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- Title
Navigating end-of-life decision-making in nursing: a systematic review of ethical challenges and palliative care practices.
- Authors
Alanazi, Majed Awad; Shaban, Marwa Mamdouh; Ramadan, Osama Mohamed Elsayed; Zaky, Mohammed Elsayed; Mohammed, Huda Hamdy; Amer, Fatma Gomaa Mohamed; Shaban, Mostafa
- Abstract
Objectives: This systematic review aimed to synthesize evidence on the ethical dilemma's nurses encounter in end-of-life care and effective palliative care practices. The objectives were to understand key ethical issues, evaluate communication and decision-making strategies, and identify approaches to support nurses and patients. Methods: A comprehensive search of major databases was conducted according to the PRISMA guidelines. Studies directly relating to nursing ethics, challenges in end-of-life decision-making, and palliative care practices were included. The risk of bias was assessed using ROBVIS-II. Data on ethical issues, palliative interventions, and outcomes was extracted and analyzed thematically. Results: 22 studies met the inclusion criteria. Key themes that emerged were: (1) Effective communication and involving patients in decision-making are essential but complex. (2) Nurses face dilemmas around balancing autonomy, beneficence and relational issues. (3) Integrating palliative care principles enhances symptom management and aligns care with patient values. (4) Education and organizational support are needed to equip nurses with skills and coping strategies. Conclusion: Navigating end-of-life care requires addressing interconnected ethical, communication and support needs. While studies provided insights, further research is required on cultural competence training, standardized education programs and longitudinal evaluations.
- Subjects
NURSES; NURSE-patient relationships; PATIENT autonomy; CORPORATE culture; MEDICAL information storage &; retrieval systems; OCCUPATIONAL roles; BENEVOLENCE; HOSPITAL nursing staff; CINAHL database; DECISION making in clinical medicine; DECISION making; NURSING; PSYCHOLOGICAL adaptation; DESCRIPTIVE statistics; SYSTEMATIC reviews; THEMATIC analysis; MEDLINE; COMMUNICATION; NURSES' attitudes; MEDICAL databases; TERMINAL care; PALLIATIVE care nursing; SOCIAL support; NURSING ethics; PATIENT participation
- Publication
BMC Nursing, 2024, Vol 23, Issue 1, p1
- ISSN
1472-6955
- Publication type
Article
- DOI
10.1186/s12912-024-02087-5