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

Silvia Gonella, Paola Di Giulio, Alexandra Antal, Nicola Cornally, Peter Martin, Sara Campagna and Valerio Dimonte
Additional contact information
Silvia Gonella: Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 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

IJERPH, 2022, vol. 19, issue 5, 1-18

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.

Keywords: challenges; communication; conversation; COVID-19; education/training; end of life; family caregivers; healthcare professionals; nursing homes; qualitative research (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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