The lived experience of family caregivers caring for patients dependent on life-sustaining technologies

Purpose:The purpose of this study was to describe the meaning of the lived experience of family caregivers caring for their loved ones who were dependent upon life-sustaining technologies while in the hospital.Methods:This study followed van Manen's hermeneutic phenomenological approach to generate and analyze data to describe the experience of ten family caregivers who met the following inclusion criteria:a family member who participated actively in caring for the loved one who was dependent upon technologies for human care.Data were collected using individual in-depth interviews.The interview transcriptions were analyzed using van Manen's phenomenological approach,while Lincoln and Guba's criteria were used to establish trustworthiness of the study.Findings:Four thematic categories structured the meaning of the experience:Being an invisible person;supporting patients'wholeness;struggling to trust technologies for human care;and living in uncertainty.These thematic categories were reflective of Van Manen's four lived worlds of body,relation,space,and time.Conclusion:Understanding the experience of family caregivers challenges nurses to express their technological competencies in caring more fully in their human care.Locsin's theory of Technological Competency as Caring in Nursing was used to explain and describe the meaning of the experiences of family caregivers caring for patients who were dependent upon technologies for human care,and foster nursing practice as caring in nursing.

Factors Relating to Nurses’ End-of-Life Care

This integrative review aimed to investigate factors relating to end-of-life care of nurses. The review was conducted according to PICo (Participant, area of Interest, and Context). Keywords identified were: “nurse” AND “end-of-life care” (“dyingcare” OR “‘deathcare”, OR “near end stage of life care” OR “palliative care” OR “hospice care” OR “comfortable care in near death” OR “quality of dying patients care”), AND “nurses”. The database searched through PubMed, ProQuest, Google Scholar, Web of Science and SCOPUS. The searching inclusion criteria were limited to English and Chinese language studies about nurses’ end-of-life care from 2010 to 2019, yielding 258 English language articles and 2Chinese language articles. Results: A total of fifteen articles were selected based on inclusion criteria. Two subjects were obtained from the results that related to nurses’ care during the process of end of life: 1) Nurses’ demographic factors;and 2) Modifiable factors. Nurses’ demographic factors were age, years of work experience, level of education and experience of the death of a family member/friend. Modifiable factors included knowledge, attitude, confidence, relationship, environment and resources, communication, nursing activities, philosophy and culture of care, skills and training. These factors were explored in various areas and majority of the studies had been conducted in public government hospitals. Conclusion: The major power ability of care was observed in nurses who acted the significant part in caring for the terminally ill during the dying process. Caring for dying patients was related to many factors which could affect the fabric of nursing care at the end stage of life. The elements found in this review could lead to recommendations with implications for nursing practice so as to improve and enhance end-of-life care. Some factors could be considered like predictors affecting nursing practice for chronical ill patients in further research. In addition, nurses’ tranquility care in community hospitals should be more focused.