title: The nursing role during end-of-life care in the intensive care unit related to the interaction between patient, family and professional: an integrative review.
abstract: OBJECTIVE
  The aim of this study was to explore how intensive care unit (ICU) nurses describe their role during End-of-Life Care (EOLC) in the ICU, related to the interaction between patient, family and professionals (care triad).
  
  
  METHODS
  Three electronic databases, PubMed, CINAHL and EMBASE, and reference lists of included studies were searched for studies in English, Dutch or German between January 2002 and August 2015. Studies were included if they presented data about EOLC in the adult ICU, and the role of ICU nurses around EOLC. Quantitative and qualitative studies and opinion articles were extracted. Inductive content analysis was carried out to analyse and categorise the data.
  
  
  RESULTS
  Twenty studies were included. Four categories emerged: care for the ICU patient, care for the family, environmental aspects of EOLC and organisational aspects of EOLC. Regarding the care triad, a gap exists between theoretical models and the actual care provided by ICU nurses during EOLC. The relational aspect of care, like aimed with care triad, is absent.
  
  
  CONCLUSIONS
  The literature clearly indicates that the role of ICU nurses concerns care for the patient, family and environment. It described which care should be given, but it remains unclear how care should be given (attitude). Therefore, it is difficult for ICU nurses to provide this care. Further, it seems that care provided to family mainly consists of giving advice on how to care for the patient; care for family members themselves was only mentioned in a few studies. Therefore, it seems that family does not always receive adequate care yet, which may be helpful in preventing problems like depression, anxiety or post-traumatic stress disorder. It can be concluded that it is important for ICU nurses to be aware of the existing relationships; however, comparing the literature, care triad does not appear to be reached.
authors.affiliation: Bachelor of Nursing, The Hague University of Applied Sciences, The Hague, The Netherlands.|Research Department of Emergency and Critical Care, HAN University of Applied Sciences, Nijmegen, The Netherlands.|Research Department Informal Care, The Hague University of Applied Sciences, The Hague, The Netherlands.
authors.forename: Marijke
authors.initials: M
authors.lastname: Noome
authors.affiliation: Research Department Informal Care, The Hague University of Applied Sciences, The Hague, The Netherlands.|Tranzo, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
authors.forename: Deirdre M
authors.initials: DM
authors.lastname: Beneken Genaamd Kolmer
authors.affiliation: Section Ethics, Philosophy and the History of Medicine, Scientific Institute for Quality of Healthcare, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
authors.forename: Evert
authors.initials: E
authors.lastname: van Leeuwen
authors.affiliation: Research Department of Emergency and Critical Care, HAN University of Applied Sciences, Nijmegen, The Netherlands.|Intensive Care Unit, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
authors.forename: Boukje M
authors.initials: BM
authors.lastname: Dijkstra
authors.affiliation: Research Department of Emergency and Critical Care, HAN University of Applied Sciences, Nijmegen, The Netherlands.|Scientific Institute for Quality of Healthcare, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
authors.forename: Lilian C M
authors.initials: LC
authors.lastname: Vloet
mesh_terms: D006801:Humans; D007362:Intensive Care Units; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D011368:Professional-Family Relations; D013727:Terminal Care
keywords: care triad; end-of-life care; intensive care units; nursing care; review