Hospice nurses' experience of caring for the elderly with wounds at the end-of-life.

Abstract

Background: The goal of hospice care is to maximize quality of life and provide peace, comfort, and dignity to patients with terminal illness. Older dying patients pose unique challenges to meeting this essential goal, especially in the care of wounds. Wound care in dying patients can be complex, expensive, and threaten quality of life. With the huge demographic shift towards older people, hospice nurses need to adequately address the comfort needs of dying elderly patients with wounds. Yet, little is known about how the phenomenon of wound care is experienced in hospice nursing practice. Problem: A review of the literature illustrated a paucity of studies concerning the experiences of hospice nurses caring for dying patients with wounds. In order for hospice nurses to give holistic care, a greater understanding of their wound care experiences, as well as psychological, social, and spiritual factors related to their wound care experiences, is needed. Aim of the Study: The purpose of this study was to gain an understanding of the experiences of hospice nurses in caring for elderly patients with wounds at the end-of-life, a phenomenon not well known. Methodology: Through the use of semi-structured interviews, this exploratory qualitative descriptive study examined the experiences of 13 hospice nurses in caring for elderly patients with wounds at the EOL. Findings: The rich descriptive data generated from this study provide a beginning understanding of hospice nurses' experiences with wounds at the end-of-life. Content analysis of participant interview data revealed five themes that provide valuable new insights into hospice nurses' experiences concerning wound care in clinical practice: Difficult to Achieve Comfort; Healing is Unrealistic; Coping with Conflict; Hospice Wound Knowledge Deficit, and Positive Affirmation. The findings have the potential to inform hospice nurse practice and to suggest areas for future research.