Discussion
This study used a qualitative descriptive method to explore the physical and emotional needs of participants and what, if any, interventions were most helpful in promoting comfort and well-being when a loved one is receiving end-of-life care.
Although prior to the study the PI was concerned that this would be a challenging time to approach loved ones, most reported welcoming participation. Of the 9 participants approached, 7 were willing to talk about this experience, indicating that loved ones not only were willing but also wanted to describe their experience. This suggests that it is an appropriate time to approach people and elicit the concerns they have around the dying experience of loved ones.
The time period between transitioning from acute to hospice care was one that created uncertainty and anxiety for family and other loved ones. This study indicates nursing presence was an important factor in easing the participants' emotional distress. Further research is needed to more fully understand the impact of nurse presence and communication on the family and loved one's experience at the end of life. As evidenced by the PI's concerns about barriers to approaching participants and loved ones, this study also suggests that researcher perceived barriers in communication that did not match the participant's experience. This study indicates participants did not perceive barriers but instead wanted to share the experience. This suggests there is a need for further research understanding nurses' perceived barriers in communication.
Another potential limitation to this study was the investigator's feeling that it would be too intrusive to record interviews with participants whose loved one was dying. To reduce this perceived barrier, the investigator interviewed participants and then hand recorded observations and comments immediately after, which limited the ability to retain detailed information. This technique did allow the investigator to have total concentration on the conversation with the participants without distraction of recorders or other devices, but in future studies, it would be important to record the interviews to gather more detailed data.
Limitations. There were several limitations to this study. The author's choice to utilize notes to increase the comfort level of participants instead of audio tapes was the primary limitation of the study. Audio tapes would have been preferable to capture complete quotes of participants and add dramatically to the richness of the data and understanding of experiences. Dialogue was rich during the interview process; however, notes were insufficient and lacked the thoroughness that is necessary for qualitative research. Expanding this study to larger samples or other settings will provide further insight on how best to support this vulnerable population and is essential to obtaining a broader understanding of how needs may differ based on varying characteristics.