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Article

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

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Department of Public Health and Pediatrics, University of Torino, Via Santena 5 bis, 10126 Turin, Italy
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Direction of Health Professions, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Corso Bramante 88–90, 10126 Turin, Italy
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Catherine McAuley School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, College Road Cork, T12 AK54 Cork, Ireland
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School of Medicine, Faculty of Health, Deakin University, 75 Pigdons Road, Waurn Ponds, VIC 3216, Australia
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2022, 19(5), 2504; https://doi.org/10.3390/ijerph19052504
Received: 24 January 2022 / Revised: 18 February 2022 / Accepted: 20 February 2022 / Published: 22 February 2022
(This article belongs to the Special Issue Challenges in Caring for Patients in the Time of COVID-19)
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. View Full-Text
Keywords: challenges; communication; conversation; COVID-19; education/training; end of life; family caregivers; healthcare professionals; nursing homes; qualitative research challenges; communication; conversation; COVID-19; education/training; end of life; family caregivers; healthcare professionals; nursing homes; qualitative research
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MDPI and ACS Style

Gonella, S.; Di Giulio, P.; Antal, A.; Cornally, N.; Martin, P.; Campagna, S.; Dimonte, V. Challenges Experienced by Italian Nursing Home Staff in End-of-Life Conversations with Family Caregivers during COVID-19 Pandemic: A Qualitative Descriptive Study. Int. J. Environ. Res. Public Health 2022, 19, 2504. https://doi.org/10.3390/ijerph19052504

AMA Style

Gonella S, Di Giulio P, Antal A, Cornally N, Martin P, Campagna S, Dimonte V. Challenges Experienced by Italian Nursing Home Staff in End-of-Life Conversations with Family Caregivers during COVID-19 Pandemic: A Qualitative Descriptive Study. International Journal of Environmental Research and Public Health. 2022; 19(5):2504. https://doi.org/10.3390/ijerph19052504

Chicago/Turabian Style

Gonella, Silvia, Paola Di Giulio, Alexandra Antal, Nicola Cornally, Peter Martin, Sara Campagna, and 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" International Journal of Environmental Research and Public Health 19, no. 5: 2504. https://doi.org/10.3390/ijerph19052504

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