- Title
- The provision of end-of-life care in hospitals: nurses' perceptions
- Creator
- Shepherd, Jan
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2021
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Despite the increasing numbers of Australians dying in acute hospitals, significant gaps remain in the provision of high-quality healthcare to people who are dying. The challenge is in finding ways to improve end-of-life care and associated outcomes in the context of resource constraints and the expected increasing demand for services. Constructive involvement of relevant stakeholders in describing the current practice and the barriers to and enablers of the implementation of high-quality care in hospitals is crucial if we are to bridge the existing gap in patient-centred care for those facing the end of their lives. There is a paucity of research focused on the provision of end-of-life care in acute hospitals from the perspective of nurses, including the key barriers and potential enablers. Such data can help to highlight aspects of care that need to be improved and inform new approaches which support health professionals to provide care that aligns with individuals’ preferences, while reducing costly and possibly unnecessary care. This thesis by publication consists of six papers, an introduction and a discussion. The introduction provides an overview of end-of-life care, including relevant standards, developments, and community expectations. There is an examination of the Australian healthcare system, statistics and trends. The introduction also provides an overview of the role of acute care nurses in providing care to patients approaching the end of their lives. Five of the six papers included in this thesis quantitatively report acute care nurses’ perceptions of the provision of end-of-life care in hospitals. Participating nurses were recruited from several rural and metropolitan hospitals in New South Wales (NSW) and Victoria, two major hospitals in Hong Kong and Korea, and one Australian oncology nursing society. The sixth paper reviews the development of research in the field. This thesis aims to: 1. Examine acute care nurses’ knowledge of, and participation in, advance care planning practices (Paper One, published); 2. Examine acute care nurses’ views about the location in which they would most and least prefer to be cared for at the end of life, and the reasons for these preferences (Paper Two, published); 3. Compare the views of oncology nurses with those of medical oncology patients regarding the provision of chemotherapy in the last six months of life (Paper Three, published); 4. Examine acute care nurses’ perceptions of the barriers to the provision of optimal end-of-life care in Australia (Paper Four); 5. Compare the perceptions of acute care nurses in Asian and Western countries regarding the barriers to the provision of optimal end-of-life care (Paper Five); 6. Examine the development of research efforts examining nurses’ perceptions of, and involvement in, end-of-life care delivered in acute hospitals, with a view to identifying areas requiring future research (Paper Six). The thesis concludes with a discussion which summarises the key findings from each study and outlines the implications for future clinical practice and policy development.
- Subject
- nurses; end of life care; acute care; hospitals; dying; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1514109
- Identifier
- uon:56813
- Rights
- Copyright 2021 Jan Shepherd
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 18 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 172 KB | Adobe Acrobat PDF | View Details Download |