Chinese oncology nurses' experience on caring for dying patients who are on their final days: a qualitative study

Abstract

Background: Caring for dying patients is stressful but an unavoidable responsibility of nurses. However, little is known about Chinese oncology nurses' experience of caring for dying cancer patients who are in their final days.

Purpose: To elucidate Chinese oncology nurses' experience of caring for dying cancer patients.

Methods: This is a qualitative descriptive study, semi-structured interviews was utilized to explore views of purposive sample of 28 nurses who have been taking care of terminally ill patients in a cancer hospital in Tianjin, mainland China. Transcripts were entered into NVivo. Qualitative thematic analysis was used to analyze the data for significant statements and phrases that in turn were organized into themes and sub-themes.

Results: Five themes were identified in the data: end-of-life care for dying cancer patients, end-of-life care for family members, cultural sensitivity and communication, moral distress and self-limitations, self-reflection and benefit-finding. Death is a taboo in traditional Chinese culture. This increases the difficulty of effective communication between nurses, patients and families. Although nurses suffered emotional distress when caring for dying cancer patients, these experiences helped them to reflect on the meaning of death and life, and positively influenced their daily lives, attitudes and behaviors toward caring for the dying. Chinese nurses had strong willingness to offer quality end-of-life care to patients and families, however, they suffered moral distress because of self-limitation, lack of knowledge and confidence and inexperience in psychological care.

Conclusions: End-of-life care in China reflects and has been influenced by the traditional Chinese culture. Chinese nurses reported suffering but also benefiting from their experiences. End-of-life cancer care training is needed by Chinese oncology nurses, especially for those who are younger and less experienced.

Keywords: Cancer; Dying; End-of-life care; Experience; Nurses; Qualitative study.