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Peaceful End of Life NURSING Theory.
Yadira Abstengo ASN
International college of Health Sciences
Nursing Theory Class
Prof. Nataly Bermudez
August 2020
Peaceful End of Life Nursing Theory
The Peaceful End of Life theory (PEOL) is classified as a medium-range theory. It was developed in 1998 by Cornelia Ruland and Shirley Moore.
This middle-range theory is more circumscribed and substantially specific, allowing's nursing professionals to discover the complexity of caring for a terminally ill patient and how they can contribute to a quiet end of life.
MAJOR ASSUMPTIONS
Peaceful End of Live theory
This middle-range theory does not address each metaparadigm concept. The theory explicitly explains nursing and person.
Person: The experiences and felling at the end of life are personal and individualized.
Nursing: Nursing care is crucial to understand the end-of-life patients' experiences. Their interventions are essential to maintain a peaceful experience appropriately, even if the patient is not able to communicate verbally.
Family: This is included because of the importance of all significant others have in the end-of-life patient's care.
The Theory of the Peaceful End of Life has its nursing goal "the best possible care will be provided through the judicious use of technology and comfort measures to enhance the quality of life and achieve a peaceful death" (Ruland & Moore, 1998)
METHAPARADIGM
NURSING CARE
PERSON AT THE END OF THEIR LIFE
Family and other relatives
The Five Significant Concepts in the Peaceful End of Life Theory.
Five significant concepts were identified: Not being in pain, experiencing comfort, experiencing dignity and respect, closeness to significant others, and being in peace.
Expert nurses created The peaceful end-of-life standards in response to a lack of direction for managing the complex care of terminally ill patients.
The nurses most important role is to identify patients' cues that indicate the process of dying in not peaceful and intervene appropriately (Ruland & Moore,1998)
Theoretical Assertions and Propositions
According to Ruland & Moore, the relational statements identified as theoretical assertions for theory as follows:
A. Monitoring and administering pain relief and applying pharmacological or non-pharmacological interventions contribute to the patient’s experiences of not being in pain.
B. Preventing, monitoring and relieving physical discomfort, facilitating rest, relaxation and contentment, and preventing complications contribute to the patient’s experience of comfort.
C. Including the patient and significant others in decision making regarding patient care, treating the patient with dignity, empathy and respect, and being attentive to the patient’s expressed needs, wishes, and preference contribute to the patient’s experience of dignity and respect.
D. Providing emotional support, monitoring and meeting the patient’s expressed needs for anti anxiety medications, inspiring trust, providing the patient and significant others with guidance in practical issue, and providing physical preference of another caring person if desired contribute to the patient’s experience of being at peace.
E Facilitating participation of significant others’ grief, worries, and questions, and facilitating opportunities for family closeness contribute to the patient’s experience of closeness to significant others or person who care.
Relevance of Peaceful End of Life theory into the Nursing Practice
Death is a common phenomena in nursing practice. Terminally ill patients demand compassionate care not curative treatment that is the importance of the nursing palliative care.
Help terminally ill patients and families find closure and peace during the final time of life treat them with dignity, respect and empathy.
Nurses can play a vital role in preparing patient and families for transition in treatment and to find a peaceful end.
Nurses can bridge the communication gap between patient, family and physician during end of life care decisions they can promotes and advocates for rights of dying patient.
We have unique relational bond with the patient and family to improve individualized patient’s needs, Individualized care planning .
Application of Peaceful End of Life theory into the Nursing Practice
The theory cover multiples aspect of PEOL care:
During the dying process. : Most essential Nursing interventions:
Pain assessment, and minimizing invasive painful procedures, therapeutic touch.
final sedation for intractable suffering, breves interruption of sedative treatment to promote patient-family interaction
Keeping continue communication with patient and family and Sharen the decision-making process
Motivating family to keep talking to the patient, explaining that it’s the last sense to loss,
Improving hygiene care, positioning, clean odor free environment
Symptoms management: dyspnea, agitation, nausea, vomitus,
Providing emotional support and empathy,
Respect patients and families cultures and believes,
Permit the family to pray or do any different cultural rituals
Application of Peaceful End of Life theory into the Nursing Practice
During the Care after death process:
Nursing interventions:
Involves family members is decision makings
Respect and dignity for the body,
Facilitating organ donation process,
Doing culturally sensitive last interventions
The primary importance of this theory and its applicability is most in the nursing palliative care field. The theory has some generalization limitations related to time, setting, and patient population
References
Alligood M.R. (2018). Nursing Theorists and Their Work. 9th ed. St. Louis, MO: Elsevier,
Ruland, C. M., & Moore, S. M. (1998). Theory construction based on standards of care: A proposed theory of the peaceful end of life. Nursing Outlook, 46[4], 174. doi:10.1016/s0029-6554(98)90069-0
Zaccara, A. A. L, Costa, S. F. G., Nóbrega, M.M.L, França, J. R F, Morais, G.S,N, & Fernandes, M. A (2017). A ANALYSIS AND ASSESSMENT OF THE PEACEFUL END OF LIFE THEORY ACCORDING TO FAWCETT’S CRITERIA. Texto & Contexto - Enfermagem, 26(4), e2920017. Epub January 08, 2018. doi.org/10.1590/0104-07072017002920017
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