Sjuksköterskors erfarenheter av etiska utmaningar i palliativ vård : En litteraturöversikt

Sammanfattning

Background Palliative care aims to alleviate suffering and promote quality of life at the end of life. Nurses have a central role in this care but are often faced with difficult ethical challenges where medical, relational and organizational factors interact. Aim The aim was to describe nurses' experiences of ethical challenges in palliative care. Method The thesis is a structured literature review based on 15 qualitative scientific articles. The articles were identified through systematic searches in the databases PubMed and CINAHL. They were quality reviewed according to Nilsson's review template and analyzed using qualitative content analysis by Graneheim and Lundman. Results The results generated three main categories with associated subcategories, showing that nurses face ethical challenges related to treatment decisions, uncertainty in care decisions, communication at the end of life and the influence of relatives. Moral and emotional stress and organizational aspects were also significant. Nurses experienced challenges in balancing patient autonomy, alleviation of suffering and relatives' wishes. Conclusions Ethical challenges in palliative care are difficult and influenced by both individual and organizational factors. Increased ethical competence, support and clear guidelines are central to promoting person-centered care.