1. Objectifs

Intentions :
«The purpose of this quality improvement project [is] to identify strengths and areas for improvement in end-of-life care, develop tailored intervention strategies and document their pilot implementation.» (p. 385) «More specifically, the project’s objectives were: [to] identify the strengths and areas of improvement desired by the various participants in end-of-life care in this [department, to] identify priority improvement targets and implement corresponding intervention [strategies, and to] evaluate the relevance of the chosen interventions within the department, as well as the satisfaction of the participants in relation to the overall project.» (p. 378)

2. Méthode

Échantillon/Matériau :
Cette étude a eu lieu dans une unité de soins intensifs de la ville de Québec. L’échantillon de la première phase du projet était composé de 25 professionnels. L’échantillon de la deuxième phase était composé de 29 professionnels. L’échantillon de la troisième phase était composé de 16 membres de l’équipe de soins. De plus, les dossiers de 6 patients ont été étudiés.

Instruments :
Guide d’entretien semi-directif

Type de traitement des données :
Analyse de contenu

3. Résumé

The «data made it possible to highlight the main strengths and sources of difficulties in end-of-life care for ICU staff, which could be grouped under three themes relating to the approach used with families, difficulties related to the end-of-life transition, and variations among medical practices regarding symptom management and the withholding of medical support devices. […] Participants consensually emphasised that the main strength of this department lay in the commitment of each team member to create meaningful relationships with the patients and their relatives, as well as to provide high quality care, especially in the end-of-life context. Several nurses reported being committed to making sure that the last moments of the patient’s life go ‘as smoothly as possible’, even if some of them shared a discomfort with the dying phase and death.» (p. 380) Overall, some «differences in perceptions [were] palpable in the discourse of the medical team when compared to that of the nurses and other team members. In general, there was a positive feeling from the physicians’ interviews about end-of-life situations, while nurses reported a number of difficulties, including a lack of clear medical conduct preceding the shift to end-of-life care.» (p. 383)