Challenges to concordance: theories that explain variations in patient responses

Failing to establish a collaborative relationship between patient and health professional can be a significant obstacle to recovery. Julie Green and Rebecca Jester delve into the psychology behind patient responses and present methods to empower patients.This article was first published in the British Journal of Community Nursing, volume 24, issue 10.Published versio

Qualitative analysis of European and Middle East intensive care unit nursing death rituals

Background: Grieving and death rituals vary widely across cultures and are often influenced by geographical regions, religions, and local norms. Nursing rituals reflect the forms of cultural behaviour that assist in communicating traditional knowledge and practices. They help nurses maintain social order through cohesion and interaction. Aim and objectives: Exploration of European and Middle Eastern intensive care nursing ceremonies and rituals surrounding care provided to patients after death has been carried out. The key question researchers asked was “Can you describe your practice of caring for a patient who has died?” Design: Prospective qualitative thematic analysis. Methods: This study used a prospective qualitative thematic analysis investigating nursing practice and rituals when caring for patients who have died in intensive care. The interviews were conducted face-to-face with nurses consenting to be interviewed for research purposes. During the interviews, researchers noted sentences and topics, which they later classified into categories and subcategories. The interview settings were international and national conferences, workshops, meetings, and seminars over a 2-year period. Thematic analysis was performed. This analysis allowed the researchers to understand and make sense of collective meanings and experiences of participants. Results: A total of 23 interviews with critical care nurses from 16 countries in Europe and Middle East were conducted. Through reflective and meaningful analytical interpretation, two main themes (with subthemes) emerged: sacredness and dignity. More similarities than differences among the nurses' experiences were found. Rituals included, opening a window, lighting a candle, blessing the deceased, and bereaving with the family. Conclusions: Post-death ritual reflects local guidelines regulating the handling of the deceased body, culturally approved expressions of mourning, and acts to perform at specific times following death. Nursing rituals expressed here demonstrated the dignity, wherein nurses show towards the deceased and relationships between deceased and bereaved. Relevance to Clinical Practice: The investigators perceived nursing culture, beliefs, ceremonies, and rituals surrounding caring for patients who have died to be creative, spiritual, meaningful, and relevant for nurses