title: [End of life care difficulties in intensive care units. The nurses' perspective].
abstract: OBJECTIVE
  To describe the difficulties perceived by nursing staff in the delivery of end-of-life care to critically ill patients within intensive care units (ICU).
  
  
  METHODS
  A descriptive phenomenological qualitative study was performed. A purposeful and snowball sampling of nursing staff with at least 1 year's previous experience working in an ICU was conducted. Twenty-two participants were enrolled. Data collection strategies included in-depth unstructured and semi-structured interviews and researcher's field notes. Data were analysed using the Giorgi proposal.
  
  
  RESULTS
  Three themes were identified: academic-cultural barriers, related to the care orientation of the ICU and lack of training in end of life care; architectural-structural barriers, related to the lack of space and privacy for the patient and family in the last moments of life; and psycho-emotional barriers, related to the use of emotional detachment as a strategy applied by nursing staff.
  
  
  CONCLUSIONS
  Nursing staff need proper training on end-of-life care through the use of guidelines or protocols and the development of coping strategies, in addition to a change in the organisation of the ICU dedicated to the terminal care of critically ill patients and family support.
authors.affiliation: Escuela de Enfermería de Cruz Roja Española, Universidad Autónoma de Madrid, Madrid, España. Electronic address: jvg@cruzroja.es.
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Velarde-García
authors.affiliation: Escuela de Enfermería de Cruz Roja Española, Universidad Autónoma de Madrid, Madrid, España.
authors.forename: Raquel
authors.initials: R
authors.lastname: Luengo-González
authors.affiliation: Escuela de Enfermería de Cruz Roja Española, Universidad Autónoma de Madrid, Madrid, España.
authors.forename: Raquel
authors.initials: R
authors.lastname: González-Hervías
authors.affiliation: Escuela de Enfermería de Cruz Roja Española, Universidad Autónoma de Madrid, Madrid, España.
authors.forename: Sergio
authors.initials: S
authors.lastname: González-Cervantes
authors.affiliation: Escuela de Enfermería de Cruz Roja Española, Universidad Autónoma de Madrid, Madrid, España.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Álvarez-Embarba
authors.affiliation: Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Universidad Rey Juan Carlos, Madrid, España.
authors.forename: Domingo
authors.initials: D
authors.lastname: Palacios-Ceña
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D064648:Critical Care Nursing; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D013727:Terminal Care
keywords: Critical care nursing; Cuidados al final de la vida; Enfermería intensiva; Intensive care units; Investigación cualitativa; Nurse-patient relationship; Qualitative research; Relación enfermera-paciente; Terminal care; Unidades de cuidados intensivos