Bereavement care and the interaction with relatives in the context of euthanasia: A qualitative study with healthcare providers.

Belgium Euthanasia Family Interview Neoplasms Nurses Physicians Psychotherapists Qualitative research

Journal

International journal of nursing studies
ISSN: 1873-491X
Titre abrégé: Int J Nurs Stud
Pays: England
ID NLM: 0400675

Informations de publication

Date de publication:
Apr 2023
Historique:
received: 09 06 2022
revised: 20 01 2023
accepted: 23 01 2023
medline: 28 3 2023
pubmed: 17 2 2023
entrez: 16 2 2023
Statut: ppublish

Résumé

A recent review shows an interdependence between healthcare providers and relatives in the context of euthanasia. Belgian guidelines do focus on the role of certain healthcare providers (physicians, nurses, and psychologists), yet they hardly specify bereavement care services before, during and after the euthanasia. A conceptual model showing underlying mechanisms of healthcare providers' experiences regarding the interaction with and the provision of bereavement care to relatives of cancer patients throughout a euthanasia process. 47 semi-structured interviews with Flemish physicians, nurses and psychologists working in hospitals and/or homecare, conducted from September 2020 to April 2022. Transcripts were analyzed using the Constructivist Grounded Theory Approach. Participants experienced the interaction with relatives as very diverse, which can be visualized as a continuum ranging from negative to positive, depending on each unique case. The achieved degree of serenity was the main contributor in determining their position on the aforementioned continuum. To create this serene atmosphere, healthcare providers undertook actions underpinned by two attitudes (wariness and meticulousness), which are guided by different considerations. These considerations can be categorized into three groups: 1) ideas about a good death and its importance, 2) having the situation well under control and 3) self-reassurance. If relatives were not at peace, most participants said that they deny a request or formulate additional requirements. Moreover, they wanted to ensure relatives can cope with the loss, which was often experienced as intense and time-consuming. Our insights shape needs-based care from healthcare providers' perspective in the context of euthanasia. Future research should explore the relatives' perspective regarding this interaction and the provision of bereavement care. Professionals strive for a serene atmosphere throughout a euthanasia process to ensure relatives can cope with the loss, and the way in which the patient died.

Sections du résumé

BACKGROUND BACKGROUND
A recent review shows an interdependence between healthcare providers and relatives in the context of euthanasia. Belgian guidelines do focus on the role of certain healthcare providers (physicians, nurses, and psychologists), yet they hardly specify bereavement care services before, during and after the euthanasia.
PURPOSE OBJECTIVE
A conceptual model showing underlying mechanisms of healthcare providers' experiences regarding the interaction with and the provision of bereavement care to relatives of cancer patients throughout a euthanasia process.
METHODS METHODS
47 semi-structured interviews with Flemish physicians, nurses and psychologists working in hospitals and/or homecare, conducted from September 2020 to April 2022. Transcripts were analyzed using the Constructivist Grounded Theory Approach.
RESULTS RESULTS
Participants experienced the interaction with relatives as very diverse, which can be visualized as a continuum ranging from negative to positive, depending on each unique case. The achieved degree of serenity was the main contributor in determining their position on the aforementioned continuum. To create this serene atmosphere, healthcare providers undertook actions underpinned by two attitudes (wariness and meticulousness), which are guided by different considerations. These considerations can be categorized into three groups: 1) ideas about a good death and its importance, 2) having the situation well under control and 3) self-reassurance.
CONCLUSIONS CONCLUSIONS
If relatives were not at peace, most participants said that they deny a request or formulate additional requirements. Moreover, they wanted to ensure relatives can cope with the loss, which was often experienced as intense and time-consuming. Our insights shape needs-based care from healthcare providers' perspective in the context of euthanasia. Future research should explore the relatives' perspective regarding this interaction and the provision of bereavement care.
TWEETABLE ABSTRACT CONCLUSIONS
Professionals strive for a serene atmosphere throughout a euthanasia process to ensure relatives can cope with the loss, and the way in which the patient died.

Identifiants

pubmed: 36796117
pii: S0020-7489(23)00015-9
doi: 10.1016/j.ijnurstu.2023.104450
pii:
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

104450

Informations de copyright

Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Charlotte Boven (C)

Department of Geriatric Medicine, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium. Electronic address: Charlotte.Boven@uzgent.be.

Liesbeth Van Humbeeck (L)

Department of Geriatric Medicine, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium.

Lieve Van den Block (L)

End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), Brussels Health Campus, Laarbeeklaan 103, 1090 Brussels, Belgium; Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Brussels, Belgium.

Ruth Piers (R)

Department of Geriatric Medicine, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium.

Nele Van Den Noortgate (N)

Department of Geriatric Medicine, Ghent University Hospital, Corneel Heymanslaan 10, Ghent, Belgium.

Let Dillen (L)

Department of Geriatric Medicine and Palliative Care Unit, Ghent University Hospital, Ghent, Belgium.

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