当前位置： SCI文献检索 > JOURNAL OF CLINICAL NURSING期刊下所有文献 > The challenge to health professionals when carers resist truth telling at the end of life: a qualitative secondary analysis.

The challenge to health professionals when carers resist truth telling at the end of life: a qualitative secondary analysis.

Abstract：

AIMS AND OBJECTIVES:To draw out the similar complexities faced by staff around truth-telling in a children's and adult population and to interrogate the dilemmas faced by staff when informal carers act to block truth-telling. BACKGROUND:Policy encourages normalisation of death, but carers may act to protect or prevent the patient from being told the truth. Little is known about the impact on staff. DESIGN:Secondary analysis of data using a supra-analysis design to identify commonality of experiences. METHODS:Secondary 'supra-analysis' was used to transcend the focus of two primary studies in the UK, which examined staff perspectives in a palliative children's and a palliative adult setting, respectively. The analysis examined new theoretical questions relating to the commonality of issues independently derived in each primary study. Both primary studies used focus groups. Existing empirical data were analysed thematically and compared across the studies. RESULTS:Staff reported a hiding of the truth by carers and sustained use of activities aimed at prolonging life. Carers frequently ignored the advance of end of life, and divergence between staff and carer approaches to truth-telling challenged professionals. Not being truthful with patients had a deleterious effect on staff, causing anger and feelings of incompetence. CONCLUSIONS:Both children's and adult specialist palliative care staff found themselves caught in a dilemma, subject to policies that promoted openness in planning for death and informal carers who often prevented them from being truthful with patients about terminal prognosis. This dilemma had adverse psychological effects upon many staff. RELEVANCE TO CLINICAL PRACTICE:There remains a powerful death-denying culture in many societies, and carers of dying patients may prevent staff from being truthful with their patients. The current situation is not ideal, and open discussion of this problem is the essential first step in finding a solution.

journal_name

J Clin Nurs

journal_title

Journal of clinical nursing

authors

Noble H,Price JE,Porter S

doi

10.1111/jocn.12634

subject

Has Abstract

pub_date

2015-04-01 00:00:00

pages

927-36

issue

7-8

eissn

0962-1067

issn

1365-2702

journal_volume

pub_type

杂志文章

在线工具

The challenge to health professionals when carers resist truth telling at the end of life: a qualitative secondary analysis.