Nurses’ experiences on end-of-life care for older patients in long-term care hospitals: Focusing on the process of practice and barriers

Purpose: The purpose of this study was to investigate the practical process and barriers of end-of-life nursing practice for older patients in long-term care hospitals by exploring nursing experts’ actual experiences. Methods: Qualitative data were collected through focus group interviews with 9 nurses in 3 different long-term care hospitals from April to May, 2019. All interviews were recorded and transcribed verbatim and analyzed using the content analysis method. Results: Five themes and 14 sub-themes emerged for nurses’ perception regarding end-of-life nursing practice in long-term care hospitals, whereas three themes and 10 sub-themes emerged for the barriers of end-of-life nursing practices. The results show that the end-of-life nursing practice is currently considered an additional area beyond nurses’ existing work in long-term care hospitals and the area of performance is focused almost exclusively on physical care. The care is especially lacking in psychological and spiritual areas. Moreover, aspects of practice vary by institutions, day or night shifts and individuals. Various factors that hinder nurses’ performances of end-of-life care are identified in the areas such as ignoring patients’ dignity, an underdeveloped system and lack of supportive environment. Conclusion: Findings of this study suggest the need to establish standardized protocols for end-of-life nursing care in long-term care hospitals and develop educational programs based on those protocols.