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Evidence-based practice is a problem-solving approach to healthcare delivery that reflects the best current scientific evidence. When healthcare providers face unexpected changes in a patient's condition or uncontrollable situations during care delivery, they may have less confidence or feel fearful / anxious about the care process and result. As people, healthcare providers may hold beliefs regarding the effect of external, supernatural forces on events, which may lead to superstitious beliefs and behaviors. Also, superstitious beliefs may be adopted by healthcare providers as a mechanism to cope with stress, anxiety, and uncertainty in situations where standard medical practices offer no ready solution. Although superstitious beliefs may help ease anxiety and feelings of failure in healthcare providers, this issue and the effects of these beliefs on medical staff behavior have not been adequately studied. The concept analysis strategy of Walker and Avant (2019) was applied in this study to define this concept and to examine (1) healthcare providers' loss of environment control and domination of irrationality in decision making, (2) the lack of objective evidence to explain cause-and-effect relationships in health-related situations, and (3) how unverified true or false claims become a compliance criterion among healthcare providers. Typical, borderline, and contrary cases were used to explain the concept of superstition in medical staff. The antecedents and possible consequences of healthcare providers holding superstitious beliefs were identified and the empirically addressed measurement tools were evaluated. This analysis may be used to improve the understanding of healthcare workers regarding superstitious beliefs. The results are expected to benefit clinical practice, facilitate further research, and enhance healthcare quality. [ABSTRACT FROM AUTHOR]

Background: Truth-telling is an important step toward reducing the cognitive gap between physicians and patients as well as reducing the psychological pressures applied to physicians by family members. There is a lack of research on the truth-telling experience and needs in the intensive care unit from the perspective of patient family members. Purpose: This study is designed to explore the experiences and needs of families in the intensive care unit. Methods: A descriptive phenomenology method was used in this study. In-depth interviews were conducted with five participants who had family members assessed with acute physiology and chronic health evaluation II scores ≥ 20. Data were analyzed using Giorgi's phenomenological methods and Nvivo 11. Results: Four experience themes were examined, including (1) nothing is clear, requires explanation; (2) helpless to find answers, need a nurse to resolve this issue; (3) professional conduct makes us feel helpless, longing for love from the medical team; (4) decisions are very difficult, hoping to get more help. Conclusions/Implications for Practice: The family members expressed that they were unable to understand the underlying causes of the progression in patient condition because the medical team only presented outcomes to the family and did not discuss related causes. Thus, it is recommended that medical teams learn to recognize the cognitive processes of patient family members and consider their emotions, including their needs and expectations, in order to provide individualized explanations based on a patient's status and progress. [ABSTRACT FROM AUTHOR]

Elderly patients with end stage renal disease (ESRD) frequently suffer from frailty, multiple comorbidities, and complications that greatly increase the mortality rate for this population. The irreversibility and variability of ESRD directly affect quality of life, which highlights the importance of gaining an early understanding of the preferences and expectations of these patients with regard to end-of-life care. This article describes a nursing experience that used ethical analysis to help an elderly ESRD patient and the dilemma faced by his family as to whether to sustain or withdraw hemodialysis. This article examines the uncertain trajectories of this disease and how to use shared decision making with the patient and his/her family to make the best decisions. A comprehensive assessment was conducted to identify the major health-related problems, to elicit the dilemmas faced in making the decision to sustain or end hemodialysis, and to understand the pain and suffering of the patient. Symptom control and comfort were identified as the most important goals of the patient, followed by building trust and rapport with his family. An analysis of the pros and cons of treatment was conducted using the 4-box ethical analysis developed by Josen, Siegler, and Winslade. The shared decision-making process was applied to help the patient express his expectations for his end-of-life care. While the health professionals considered that pain and suffering may influence the patient's decision, the patient found his connection between himself and others, self-value, and meaning of life through family love and support. A needs-based, flexible approach was adopted that established a continuous-care plan that was designed to provide the best care for the patient under a variety of possible scenarios while involving the family, which created a family-centered decision-making process that improved the quality of life of the elderly ESRD patient. [ABSTRACT FROM AUTHOR]