Conflicts at the End of Life Experiences in Nurse-Client Relationships from the Point of View of Seriously Ill and Dying People

Abstract

Background Palliative care of seriously ill and dying persons in outpatient and inpatient nursing care settings as well as specialized palliative care settings requires interprofessional cooperation. Due to the specific burden and the characteristics of different institutional palliative care settings, those affected are confronted with numerous communication difficulties and related conflicts. Method The aim was to explore the needs and expectations of seriously ill and dying persons in relation to communicating with nurses and to find out to what extend conflict situations occur and how they were addressed. As part of a qualitative research approach, 58 problem-centered interviews were conducted with persons in a palliative situation in five different care settings (palliative care unit, hospice, oncological inpatient unit, inpatient care for the elderly, outpatient care) and analyzed by qualitative content analysis. Results The majority of interviewees describe institutional and staffing conditions as well as nurses' behavior as conflict causes. In the area of information asymmetries, there are conflicts that primarily relate to mutual lack of openness, honesty and transparency. Conclusion Based on the findings of the exploratory research project, a contribution to the improvement of the quality of care at the end of life should be made within the scope of a planned theory-practice transfer project.