Nurses' roles and challenges in providing end-of-life care in neonatal intensive care units in South Korea

Appl Nurs Res. 2019 Dec:50:151204. doi: 10.1016/j.apnr.2019.151204. Epub 2019 Oct 21.

Abstract

Background: Neonatal Intensive Care Unit (NICU) nurses in Korea often experience challenges in providing care for dying infants and their families. However, there is limited understanding about what contributes to the challenges related to end-of-life care.

Purpose: To describe NICU nurses' perceived roles and challenges faced while providing end-of-life care in South Korea.

Methods: A qualitative descriptive study was conducted with 20 NICU nurses in South Korea using semi-structured interviews. Participants were recruited from two NICUs in Seoul, where infant mortality is the highest in South Korea. Transcribed interviews were coded by two research personnel, and subsequently, a developed coding book was translated by three research personnel. The codes developed were categorized and peer-reviewed to develop themes using conventional content analysis.

Results: Nurses' roles during end-of-life care were grouped into four categories: providing information and support, enhancing attachment between the parents and infants, providing direct care to the infant, and completing documentation. Nurses' perceived challenges during end-of-life care included providing end-of-life care without adequate experience and knowledge, environmental constraints on end-of-life care, and conflicted situations during end-of-life care.

Conclusion: Although the nurses provided the best care they could, their end-of-life care practice was hindered for various reasons. To enhance NICU nurses' ability to provide and make them more capable of providing high quality EOL care, hospitals need to support nurse education and improve staffing level, and create in NICUs an environment that is favorable for providing EOL care.

Keywords: End-of-life care; NICU; Neonates; Nursing role; South Korea.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Neonatal / standards*
  • Intensive Care Units, Neonatal / statistics & numerical data
  • Male
  • Middle Aged
  • Nurse's Role / psychology*
  • Nurses, Neonatal / psychology*
  • Practice Guidelines as Topic*
  • Qualitative Research
  • Republic of Korea
  • Terminal Care / psychology*