Caring for families of the terminally ill in Malaysia from palliative care nurses' perspectives
Namasivayam, P and Lee, S and O'Connor, M and Barnett, T, Caring for families of the terminally ill in Malaysia from palliative care nurses' perspectives, Journal of Clinical Nursing, 23, (1-2) pp. 173-180. ISSN 1365-2702 (2013) [Refereed Article]
Aims and objectives. To describe the process that nurses experienced in engaging with families in Malaysian palliative care
settings and the challenges they faced.
Background. In palliative care settings, nurses and the terminally ill person’s family members interact very closely with each
other. It is important for nurses to work with families to ensure that the care of the terminally ill person is optimised.
Research design. A qualitative design using grounded theory methods was used to describe how nurses engaged with families
and the challenges they faced.
Methods. Twenty-two nurses from home care and inpatient palliative care settings across Malaysia participated in this
study. Data were collected through seven interviews and eight focus group discussions conducted between 2007–2009.
Results. The main problem identified by nurses was the different expectations to patient care with families. The participants
used the core process of Engaging with families to resolve these differences and implemented strategies described as Preparing
families for palliative care, Modifying care and Staying engaged to promote greater consistency and quality of care.
When participants were able to resolve their different expectations with families, these resulted in positive outcomes,
described as Harmony. However, negative outcomes of participants not being able to resolve their different expectations
with families were Disharmony.
Conclusions. This study highlights the importance of engaging and supporting families of the terminally ill as well as providing
a guide that may be used by nurses and carers to better respond to families’ needs and concerns.
Relevance to clinical practice. The study draws attention to the need for formal palliative care education, inclusive of family
care, to enable nurses to provide the terminally ill person and their family effective and appropriate care.
beliefs, families, grounded theory, Malaysia, multicultural, nurses, nursing care, palliative care, terminally ill