Home care nurses’ ethical compass in palliative decision-making processes

IF 2.4 3区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatric Nursing Pub Date : 2025-08-01 DOI:10.1016/j.gerinurse.2025.103561

Sandra Jahr Svendsen RN MClinNurs PhD candidate , Ellen Karine Grov RN MScN PhD Professor , Katrine Staats RN MClinNurs Associate Professor

{"title":"Home care nurses’ ethical compass in palliative decision-making processes","authors":"Sandra Jahr Svendsen RN MClinNurs PhD candidate , Ellen Karine Grov RN MScN PhD Professor , Katrine Staats RN MClinNurs Associate Professor","doi":"10.1016/j.gerinurse.2025.103561","DOIUrl":null,"url":null,"abstract":"<div><div>This study explored home care nurses' experiences with shared decision-making regarding treatment and care for home-dwelling patients in the palliative phase, focusing on their perceptions of their role. An exploratory qualitative design was used to conduct and interpret four focus group interviews with 24 home care nurses from four municipalities, guided by Gadamer's hermeneutics. Two themes emerged: (1) Being captured between guidelines and personal values, highlighting the importance of covering one’s back and the challenges of addressing a patient’s ambivalence in decisions about life and death, and (2) Navigating the home care nurses’ role, involving being caught in a network of blurry boundaries and sitting tight – understood as holding back one’s views or actions even when a clear course seems evident – when decisions need to be made. This study highlights home care nurses' ethical challenges in shared decision-making. It suggests the core principles of healthcare ethics as a framework to support home care nurses in clarifying their roles and enhancing shared decision-making in palliative care.</div></div>","PeriodicalId":56258,"journal":{"name":"Geriatric Nursing","volume":"65 ","pages":"Article 103561"},"PeriodicalIF":2.4000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Geriatric Nursing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0197457225004045","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

This study explored home care nurses' experiences with shared decision-making regarding treatment and care for home-dwelling patients in the palliative phase, focusing on their perceptions of their role. An exploratory qualitative design was used to conduct and interpret four focus group interviews with 24 home care nurses from four municipalities, guided by Gadamer's hermeneutics. Two themes emerged: (1) Being captured between guidelines and personal values, highlighting the importance of covering one’s back and the challenges of addressing a patient’s ambivalence in decisions about life and death, and (2) Navigating the home care nurses’ role, involving being caught in a network of blurry boundaries and sitting tight – understood as holding back one’s views or actions even when a clear course seems evident – when decisions need to be made. This study highlights home care nurses' ethical challenges in shared decision-making. It suggests the core principles of healthcare ethics as a framework to support home care nurses in clarifying their roles and enhancing shared decision-making in palliative care.

查看原文本刊更多论文

家庭护理护士在姑息治疗决策过程中的道德指南针

本研究探讨了家庭护理护士在姑息期家庭居住患者的治疗和护理方面共同决策的经验，重点是他们对自己角色的看法。在伽达默尔解释学的指导下，采用探索性定性设计对来自四个城市的24名家庭护理护士进行了四次焦点小组访谈，并进行了解释。出现了两个主题：(1)在指导方针和个人价值观之间进退两难，强调保护自己的重要性，以及解决患者在生死抉择中矛盾心理的挑战；(2)在需要做出决定时，如何定位家庭护理护士的角色，包括陷入模糊的界限网络中，坐着不动——被理解为即使在一个清晰的过程似乎显而易见的情况下，也要保留自己的观点或行动。本研究强调了家庭护理护士在共同决策中的伦理挑战。它建议医疗保健伦理的核心原则作为一个框架，以支持家庭护理护士明确自己的角色和加强共同决策在姑息治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Geriatric Nursing 医学-护理

CiteScore

3.80

自引率

7.40%

发文量

257

审稿时长

>12 weeks

期刊介绍： Geriatric Nursing is a comprehensive source for clinical information and management advice relating to the care of older adults. The journal''s peer-reviewed articles report the latest developments in the management of acute and chronic disorders and provide practical advice on care of older adults across the long term continuum. Geriatric Nursing addresses current issues related to drugs, advance directives, staff development and management, legal issues, client and caregiver education, infection control, and other topics. The journal is written specifically for nurses and nurse practitioners who work with older adults in any care setting.