Introduction: Oncology nurses provide end-of-life (EOL) care to their patients daily. Oncology nurses' perceptions regarding how to provide quality care to dying patients could be an important addition to the ongoing research on quality EOL care. The purpose of this study was to determine the impact of specific obstacle and supportive behaviors in EOL care as perceived by hospital-based oncology nurses. This study extended the work of Beckstrand, Moore, Callister, and Bond (2009).

Methods: A 69-item questionnaire adapted from previous studies (Beckstrand & Kirchhoff, 2005; Beckstrand, Smith, Heaston, & Bond, 2008) was sent to 1,000 nurses who were members of the Oncology Nursing Society (ONS) and who had provided EOL care to dying oncology patients. Three mailings of the questionnaire yielded 380 usable responses from 907 eligible respondents, which resulted in a 41.9% return rate. Oncology nurses were asked to rate obstacle and supportive items on both size and frequency of occurrence as they related to oncology patients in a hospital setting.

Results: Obstacle items which received the three highest perceived impact scores were: (1) dealing with anxious family members, (2) families not accepting what the physician is telling them about the patient's poor prognosis, and (3) being called away from the patient and family because of the need to help with a new admit or to help another nurse care for his/her patients. Supportive behavior items which received the three highest impact scores were: (1) allowing family members adequate time to be alone with the patient after he or she has died, (2) providing a peaceful, dignified bedside scene for family members once the patient has died, and (3) allowing families unlimited access to the dying patient even if it conflicts with nursing care at times.

Implications: Oncology nurses are dedicated to providing the best EOL care to their patients and patients' families. This study identified obstacle and supportive behavior items with the largest impact on providing quality EOL care.

Recommendations: Results of this research demonstrated the need for more EOL education and guidance in forming teams of nurses, social and palliative care workers, and physicians to support the giving of quality care. Nurses also reported the need for more time to support the dying patient and family.



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End-of-Life, oncology, oncology nurses, death, cancer



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Nursing Commons