Hostname: page-component-848d4c4894-nr4z6 Total loading time: 0 Render date: 2024-05-04T18:11:55.119Z Has data issue: false hasContentIssue false
  • English
  • Français

Nurses’ involvement in end-of-life discussions with incurable cancer patients and family caregivers: An integrative review

Published online by Cambridge University Press:  06 May 2021

T. Ikander Open the ORCID record for T. Ikander [Opens in a new window] ,
M. Raunkiær ,
O. Hansen  and
K.B. Dieperink
T. Ikander*
Affiliation:
Department of Oncology, Odense University Hospital, Odense, Denmark REHPA, Danish Knowledge Centre of Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark Family Focused Healthcare Research Centre (FaCe), Department of Clinical Research, University of Southern Denmark, Odense, Denmark Department of Clinical Research, University of Southern Denmark, Odense, Denmark Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
M. Raunkiær
Affiliation:
REHPA, Danish Knowledge Centre of Rehabilitation and Palliative Care, Odense University Hospital, Odense, Denmark Department of Clinical Research, University of Southern Denmark, Odense, Denmark
O. Hansen
Affiliation:
Department of Oncology, Odense University Hospital, Odense, Denmark Department of Clinical Research, University of Southern Denmark, Odense, Denmark
K.B. Dieperink
Affiliation:
Department of Oncology, Odense University Hospital, Odense, Denmark Family Focused Healthcare Research Centre (FaCe), Department of Clinical Research, University of Southern Denmark, Odense, Denmark Department of Clinical Research, University of Southern Denmark, Odense, Denmark
*
Author for correspondence: Tine Ikander, Department of Oncology, Odense University Hospital, J.B. Winsløws Vej 4, 5000 Odense, Denmark. E-mail: tine.moller.ikander@rsyd.dk
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim

To review current evidence of nurses’ involvement in end-of-life discussions with incurable cancer patients and their family caregivers.

Design

We conducted a systematic integrative review in accordance with PRISMA guidelines: PROSPERO, registration number: CRD42020186204.

Data sources

CINAHL, Medline, PsycInfo, Embase. We searched for primary research between 2010 and 2020.

Results

Of 3,271 references, we found 15 eligible articles: qualitative (n = 12) and quantitative (n = 3). The studies focused on oncology nurses' perspective of involvement in end-of-life discussions. The data analysis resulted in four overall themes: (1) Nursing roles; the advocating, supporting, and reframing roles, and an undefined task, for example in medical consultations, (2) Trust building, (3) Nurse competences, and (4) Medical issues.

Significance of results

The nurses have several roles in end-of-life discussions, but insufficient competencies to be involved in that kind of discussions, for example to involve and communicate with families. The findings implicate an educational need among the nurses. However, it also points toward an organizational change in the outpatient clinics, for example that end-of-life discussions follow a more structured approach, are offered in a scheduled manner, and that nurses invite the family caregivers to attend.

Keywords

Advanced cancerEnd-of-life discussionsOncology nursesPalliative care
Type
Review Article
Information
Palliative & Supportive Care , Volume 20 , Issue 4 , August 2022 , pp. 570 - 581
Check for updates
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Al Qadire, M (2014) Nurses’ knowledge about palliative care: A cross-sectional survey. Journal of Hospice and Palliative Nursing 16(1), 23–30.CrossRefGoogle Scholar
Beck, P (2014) Essentials of Nursing Research — Appraising Evidence for Nursing Practice. Philadelphia: Wolters Kluwer Health I Lippincott Williams & Wilkins.Google Scholar
Beckstrand, RL, Collette, J, Callister, L, et al. (2012) Oncology nurses’ obstacles and supportive behaviors in end-of-life care: Providing vital family care. Oncology Nursing Forum 39(5), E398–E406.CrossRefGoogle ScholarPubMed
Belanger, E, Rodriguez, C and Groleau, D (2011) Shared decision-making in palliative care: A systematic mixed studies review using narrative synthesis. Palliative Medicine 25(3), 242–261.CrossRefGoogle ScholarPubMed
Blackwood, DH, Walker, D, Mythen, MG, et al. (2019) Barriers to advance care planning with patients as perceived by nurses and other healthcare professionals: A systematic review. Journal of Clinical Nursing 28(23–24), 4276–4297.CrossRefGoogle ScholarPubMed
Blazeviciene, A, Newland, JA, Civinskiene, V, et al. (2017) Oncology nurses’ perceptions of obstacles and role at the end-of-life care: Cross sectional survey. BMC Palliative Care 16(1), 74.CrossRefGoogle ScholarPubMed
Boyd, D, Merkh, K, Rutledge, D, et al. (2011) Nurses’ perceptions and experiences with end-of-life communication and care. Oncology Nursing Forum 38, 229–239.CrossRefGoogle ScholarPubMed
Broom, A, Kirby, E, Good, P, et al. (2015) Negotiating futility, managing emotions: Nursing the transition to palliative care. Qualitative Health Research 25(3), 299–309.CrossRefGoogle ScholarPubMed
Broom, A, Kirby, E, Good, P, et al. (2016) Nursing futility, managing medicine: Nurses’ perspectives on the transition from life-prolonging to palliative care. Health (London) 20(6), 653–670.CrossRefGoogle ScholarPubMed
Butler, R, Monsalve, M, Thomas, GW, et al. (2018) Estimating time physicians and other health care workers spend with patients in an intensive care unit using a sensor network. American Journal of Medicine 131(8), 972 e909–972 e915.CrossRefGoogle Scholar
Cahill, PJ, Lobb, EA, Sanderson, C, et al. (2017) What is the evidence for conducting palliative care family meetings? A systematic review. Palliative Medicine 31(3), 197–211.CrossRefGoogle ScholarPubMed
Coyne, E and Dieperink, KB (2017) A qualitative exploration of oncology nurses’ family assessment practices in Denmark and Australia. Supportive Care in Cancer 25(2), 559–566.CrossRefGoogle ScholarPubMed
Coyne, E, Heynsbergh, N and Dieperink, KB (2020) Acknowledging cancer as a family disease: A systematic review of family care in the cancer setting. European Journal of Oncology Nursing 49, 101841.CrossRefGoogle ScholarPubMed
de Angst, BI, Kil, PJM, Bangma, HC, et al. (2019) Should we involve patients more actively? Perspectives of the multidisciplinary team on shared decision-making for older patients with metastatic castration-resistant prostate cancer. Journal of Geriatric Oncology 10, 653–658.CrossRefGoogle Scholar
De Vlieger, M, Gorchs, N, Larkin, PJ, et al. (2003) A Guide for the Development of Palliative Nurse Education in Europe. In Palliative Nurse Education: Report of the EAPC Task Force. Milano: Istituto Nazionale dei Tumori.Google Scholar
Duhamel, F and Dupuis, F (2003) Families in palliative care: Exploring family and health-care professionals’ beliefs. International Journal of Palliative Nursing 9(3), 113–119.CrossRefGoogle ScholarPubMed
Fukada, M (2018) Nursing competency: Definition, structure and development. Yonago Acta Medica 61(1), 1–7.CrossRefGoogle ScholarPubMed
Hawker, S, Payne, S, Kerr, C, et al. (2002) Appraising the evidence: Reviewing disparate data systematically. Qualitative Health Research 12(9), 1284–1299.CrossRefGoogle ScholarPubMed
Holstein, JA and Gubrium, J (1999) What is family? Marriage & Family Review 28(3–4), 3–20.CrossRefGoogle Scholar
Hudson, P, Girgis, A, Thomas, K, et al. (2020) Do family meetings for hospitalised palliative care patients improve outcomes and reduce health care costs? A cluster randomised trial. Palliative Medicine 35(1), 188–199.CrossRefGoogle ScholarPubMed
Ikander, T, Jeppesen, SS, Hansen, O, et al. (2021) Patients and family caregivers report high treatment expectations during palliative chemotherapy: A longitudinal prospective study. BMC Palliative Care 20(1), 37.CrossRefGoogle ScholarPubMed
Khomeiran, RT, Yekta, ZP, Kiger, AM, et al. (2006) Professional competence: Factors described by nurses as influencing their development. International Nursing Review 53(1), 66–72.CrossRefGoogle ScholarPubMed
Klarare, A, Hagelin, CL, Furst, CJ, et al. (2013) Team interactions in specialized palliative care teams: A qualitative study. Journal of Palliative Medicine 16(9), 1062–1069.CrossRefGoogle ScholarPubMed
Laryionava, K, Heussner, P, Hiddemann, W, et al. (2018) “Rather one more chemo than one less…”: Oncologists and oncology nurses’ reasons for aggressive treatment of young adults with advanced cancer. Oncologist 23(2), 256–262.CrossRefGoogle ScholarPubMed
Lauvås, PaKL (2006) Tværfagligt samarbejde — perspektiv og strategi (Interdisciplinary Collaboration — Perspective and Strategy), Åhus Forlaget Klim.Google Scholar
McCullough, L, McKinlay, E, Barthow, C, et al. (2010) A model of treatment decision making when patients have advanced cancer: How do cancer treatment doctors and nurses contribute to the process? European Journal of Cancer Care (English Language Edition) 19(4), 482–491.CrossRefGoogle Scholar
McLennon, SM, Lasiter, S, Miller, WR, et al. (2013a) Oncology nurses’ experiences with prognosis-related communication with patients who have advanced cancer. Nursing Outlook 61(6), 427–436.CrossRefGoogle Scholar
McLennon, SM, Uhrich, M, Lasiter, S, et al. (2013b) Oncology nurses’ narratives about ethical dilemmas and prognosis-related communication in advanced cancer patients. Cancer Nursing 36(2), 114–121.CrossRefGoogle Scholar
Mohammed, S, Savage, P, Kevork, N, et al. (2020) “I'm going to push this door open. You can close it”: A qualitative study of the brokering work of oncology clinic nurses in introducing early palliative care. Palliative Medicine 34(2), 209–218.CrossRefGoogle ScholarPubMed
Moher, D, Liberati, A, Tetzlaff, J, et al. (2009) Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. Open Medicine 3(3), e123–e130.Google ScholarPubMed
Neergaard, MA, Skorstengaard, MH, Brogaard, T, et al. (2020) Advance care planning and longer survival in the terminally ill: A randomised controlled trial unexpected finding. BMJ Supportive and Palliative Care 10(2), 221–222.CrossRefGoogle ScholarPubMed
Ostergaard, BC, Clausen, AM, Agerskov, H, et al. (2020) Nurses attitudes towards family involvement among Danish nurses. Journal of Clinical Nursing 29(7–8), 1290–1301.Google Scholar
Pettersson, M, Hedstrom, M and Hoglund, AT (2014) Striving for good nursing care: Nurses’ experiences of do not resuscitate orders within oncology and hematology care. Nursing Ethics 21(8), 902–915.CrossRefGoogle Scholar
Pettersson, M, Hedstrom, M and Hoglund, AT (2018) Ethical competence in DNR decisions — A qualitative study of Swedish physicians and nurses working in hematology and oncology care. BMC Medical Ethics 19(1), 63.CrossRefGoogle Scholar
Rietze, L and Stajduhar, K (2015) Registered nurses’ involvement in advance care planning: An integrative review. International Journal of Palliative Nursing 21(10), 495–503.CrossRefGoogle ScholarPubMed
Rylander, R, Stenwall E, FS and Gustafsson, KL (2019) Significant aspects of nursing within the process of end-of-life communication in an oncological context. Nordic Journal of Nursing Research 39(2), 85–91.CrossRefGoogle Scholar
Skorstengaard, MH, Brogaard, T, Jensen, AB, et al. (2019) Advance care planning for patients with lung, heart and cancer diseases and their relatives. International Journal of Palliative Nursing 25(3), 112–127.CrossRefGoogle ScholarPubMed
Tariman, JD and Szubski, KL (2015) The evolving role of the nurse during the cancer treatment decision-making process: A literature review. Clinical Journal of Oncology Nursing 19(5), 548–556.CrossRefGoogle ScholarPubMed
Tariman, JD, Mehmeti, E, Spawn, N, et al. (2016) Oncology nursing and shared decision making for cancer treatment. Clinical Journal of Oncology Nursing 20(5), 560–563.CrossRefGoogle ScholarPubMed
Valente, S (2011) Nurses’ perspectives of challenges in end of life care. JOCEPS: The Journal of Chi Eta Phi Sorority 55(1), 28–31.Google Scholar
Whittemore, R and Knafl, K (2005) The integrative review: Updated methodology. Journal of Advanced Nursing 52(5), 546–553.CrossRefGoogle ScholarPubMed
WHO (2002) National Cancer Control Programmes: Policies and Managerial Guidelines. Geneva: WHO.Google Scholar
Wiencek, C and Coyne, P (2014) Palliative care delivery models. Seminars in Oncology Nursing 30(4), 227–233.CrossRefGoogle ScholarPubMed