Dimensions of good palliative nursing care: Expert panel consensus and perceptions of palliative professionals

Abstract

Aims and Objectives: To analyse the dimensions of quality of palliative nursing care and to explore the perceptions of professionals for the development and validation of the Palliative Nursing Care Quality Scale. Background: The study of palliative nursing care quality has been approached from analysis of the competencies of palliative care nurses, based on various theoretical models. However, there are fewer qualitative empirical studies that have evaluated what good palliative nursing care is and what its dimensions are. Design: Mixed-method, Delphi approach and exploratory qualitative study. Methods: Consensus by a panel of experts using the Delphi technique and semi-structured interviews. The study was reported in a comprehensive manner following COREQ criteria. Data collection took place between January and June 2018. Results: The eight-person expert panel reached consensus on the following dimensions of the Palliative Nursing Care Quality Scale: control and relief of symptoms, family and/or primary caregiver, therapeutic relationship, spiritual support and continuity of care. Thematic analysis of ten interviews identified four emergent themes related to good nursing care: (1) the patient and family as a whole; (2) finding meaning; (3) responsible communication; and (4) caring for the human element. Conclusions: The quality of palliative nursing care goes beyond providing comprehensive care; it means meticulously looking after every detail of what is important to the patient. The expectations of professionals are not as important. Instead, care should be based primarily on the needs and respect for the wishes of the patient and their family. Relevance to Clinical Practice: Specifying the quality of nursing care in routine practice and reaching a consensus on its dimensions means moving towards excellence in care, as well as improving the professional profile of advanced practice palliative care nurses. Patient or Public Contribution: Two primary caregivers participated in the panel of experts and the semi-structured interview.