Barriers to Attending End of Life Discussions with Advanced Cancer Patients as Perceived by Ward Nurses

• Published in: Journal of Japanese Society of Cancer Nursing Vol. 35; p. 35_158_harada
• Main Authors: Harada, Tomoko, Kimura, Yasutaka
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Cancer Nursing 18.05.2021; 一般社団法人 日本がん看護学会
• Subjects: advanced cancer; decision making; end of life discussion; 意思決定; 終末期の話し合い; 進行がん
• ISSN: 0914-6423; 2189-7565
• DOI: 10.18906/jjscn.35_158_harada

[Objective]: Patients with advanced cancer must make difficult decisions as their disease progresses. End of Life Discussion (EOLD) has been shown to be effective in the decision-making process. However, nurses are not currently able to attend EOLD adequately. Therefore, our aim of this study is to clarify the factors that prevent nurses from attending the EOLD of patients with advanced cancer.[Methods]: The subjects were eight ward nurses who were engaged in cancer nursing practice at three designated cancer hospitals in A Prefecture. Semi-structured interviews were conducted on the factors preventing their attendance at the EOLD, and the data obtained were analyzed qualitatively and inductively using Krippendorff’s content analysis method.[Results]: The subjects were three males and five females with 5-24 years of clinical experience. From the verbatim record, 155 codes, 14 subcategories, and five categories were created. Factors that prevented ward nurses from attending the EOLD were “lack of awareness of the need to attend the EOLD”, “lack of collaboration between health care providers”, “lack of a work system to attend the EOLD”, “lack of role awareness and communication skills in the EOLD”, and “difficulty in engaging with patients’ families according to their characteristics”.[Discussion]: To promote the attendance of nurses in the EOLD for patients with advanced cancer, the following three solutions are proposed: unified awareness of the need for nurses to attend the EOLD, improved knowledge about the EOLD and communication skills of nurses, and collaboration with the team and experts in difficult cases that may make patients emotional or create ethical conflicts after serious notification.