Role of nurses in medication management at the end of life: a qualitative interview study.

Autor: Huisman BAA; Department of Anesthesiology, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands. b.huisman@amsterdamumc.nl.; Hospice Kuria, Amsterdam, Netherlands. b.huisman@amsterdamumc.nl., Geijteman ECT; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands.; Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands., Dees MK; Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Netherlands., Schonewille NN; Department of Anesthesiology, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands.; Department of Gynaecology, OLVG West, Amsterdam, the Netherlands., Wieles M; Hospice Kuria, Amsterdam, Netherlands., van Zuylen L; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, Netherlands., Szadek KM; Department of Anesthesiology, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, Netherlands., van der Heide A; Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands.
Jazyk: angličtina
Zdroj: BMC palliative care [BMC Palliat Care] 2020 May 13; Vol. 19 (1), pp. 68. Date of Electronic Publication: 2020 May 13.
DOI: 10.1186/s12904-020-00574-5
Abstrakt: Background: Patients in the last phase of their lives often use many medications. Physicians tend to lack awareness that reviewing the usefulness of medication at the end of patients' lives is important. The aim of this study is to gain insight into the perspectives of patients, informal caregivers, nurses and physicians on the role of nurses in medication management at the end of life.
Methods: Semi-structured interviews were conducted with patients in the last phase of their lives, in hospitals, hospices and at home; and with their informal caregivers, nurses and physicians. Data were qualitatively analyzed using the constant comparative method.
Results: Seventy-six interviews were conducted, with 17 patients, 12 informal caregivers, 15 nurses, 20 (trainee) medical specialists and 12 family physicians. Participants agreed that the role of the nurse in medication management includes: 1) informing, 2) supporting, 3) representing and 4) involving the patient, their informal caregivers and physicians in medication management. Nurses have a particular role in continuity of care and proximity to the patient. They are expected to contribute to a multidimensional assessment and approach, which is important for promoting patients' interest in medication management at the end of life.
Conclusions: We found that nurses can and should play an important role in medication management at the end of life by informing, supporting, representing and involving all relevant parties. Physicians should appreciate nurses' input to optimize medication management in patients at the end of life. Health care professionals should recognize the role the nurses can have in promoting patients' interest in medication management at the end of life. Nurses should be reinforced by education and training to take up this role.
Databáze: MEDLINE
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