Abstract
Objective: This study aimed to elucidate the roles and actual practices of accompanying nurses engaged in home-based end-of-life care by comparing their involvement with terminally ill and chronically ill patients and their families. Methods: A self-administered questionnaire allowing multiple responses was administered to 10 accompanying nurses working at enhanced-function home care support clinics. Nursing practices were investigated in both consultation settings (during physician home visits) and non-consultation settings. The data were analyzed using the chi-square (χ2) test to compare differences between the terminal and chronic patient groups. Results: During the study period, 1,533 nursing practices were recorded for 286 patients (61terminally ill and 225 chronically ill). Group comparisons revealed significant differences in the terminal group during consultation settings in “preparation of medical equipment and medications,” “decision-making support,” and “interprofessional collaboration and care management during consultations.” In non-consultation settings, a significant difference was observed in “consultations” for newly referred patients. Conclusion: The findings suggest that accompanying nurses have distinctive roles, particularly in home visits for terminally ill patients. They facilitate decision-making by mediating between physicians and patients/families, coordinate interprofessional care management to ensure continuity of care, and contribute to the establishment of a supportive home care environment. These results underscore the critical role of accompanying nurses in home-based end-of-life care.
