Recognizing and acknowledging end-of-life for patients with cancer - a balancing act. A qualitative study of doctors' and nurses' experiences

Eur J Oncol Nurs. 2024 Aug:71:102654. doi: 10.1016/j.ejon.2024.102654. Epub 2024 Jul 9.

Abstract

Purpose: Doctors and nurses are central in the challenging task of end-of-life (EOL) care, and this study aims to explore and describe doctors' and nurses' experiences of recognition and acknowledgment of the end of life for patients with cancer.

Methods: A qualitative, explorative research design with individual interviews was carried out based on a semi-open interview guide. A total of 6 doctors and 6 nurses working in medical or surgical departments at a Norwegian University hospital were interviewed. The interviews were analyzed using qualitative content analysis.

Results: The study's findings highlight that recognizing and acknowledging patients with cancer as being at end-of-life is a challenging process. Three subthemes emerged from the analysis; the significance of being experienced, the significance of organizational structures, and the significance of having a common understanding. A main theme was analyzed further and abstracted from the subthemes; Being safe to manage the balancing act of recognizing and acknowledging the end of life.

Conclusions: Much is at stake in the EOL setting, and healthcare professionals (HCP) must balance several aspects regarding EOL decisions. Striking the right balance in these situations is challenging. HCPs need a safety net through collaboration with, and support from, colleagues, supporting organizational structures and experience. Strengthening the safety net will have a clear impact on improving clinical practice to reduce futile treatment and provide high-quality EOL care for all dying patients in hospitals.

Keywords: Acknowledging end-of-life; Awareness of dying; Cancer patients; End-of-life; Health care professionals; Palliative care; Qualitative; Terminally ill; Timely end-of-life recognition.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Attitude to Death
  • Female
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Neoplasms*
  • Norway
  • Nursing Staff, Hospital / psychology
  • Qualitative Research*
  • Terminal Care* / psychology