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Brazilian Neonatal Nurses' Palliative Care Experiences

de Castro de Oliveira, Fernanda, MSN; Cleveland, Lisa M., PhD, RN, CPNP, IBCLC; Darilek, Umber, RN, BSN; Borges Silva, Ana Regina, PhD; Carmona, Elenice Valentim, PhD

The Journal of Perinatal & Neonatal Nursing: October/December 2018 - Volume 32 - Issue 4 - p E3–E10
doi: 10.1097/JPN.0000000000000361
Feature Articles

The purpose of palliative care (PC) is to minimize suffering and improve quality of life. Although PC has been well studied, the experience of neonatal intensive care unit (NICU) nurses in Brazil, where little PC training is provided, requires further investigation. The objective of this study was to explore the PC experiences of Brazilian NICU nurses. An exploratory, qualitative, descriptive study was conducted using semistructured, individual interviews with NICU nurses. This study was conducted in a 30-bed NICU in a teaching hospital in Sao Paulo, Brazil. A convenience sample of registered nurses (N = 9) was recruited. Interviews were recorded and transcribed verbatim, and thematic analysis was used to analyze the data. Four themes were identified: (a) living with the grief, (b) identifying with the family, (c) providing humane care, and (d) feeling unprepared. Nurses experienced intense grief while providing PC. They closely identified with the families and aimed to provide humane care that respected the families' values and the infants as human beings. The nurses also felt they lacked adequate training in PC and expressed a need for additional education and emotional support. NICU nurses need adequate education and emotional support to ensure quality nursing care for this vulnerable population of infants and their families.

Women's Hospital (Ms de Castro de Oliveira), University of Campinas (Drs Silva and Carmona), Sao Paulo, Brazil; and UT Health San Antonio, San Antonio, Texas (Dr Cleveland and Ms Darilek).

Corresponding Author: Lisa M. Cleveland, PhD, RN, CPNP, IBCLC, UT Health San Antonio, School of Nursing, 7703 Floyd Curl Dr, San Antonio, TX 78229 (

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Each author has indicated that he or she has met the journal's requirements for Authorship.

Submitted for publication: November 11, 2017; accepted for publication: March 10, 2018.

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