Open Journal of Nursing
Vol.09 No.08(2019), Article ID:94200,8 pages
10.4236/ojn.2019.98061
Contents of Care and Perception of Home Hospice Nurses Who Work at Visiting Medical Treatment Hospitals
Michiyo Ando1*, Hiroko Kukihara2, Mayumi Yamamoto3, Yasuyoshi Ninosaka4
1Faculty of Nursing, St. Mary’s College, Kurume City, Fukuoka, Japan
2Department of Medicine, Fukuoka University, Fukuoka, Japan
3International University of Health and Welfare, School of Nursing at Fukuoka, Fukuoka, Japan
4Ninosaka Clinic, Fukuoka, Japan
Copyright © 2019 by author(s) and Scientific Research Publishing Inc.
This work is licensed under the Creative Commons Attribution-NonCommercial International License (CC BY-NC 4.0).
http://creativecommons.org/licenses/by-nc/4.0/
Received: July 3, 2019; Accepted: August 5, 2019; Published: August 8, 2019
ABSTRACT
Goal: The aim of this study was to examine the perception of nurses who worked at the clinic which proposed home hospice and contents of care to better understand home hospice and enhance home care. Methods: Six nurses who worked at the clinic where proposed visiting medical treatment participated voluntarily. They received one interview for approximately one hour, in which they narrated their perception of home hospice and content of nursing care. The narrative was recorded by an IC recorder and analyzed as contents analysis. This study was approved by the Ethical Board at St. Mary’s College. Results: About the content of nursing care, some categories were selected such as “Understanding a patient as a living person,” “Examining if a patient and caregiver live at ease,” or “Caring for a caregiver accepting a loved one’s death and care given at death.” Nurses perceived the
Keywords:
Home Hospice, Visiting Nurse, Perception, Contents of Care
1. Introduction
Recently the elderly population is increasing and the number of aging people is expected to continue to increase. Many people hope to die in their own home [1] , however, not many are able to do so [2] [3] .
Family caregivers experience some difficulties. Family caregivers of advanced cancer patients feel distressed along with sadness, sorrow and exhaustion, or anxiety and depression [4] . Family caregivers at home hospice had moderate-to-severe anxiety or similar symptoms [5] , and they experienced crisis, such as patient signs and symptoms, emotional distress, and burdens [6] . Also, Reblin, et al. [7] showed that caregivers had moderate levels of depression. These researches suggest the need for support for a patient and a family caregiver in home hospice. Visiting nurse is a very important role. However, there are few studies about the care or perception of home visiting nurses. Thus the present study examined the content of nursing and perception for home hospice patients with nurses who worked at a clinic which propose visiting medical care.
2. Methods
2.1. Participants
The participants were six nurses. The inclusion criteria were followings; they worked at clinics which proposed visiting medical treatment, they accompanied a physician and visiting medical treatments, apart from the daily visiting nurse station, their nursing experience was over five years. The exclusion criteria was that the nurse who might feel burden to talk in the interview was excluded.
2.2. Procedure
The researchers recruited nurses who worked at one of four home hospice clinics where visiting medical treatments were proposed and the nurses agreed with participation.
The research interviewers visited clinics, explained about the research again, and received informed consent after agreement for participation. There were three interviewers and all had counseling certification.
The interview lasted approximately 60 minutes and was only completed once. The questions were; “How do you care for a patient and a family member when you visit their home as a nurse with a physician?” and “How do you perceive home hospice? Each nurses’ narrative was recorded by an IC recorder after getting their permission. This study was approved by the ethical boards of St. Mary’s College (June, 2017).
2.3. Analysis
For the narrative data, we employed “qualitative analysis” by Funashima [8] based on the work of Berelson [9] . In narratives, we separated sentences into each shortest sentence without losing meanings, which is called as code. The similar codes were integrated into subcategories. Then similar subcategories were integrated into one category. Categories are separated into some themes. To maintain reliability, the categorization and coding were validated independently by researchers. Inconsistencies were discussed and negotiated until agreement was reached.
3. Results
3.1. Contents of Care in Home Hospice
We selected categories from narratives about importance, changes, and hopes. We show the subcategory as < > and category as “ ”. A “clinic” means a “clinic which proposed visiting medical treatment”.
About the contents of care by a nurse, we chose six categories (Table 1). The category “1) Understanding a patient as a living person” included subcategories such as
3.2. Perception for Home Hospice
The nurse’s narratives were categorized into 11 groups of about four themes (Table 2).
About the theme [Environment of home hospice], there are three categories. The category “7) Time and space for listening carefully” included subcategories like
About the theme [Care of nurses], there are four categories. The category “10) Feeling of responsibility and attractiveness of work” included subcategories like
About the theme [Introduction to home hospice and continuation], there are two categories. The category “14) Hopes for home hospice by a patient and caregiver for introduction” included . The category “15) Economics and man-power to continue home care” included subcategories like
Table 1. Contents of care by a nurse.
Table 2. Perception for home hospice by a visiting medical treatment nurse.
4.1. Contents of Care of Nurses in Visiting Medical Care
4.2. Perception of Nurses for Home Hospice by Visiting Medical Treatment
This study is supported by KAKENHI (17K12559).
The authors declare no conflicts of interest regarding the publication of this paper.
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