Roscoe, L. A., & Hyer, K. (2008). Quality of life at the end of life for nursing home residents: Perceptions of hospice and nursing home staff members. Journal of pain and symptom management, 35(1), 1-9.
The main focus for the study by Roscoe and Hyer (2008) was to identify whether the perceptions of the nursing staff about the significance of the quality of life domains and their perceived ability to influence the domains were affected by their institutional affiliation training and the resident cognitive status. The researchers conducted the study on 50 Registered Nurses (RNs) and 50 Certified Nursing Assistant (CNA) from the Florida Nursing homes. In the exercise, the study was able to get 146 participants for the study who were recruited as the statewide conference for the long-term care providers. The researchers adopted the use of both open-ended and closed-ended questionnaires. They also conducted interviews with all the participants. The participants were able to participate by filling the questionnaires when they were in breaks from the conference. The approach allowed the researchers to obtain both qualitative and quantitative data. The main strength of the study was its respondents were RNs and CNAs who are the one directly involved with the patient end of life care and quality of life and they find themselves in several dilemmas. The population was made of nurses only which increases the reliability and the validity of the results that were obtained from the study. Additionally, the study used a comparative analysis between the CNAs and the RNs. However, one weakness was that the article failed to outline if the study adequately measured end of life experience in the nursing homes.
The study method of measurement was the use of the magnitude scales that proved critical in the measurement of the importance of the perceived influence on the 11 quality of life domains. The results from the study indicated that there were no significant major effects for the levels of education or training on any of the ratings on the quality of life domains. It was contrary to the do studies hypothesis. However, the CNA reported an increases influence on the rating on four domains more than the RNs. Overall, the study was well conducted and had no significant limitation apart from the fact that it was conducted within a short period. The two researchers are both Ph.D. holders from the school of Studies in Aging Studies that make them adequately qualified to conduct such a study. From the study, Nurses are able to understand the domains that they can focus on and improve the quality of life in the end of life care. It also emphasizes on importance of training both RNs and the CNAs on the end of life care.
Stajduhar, K. I., Funk, L., Roberts, D., McLeod, B., Cloutier‐Fisher, D., Wilkinson, C., & Purkis, M. E. (2011). Home care nurses’ decisions about the need for and amount of service at the end of life. Journal of Advanced Nursing, 67(2), 276-286.
The article’s main focus was on highlighting the decision that the nurses have to make at the end of life care. The article also focused on the factors that influenced the decision of the nurses whenever they are supposed to make the decisions. The researchers decided to use qualitative data collection approach where they collected data for two years from 2006-2008. The approach was ideal for this kind of study as it allowed the researchers to be able to collect data from two sample home nurses, their descriptions, and narrative from 29 participants, then 27 participants in the second study.
The researchers, who are both qualified researchers, settled and applied the use of constant comparative analysis and thematic code as the analysis approach. From the investigation, the study was able to find that nurses always had to consider the patients and the family needs while giving the care. However, the considerations were highly dependent on the relationship they had with the family and their interactions or from an informed predictive perspective — however, the nurse’s expertise, practical ideas and approaches to care profoundly impacted the end of life decisions.
The main strength of the article that its data coverage and comprehension is simple yet comprehensive and informative on all angles. That data presentation by use of table and discussion allows for an in-depth understanding of the whole end of life caregiving. The data can be generalized to a larger population as it was a qualitative data. However, the studies main weakness is that it included a few people in the study that may limit it generalizability. It was also conducted on the western Canadian health authority that is highly influenced by the organizational structure and the local history. The study was, however, able to clearly highlight the role of the family and caregiver interactions, nurse’s expertise, context of practice and how they intertwine in the sophisticated end of life caregiving. The implication of the article is that it emphasizes that nurses should incorporate relationships in the models for clinical decision making. The article also promotes appropriate access but consider the complexity in the decision making thus allowing for flexibility on all approaches. The nurses also need to have the competence and structural and educational support for the palliative care.