Staff Nurses' Perceptions Regarding Palliative Care for Hospitalized Older Adults

Purpose This exploratory study addressed the research question What are the perceptions of staff nurses regarding palliative care for hospitalized older adults? Design A qualitative descriptive study design using focus groups was selected. Methods Eighteen staff nurses participated in semistructured focus group interviews. The audio-recorded data were transcribed, sorted, and coded using NVivo 9 software and analyzed using Ritchie and Spencer's framework approach to qualitative data analysis. Findings Five main thematic categories emerged that captured the essence of the nurses' perceptions: ambiguity regarding the concept of palliative care, communication challenges, a sense of informed advocacy, cognitive and emotional dissonance, and health care system constraints. Conclusions For many seriously ill hospitalized older patients, staff nurses can be pivotal as informed advocates for palliative care early in the course of an illness trajectory. But nurses (and other providers) often confuse palliative and hospice care; thus there is a need for increased understanding and knowledge in this area. Collaborative interdisciplinary education regarding the evolving concept of palliative care may be useful. Further research into the perceptions and experiences of staff nurses who care for hospitalized older adults is warranted.