End-of-Life Care Based on Regional Culture by Home-Visit Nurses in Rural Areas Lacking Adequate Medical Care Services

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  • 中山間地域における地域文化に根ざした訪問看護師の終末期ケア
  • ナカヤマ カン チイキ ニ オケル チイキ ブンカ ニ ネザシタ ホウモン カンゴシ ノ シュウマツキ ケア

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<p>Purpose<br>To clarify the actual conduct of home-visit nurses for end-of-life care in a rural mountainous region with having a shortage of medical resources, and to investigate the relationship between nurses’ the roles of nurses and regional culture. <br>Methods <br>Semi-structured interviews were conducted with 2 home-visit nurses who had experienced in dealing handling “cases in which a patient died in the course of home-visit nursing practice care” in a region lacking adequate numbers of doctors or with, decreasing birthrate and aging population. The modified grounded theory approach (M-GTA) was used to qualitatively analyze the obtained data. <br>Results<br>Home-visit nurses were found to “provide “opportunities for emotional happiness” of each patient by conducting “assessment of the health conditions and normal life-style” and “understanding needs to maintain the patient’s life-style till time of death”. For “preparation of environment surrounding a dying patient”, nurses provided consultation, coordination, education, and close connection with the patient’s family, local community people, and administrative organizations including medical/public health specialists for care of the patient. Home-visit nurses were “built ding up human relationships surrounding the patient” for to support the patient with from the regional people through by “educating families about physical indicators of the end-of-life” and “acted served as a liaison and coordinated as a medical specialist aware of the patient’s ordinary life-style between the patient and hospital staffs with relatively high threshold”. <br>Discussion<br>In practicing nursing care, home-visit nurses provide heart-felt care are providing heartful consideration while respecting individual patients, through understanding patients’ and their family’s the sense of values of the patients and their families. This indicates home-visit nurses are trying to care help dying patients, while considering regional culture of the region and wishes of each patient. </p>

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