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Palliative care nurses' perceptions of suffering in palliative care patients Flinn, Monica Mary

Abstract

Suffering has been part of the human condition since time began, and people have long sought answers to the questions it raises from religion, philosophy, medicine, and the arts. People living with progressive, life threatening illness can suffer greatly from physical symptoms and a variety of personal issues. Palliative care offers these patients quality of life through symptom management and a unique approach of competent, compassionate care in which nurses play a major role. Many health professionals and others in society believe that assisted suicide and voluntary euthanasia should be options for people who are suffering despite the best efforts of palliative care. Throughout the health literature on suffering, there is a wealth of philosophical perspectives and research using both quantitative and qualitative methods. Although many papers focus on suffering in palliative care, none were done from the perspective of palliative care nurses. Using a qualitative method based on grounded theory, this study explored the perceptions of eight palliative care nurses about the suffering of their patients. Specifically, findings describe how the nurses recognize suffering, their strategies for helping patients who are suffering, the conditions which help or hinder the alleviation of suffering, and the personal impact on the nurses of caring for patients who suffer. Findings suggested that patients suffer in three realms: bodily discomfort, interpersonal discord, and personal distress. Strategies that patients and nurses used to alleviate suffering were specific to each realm. Their goals were to achieve bodily comfort, create interpersonal harmony, and find inner peace. The work pattern of patients and nurses was unique; as suffering became progressively less tangible through the bodily, interpersonal, and personal realms, the work of patients increased, and the work of nurses decreased. Physical suffering was more amenable to direct nursing interventions; suffering at the interpersonal and personal levels was essentially something only patients could resolve, and the nursing role became more supportive. Caring for patients who suffer affected the nurses positively and negatively. The nurses derived great satisfaction from being able to help alleviate suffering. Unfortunately, the nurses, too, suffered when they could not prevent or relieve suffering in their patients. They coped with these difficulties by setting realistic expectations of themselves, being able to learn from their experience, and feeling supported by their colleagues and by management in specific ways. From the results of this study, nursing implications for practice, education, administration, and research were identified.

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