Commitment to care: A qualitative study of intensive care nurses' perspectives of end-of-life care in an Islamic context

摘要

Background: Currently, end-of-life care is a significant issue and a topic of debate in intensive care settings but understanding of nurses' perspectives about this within an Islamic context is surprisingly lacking. Aim: The purpose of this study was to explore intensive care nurses' perspectives of the end-of-life care in South-east of Iran. Methods: A descriptive qualitative research approach was used to engage 12 intensive care nurses from three intensive care units of teaching hospitals affiliated to Kerman University of Medical Science in a semi-structured interview. Interview transcripts were analysed using an inductive coding approach. Results: Four major categories emerged from analysis of the interviews: commitment to care, awareness of dying patients, caring relationships, and dealing with barriers and ethical issues. The first category was emphasized and appeared dominant in all interviews. Limitation: Because of specific socio-cultural and environmental factors, the findings of this study may not be applicable in other contexts, but enhance our knowledge about the topic in an Islamic context. Conclusions: This study emphasizes the importance of looking at the end-of-life care for critical terminally ill patients within the context of spiritual milieu associated with commitment to a compassionate care until the last moment of their life. Intensive nurses, faced with various barriers and ethical issues, instead were focused on physical and spiritual care and believed that it should fulfil their role in the challenging process. Implications for nursing and health policy: These findings indicate that there is a need for policies that help increase the quality of life of dying patients. It is imperative that nursing managers and policy makers in Iran consider these findings to improve end-of-life care in intensive setting. More training programmes, further education and research on the topic, should be implemented.