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death, nursing, palliative care, qualitative research, university hospital



  1. Zeilinger, Elisabeth L. PhD, MSc
  2. Gabal, Ablah MD
  3. Adamidis, Feroniki MD
  4. Popov, Petar MD
  5. Jaeger, Karin MD
  6. Hufgard-Leitner, Miriam MD, MSc
  7. Brettner, Robert MSc
  8. Titzer, Harald MSc, RN
  9. Masel, Eva Katharina MD, PhD, MSc
  10. Unseld, Matthias MD, PhD


We examined the perception of palliative care nurses regarding challenges, coping strategies, resources, and needs when working in a university hospital in Austria. A qualitative descriptive design was applied, using semistructured interviews with 8 female and 2 male nurses. All interviews were recorded as digital audio and transcribed verbatim. We used thematic analysis and MAXQDA. In our analysis, 6 themes emerged: Four themes related to challenges: (a) lack of a supporting structural framework, (b) conflict in interdisciplinary work, (c) conflict with caregivers, and (d) dealing with death in a highly specialized university environment. One theme related to (e) individual solutions and coping strategies, and 1 theme comprised (f) needs and suggestions for improvements. Taking care of the family of a dying person, handling threatening situation, and working with inexperienced physicians were among the most important challenges reported by nurses. A supportive team, professional counseling, and training related to communication skills and to culturally specific needs of families are perceived to be necessary to provide high-quality palliative care. Addressing the needs of nurses can substantially improve their working condition and has an impact not only on the nurses themselves but also on the quality of patient care.