Drawing upon the intersection of the fields of Hospice, Nursing and Posttraumatic Stress Disorder (PTSD), this study investigated the lived experiences of hospice nurses in recognizing hospice patients who exhibited signs indicative of abuse or trauma from earlier in their lives manifesting as PTSD-type symptoms. Phenomenological interviews were conducted with 15 expert hospice nurses each of whom had eight or more years of hospice nursing experience. The constant comparative method was used to generate, process, and analyze data from the verbatim interview transcripts. Four emergent themes were revealed.
Theme one described patient behaviors which may be indicative of secret keeping regarding former abuse or trauma and discussed the significance of the life review process in revealing secrets. Theme two highlighted the existence of current abuse where hospice patients can be either victims or perpetrators, and disclosed the concept of payback. Theme three, resolution, revealed the importance and value of the nurses' skilled listening activities. Listening became crucial during the process of resolution, particularly when patients sought relief from soul pain, and while supporting patients working toward a peaceful death. Theme four described the deep and enduring commitment of hospice nurses to humane pain management and patient comfort, the patients' life review process, adequate length of stay in hospice and their own professional growth. Analysis revealed that expert nurses did recognize and appropriately respond to abuse, but did not recognize behaviors of their patients as PTSD-type symptoms because they lack the necessary specific education.
These findings have implications for educating hospice workers. This study can be useful to healthcare providers in serving patients with histories of abuse or trauma and who now exhibit PTSD-type symptoms. Educating hospice nurses about trauma, abuse and PTSD-type symptoms will directly affect the care given to this vulnerable population.
|Advisor:||Searl, Stanford J., Jr.|
|School:||Union Institute and University|
|School Location:||United States -- Ohio|
|Source:||DAI-B 73/12(E), Dissertation Abstracts International|
|Subjects:||Mental health, Aging, Nursing|
|Keywords:||Hospice care, Hospice nurses, Posttraumatic stress disorder, Signs of abuse|
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