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Palliative care nursing involvement in end-of-life decision-making: qualitative secondary analysis

dc.contributor.authorHernández-Marrero, Pablo
dc.contributor.authorFradique, Emília
dc.contributor.authorPereira, Sandra Martins
dc.date.accessioned2020-03-18T09:50:43Z
dc.date.available2020-03-18T09:50:43Z
dc.date.issued2019
dc.description.abstractBackground: Nurses are the largest professional group in healthcare and those who make more decisions. In 2014, the Committee on Bioethics of the Council of Europe launched the “Guide on the decision-making process regarding medical treatment in end-of-life situations” (hereinafter, Guide), aiming at improving decision-making processes and empowering professionals in making end-of-life decisions. The Guide does not mention nurses explicitly. Objectives: To analyze the ethical principles most valued by nurses working in palliative care when making end-of-life decisions and investigate if they are consistent with the framework and recommendations of the Guide; to identify what disputed/controversial issues are more frequent in these nurses’ current end-of-life care practices. Design: Qualitative secondary analysis. Participants/context: Three qualitative datasets including 32 interviews from previous studies with nurses working in palliative care in Portugal. Ethical consideration: Ethical approval was obtained from the Ethics Research Lab of the Instituto de Bioética (Ethics Research Lab of the Institute of Bioethics) (Ref.04.2015). Ethical procedures are thoroughly described. Findings: All participant nurses referred to autonomy as an ethical principle paramount in end-of-life decision-making. They were commonly involved in end-of-life decision-making. Palliative sedation and communication were the most mentioned disputed/controversial issues. Discussion: Autonomy was highly valued in end-of-life care and decision-making. Nurses expressed major concerns in assessing patients’ preferences, wishes, and promoting advance care planning. Nurses working in palliative care in Portugal were highly involved in end-of-life decision-making. These processes embraced a collective, inclusive approach. Palliative sedation was the most mentioned disputed issue, which is aligned with previous findings. Communication also emerged as a sensitive ethical issue; it is surprising, however, that only three nurses referred to it. Conclusion: While the Guide does not explicitly mention nurses in its content, this study shows that nurses working in palliative care in Portugal are involved in these processes. Further research is needed on nurses’ involvement and practices in end-of-life decision-making.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationHernández-Marrero, P., Fradique, E., Pereira, S. M. (2019). Palliative care nursing involvement in end-of-life decision-making: qualitative secondary analysis. Nursing ethics, 26(6), 1680-1695pt_PT
dc.identifier.doi10.1177/0969733018774610pt_PT
dc.identifier.eid85047667467
dc.identifier.eissn1477-0989
dc.identifier.issn0969-7330
dc.identifier.pmid29807491
dc.identifier.urihttp://hdl.handle.net/10400.14/30013
dc.identifier.wos000484692700009
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSAGE Publicationspt_PT
dc.subjectDecision-makingpt_PT
dc.subjectEnd-of-lifept_PT
dc.subjectEnd-of-life decisionspt_PT
dc.subjectEthical principlespt_PT
dc.subjectGuidelinespt_PT
dc.subjectNursing ethicspt_PT
dc.subjectPalliative carept_PT
dc.subjectQualitative secondary analysispt_PT
dc.titlePalliative care nursing involvement in end-of-life decision-making: qualitative secondary analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1695pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage1680pt_PT
oaire.citation.titleNursing Ethicspt_PT
oaire.citation.volume26pt_PT
person.familyNameHernández-Marrero
person.familyNameMartins Pereira
person.givenNamePablo
person.givenNameSandra
person.identifierN-3873-2015
person.identifier.ciencia-idFA1A-47B9-5AE5
person.identifier.orcid0000-0002-8893-3491
person.identifier.orcid0000-0003-4113-8957
person.identifier.ridN-3873-2015
person.identifier.ridN-3890-2015
person.identifier.scopus-author-id16417188300
person.identifier.scopus-author-id24169551000
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication0bcd4bfb-7d66-4cfc-8516-3744378fb35e
relation.isAuthorOfPublication60b77242-ab9e-45f4-8f73-3e6b67d68067
relation.isAuthorOfPublication.latestForDiscovery60b77242-ab9e-45f4-8f73-3e6b67d68067

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