Dartey Anita Fafa, Johnson Beatrice Bella, Klutsey Ellen Eyi, Zigah John, Okai Beauty, Ahorli Regina, Appati Joan Asiwome, Essiakoh Beatrice, Afaya Agani
School of Nursing and Midwifery, University of Health and Allied Sciences, PMB 31, Ho, Volta Region, Ho, Volta Region, Ghana.
St. Anthony Catholic Hospital, P.O. Box 11, Dzodze, Volta Region, Ghana.
BMC Nurs. 2025 Jul 1;24(1):699. doi: 10.1186/s12912-025-03226-2.
Healthcare workers have an ethical obligation to provide quality end-of-life (EOL) care. Yet, substantial gaps persist in EOL practices globally and in Ghana specifically. Intensive care unit (ICU) nurses are pivotal in EOL care but frequently experience distress and unpreparedness when caring for dying patients. Ho Teaching Hospital, a major regional referral center in Ghana, has begun initial efforts to improve EOL care. However, systematic integration of EOL care principles is still lacking.
This study aims to explore the experiences of ICU nurses providing EOL care at the Ho Teaching Hospital in Ghana, to understand the specific needs and challenges faced by this facility, and to drive targeted improvements.
The study employed an exploratory qualitative design and a purposive sampling method to recruit 20 nurses working in the ICU of the Ho Teaching Hospital in Ghana. The study used semi-structured interviews to gather data from the nurses who had experience providing EOL care to patients. Data was analysed thematically using NVivo version 14.
Key findings from the interviews with ICU nurses revealed some major challenges which included inadequate equipment, understaffing, excessive workloads, and managing family-related issues. Nurses described the work as extremely stressful and emotionally draining. They frequently encounter traditional practices by families that interfere with medical care. The nurses recommended improving resources and equipment, enhancing training and support for staff, implementing communication and education programs, and increasing staffing.
This study highlights the importance of improving intensive care nursing practices, including staffing, equipment availability, specialized training, and mental health support. These improvements can enhance care quality and nurse retention while also reducing burnout and emotional distress. Empowering frontline nurses and implementing evidence-based interventions can further improve care quality. The study recommends that policymakers should consider integrating EOL care modules into ICU nurses' continuing professional development, establishing mandatory staff counselling programs, and prioritizing resource allocation to critical care units.
医护人员有道德义务提供优质的临终关怀。然而，全球范围内，尤其是在加纳，临终关怀实践仍存在巨大差距。重症监护病房（ICU）护士在临终关怀中起着关键作用，但在照顾临终患者时经常感到痛苦和准备不足。加纳的主要区域转诊中心霍教学医院已开始初步努力改善临终关怀。然而，临终关怀原则的系统整合仍然缺乏。
本研究旨在探索加纳霍教学医院提供临终关怀的ICU护士的经历，了解该机构面临的具体需求和挑战，并推动有针对性的改进。
本研究采用探索性定性设计和目的抽样方法，招募了20名在加纳霍教学医院ICU工作的护士。该研究使用半结构化访谈从有照顾临终患者经验的护士那里收集数据。使用NVivo 14版本对数据进行主题分析。
对ICU护士访谈的主要发现揭示了一些重大挑战，包括设备不足、人员配备不足、工作量过大以及处理与家庭相关的问题。护士们将这项工作描述为压力极大且情感耗竭。他们经常遇到家属的传统做法干扰医疗护理。护士们建议改善资源和设备，加强对员工的培训和支持，实施沟通和教育计划，并增加人员配备。
本研究强调了改善重症护理实践的重要性，包括人员配备、设备可用性、专业培训和心理健康支持。这些改进可以提高护理质量并留住护士，同时还能减少倦怠和情感困扰。赋予一线护士权力并实施循证干预措施可以进一步提高护理质量。该研究建议政策制定者应考虑将临终关怀模块纳入ICU护士的持续专业发展，建立强制性的员工咨询计划，并优先为重症监护病房分配资源。
