{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:44:03Z","timestamp":1791906243433,"version":"4.3.4"},"reference-count":25,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"unspecified","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,12,4]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>During the COVID-19 pandemic, the need for end-of-life care has increased. This type of care is different for patients with COVID-19 compared with other patients. This study aims to explain the experiences of intensive care unit (ICU) nurses in providing end-of-life care to patients with COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative content analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The study population consisted of ICU nurses working in hospitals affiliated with the Kerman University of Medical Sciences in southeastern Iran.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>14 ICU nurses, including 9\u2009women and 5 men, participated in this study. Their mean age was 33.79\u00b15.07 years, and their mean work experience was 8.64\u00b13.5 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary objectives<\/jats:title>\n                    <jats:p>The purpose of this qualitative content analysis was to explore the experiences of Iranian intensive care nurses using purposive sampling and semistructured in-depth interviews. Sampling was based on maximum variation (age, gender, professional experience and educational level) to obtain rich information. Guba and Lincoln\u2019s criteria were applied to increase the trustworthiness and rigour of the study, and the data were analysed using Graneheim and Lundman\u2019s method and MAXQDA 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ICU nurses\u2019 experiences of caring for patients with COVID-19 at the end of life are comprehensive, and four main themes emerged from the responses: fear of death due to COVID-19 infection; physical and psychological consequences of caring for patients dying from COVID-19; confusion in caring for patients with COVID-19 at the end of life and unbelievable deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The present study looked at the experiences of Iranian nurses providing end-of-life care during the COVID-19 pandemic. The findings suggest that the nurses experienced anxiety, excessive fatigue and guilt during end-of-life care and that the high mortality and unbelievable deaths were traumatic experiences for them.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-087329","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T22:41:05Z","timestamp":1737585665000},"page":"e087329","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Care intertwined with anxiety and helplessness: the experiences of ICU nurses from COVID-19 disease\u2019s end of life\u2014a qualitative study"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7573-0452","authenticated-orcid":false,"given":"Neda","family":"Asadi","sequence":"first","affiliation":[{"name":"Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Royani","sequence":"additional","affiliation":[{"name":"Golestan University of Medical Sciences, Gorgan, Golestan, Iran (the Islamic Republic of)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirous","family":"Pourkhajoei","sequence":"additional","affiliation":[{"name":"Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"2025120618043556000_15.1.e087329.1","doi-asserted-by":"crossref","first-page":"33578","DOI":"10.1007\/s12144-024-06058-6","article-title":"Exploring the interplay between individual and family functioning during the COVID-19 pandemic: a cross-sectional study","volume":"43","author":"Lucia La Rosa","year":"2024","journal-title":"Curr Psychol"},{"key":"2025120618043556000_15.1.e087329.2","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1177\/00302228211053475","article-title":"The Relationship Between Death Anxiety and Alexithymia in Emergency Medical Technicians","volume":"85","author":"Asadi","year":"2022","journal-title":"Omega (Westport)"},{"key":"2025120618043556000_15.1.e087329.3","first-page":"1477","article-title":"University Experience during the First Two Waves of COVID-19: Students\u2019 Experiences and Psychological Wellbeing","volume":"13","author":"La Rosa","year":"2023","journal-title":"Eur J Investig Health Psychol Educ"},{"key":"2025120618043556000_15.1.e087329.4","doi-asserted-by":"crossref","first-page":"e30","DOI":"10.1017\/dmp.2020.394","article-title":"Professional Life During COVID-19 Crisis: An Emotional and Ethical Dilemma for the Medical Staff","volume":"15","author":"Chehrehgosha","year":"2021","journal-title":"Disaster Med Public Health Prep"},{"key":"2025120618043556000_15.1.e087329.5","doi-asserted-by":"crossref","DOI":"10.1148\/radiol.2020200463","article-title":"Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection","volume":"295","author":"Bernheim","year":"2020","journal-title":"Radiology"},{"key":"2025120618043556000_15.1.e087329.6","doi-asserted-by":"crossref","DOI":"10.3389\/fsoc.2022.1039003","article-title":"Managing the end of life in COVID patients. 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