Who Wants to Talk About Death? Qualitative Research on Nurses' Experiences of Talking to Terminally Ill Patients

Purpose: Discussing death with terminally ill patients is a challenging yet essential part of palliative care nursing. This study explored nurses' perceptions and experiences, emphasizing holistic care that addresses patients' physical, emotional, social, cultural, and spiritual needs. Design: A descriptive, exploratory qualitative design was used with content analysis. Methods: Data were collected through in-depth interviews with 16 participants and analyzed using traditional content analysis. MAXQDA software was used for coding and organizing the qualitative data. Results: Four main themes emerged: "Professional Readiness and Communication Competence," "Experiences in Talking About Death," "Factors Shaping Death-Related Communication," and "Internalization of Death and Its Influence on Care." Nurses stated that talking about death was influenced by patient requests, disease progression, family expectations, and the nurse's communication skills. Training and expertise were seen as essential. Some nurses felt this task was more appropriate for physicians or psychosocial teams. Conversations included both positive experiences (e.g., offering hope) and challenges (e.g., emotional strain, patient resistance). Nurses described death as both a fearful and natural experience. Conclusions: Supporting nurses through communication-focused in-service training, with an emphasis on holistic care principles, is recommended to enhance the quality of end-of-life care and better address the multidimensional needs of patients facing death.