School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.
School of Nursing, University of Auckland. School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Australia.
J Adv Nurs. 2022 Oct;78(10):3101-3115. doi: 10.1111/jan.15324. Epub 2022 Jun 24.
Describe the reported lived experiences of nurses who have participated at any stage of voluntary assisted dying (VAD), from the initial request to the end of life.
A qualitative meta-synthesis.
Databases searched were CINAHL, MEDLINE, Emcare, Scopus and PsycInfo. The search was undertaken in September 2021 with no date limitations. Qualitative studies were considered if published in English, reported primary data analysis of nurses' experiences who had been involved in VAD and reported direct quotes from nurses.
Qualitative studies meeting the selection criteria were critically appraised, then an open card-sort method was applied. Quotes from nurses were organized to group similar experiences, constructing themes and metaphors across studies as a new understanding of nurses' experiences of VAD.
Eight studies were included. Three major themes were constructed: An orderly procedure, reflecting the need for structure to feel adequately prepared; A beautiful death, reflecting the autonomy the patient exercised when choosing VAD facilitated an exceptionally positive death; and Psychological and emotional impact, where nurses recognized the emotional and ethical weight that they carried for themselves and the team when undertaking VAD.
Nurses may benefit from clear policy, supervision and communication training to support them as countries transition to providing VAD services. Policy provides nurses with confidence that they are undertaking the steps of VAD correctly and provides a layer of emotional protection. Communication training specific to VAD is necessary to prepare nurses to recognize their own emotional experiences when responding to the needs of the patient and their family.
VAD is increasingly becoming a legal option that nurses are encountering in their professional practice. Understanding nurses' experiences of being involved in VAD is required to support nurses in countries where VAD is becoming available to prepare professionally and psychologically.
描述参与自愿协助死亡(VAD)的护士在从最初请求到生命结束的各个阶段的报告的生活经历。
定性元综合。
9 月 2021 年对 CINAHL、MEDLINE、Emcare、Scopus 和 PsycInfo 进行了数据库搜索,无日期限制。如果研究以英文发表,报告了参与 VAD 的护士的经验的原始数据分析,并报告了护士的直接引语,则认为是定性研究。
对符合选择标准的定性研究进行了批判性评价,然后应用了开放式卡片分类法。将护士的引语组织在一起,对相似的经验进行分组,构建主题和隐喻,以形成对护士对 VAD 经验的新理解。
纳入了 8 项研究。构建了三个主要主题:有序的程序,反映了需要结构以充分做好准备的需求;美丽的死亡,反映了患者在选择 VAD 时行使的自主权,促成了异常积极的死亡;心理和情绪影响,护士认识到在实施 VAD 时他们自己和团队所承受的情绪和伦理负担。
随着各国过渡到提供 VAD 服务,护士可能会受益于明确的政策、监督和沟通培训,以支持他们。政策使护士有信心他们正在正确地进行 VAD 的步骤,并提供了一层情感保护。需要专门针对 VAD 的沟通培训,以使护士在应对患者及其家属的需求时能够识别自己的情绪体验。
VAD 越来越成为一种合法选择,护士在他们的专业实践中遇到。在 VAD 在可用的国家中,了解护士参与 VAD 的经历对于支持护士在专业和心理上做好准备是必要的。