Challenges in Providing End-of-Life Nursing Care: A Qualitative Content Analysis.

AIM: To explore the challenges of providing end-of-life nursing care in Iran.

DESIGN

Qualitative content analysis.

METHODS

Fifteen participants, including seven nurses, two head nurses, two educational supervisors, two academic staff, one nursing service manager and one critical care physician, were purposively selected from across Iran from October to December 2023. Data were collected through in-depth semi-structured interviews in person and by telephone and analyzed using MAXQDA 2020 software using the inductive content analysis approach of Elo and Kingas. We also examined trustworthiness using Elo et al.'s checklist and Lincoln and Guba's criteria.

RESULTS

Four main themes emerged: (1) Emotional burden of caring for dying patients (fear and anxiety, compassion fatigue, moral distress and grief responses); (2) Systemic neglect of end-of-life care (educational gaps, lack of national standards and absence of a palliative care organization); (3) Fragmented interdisciplinary care and communication gaps (poor teamwork, physician-centred system, unclear role definitions and cultural and religious barriers); and (4) Absence of supportive infrastructure (economic, social and technological constraints). Participants believed that these themes were related and mutually reinforcing.

CONCLUSION

End-of-life nursing care in Iran faces serious, interconnected challenges. Therefore, it requires comprehensive institutionalization, planning and educational and clinical interventions.

IMPLICATIONS FOR NURSING PRACTICE: To improve care quality, nurses need appropriate policies and specific clinical protocols for end-of-life care.

IMPACT: This study examines an important gap in understanding the challenges of end-of-life care in Iran and provides evidence for policymaking, education and health system management.

REPORTING METHOD: The study report was guided by the COREQ checklist.

PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.