Ali Victoria, Preston Nancy, Machin Laura, Malone Jackie
Lancaster University, Lancaster, UK.
Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.
Palliat Med. 2025 Jun;39(6):644-664. doi: 10.1177/02692163251331162. Epub 2025 Apr 29.
Nurses can be involved in interventions that they perceive as hastening death. These interventions may intentionally cause death, as in the case of assisted dying or result in death as an unintended consequence, such as when life-sustaining treatment is withdrawn. There is increasing evidence regarding nurses' experiences of providing care in these separate contexts. However, it remains less clear whether parallels exist in experiences across various acts that nurses might consider death hastening.
To synthesise qualitative research findings on the lived experiences of nurses when involved with acts that may be perceived as death hastening.
A qualitative evidence synthesis utilising thematic synthesis.
An initial search of CINHAL, PsychInfo and Medline was undertaken in December 2022 and updated in August 2024. Papers were quality assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research.
Twenty-three papers were included in the review. An overarching theme linked to the emotional labour required to provide care was developed. Three sub-themes influence emotional labour: (1) experiencing personal and professional conflicts, (2) the provision of 'normal(ised)' care and (3) perceptions of palliative care as a proxy for hastening death.
This synthesis demonstrates that nurses experience significant emotional labour across acts that may be perceived as death hastening. The level of emotional labour is influenced by nurses' uncertainty of the ethical and moral status of these interventions and navigating these uncertainties alongside colleagues, patients and those important to them during care delivery.
护士可能会参与到他们认为会加速死亡的干预措施中。这些干预措施可能会故意导致死亡，如协助死亡的情况，或者作为意外后果导致死亡，例如撤除维持生命的治疗时。关于护士在这些不同情况下提供护理的经历，证据越来越多。然而，对于护士可能认为会加速死亡的各种行为的经历中是否存在相似之处，仍不太清楚。
综合关于护士参与可能被视为加速死亡行为时的生活经历的定性研究结果。
采用主题综合法进行定性证据综合。
2022年12月对CINHAL、PsychInfo和Medline进行了初步检索，并于2024年8月更新。使用乔安娜·布里格斯研究所定性研究批判性评价清单对论文进行质量评估。
该综述纳入了23篇论文。形成了一个与提供护理所需的情感劳动相关的总体主题。三个子主题影响情感劳动：（1）经历个人和职业冲突，（2）提供“正常（化）”护理，（3）将姑息治疗视为加速死亡的替代方式的看法。
本综合研究表明，护士在可能被视为加速死亡的行为中经历了重大的情感劳动。情感劳动的程度受到护士对这些干预措施的伦理和道德地位的不确定性以及在护理过程中与同事、患者及对他们重要的人一起应对这些不确定性的影响。
