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Stressors Experienced by Nurses Providing End-of-Life Palliative Care in the Intensive Care Unit Les facteurs de stress du personnel infirmier qui fournit des soins palliatifs de fin de vie dans les services de soins intensifs

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Abstract:

The purpose of this study was to describe stressors experienced by nurses in providing end-of-life palliative care (EoL/PC) in intensive care units (ICUs). A descriptive qualitative design was used. A total of 42 nurses from 5 ICUs in the province of Quebec, Canada, participated in 10 focus groups. Stressors were found to be clustered in 3 categories: organizational, professional, and emotional. The major organizational stressors were lack of a palliative care approach, interprofessional difficulty, lack of continuity in life-support and treatment plans, and conflicting demands. Professional stressors included lack of EoL/PC competencies and difficulty communicating with families and collaborating with the medical team. Emotional stressors were described as value conflicts, lack of emotional support, and dealing with patient and family suffering. The authors conclude that providing EoL/PC is stressful for ICU nurses and that education and support programs should be developed to ensure quality EoL/PC in the critical care environment.

French
Cette étude avait pour objectif de décrire les facteurs de stress du personnel infirmier qui fournit des soins palliatifs de fin de vie (SPFV) dans des services de soins intensifs (SSI). L'étude a été réalisée selon un plan d'analyse descriptive et qualitative, et 42 infirmières au total provenant de cinq SSI de la province de Québec, au Canada, y ont participé, réparties dans 10 groupes de discussion. Les facteurs de stress ont été regroupés dans trois catégories : organisationnels, professionnels et affectifs. Les principaux facteurs de stress organisationnels mentionnés ont été le manque d'une approche en matière de soins palliatifs, les difficultés interprofessionnelles, l'absence de continuité dans les plans de maintien des fonctions vitales et de traitement, et les demandes contradictoires. Les facteurs de stress professionnels étaient le manque de compétences en SPFV ainsi que la difficulté de communiquer avec les familles et de collaborer avec les autres membres de l'équipe médicale. Les facteurs de stress affectifs décrits comprenaient les conflits de valeurs, le manque de soutien affectif, et la souffrance des patients et de leur famille. Les auteures concluent que la prestation des SPFV est stressante pour le personnel infirmier des SSI et qu'il faudrait élaborer des programmes de formation et de soutien permettant d'assurer la qualité des SPFV dans un environnement de soins intensifs.

Keywords: ADULTS; END OF LIFE; INTENSIVE CARE UNIT; NURSES; PALLIATIVE CARE; STRESSORS

Document Type: Research Article

Publication date: March 1, 2012

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