Table 2 Codes, subcategories, categories and themes raised regarding the educational needs of Iranian undergraduate nursing students in end-of-life care
Themes | Categories | Sub categories | Code(s) |
|---|---|---|---|
Principles of end-of-life care | Definitions | Death process | Knowledge of death as a process, death as part of the process of evolution |
Death with dignity | Respecting the human body, providing suitable conditions for a dignified death | ||
Grief and loss | Getting to know the definitions of grief and loss, grief and loss management in the patient and caregivers | ||
Definition of palliative care and end of life care | Familiarity with end-of-life care, understanding the differences between palliative and end-of-life care | ||
Indicators | Evidence-based | Providing care based on prior evidence | |
Holistic | A comprehensive view of the dying patient, providing care at various levels from the lowest to the highest | ||
Culture-based | Knowledge of the cultural background of the patient and family, care based on the cultural competence of the nurse | ||
Team-centered | Being a team in end-of-life care, knowing teamwork skills, having team leadership skills | ||
Family-centered | The importance of paying attention to the needs of patients’ families, trying to empower the family | ||
Patient-centered | Care based on patient needs, considering the patient at the center of care | ||
Physical care | Care of the eyes | Corneal protection | Paying attention to possible damage to the eyes, knowing how to care for the cornea |
Pain management | Pharmaceutical treatments | Knowledge of narcotic and non-narcotic pain relievers | |
Non-pharmacological treatments | Knowledge of non-pharmacological methods of pain relief | ||
Management of excretion | Care related to the patient’s excretory condition | Paying attention to the hygiene of excretory areas, having the skill of placing a sterile urinary catheter | |
Nutritional management | Nausea and vomiting | Control of nausea and vomiting with pharmaceutical and non-pharmacological methods | |
Oral and total parenteral nutrition | Knowledge about the suitable oral diet of these patients, familiarity with the types of total parenteral methods and their attentions | ||
Oral care | Understanding the importance of oral care, getting familiar with various effective oral care methods | ||
Skin management | Prevention of pressure ulcers | Understanding the importance of changing the position in these patients, knowing the types of positions to change the position, knowing the scales for calculating the probability of pressure ulcers | |
Treatment of pressure ulcers | Reviewing the types of pressure ulcers, knowing the types of dressings, the need to be familiar with the types of treatment methods for pressure ulcers | ||
Respiratory management | Natural airway care | Recognizing respiratory disorders caused by immobility, learning physiotherapy and cleaning respiratory secretions | |
Alternate airway care | Ability to provide respiratory care for patients with endotracheal tube and tracheostomy | ||
Psychosocial care | Patient | Provide a suitable environment | Creating a cheerful environment for the patient, creating a relaxing environment for the patient |
Respectful care | Acceptance of the patient, respect for the totality of the patient’s existence | ||
Maintaining maximum patient independence | Knowing the methods of helping the patient to maintain independence | ||
Effective communication | Familiarity with communication techniques and communication barriers | ||
Hopeful presence | Effective presence at the patient’s bedside, knowledge of ways to strengthen the patient’s morale | ||
Anxiety management | Knowledge of pharmaceutical and non-pharmacological methods | ||
Depression management | Knowledge of pharmaceutical and non-pharmacological methods | ||
Caregivers | Effective communication | Helping to establish proper communication between caregivers and patients, familiarizing with the principles of proper communication between nurses and patient caregivers | |
Anxiety management | Learning anxiety management methods in caregivers | ||
Nurses | Psychological problems caused by these cares | Understanding the possibility of psychological damage caused by these cares in nurses, psychological care of nursing colleagues | |
Spiritual care | Identify spiritual needs | Attention to the spiritual needs of patients and caregivers | Learning how to identify the spiritual needs of patients and caregivers |
Care based on spiritual beliefs | Respecting the spiritual values and beliefs of patients and caregivers | Understanding the importance of respecting the spiritual values of patients and caregivers | |
Developing knowledge of spiritual care | The necessity of familiarizing students with spiritual care | ||
Challenges of end-of-life care | Family economic problems | Economic support of the family | Understanding how family economic conditions affect the quality of care, Knowledge of family economic support methods |
Ethical and legal challenges | Patients and caregivers desire and preferences | Respect patients and caregivers desire and preferences | |
Surrogate decision-making | Knowledge of the ethical and legal aspects of the Surrogate decision-making | ||
Withholding and withdrawing treatment | Knowledge of the ethical and legal aspects of the withholding and withdrawing treatment | ||
Do not resuscitate (DNR) | Familiarity with the concept of DNR, knowledge about different aspects of DNR | ||
Brain death | Learning brain death diagnosis methods, recognizing the legal challenges of brain death | ||
Autopsy | Familiarity with autopsy care | ||
Organ donation | Knowing the nurse’s role in organ donation, supporting donor families | ||
After-death care | Deceased | Corpse care | Learning how to prepare a corpse |
Family | Family support | Knowing the methods of supporting the family of the deceased |