A Hermeneutic Phenomenological Study of Aesthetics in Nursing Practice Among Hospitalized Cancer Patients in Nepal.

Background: Aesthetics is the art of nursing that is expressive, subjective, and visible in the act of caring in nursing practice. Aesthetics in nursing practice satisfies holistic needs and achieves the quality of whole-person care. Purpose: The aim of this study is to describe the meanings of the lived experiences of cancer patients in terms of receiving care from the perspective of aesthetics in nursing practice. Methods: The hermeneutic phenomenological approach grounded on Gadamerian philosophy guided this study. Eleven Nepalese cancer patients who met the inclusion criteria shared their experiences through graphic illustrations (drawings) and interviews. Data were analyzed and interpreted following van Manen's phenomenological approach reflective of the four life worlds. The trustworthiness of findings was established following the criteria by Lincoln and Guba. Results: Thematic categories of the lived experience of cancer patients were revealed, reflecting the four life worlds: lived relation expressed as being nurtured as a family; lived space as appreciating the healing space; lived time as being hopeful; and lived body as receiving a new life. This experience was described as experiencing self and other while appreciating the healing space, being hopeful and nurtured as family and having a new life Implications for Practice: Aesthetics in nursing practice values on politely nurturing cancer patients as nurses' family members in a pleasant healing environment. Further, cancer patients experience having a new life.

Aesthetics in Nursing Practice for Cancer Patients as Experienced by Nurses in Nepal: A Hermeneutic Phenomenological Study.

BACKGROUND: Aesthetics in nursing practice address creating beautiful, meaningful, desirable, and satisfying experiences for both the nurse and the patient. However, little is known about aesthetics in nursing practice. OBJECTIVE: The aim of this study was to describe the lived experiences of nurses who provide aesthetically pleasant care in nursing practice for cancer patients. METHODS: The hermeneutic phenomenological approach grounded on Gadamer's philosophy was used in this study. Sixteen Nepalese nurses who met the inclusion criteria were the participants. The data collection consisted of 2 methods of drawing graphic illustrations to reflect aesthetic nursing practices and in-depth interviews to explain them. The researchers analyzed and interpreted art-based graphic illustrations and interview transcriptions of 16 Nepalese nurses using van Manen's approach. RESULTS: The 5 thematic categories covering these meanings comprised (1) knowing persons as whole, (2) creating a pleasant healing environment, (3) creative use of palliative care resources, (4) nurturing hope, and (5) rewarding the self. CONCLUSION: This study provides the understanding of the nurses' thoughts and actions of aesthetics in their nursing practice. The inductive knowledge from the experiences of the nurses informs the nursing discipline and profession to promote aesthetics in nursing. IMPLICATIONS FOR PRACTICE: These findings can be used to promote aesthetics in nursing practice to improve patients' well-being holistically and increase nurses' satisfaction from caring.

Grief reactions and coping strategies of Muslim nurses dealing with death.

BACKGROUND: An intensive care unit (ICU) features high mortality rates. Witnessing subsequent deaths may affect nurses psychologically and spiritually. Islam has an influence on Muslims' life and death. Nevertheless, little is known about Muslim intensive care nurses' experiences of grief in dealing with the deaths of patients. AIM AND OBJECTIVES: This study aimed to describe the grief reactions and coping strategies of Muslim nurses in dealing with the death of patients. DESIGN: This is a qualitative study with a phenomenological approach. METHODS: Semi-structured individual interviews were conducted. Fourteen participants from an ICU in an Indonesian tertiary public hospital participated in this study. Data were analysed by thematic analysis. Trustworthiness was established by Lincoln and Guba's criteria. RESULTS: The findings identified four reactions of grief, four factors influencing reactions of grief, and three coping strategies used in dealing with death in an ICU. The reactions of nurse's grief were crying, being sad, feeling disappointed, and feeling guilty. These reactions were related to several factors including the circumstances of the patient's death, nurse's expectation of patient's recovery, relationships with the patient, and the reactions of family. Coping management strategies used by nurses in dealing with their grief comprised: sharing with colleagues, avoiding dying and death situations, and engaging in spirituality. CONCLUSIONS: The Muslim ICU nurse participants experienced their grieving through a variety of psychological reactions influenced by several factors. Personal coping strategies were revealed in dealing with their grief. However, avoiding dying and death situations affected their duty. RELEVANCE TO CLINICAL PRACTICE: Attention to nurses' grief should be paid to maintain their psychological well-being and quality of end-of-life care. Providing formal support to enhance grief management is recommended.

Lived experiences of intensive care nurses in caring for critically ill patients.

BACKGROUND: Caring for critically ill patients requires competent nurses to help save and secure the lives of patients, using technological developments while maintaining humanistic care. Nepal is a developing country with limited advanced technologies and resources. It is important to understand nursing care for critically ill patients under these shortages. AIM: To describe the lived experiences of intensive care nurses in caring for critically ill patients in intensive care units. METHODS: A hermeneutic phenomenological study was conducted. Purposive sampling was used to recruit 13 nurses from three intensive care units, who met the inclusion criteria. Face-to-face, in-depth individual interviews with an audio recorder were used to collect the data. The interview transcriptions were analysed and interpreted using van Manen's approach. Trustworthiness was established following the criteria of Lincoln and Guba. FINDINGS: Seven thematic categories emerged from the experiences of nurses and were reflected within the four life worlds of space, body, relation and time. The categories were: low technology of care and insufficient resources (lived space); physical and psychological distress and requiring competency in caring (lived body); connecting relationship as a family, trusting technology of care, and realizing team working (lived relation); and less time to be with the patient as a whole person (lived time). CONCLUSIONS: This study provides an understanding of the lived experience of nurses caring for critically ill patients, with inadequate support that can affect holistic care of patients and nurses' health. RELEVANCE TO CLINICAL PRACTICE: Intensive care nurses need to enhance their knowledge and skills related to the use of technologies and patient care by attending training programs and gaining further education. This study recommends that hospital administrators should support sufficient facilities and technologies of care and, in particular, increase the competency of nurses in caring for critically ill patients as the whole person.

Thai Buddhist families' perspective of a peaceful death in ICUs.

AIM: To describe the concept of a peaceful death in intensive care units (ICUs) from the perspective of Thai Buddhist family members. METHODS: This descriptive qualitative study was based on data generated from individual in-depth interviews of nine Thai Buddhist family members from the southern region of Thailand whose loved ones died in adult ICUs. Colaizzi's phenomenological approach was used to analyse the data. Rigour for the study was established by Lincoln and Guga's guidelines for qualitative research studies. FINDINGS: Five core qualities emerged that made-up the concept of a peaceful death as described by Thai Buddhist family members who cared for their loved ones while they were dying in ICUs. These core qualities were 'knowing death was impending, preparing for a peaceful state of mind, not suffering, being with family members and not alone, and family members were not mourning'. CONCLUSION: Thai Buddhist family members described what they meant by a peaceful death. 'This was: preparing for a peaceful state of mind in knowing that one's impending death is not a situation of suffering or being alone, but rather a time of being with family members who are not yet mourning one's death.' The findings support that family members should participate in promoting a peaceful death for their loved ones dying in ICUs. IMPLICATIONS FOR PRACTICE: The five core qualities of a peaceful death reported in this study could be used as a framework for nurses to create nursing practice interventions for quality end-of-life care for Thai Buddhists.

Aesthetic expressions illuminating the lived experience of Thai ICU nurses caring for persons who had a peaceful death.

This article, through art and aesthetic expression, illustrates and illuminates the experiences of persons caring for those who had peaceful deaths in intensive care units (ICUs) in southern Thailand. Aesthetic expression, categorized as a descriptive thematic experience, enhanced the appreciation of the experiences, which has implications for holistic end-of-life care.

Promoting peaceful death for Thai Buddhists: implications for holistic end-of-life care.

The conceptual model of promoting a peaceful death was synthesized from Buddhist philosophy, the theory of "Peaceful End of Life," related literature, and a story from experience. Nurses can use this model as a practical guide for the holistic care of Thai Buddhists who are dying.