'Close to' a palliative approach: nurses' and care aides' descriptions of caring for people with advancing chronic life-limiting conditions.
OBJECTIVE
The purpose of the study was to examine nurses' and nursing assistants' perspectives of a palliative approach in a variety of nursing care settings that do not specialise in palliative care.


BACKGROUND
Ageing populations worldwide are drawing increasing attention to palliative care. In particular, people with advancing chronic life-limiting conditions often have unmet needs and may die in acute medical, residential care and home health settings without access to palliative care. A palliative approach offers an upstream orientation to adopt palliative care principles to meet the needs of people with life-limiting chronic conditions, adapt palliative care knowledge to other chronic illness conditions, and integrate and contextualise this knowledge within the healthcare system (Sawatzky et al. 2016).


METHODS
A qualitative study using the method of interpretive description carried out by a nursing research-practice collaborative, Initiative for a Palliative Approach: Evidence and Leadership (iPANEL).


METHODS
Twenty-five nurses and five nursing assistants from across British Columbia, Canada participated in interviews and focus groups. Thematic analysis was used to analyse the data.


RESULTS
The overarching theme was that of participants close to a palliative approach in that they cared for people who would benefit from a palliative approach, they were committed to providing better end-of-life care, and they understood palliative approach as an extension of specialised palliative care services. Participants varied in their self-reported capacity to integrate a palliative approach, as they were influenced by role clarity, interprofessional collaboration and knowledge.


CONCLUSIONS
Integration of a palliative approach requires a conceptual shift and can be enhanced through interpersonal relationships and communication, role clarification and education.


CONCLUSIONS
Nurses care for people with advancing chronic life-limiting conditions in a variety of settings who would benefit from a palliative approach.
School of Nursing, Trinity Western University, Langley, BC, Canada.
Sheryl
S
Reimer-Kirkham
School of Nursing, Trinity Western University, Langley, BC, Canada.
Richard
R
Sawatzky
Fraser Health, Delta, BC, Canada.
Della
D
Roberts
Trinity Western University, Langley, BC, Canada.
Marie
M
Cochrane
School of Nursing and Centre on Aging, University of Victoria, Victoria, BC, Canada.
Kelli
K
Stajduhar
D000328:Adult; D000368:Aged; D002170:Canada; D003142:Communication; D004645:Empathy; D005260:Female; D017144:Focus Groups; D006801:Humans; D007857:Leadership; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D009728:Nursing Assistants; D009740:Nursing Staff; D010166:Palliative Care; D036301:Qualitative Research; D013727:Terminal Care
advance care planning; chronic conditions; chronic illness; dying; end-of-life care; nursing; nursing assistant; palliative approach; palliative care; qualitative research