Families are struggling with many challenges in the final stages of patient life. It is important to understand what actions nurses do for the family of the end-of-life (EOL) patients. This study aimed to explain the main strategy of nurses’ dealing with the family of the EOL patients. Data were analyzed using conventional content analysis. Semistructured interviews were conducted on 32 nurses from hospitals in Tehran. Nurses used six measures of explaining the bitter reality, effective communication, management of violence, referral, consolation, and reinforcement. “Contingency help” was conceptualized as the main strategy. Nurses through “contingency help” were involved in solving the emotional, physical, financial, and spiritual needs of the family. Nurses will be able to apply the results of this study to the development of care policies for the family of the EOL patients.
AdamsJ. A.AndersonR. A.DochertyS. L.TulskyJ. A.SteinhauserK. E.BaileyD. E. (2014).
Nursing strategies to support family members of ICU patients at high risk of dying. Heart & Lung: The Journal of Acute and Critical Care,
43(5), 406–415.
2.
AdamsJ. A.BaileyD. E.Jr.AndersonR. A.DochertyS. L. (2011).
Nursing roles and strategies in end-of-life decision making in acute care: A systematic review of the literature. Nursing Research and Practice,
2011, 527834–527815.
3.
AliM. M. (2011). Holy Quran: Ahmadiyya Anjuman Ishaat Islam Lahore USA. USA: Ahmadiyya Anjuman Ishaat Islam Lahore, USA.
4.
AndershedB.HarstadeC. W. (2007).
Next of kin’s feelings of guilt and shame in end-of-life care. Contemporary Nurse,
27(1), 61–72.
5.
AyersN. E.VydelingumV.ArberA. (2017).
An ethnography of managing emotions when talking about life-threatening illness. International Nursing Review,
64(4), 486–493.
6.
BalizaM. F.BoussoR. S.PolesK.SantosM. R. D.SilvaL.PaganiniM. C. (2015).
Factors influencing intensive care units nurses in end-of-life decisions. Revista da Escola de Enfermagem da USP,
49(4), 0572–0579.
7.
BaumhoverN. C. (2015).
The process of death imminence awareness by family members of patients in adult critical care. Dimensions of Critical Care Nursing,
34(3), 149–160.
8.
BengtssonM. (2016).
How to plan and perform a qualitative study using content analysis. NursingPlus Open,
2, 8–14.
9.
BirtL.ScottS.CaversD.CampbellC.WalterF. (2016).
Member checking: A tool to enhance trustworthiness or merely a nod to validation?Qualitative Health Research,
26(13), 1802–1811.
10.
BjarnasonD. (2009).
Nursing, religiosity, and end-of-life care: Interconnections and implications. Nursing Clinics of North America,
44(4), 517–525.
11.
BlazevicieneA.NewlandJ. A.CivinskieneV.BeckstrandR. L. (2017).
Oncology nurses’ perceptions of obstacles and role at the end-of-life care: Cross sectional survey. BMC Palliative Care,
16(1), 74.
12.
BoroujeniA. Z.MohammadiR.OskouieS. F. H.SandbergJ. (2009).
Iranian nurses’ preparation for loss: Finding a balance in end‐of‐life care. Journal of Clinical Nursing,
18(16), 2329–2336.
13.
CarterM. A. (2009).
Trust, power, and vulnerability: A discourse on helping in nursing. Nursing Clinics,
44(4), 393–405.
14.
CyrolK.FrohlichM. R.PiattiF.ImhofL. (2018).
[End-of-life care in intensive care units: Nursing strategies of family involvement at the end of life]. Pflege,
31(3), 135–143.
15.
EloS.KääriäinenM.KansteO.PölkkiT.UtriainenK.KyngäsH. (2014).
Qualitative content analysis: A focus on trustworthiness. Sage Open,
4(1), 2158244014522633.
16.
Fernandes MdeF.KomessuJ. H. (2013).
[Nurses’ challenges in view of the pain and suffering of families of terminal patients]. Revista da Escola de Enfermagem da USP,
47(1), 250–257.
17.
FridhI. (2014).
Caring for the dying patient in the ICU—The past, the present and the future.Intensive and Critical Care Nursing,
30(6), 306–311.
18.
GhaljehM.IranmaneshS.NayeriN. D.TirgariB. (2016).
Organizational challenges: A major obstacle at end of life care in Iran.British Journal of Medicine and Medical Research,
16(7), 1–12.
19.
GraneheimU. H.LundmanB. (2004).
Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today,
24(2), 105–112.
20.
Granero-MolinaJ. (2012). End-of-life care: A paradigm of nursing knowledge. Nurs Care. DOI:10.4172/2167-1168.1000e113
21.
GruenewaldD. A.GabrielM.RizzoD.LuhrsC. A. (2017).
Improving family meetings in intensive care units: A quality improvement curriculum. American Journal of Critical Care,
26(4), 303–310.
22.
HarropE.ByrneA.NelsonA. (2014). “
It’s alright to ask for help”: Findings from a qualitative study exploring the information and support needs of family carers at the end of life. BMC Palliative Care,
13(1), 22.
23.
HarropE.MorganF.ByrneA.NelsonA. (2016). “
It still haunts me whether we did the right thing”: A qualitative analysis of free text survey data on the bereavement experiences and support needs of family caregivers. BMC Palliative Care,
15(1), 92.
24.
HeidariM. R.AnooshehM.Azad ArmakiT.MohammadiE. (2011).
Nurses experiences in the care of end stage patients. Iranian Journal of Medical Ethics and History of Medicine,
4(6), 75–86.
25.
HinkleL. J.BossletG. T.TorkeA. M. (2015).
Factors associated with family satisfaction with end-of-life care in the ICU: A systematic review. CHEST Journal,
147(1), 82–93.
26.
HoJ. Q.NguyenC. D.LopesR.Ezeji-OkoyeS. C.KuschnerW. G. (2018).
Spiritual care in the intensive care unit: A narrative review. Journal of Intensive Care Medicine,
33(5), 279–287
27.
HsiehH.-F.ShannonS. E. (2005).
Three approaches to qualitative content analysis. Qualitative Health Research,
15(9), 1277–1288.
28.
Imber-BlackE. (2014).
Will talking about it make it worse? Facilitating family conversations in the context of chronic and life-shortening illness. Journal of Family Nursing,
20(2), 151–163.
29.
IranmaneshS.BanazadehM.ForozyM. A. (2016).
Nursing staff’s perception of barriers in providing end-of-life care to terminally ill pediatric patients in Southeast Iran. American Journal of Hospice and Palliative Medicine®,
33(2), 115–123.
30.
IranmaneshS.HosseiniH.EsmailiM. (2011).
Evaluating the “good death” concept from Iranian bereaved family members’ perspective. Journal of Supportive Oncology,
9(2), 59–63.
31.
IranmaneshS.RazbanF.NejadA. T.GhazanfariZ. (2014).
Nurses’ professional autonomy and attitudes toward caring for dying patients in South-East Iran. International Journal of Palliative Nursing,
20(6), 294–300.
32.
JohnstoneM. J.HutchinsonA. M.RedleyB.RawsonH. (2016).
Nursing roles and strategies in end-of-life decision making concerning elderly immigrants admitted to acute care hospitals: An Australian study. Journal of Transcultural Nursing,
27(5), 471–479.
33.
KehlK. A.KirchhoffK. T.KramerB. J.Hovland-ScafeC. (2009).
Challenges facing families at the end of life in three settings. Journal of Social Work in End-of-Life Palliative Care,
5, 144–168.
34.
KhosravanS.MazlomB.AbdollahzadeN.JamaliZ.MansoorianM. R. (2014).
Family participation in the nursing care of the hospitalized patients. Iranian Red Crescent Medical Journal,
16(1), e12686.
35.
KirchhoffK. T.FaasA. I. (2007).
Family support at end of life. AACN Advanced Critical Care,
18(4), 426–435.
36.
Koenig KellasJ.CastleK. M.JohnsonA.CohenM. Z. (2017).
Communicatively constructing the bright and dark sides of hope: Family caregivers’ experiences during end of life cancer care. Behavioral Sciences,
7(2), 33.
37.
KongsuwanW.MatchimY.NilmanatK.LocsinR. C.TaniokaT.YasuharaY. (2016).
Lived experience of caring for dying patients in emergency room. International Nursing Review,
63(1), 132–138.
38.
KristjansonL. J.AounS. (2004).
Palliative care for families: Remembering the hidden patients. The Canadian Journal of Psychiatry,
49(6), 359–365.
39.
LichtenthalW. G.KissaneD. W. (2008).
The management of family conflict in palliative care. Progress in Palliative Care,
16(1), 39–45.
40.
MilsteinJ. (2005).
A paradigm of integrative care: Healing with curing throughout life, “being with” and “doing to.” Journal of Perinatology,
25(9), 563–568.
41.
MontazeriA.TavoliA.MohagheghiM. A.RoshanR.TavoliZ. (2009).
Disclosure of cancer diagnosis and quality of life in cancer patients: Should it be the same everywhere?BMC Cancer,
9(1), 39.
42.
MortazaviH.PeyroviH.JoolaeeS. (2015).
How do family caregivers of older people give up caregiving?International Journal of Community Based Nursing and Midwifery,
3(3), 187.
43.
MullenJ. E.ReynoldsM. R.LarsonJ. S. (2015).
Caring for pediatric patients’ families at the child’s end of life. Critical Care Nurse,
35(6), 46–56.
44.
ÖhlénJ.AndershedB.BergC.FridI.PalmC. A.TernestedtB. M.SegestenK. (2007).
Relatives in end‐of‐life care—Part 2: A theory for enabling safety. Journal of Clinical Nursing,
16(2), 382–390.
45.
PalinkasL. A.HorwitzS. M.GreenC. A.WisdomJ. P.DuanN.HoagwoodK. (2015).
Purposeful sampling for qualitative data collection and analysis in mixed method implementation research. Administration and Policy in Mental Health and Mental Health Services Research,
42(5), 533–544.
46.
PergertP.LützénK. (2012).
Balancing truth-telling in the preservation of hope: A relational ethics approach. Nursing Ethics,
19(1), 21–29.
47.
Rassouli, M., & Sajjadi, M. (2016). Palliative care in Iran: Moving toward the development of palliative care for cancer. American Journal of Hospice and Palliative Medicine®, 33(3), 240--244.
48.
RaymondA.LeeS. F.BloomerM. J. (2017).
Understanding the bereavement care roles of nurses within acute care: A systematic review. Journal of Clinical Nursing,
26(13-14), 1787–1800.
49.
SadeghiN.HasanpourM.HeidarzadehM. (2016).
Information and communication needs of parents in infant end-of-life: A qualitative study. Iranian Red Crescent Medical Journal,
18(6), e25665.
50.
SalemA.SalemA.-F. (2013).
Breaking bad news: Current prospective and practical guideline for Muslim countries. Journal of Cancer Education,
28(4), 790–794.
51.
SchmidtM.AzoulayE. (2012).
Having a loved one in the ICU: The forgotten family. Current Opinion Critical Care,
18(5), 540–547.
52.
SearightH. R.GaffordJ. (2005).
Cultural diversity at the end of life: Issues and guidelines for family physicians. American Family Physician,
71(3), 515–522.
53.
SinclairS.BeamerK.HackT. F.McClementS.Raffin BouchalS.ChochinovH. M.HagenN. A. (2017).
Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understandings, experiences, and preferences. Palliative Medicine,
31(5), 437–447.
54.
SmithH. (2014).
Giving hope to families in palliative care and implications for practice. Nursing Children and Young People,
26(5), 21.
55.
StajduharK. I.MartinW.CairnsM. (2010).
What makes grief difficult? Perspectives from bereaved family caregivers and healthcare providers of advanced cancer patients. Palliative & Support Care,
8(3), 277–289.
56.
ThirskL. M.MoulesN. J. (2013). “
I can just be me”: Advanced practice nursing with families experiencing grief. Journal of Family Nursing,
19(1), 74–98.
57.
TornøeK. A.DanboltL. J.KvigneK.SørlieV. (2014).
The power of consoling presence-hospice nurses’ lived experience with spiritual and existential care for the dying. BMC Nursing,
13(1), 25.
58.
TornøeK. A.DanboltL. J.KvigneK.SørlieV. (2015).
The challenge of consolation: Nurses’ experiences with spiritual and existential care for the dying-a phenomenological hermeneutical study. BMC Nursing,
14(1), 62.
59.
ValieeS.NegarandehR.Dehghan NayeriN. (2012).
Exploration of Iranian intensive care nurses’ experience of end-of-life care: A qualitative study. Nursing in Critical Care,
17(6), 309–315.
60.
Vanden BerghH.WildD. M. (2015).
[Conversations about end-of-life in the intensive care unit]. Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS,
50(1), 56–63.
61.
Van KeerR.-L.DeschepperR.FranckeA. L.HuyghensL.BilsenJ. (2015).
Conflicts between healthcare professionals and families of a multi-ethnic patient population during critical care: An ethnographic study. Critical Care,
19(1), 441.
62.
WallR. J.EngelbergR. A.GriesC. J.GlavanB.CurtisJ. R. (2007).
Spiritual care of families in the intensive care unit. Critical Care Medicine,
35(4), 1084–1090.
63.
WiegandD. L.GrantM. S.CheonJ.GergisM. A. (2013).
Family-centered end-of-life care in the ICU. Journal of Gerontological Nursing,
39(8), 60–68.
64.
WilliamsB. R.LewisD. R.BurgioK. L.GoodeP. S. (2012). “
Wrapped in their arms”: Next-of-kin’s perceptions of how hospital nursing staff support family presence before, during, and after the death of a loved one. Journal of Hospice & Palliative Nursing,
14(8), 541–550.
