Nurses’ perceptions of the challenges involved in providing of end-of-life care to people with heart failure: a context-based study

Abstract

Background: High quality end-of-life care is essential. Yet for those experiencing heart failure, the provision of high-quality end- of -life care can be challenging. The aim of this study was to explore Iranian nurses’ perceptions of the challenges involved in providing of end-of-life care to people with heart failure. Methods: Conventional content analysis was used to analyze qualitative data collected from nurses (n = 33) using semi-structured and individual interviews. Participants were aged between 29 and 51 years. The majority of participants were women (n = 20). Most had a bachelor’s degree (n = 24), and work experience of between 7 and 18 years. Results: Nurses challenges in providing end-of-life care to those with heart failure included (1) adverse consequences relating to compassion fatigue and continued futility in care and (2) lack of palliative care services with regards to a lack of specialists, lack of support from health systems, and poor teamwork. Conclusions: This is the first qualitative study to explore Iranian nurses’ challenges in providing end-of-life care to those with heart failure. Investment is required in education and research in this area. Particular attention must be paid to prevention of compassion fatigue. Law changes would enable the delivery of higher-quality palliative care in this context overall.