An investigation into the differing health information needs of patients who have Chronic Obstructive Pulmonary Disease Excellence in Practice: a comparison of hospice nurses' perspectives of care of the dying patient in the UK and North America

Hill, Olivia (2014) An investigation into the differing health information needs of patients who have Chronic Obstructive Pulmonary Disease Excellence in Practice: a comparison of hospice nurses' perspectives of care of the dying patient in the UK and North America. [Dissertation (University of Nottingham only)] (Unpublished)

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Abstract

Abstract

Aim

To investigate and compare hospice nurses’ perspectives of excellent end-of-life care (EOLC), in the United Kingdom (UK) and United States of America (USA).

Background

The increasing demands and universal concern of EOLC, regardless of speciality, requires acknowledgement of the need for excellence in EOLC practice. There remains inadequacy in EOLC, highlighted by existing literature, largely within settings outside of hospice; whilst hospice is well documented for being high in patient and family satisfaction of EOLC. Although research has been widely conducted on the topic of end-of-life (EOL), few studies have looked at nurses’ perspectives providing EOLC and none thoroughly address the perspectives of hospice nurses and their ideas of excellent practice.

Method

Nine semi-structured interviews were conducted with specialist hospice nurses providing EOLC. Six interviews were conducted in a hospice in San Diego, USA, and three were conducted in a hospice in Leicestershire, UK. The interviews were recorded and subsequently analysed using Richie and Spencer’s qualitative framework (1993) and NVivo software.

Findings

Six main themes were identified within the data from both countries: practical aspects of excellent EOLC; essential nurse qualities to be an excellent EOL practitioner; resources needed to enable excellent EOLC; tools used to guide excellent EOLC; improving access to EOLC; transferrable skills of excellent EOLC. Although there was a constancy seen in the perspectives of hospice nurses in both countries, these themes were interwoven within the context of their setting, in order to aid comparison, and taking into account the impact of health system and culture on EOLC.

Conclusions

The unique experiences of hospice nurses caring for the dying in a range of settings, with variable resources and within unpredictable family dynamics, provided rich information on excellent EOLC that is sensitive to challenges faced in practice. The comparison of two affluent, developed countries, with different health systems and hospice models highlighted transferrable skills of excellent EOLC adaptable to different settings, cultures and organisations of care.

Item Type: Dissertation (University of Nottingham only)
Depositing User: EP, Services
Date Deposited: 02 Jul 2014 10:20
Last Modified: 23 Oct 2016 19:52
URI: http://eprints.nottingham.ac.uk/id/eprint/27078

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