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Challenges Experienced by Italian Nursing Home Staff in End-of-Life Conversations with Family Caregivers during COVID-19 Pandemic: A Qualitative Descriptive Study

Author

Listed:
  • Silvia Gonella

    (Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Turin, Italy
    Direction of Health Professions, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Corso Bramante 88–90, 10126 Turin, Italy)

  • Paola Di Giulio

    (Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Turin, Italy)

  • Alexandra Antal

    (Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Turin, Italy)

  • Nicola Cornally

    (Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, College Road Cork, T12 AK54 Cork, Ireland)

  • Peter Martin

    (School of Medicine, Faculty of Health, Deakin University, 75 Pigdons Road, Waurn Ponds, VIC 3216, Australia)

  • Sara Campagna

    (Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Turin, Italy)

  • Valerio Dimonte

    (Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Turin, Italy
    Direction of Health Professions, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Corso Bramante 88–90, 10126 Turin, Italy)

Abstract

End-of-life conversations are among the most challenging of all communication scenarios and on the agenda of several healthcare settings, including nursing homes (NHs). They may be also difficult for experienced healthcare professionals (HCPs). This study explores the difficulties experienced by Italian NH staff in end-of-life conversations with family caregivers (FCs) during COVID-19 pandemic to uncover their educational needs. A qualitative descriptive study based on inductive thematic analysis was performed. Twenty-one HCPs across six Italian NHs were interviewed. Four themes described their experiences of end-of-life conversations: (1) communicating with FCs over the overall disease trajectory; (2) managing challenging emotions and situations; (3) establishing a partnership between HCPs and FCs; (4) addressing HCPs’ communication skills needs. HCPs had to face multiple challenging situations that varied across the care period as well as complex emotions such as anxiety, guilt, uncertainty, fear, anger, or suffering, which required tailored answers. COVID-19 pandemic increased FCs’ aggressive behaviors, their distrust, and uncertainty due to visitation restrictions. HCPs had to overcome this by developing a set of strategies, including adoption of an active-listening approach, supportive communication, and explicit acknowledgement of FCs’ emotions. Since communication needs were mostly practical in nature, HCPs valued practical communication training.

Suggested Citation

  • Silvia Gonella & Paola Di Giulio & Alexandra Antal & Nicola Cornally & Peter Martin & Sara Campagna & Valerio Dimonte, 2022. "Challenges Experienced by Italian Nursing Home Staff in End-of-Life Conversations with Family Caregivers during COVID-19 Pandemic: A Qualitative Descriptive Study," IJERPH, MDPI, vol. 19(5), pages 1-18, February.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:5:p:2504-:d:755256
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    References listed on IDEAS

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    1. Kavita Batra & Tejinder Pal Singh & Manoj Sharma & Ravi Batra & Nena Schvaneveldt, 2020. "Investigating the Psychological Impact of COVID-19 among Healthcare Workers: A Meta-Analysis," IJERPH, MDPI, vol. 17(23), pages 1-33, December.
    2. Hanneke J. A. Smaling & Bram Tilburgs & Wilco P. Achterberg & Mandy Visser, 2022. "The Impact of Social Distancing Due to the COVID-19 Pandemic on People with Dementia, Family Carers and Healthcare Professionals: A Qualitative Study," IJERPH, MDPI, vol. 19(1), pages 1-12, January.
    3. Lidia Borghi & Elaine C. Meyer & Elena Vegni & Roberta Oteri & Paolo Almagioni & Giulia Lamiani, 2021. "Twelve Years of the Italian Program to Enhance Relational and Communication Skills (PERCS)," IJERPH, MDPI, vol. 18(2), pages 1-14, January.
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    Cited by:

    1. Silvia Gonella & Sara Campagna & Valerio Dimonte, 2023. "A Situation-Specific Theory of End-of-Life Communication in Nursing Homes," IJERPH, MDPI, vol. 20(1), pages 1-22, January.
    2. Silvia Gonella & Paola Di Giulio & Paola Berchialla & Mario Bo & Paolo Cotogni & Giorgia Macchi & Sara Campagna & Valerio Dimonte, 2022. "The Impact of Health and Social Care Professionals’ Education on the Quality of Serious Illness Conversations in Nursing Homes: Study Protocol of a Quality Improvement Project," IJERPH, MDPI, vol. 20(1), pages 1-20, December.

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