmarking
Nursing Research
Research Ethics Committees
Midwifery
Decision Making
Cross-Sectional Studies
Organizations
Education

Keywords

  • Palliative care
  • Nursing Homes
  • Ethics
  • Adult Nursing
  • Healthcare Assistants
  • Mixed methods
  • care homes

Cite this

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abstract = "Background: Palliative care is acknowledged as an appropriate approach to support older people in nursing homes. Ethical issues arise from many aspects of palliative care provision in nursing homes; however, they have not been investigated in this context.Aim: To explore the ethical issues associated with palliative care in nursing homes in the United Kingdom.Design: Exploratory, sequential, mixed-methods design.Methods: Semi-structured interviews with 13 registered nurses and 10 healthcare assistants (HCAs) working in 13 nursing homes in the United Kingdom were used to explore ethical issues in palliative care. The ‘Ethical Issues in Palliative Care for Nursing Homes’ instrument was used to measure the frequency and level of distress of ethical issues through a cross-sectional survey with 69 registered nurses and 129 healthcare assistants. Data collection occurred between December 2014 and November 2015.Ethics: Ethical approval was granted by Queen’s University’s School of Nursing and Midwifery Research Ethics Committee and governance sought from each nursing home’s manager.Findings: The interviews revealed three themes: ethical issues in practice; relational issues; and organisational issues. No significant differences between registered nurses and healthcare assistants were evident, confirming the patterns emerging from the interviews. Relational issues, primarily issues with residents and families, occurred most frequently and caused greater distress.Conclusion: The shared environment is key in the experience of ethical issues; therefore, multidisciplinary education is needed for ethical decision making in palliative care. Addressing staff knowledge and service organisation may reduce ethical issues locally and provide a benchmark forglobal change.",
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Ethical issues experienced during palliative care provision in nursing homes. / Muldrew, Deborah; Mclaughlin, Dorry; Brazil, Kevin.

In: Nursing Ethics, 26.06.2018.

Research output: Contribution to journalArticle

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