NURS3012 Annotated Bibliography

Annotated Bibliography

1. In this study conducted by Yamamoto et al., (2017), there is an elaborate discussion concerning the factors outlining decisions by families, for opting life ceasing care in cancer patients. The research was conducted with a cross sectional survey by mail, with the aid of a questionnaire, in Japan, across 113 medical units. 700 individuals who were family members of critically ill cancer patients further burdened with the decision of undertaking life ceasing care were participants. Increased rates of depressive symptoms were also observed in individuals who were highly burdened (p < 0.001). Factors which contributed to the increased burden were selection of care locations differing from the desires of the subjects (p < 0.001) and patients (p = 0.034), an absence of awareness of patient’s consent (p < 0.001) as well as absence of sharing subject opinions with the respective doctor (p = 0.022), in addition to critical decisions relying on due dates concerning discharge from previous medical scenarios (p = 0.005). The possibilities for bias due to distress, an absence of assessing additional burdening factors such as disease conditions and surrounding environment, participation of additional families, an absence of responder analysis and a lack of casualty data due to the cross sectional feature of the research are some of the shortcomings of this research.  

However, the key strengths of this research is an elaborate discussion of the various factors determining the burden faced by family members, upon undertaking decision for the conductance of end of light treatment in the concerned cancer patients. Hence, such information can be useful in modifying nursing practice, where nurses who are concerned with the treatment of such patients, may implement empathetic relationships with the patients and their families undergoing emotional burden at critical situations. Further, as evident from the increased sense of emotional distress faced by the concerned patients, there may be a need to adopt greater patient centric and family centered approach by nurses and the practicing doctors. Hence, conducting collaborative discussions concerning the need for end of life treatment with due consideration of the patient’s families is of utmost importance. Nurses can consider the opinion of the patient as well the family, and engage in informing the need for such treatment at earlier timeframes, in order to reduce the magnitude of emotional burden on the concerned family.

2. The research conducted by Odachi et al., (2017), extensively evaluated the experiences of nurses undertaking care treatments, for patients undergoing end-of-life treatment. The study was undertaken by assessing nineteen nurses, engaged in various wards concerned with the provision of hospice services or long term care, in western region of Japan. The research aimed at assessing the various practices undertaken by the nurses, in response to patients undergoing prolonged care. There was the prevalence of uncertainty amongst the nurses, due to the need to adhere to the principle of enhancing the quality of life of the patient through the utilization of care procedures carrying considerable risk. The participants reported a sense of absence of decision-making and knowledge concerning the appropriateness of their concerned treatment procedures, after the death of the concerned patient. Hence, this further led to a feeling of avoidance for the discussion of the concerned topic. Additional results of the study was indicated a lack of communication of the nurses towards the patients,  followed by a difficulty in striking an equilibrium, between  improvement of the patient’s quality of life and enhancement of lifespan. One of the major strengths outlining this study, was the concentration of the study to the problems pertaining to nurses and the usage of an inter-professional team. However, the absence of assessment of additional medical staff as well the members of the families of the respective patients, regarding the burden of provision of end of life treatment, was a major limitation of this study.

Hence, the findings from the above research shed an impressive light on the problems faced by nurses, when faced with the decision of provision of care treatment to patients undergoing end of life treatment. Hence, further implications can be considered for the usage of the same in the contemporary nursing practice. Nurses should be educated and encouraged concerning the importance of establishing empathetic communication with the patient. Since patient undergoing end of life treatment are overcome by considerable burden distress, the usage of empathy by nurses would be a beneficial way to reduce the same, along with conducting communication with the concerned family. Nurses should be encouraged to discuss their feelings of distress concerning death in order to understand the patient conditions as well the validity of their treatment.

Bibliography

Odachi, R., Tamaki, T., Ito, M., Okita, T., Kitamura, Y., & Sobue, T. (2017). Nurses' Experiences of End-of-life Care in Long-term Care Hospitals in Japan: Balancing Improving the Quality of Life and Sustaining the Lives of Patients Dying at Hospitals. Asian nursing research, 11(3), 207-215.

Yamamoto, S., Arao, H., Masutani, E., Aoki, M., Kishino, M., Morita, T., ... & Miyashita, M. (2017). Decision making regarding the place of end-of-life cancer care: the burden on bereaved families and related factors. Journal of pain and symptom management, 53(5), 862-870.