To explore palliative care unit and home care nurses' experiences of caring for patients with terminal delirium.
A qualitative exploratory design using individual interviews.
Participants included five nurses working in an interdisciplinary palliative care unit located in a large Canadian city hospital, and four nurses from a palliative home care nursing team located in the same city.
Nurses in both sites experienced multiple challenges caring for delirious patients. Additional education on delirium and collaborative teamwork were viewed as key factors in enhancing their ability to care for and support this patient and family population. Four core themes reflected the participants' perceptions and experiences: experiencing distress; the importance of presence; valuing the team; and the need to know more.
Findings suggest the need for interdisciplinary educational initiatives focused on the identification and management of terminal delirium, and targeted to the specific context in which nurses practise.
To examine whether primary caregivers' helping behaviors are predicted by their illness attribution reactions as proposed in Weiner's model.
Latent-variable structural equation modeling.
Five oncology outpatient settings in central Canada.
100 dyads consisting of patients with lung cancer and their primary caregivers.
Self-report questionnaires, abstracted medical record data, confirmatory factor analysis, and structural equation modeling.
Smoking history, judgments of responsibility for controlling the disease, anger, pride, and helping behaviors.
An interrelation was seen between judgments of responsibility toward patients to control aspects of the disease, affective reactions of anger and pride, and helping behavior. Anger and pride had a stronger influence on helping behavior than smoking history did.
Judgments of responsibility for controlling lung cancer and anger toward patients put caregivers at risk for dysfunctional helping behavior, particularly if patients had a history of tobacco use.
Primary caregivers' affective states directly affect their helping behavior toward patients with lung cancer. Clinicians should be aware that caregivers who perceive the patient to be largely responsible for managing the disease also may be angry toward that patient. Angry caregivers are at risk of providing suboptimal helping behavior.