Palliative care for patients with cancer: district nurses’ experiences

K Dunne, K Sullivan, WG Kernohan

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Aim. This paper reports a study exploring district nurses’ experiences of providingpalliative care for patients with cancer and their families.Background. There is an increasing demand for palliative care in the community, asmany patients wish to die at home. District nurses are central to providing palliativecare in the community, but there is a dearth of literature on district nurses’experiences in palliative care.Method. A Husserlian phenomenological approach was adopted with a purposivesample of 25 female district nurses. Data were collected using unstructured, taperecordedinterviews and analysed using Colaizzi’s seven stages of data analysis.Findings. Four themes were identified: the communication web; the family as anelement of care; challenges for the district nurse in symptom management and thepersonal cost of caring.Conclusions. District nurses’ experiences of providing palliative care to family unitswas challenging but rewarding. The emotive nature of the experience cannot beunder-estimated, as many district nurses were touched by the varying situations.Whilst acknowledging the need to maintain an integrated approach to care, districtnurses should be identified as the key workers in the complex situation of palliativecare.
LanguageEnglish
Pages372-380
JournalJournal of Advanced Nursing
Volume50
Issue number4
Early online date12 Apr 2005
DOIs
Publication statusE-pub ahead of print - 12 Apr 2005

Fingerprint

Palliative Care
Nurses
Neoplasms
Patient Care
Communication
Costs and Cost Analysis

Keywords

  • district nursing
  • palliative care
  • Husserlian phenomenology
  • end-of-life
  • care
  • cancer nursing

Cite this

@article{194cc760dc5b42e8802cd885a7fdf8f9,
title = "Palliative care for patients with cancer: district nurses’ experiences",
abstract = "Aim. This paper reports a study exploring district nurses’ experiences of providingpalliative care for patients with cancer and their families.Background. There is an increasing demand for palliative care in the community, asmany patients wish to die at home. District nurses are central to providing palliativecare in the community, but there is a dearth of literature on district nurses’experiences in palliative care.Method. A Husserlian phenomenological approach was adopted with a purposivesample of 25 female district nurses. Data were collected using unstructured, taperecordedinterviews and analysed using Colaizzi’s seven stages of data analysis.Findings. Four themes were identified: the communication web; the family as anelement of care; challenges for the district nurse in symptom management and thepersonal cost of caring.Conclusions. District nurses’ experiences of providing palliative care to family unitswas challenging but rewarding. The emotive nature of the experience cannot beunder-estimated, as many district nurses were touched by the varying situations.Whilst acknowledging the need to maintain an integrated approach to care, districtnurses should be identified as the key workers in the complex situation of palliativecare.",
keywords = "district nursing, palliative care, Husserlian phenomenology, end-of-life, care, cancer nursing",
author = "K Dunne and K Sullivan and WG Kernohan",
note = "Reference text: Addington-Hall J.M. & McCarthy M. (1995) Dying from cancer: results of a national based investigation. Palliative Medicine 9(4), 295–305. Addington-Hall J.M., Altmann D. & McCarthy M. (1998) Which terminally ill patients receive hospice in-patient care? Social Science and Medicine 46(8), 1011–1016. Beck C. (1994) Phenomenology: Its use in nursing research. International Journal of Nursing Studies 31(6), 499–510. Bergen A. (1992a) Evaluating nursing care of the terminally ill in the community: a case study approach. International Journal of Nursing Studies 29(3), 81–94. Bergen A. (1992b) Nurses caring for the terminally ill in the community: a review of literature. Journal of Advanced Nursing 28(3), 89–101. Bliss J. (1998) District nurses and social workers understanding of each other’s role. British Journal of Community Nursing 3(7), 330–336. Bliss J., Cowley S. & While A. (2000) Interprofessional working in palliative care in the community: a review of the literature. Journal of Interprofessional Care 14(3), 281–290. Bonica J. (1991) The Management of Pain. Lea and Febiger, Philadelphia, PA. Buckman R. (1998) Communication and palliative care: a practical guide. In Oxford Textbook of Palliative Medicine (Doyle D., Hanks G. & MacDonald N., eds), Oxford University Press, Oxford, pp. 141–156. Cancer Relief Macmillan Fund (1994) Organisational Audit for Specialist Palliative Care Services. Cancer Relief Macmillan, London. Cancer Research Campaign (2000) Fighting Cancer on All Fronts. The Campaign, London. Carter B. & McGoldrick M. (1999) The Extended Family Life Cycle, 3rd edn. Gardiner Press, New York. Christ G., Siegel K. & Sperber D. (1994) Impact of parental terminal cancer on adolescents. American Journal of Orthospsychiatry 64(4), 604–613. Colaizzi P. (1978) Psychological research as a phenomenologist views it. In Existential Phenomenological Alternatives for Psychology (Valle R. & King M., eds), Oxford University Press, New York, pp. 48–71. Corner J., Plant H. & Warner L. (1995) Developing a nursing approach to managing dyspnoea in lung cancer. International Journal of Palliative Nursing 1(1), 5–10. Davis B., Cowley S. & Ryland R. (1996) The effects of terminal illness on patients and their carers. Journal of Advanced Nursing 23(3), 512–520. Davison D., Johnston G. & Reilly P. (1999) The Place of Death of Cancer Patients in Belfast. Queens University, Belfast. Department of Health and Social Security (1996) Cancer ServicesInvesting for the Future. DHSS, Belfast. Department of Health and Social Services (1999) Regional Palliative Care Review. DHSS, Belfast. Department of Health and Social Services and Public Safety (2000a) Partnerships in Caring. DHSSPS, Belfast. Department of Health, Social Services and Public Safety (2000b) Building the Way Forward in Primary Care. DHSSPS, Belfast. Dickson D., Hargie O. & Morrow N. (1997) Communication Skills Training for Health Care Professionals. Chapman and Hall, London. Dimond B. (1999) Confidentiality II: terminal illness and the duty of confidentiality. British Journal of Nursing 8(21), 1458–1459. Dunne K. & Sullivan K. (2000) Family members’ experience of palliative care in the acute hospital setting. International Journal of Palliative Nursing 6(4), 170–178. Field D. (1998) Special not different: General Practitioners’ accounts of their care of dying people. Social Science Medicine 46(9), 1111– 1120. Field D. & McCaughey J. (1998) An evaluation of palliative care services for cancer patients in the Southern Health and Social Services Board of Northern Ireland. Palliative Medicine 12(2), 83–97. Field D., Douglas C., Jagger C. & Dand P. (1995) Terminal illness: viewsofpatientsandtheirlaycarers.PalliativeMedicine9(1),45–54. Finlay I. (1999) Families as secondary patients. Palliative Care Today 8(3), 42. Goodman C., Knight D., Machen I. & Hunt B. (1998) Emphasising terminal care as district nursing work: a helpful strategy in a purchasing environment. Journal of Advanced Nursing 28(3), 491– 498. Grande G.E., Todd C.J., Barclay S. & Doyle J. (1996) What terminally ill patients value in the support provided by GP’s, District Nurses and Macmillan Nurses. International Journal of Palliative Nursing 2(3), 138–143. Griffin J. (1991) Dying with Dignity. Office of Health Economics, London. Guba E.G. & Lincoln Y. (1981) Effective Evaluation. Jossey-Bass, San Francisco, CA. Hatcliffe S., Smith P. & Daw R. (1996) District nurses’ perceptions of palliative care at home. Nursing Times 92(41), 36–37. Heinzer M. (1995) Loss of a parent in childhood: attachment and coping: a model of adolescence resilience. Holistic Nursing Practice 9(3), 27–37. Higginson I. & Priest P. (1996) Predictors of family anxiety in the weeks before bereavement. Social Science Medicine 43(II), 1621– 1625. Hinton J. (1994) Which patients with terminal cancer are admitted from home care? Palliative Medicine 8(3), 197–210. Husserl E. (1962) Ideas: General Introduction to Pure Phenomenology. Collier, New York. Jarrett N., Payne S., Turner P. & Hillier R. (1999) ‘Someone to talk to’ and ‘pain control’: what people expect from a specialist palliative care team. Palliative Medicine 13(3), 139–144. Karlsen S. & Addington-Hall J.M. (1998) How do cancer patients who die at home differ from those who die elsewhere? Palliative Medicine 12(4), 279–286. Kaye P. (1992) The A to Z of Hospice and Palliative Medicine. EPL Publications, Northampton. Kendall M. (1995) Truth telling and collusion: the ethical dilemmas of palliative nursing. International Journal of Palliative Nursing 1(3), 160–164. Leedham K. (1995) District nurses’ views on the role of rehabilitation in palliative care. International Journal of Palliative Nursing 1(3), 141–144. Lincoln Y. & Guba E. (1985) Naturalistic Inquiry. Sage, Newbury Park, CA. Luker K., Austin L., Caress A. & Hallett C. (2000) The importance of knowing the patient: community nurses constructions of quality in providing palliative care. Journal of Advanced Nursing 31(4), 775–782. Maguire P., Faulkner A., Booth K., Elliott C. & Hillier V. (1996) Helping cancer patients disclose their concerns. European Journal of Cancer 32A(1), 78–81. McIlfatrick S. & Curran C. (2000) District nurses’ perceptions of palliative care services: part 2 International. Journal of Palliative Nursing 6(1), 32–38. Meghani S.H. (2004) A concept analysis of palliative care in the United States. Journal of Advanced Nursing 46(2), 152–161. Moustakas C. (1994) Phenomenological Research Methods. Sage Publications, London. National Council for Hospice and Specialist Palliative Care Services (1995) Working Party on Clinical Guidelines on Palliative Care: Information for Purchasers. NCHSPCS, London. National Council for Hospice and Specialist Palliative Care Services (1997) Feeling Better: Psychosocial Care in Specialist Palliative Care. NCHSPCS, London. National Council for Hospice and Specialist Palliative Care Services (2000) National Plan and Strategic Framework for Palliative Care: 2000–2005. NCHSPCS, London. Neuenschwander H. & Bruera E. (1998) Asthenia. In The Oxford Textbook of Palliative Medicine, 2nd edn (Doyle D., Hanks G.W. & Mac Donald N., eds), University Press, Oxford, pp. 573–585. Nursing and Midwifery Council (2002) Code of Professional Conduct. Nursing and Midwifery Council, London. O’Driscoll M., Corner J. & Bailey C. (1999) The experience of breathlessness in lung cancer. European Journal of Cancer Care 8(1), 37–43. Palsson M. & Norberg A. (1995) District nurses’ stories of difficult care episodes during systematic clinical supervision sessions. Scandinavian Journal of Caring Sciences 9(1), 17–27. Polit D. & Hungler B. (2001) Nursing Research: Principles and Methods, 6th edn. Lippincott, Philadelphia, PA. Randall F. & Downie R. (1996) Palliative Care Ethics: A Good Companion. Oxford Medicine Publications, Oxford. Rose K. (1998) Perceptions related to time in a qualitative study of informal carers of terminally ill patients. Journal of Clinical Nursing 7(4), 343–350. Rout U. (2000) Stress among district nurses: a preliminary investigation. Journal of Clinical Nursing 9(2), 303–309. Sahlberg-Blom E., Teruestedt B.M. & Johansson J.E. (1998) The last month of life: continuity, care, site and place of death. Palliative Medicine 12(3), 287–296. Seale C. (1992) Community nurses and the care of the dying. Social Science and Medicine 34(4), 375–382. Smith M. & Hart G. (1994) Nurses’ response to patient anger: from disconnecting to connecting. Journal of Advanced Nursing 20(4), 643–651. Snelgrove S. (1998) Occupational stress and job satisfaction: a comparative study of health visitors, district nurses and community psychiatric nurses. Journal of Nursing Management 6(2), 97–104. Spiegelberg H. (1975) The Phenomenological Movement: A Historical Introduction, 2nd edn, Vol. 1–2. Nijhoff, The Hague. Townsend J., Frank H.O. & Fremont D. (1990) Terminal care and patients’ preference for place of death: a prospective study. British Medical Journal 301(6749), 415–417. Vachon M.L., Kristjanson L. & Higginson M.B. (1995) Psychosocial issues in palliative care. Journal of Pain and Symptom Management 10(2), 142–150. Valle R. & King M. (1978) Existential – Phenomenological. Alternatives for Psychology. Oxford University Press, New York. Walsh D., Donnelly S. & Rybicki L. (2000) The symptoms of advanced cancer: relationship to age, gender and performance status in 1,000 patients. Support Care Cancer 8(3), 175–179. Wilkes L., Beale B., Hall E., Rees E., Watts B. & Denne C. (1998) Community nurses’ descriptions of stress when caring in the home. International Journal of Palliative Nursing 1(1), 14–20. Wilkinson S. (1991) Factors which influence how nurses communicate with cancer patients. Journal of Advanced Nursing 16(6), 677–688. Worden J. (1991) Grief Counselling and Grief Therapy. Tavistock Publications, London.",
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Palliative care for patients with cancer: district nurses’ experiences. / Dunne, K; Sullivan, K; Kernohan, WG.

In: Journal of Advanced Nursing, Vol. 50, No. 4, 12.04.2005, p. 372-380.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Palliative care for patients with cancer: district nurses’ experiences

AU - Dunne, K

AU - Sullivan, K

AU - Kernohan, WG

N1 - Reference text: Addington-Hall J.M. & McCarthy M. (1995) Dying from cancer: results of a national based investigation. Palliative Medicine 9(4), 295–305. Addington-Hall J.M., Altmann D. & McCarthy M. (1998) Which terminally ill patients receive hospice in-patient care? Social Science and Medicine 46(8), 1011–1016. Beck C. (1994) Phenomenology: Its use in nursing research. International Journal of Nursing Studies 31(6), 499–510. Bergen A. (1992a) Evaluating nursing care of the terminally ill in the community: a case study approach. International Journal of Nursing Studies 29(3), 81–94. Bergen A. (1992b) Nurses caring for the terminally ill in the community: a review of literature. Journal of Advanced Nursing 28(3), 89–101. Bliss J. (1998) District nurses and social workers understanding of each other’s role. British Journal of Community Nursing 3(7), 330–336. Bliss J., Cowley S. & While A. (2000) Interprofessional working in palliative care in the community: a review of the literature. Journal of Interprofessional Care 14(3), 281–290. Bonica J. (1991) The Management of Pain. Lea and Febiger, Philadelphia, PA. Buckman R. (1998) Communication and palliative care: a practical guide. In Oxford Textbook of Palliative Medicine (Doyle D., Hanks G. & MacDonald N., eds), Oxford University Press, Oxford, pp. 141–156. Cancer Relief Macmillan Fund (1994) Organisational Audit for Specialist Palliative Care Services. Cancer Relief Macmillan, London. Cancer Research Campaign (2000) Fighting Cancer on All Fronts. The Campaign, London. Carter B. & McGoldrick M. (1999) The Extended Family Life Cycle, 3rd edn. Gardiner Press, New York. Christ G., Siegel K. & Sperber D. (1994) Impact of parental terminal cancer on adolescents. American Journal of Orthospsychiatry 64(4), 604–613. Colaizzi P. (1978) Psychological research as a phenomenologist views it. In Existential Phenomenological Alternatives for Psychology (Valle R. & King M., eds), Oxford University Press, New York, pp. 48–71. Corner J., Plant H. & Warner L. (1995) Developing a nursing approach to managing dyspnoea in lung cancer. International Journal of Palliative Nursing 1(1), 5–10. Davis B., Cowley S. & Ryland R. (1996) The effects of terminal illness on patients and their carers. Journal of Advanced Nursing 23(3), 512–520. Davison D., Johnston G. & Reilly P. (1999) The Place of Death of Cancer Patients in Belfast. Queens University, Belfast. Department of Health and Social Security (1996) Cancer ServicesInvesting for the Future. DHSS, Belfast. Department of Health and Social Services (1999) Regional Palliative Care Review. DHSS, Belfast. Department of Health and Social Services and Public Safety (2000a) Partnerships in Caring. DHSSPS, Belfast. Department of Health, Social Services and Public Safety (2000b) Building the Way Forward in Primary Care. DHSSPS, Belfast. Dickson D., Hargie O. & Morrow N. (1997) Communication Skills Training for Health Care Professionals. Chapman and Hall, London. Dimond B. (1999) Confidentiality II: terminal illness and the duty of confidentiality. British Journal of Nursing 8(21), 1458–1459. Dunne K. & Sullivan K. (2000) Family members’ experience of palliative care in the acute hospital setting. International Journal of Palliative Nursing 6(4), 170–178. Field D. (1998) Special not different: General Practitioners’ accounts of their care of dying people. Social Science Medicine 46(9), 1111– 1120. Field D. & McCaughey J. (1998) An evaluation of palliative care services for cancer patients in the Southern Health and Social Services Board of Northern Ireland. Palliative Medicine 12(2), 83–97. Field D., Douglas C., Jagger C. & Dand P. (1995) Terminal illness: viewsofpatientsandtheirlaycarers.PalliativeMedicine9(1),45–54. Finlay I. (1999) Families as secondary patients. Palliative Care Today 8(3), 42. Goodman C., Knight D., Machen I. & Hunt B. (1998) Emphasising terminal care as district nursing work: a helpful strategy in a purchasing environment. Journal of Advanced Nursing 28(3), 491– 498. Grande G.E., Todd C.J., Barclay S. & Doyle J. (1996) What terminally ill patients value in the support provided by GP’s, District Nurses and Macmillan Nurses. International Journal of Palliative Nursing 2(3), 138–143. Griffin J. (1991) Dying with Dignity. Office of Health Economics, London. Guba E.G. & Lincoln Y. (1981) Effective Evaluation. Jossey-Bass, San Francisco, CA. Hatcliffe S., Smith P. & Daw R. (1996) District nurses’ perceptions of palliative care at home. Nursing Times 92(41), 36–37. Heinzer M. (1995) Loss of a parent in childhood: attachment and coping: a model of adolescence resilience. Holistic Nursing Practice 9(3), 27–37. Higginson I. & Priest P. (1996) Predictors of family anxiety in the weeks before bereavement. Social Science Medicine 43(II), 1621– 1625. Hinton J. (1994) Which patients with terminal cancer are admitted from home care? Palliative Medicine 8(3), 197–210. Husserl E. (1962) Ideas: General Introduction to Pure Phenomenology. Collier, New York. Jarrett N., Payne S., Turner P. & Hillier R. (1999) ‘Someone to talk to’ and ‘pain control’: what people expect from a specialist palliative care team. Palliative Medicine 13(3), 139–144. Karlsen S. & Addington-Hall J.M. (1998) How do cancer patients who die at home differ from those who die elsewhere? Palliative Medicine 12(4), 279–286. Kaye P. (1992) The A to Z of Hospice and Palliative Medicine. EPL Publications, Northampton. Kendall M. (1995) Truth telling and collusion: the ethical dilemmas of palliative nursing. International Journal of Palliative Nursing 1(3), 160–164. Leedham K. (1995) District nurses’ views on the role of rehabilitation in palliative care. International Journal of Palliative Nursing 1(3), 141–144. Lincoln Y. & Guba E. (1985) Naturalistic Inquiry. Sage, Newbury Park, CA. Luker K., Austin L., Caress A. & Hallett C. (2000) The importance of knowing the patient: community nurses constructions of quality in providing palliative care. Journal of Advanced Nursing 31(4), 775–782. Maguire P., Faulkner A., Booth K., Elliott C. & Hillier V. (1996) Helping cancer patients disclose their concerns. European Journal of Cancer 32A(1), 78–81. McIlfatrick S. & Curran C. (2000) District nurses’ perceptions of palliative care services: part 2 International. Journal of Palliative Nursing 6(1), 32–38. Meghani S.H. (2004) A concept analysis of palliative care in the United States. Journal of Advanced Nursing 46(2), 152–161. Moustakas C. (1994) Phenomenological Research Methods. Sage Publications, London. National Council for Hospice and Specialist Palliative Care Services (1995) Working Party on Clinical Guidelines on Palliative Care: Information for Purchasers. NCHSPCS, London. National Council for Hospice and Specialist Palliative Care Services (1997) Feeling Better: Psychosocial Care in Specialist Palliative Care. NCHSPCS, London. National Council for Hospice and Specialist Palliative Care Services (2000) National Plan and Strategic Framework for Palliative Care: 2000–2005. NCHSPCS, London. Neuenschwander H. & Bruera E. (1998) Asthenia. In The Oxford Textbook of Palliative Medicine, 2nd edn (Doyle D., Hanks G.W. & Mac Donald N., eds), University Press, Oxford, pp. 573–585. Nursing and Midwifery Council (2002) Code of Professional Conduct. Nursing and Midwifery Council, London. O’Driscoll M., Corner J. & Bailey C. (1999) The experience of breathlessness in lung cancer. European Journal of Cancer Care 8(1), 37–43. Palsson M. & Norberg A. (1995) District nurses’ stories of difficult care episodes during systematic clinical supervision sessions. Scandinavian Journal of Caring Sciences 9(1), 17–27. Polit D. & Hungler B. (2001) Nursing Research: Principles and Methods, 6th edn. Lippincott, Philadelphia, PA. Randall F. & Downie R. (1996) Palliative Care Ethics: A Good Companion. Oxford Medicine Publications, Oxford. Rose K. (1998) Perceptions related to time in a qualitative study of informal carers of terminally ill patients. Journal of Clinical Nursing 7(4), 343–350. Rout U. (2000) Stress among district nurses: a preliminary investigation. Journal of Clinical Nursing 9(2), 303–309. Sahlberg-Blom E., Teruestedt B.M. & Johansson J.E. (1998) The last month of life: continuity, care, site and place of death. Palliative Medicine 12(3), 287–296. Seale C. (1992) Community nurses and the care of the dying. Social Science and Medicine 34(4), 375–382. Smith M. & Hart G. (1994) Nurses’ response to patient anger: from disconnecting to connecting. Journal of Advanced Nursing 20(4), 643–651. Snelgrove S. (1998) Occupational stress and job satisfaction: a comparative study of health visitors, district nurses and community psychiatric nurses. Journal of Nursing Management 6(2), 97–104. Spiegelberg H. (1975) The Phenomenological Movement: A Historical Introduction, 2nd edn, Vol. 1–2. Nijhoff, The Hague. Townsend J., Frank H.O. & Fremont D. (1990) Terminal care and patients’ preference for place of death: a prospective study. British Medical Journal 301(6749), 415–417. Vachon M.L., Kristjanson L. & Higginson M.B. (1995) Psychosocial issues in palliative care. Journal of Pain and Symptom Management 10(2), 142–150. Valle R. & King M. (1978) Existential – Phenomenological. Alternatives for Psychology. Oxford University Press, New York. Walsh D., Donnelly S. & Rybicki L. (2000) The symptoms of advanced cancer: relationship to age, gender and performance status in 1,000 patients. Support Care Cancer 8(3), 175–179. Wilkes L., Beale B., Hall E., Rees E., Watts B. & Denne C. (1998) Community nurses’ descriptions of stress when caring in the home. International Journal of Palliative Nursing 1(1), 14–20. Wilkinson S. (1991) Factors which influence how nurses communicate with cancer patients. Journal of Advanced Nursing 16(6), 677–688. Worden J. (1991) Grief Counselling and Grief Therapy. Tavistock Publications, London.

PY - 2005/4/12

Y1 - 2005/4/12

N2 - Aim. This paper reports a study exploring district nurses’ experiences of providingpalliative care for patients with cancer and their families.Background. There is an increasing demand for palliative care in the community, asmany patients wish to die at home. District nurses are central to providing palliativecare in the community, but there is a dearth of literature on district nurses’experiences in palliative care.Method. A Husserlian phenomenological approach was adopted with a purposivesample of 25 female district nurses. Data were collected using unstructured, taperecordedinterviews and analysed using Colaizzi’s seven stages of data analysis.Findings. Four themes were identified: the communication web; the family as anelement of care; challenges for the district nurse in symptom management and thepersonal cost of caring.Conclusions. District nurses’ experiences of providing palliative care to family unitswas challenging but rewarding. The emotive nature of the experience cannot beunder-estimated, as many district nurses were touched by the varying situations.Whilst acknowledging the need to maintain an integrated approach to care, districtnurses should be identified as the key workers in the complex situation of palliativecare.

AB - Aim. This paper reports a study exploring district nurses’ experiences of providingpalliative care for patients with cancer and their families.Background. There is an increasing demand for palliative care in the community, asmany patients wish to die at home. District nurses are central to providing palliativecare in the community, but there is a dearth of literature on district nurses’experiences in palliative care.Method. A Husserlian phenomenological approach was adopted with a purposivesample of 25 female district nurses. Data were collected using unstructured, taperecordedinterviews and analysed using Colaizzi’s seven stages of data analysis.Findings. Four themes were identified: the communication web; the family as anelement of care; challenges for the district nurse in symptom management and thepersonal cost of caring.Conclusions. District nurses’ experiences of providing palliative care to family unitswas challenging but rewarding. The emotive nature of the experience cannot beunder-estimated, as many district nurses were touched by the varying situations.Whilst acknowledging the need to maintain an integrated approach to care, districtnurses should be identified as the key workers in the complex situation of palliativecare.

KW - district nursing

KW - palliative care

KW - Husserlian phenomenology

KW - end-of-life

KW - care

KW - cancer nursing

U2 - 10.1111/j.1365-2648.2005.03402

DO - 10.1111/j.1365-2648.2005.03402

M3 - Article

VL - 50

SP - 372

EP - 380

JO - Journal of Advanced Nursing

T2 - Journal of Advanced Nursing

JF - Journal of Advanced Nursing

SN - 0309-2402

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ER -