Purpose
To explore nurses’ perceptions of end-of-life care in neonatal and pediatric intensive care units, focusing on the components, facilitators, and challenges of such care in daily practice.
Methods
A qualitative descriptive study was conducted. Data were collected from June to October 2023 through semi-structured individual interviews with 17 nurses from the neonatal and pediatric intensive care units of four tertiary general hospitals in a metropolitan area of South Korea, and were analyzed using thematic analysis techniques.
Results
We identified three themes and nine subthemes: (1) supporting families’ emotional and relational closure, (2) perceiving relational and systemic support as enabling end-of-life care, and (3) feeling constrained by systemic and practical challenges. Participants perceived fostering an emotional connection with the child, ensuring opportunities for meaningful farewell, and supporting emotional acceptance of death as ways to support families’ emotional and relational closure with their child. Although relational and systemic support, such as collaborative teamwork, clear communication, shared planning, and structured tools, enabled compassionate care, participants also felt unprepared, burdened by heavy workloads, and hindered by environmental barriers.
Conclusion
The findings highlight that delivering quality end-of-life care in neonatal and pediatric intensive care units requires supporting families’ emotional needs, strengthening relational and systemic support, and addressing practical challenges. Further research is needed to develop and test practical strategies (e.g., specialized education in compassionate communication, standardized protocols, and supportive care environments) that can improve the quality of end-of-life care for neonatal and pediatric patients and their families.

Purpose
The purpose of this study was to investigate the influence of perceptions of death, end-of-life (EOL) care stress, and emotional intelligence on attitudes toward EOL care among nurses in the neonatal intensive care unit (NICU).
Methods
The participants were 111 nurses working in a NICU who had experienced EOL care at least once. Data were analyzed using the t-test, Pearson correlation coefficient, and stepwise multiple regression analysis in SPSS for Windows.
Results
The mean score for perceptions of death was 3.16 out of 5, the mean score for EOL care stress was 3.61 out of 5, the mean emotional intelligence score was 4.66 out of 7, and the average score for EOL care attitudes was 2.77 out of 4. The factors affecting attitudes towards EOL care were academic degree, anxiety regarding death, negativity towards death, experiences of patient death, and emotional intelligence. The explanatory power of these variables for attitudes towards EOL care was 24.7%.
Conclusion
The results of this study are expected to serve as a basic reference for the development of nursing education programs and EOL care protocols to improve attitudes toward EOL care among NICU nurses.

Citations

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  Royani Zahra, Yazdi Khadijeh, Mahmoodi Shen Gholam Reza
  International Journal of Palliative Nursing.2025; 31(1): 30.     CrossRef
• The Effectiveness of Emotional Intelligence-Driven End-of-Life Care Simulation for Nursing Students
  Nasreen M. Alghamdi, Hsiao-Lan Wang, Harleah G. Buck, Laura Szalacha
  Clinical Simulation in Nursing.2024; 87: 101490.     CrossRef
• Palliative Care for Infants in the Neonatal Intensive Care Unit
  Eun Sook Kim, Sue Kim, Sanghee Kim, Sujeong Kim, So Yoon Ahn, Hyejung Lee
  Journal of Hospice & Palliative Nursing.2024; 26(1): 14.     CrossRef
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  Julia St. Louis, Karen Benzies, Shelley Raffin-Bouchal, Shane Sinclair
  Neonatal Network.2024; 43(1): 35.     CrossRef
• Do spirituality and emotional intelligence improve the perception of the ability to provide care at the end of life? The role of knowledge and self-efficacy
  Maria de Lurdes da Costa Martins, Ana Paula Rodrigues, Carlos Duarte Coelho Peixeira Marques, Rui Miguel Barros Cunha Carvalho
  Palliative and Supportive Care.2024; 22(5): 1109.     CrossRef
• Simulation, Storytelling, and Pediatric End-of-Life Care: A Continuing Professional Development Approach for Nurse Residents
  Avery McNall, Karen Lucas Breda, Katherine A. Hinderer
  Journal of Pediatric Hematology/Oncology Nursing.2024; 41(3): 220.     CrossRef
• The Effect of Neonatal Intensive Care Nurses’ Attitudes Towards Palliative Care on Death Anxiety and Burnout: An Analytic Cross-Sectional Study
  Fatma Uslu-Sahan, Fusun Terzioglu, Evrim A. Dizdar, Neslihan Kayademir, Derya K. Mutlu, Garibe Adıguzel, Gönül Tozlu, Tugce Baykal
  OMEGA - Journal of Death and Dying.2024;[Epub]     CrossRef
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  Kathryn Nicole Velichko, Annette Callis
  MEDSURG Nursing.2024; 33(3): 110.     CrossRef
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  C. Louwen, D. Reidlinger, N. Milne
  BMC Medical Education.2023;[Epub]     CrossRef
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  Eeva Talus, Hanna Seppänen, Kristina Mikkonen, Anna-Kaija Palomaa, Tarja Pölkki
  Nurse Education Today.2023; 128: 105892.     CrossRef
• Nurses’ attitudes and stress related to perinatal bereavement care in Korea: a cross-sectional survey
  Eunhui Kim, Hae Won Kim
  Korean Journal of Women Health Nursing.2022; 28(2): 134.     CrossRef
• Hospital Nurses’ Perception of Death and Self-Reported Performance of End-of-Life Care: Mediating Role of Attitude towards End-of-Life Care
  Hyo-Jin Park, Yun-Mi Lee, Mi Hwa Won, Sung-Jun Lim, Youn-Jung Son
  Healthcare.2020; 8(2): 142.     CrossRef

Purpose
This study aimed to identify stress levels due to end-of-life care, coping strategies, and psychological well-being among nurses in neonatal intensive care unit, and to investigate the effect of stress levels and coping strategies on their well-being.
Methods
A total of 128 nurses in the neonatal intensive care units of general hospitals in B city participated. The data were collected using a self-report questionnaire. The collected data were analyzed using descriptive statistics, the t-test, ANOVA, the Pearson correlation coefficient, and hierarchical regression with SPSS version 22.0.
Results
The coping strategy that nurses most often used was seeking social support. The factors affecting the well-being of the participants were wishful thinking, problem-focused coping and seeking social support, in order. Those 3 variables explained 21 % of the total variance in psychological well-being. Problem-focused coping and seeking social support were positively associated with psychological well-being, while wishful thinking showed a negative association.
Conclusion
In order to improve the psychological well-being of nurses in neonatal intensive care units, it is necessary to provide nurses with a program to build a social support system and to improve their problem-based coping skills.

Citations

• Emotional and psychological experiences of nursing students caring for dying patients: an explorative study at a national referral hospital in Uganda
  Asha K. Nabirye, Ian G. Munabi, Aloysius G. Mubuuke, Sarah Kiguli
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  Sara Gonçalves, Rita S. Matos
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  Sara Diogo Gonçalves, Rita S. Matos
  Enfermería Clínica (English Edition).2025; 35(5): 502190.     CrossRef
• Palliative Care for Infants in the Neonatal Intensive Care Unit
  Eun Sook Kim, Sue Kim, Sanghee Kim, Sujeong Kim, So Yoon Ahn, Hyejung Lee
  Journal of Hospice & Palliative Nursing.2024; 26(1): 14.     CrossRef
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  Soojeong Han, Haeyoung Min, Sujeong Kim
  Nursing Ethics.2023; 30(2): 276.     CrossRef
• Psychometric properties of the Korean version of the Palliative Care Nursing Self-Competence scale for infant use
  Eun Sook Kim, Sujeong Kim, Kyua Kim, Hyejung Lee
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  Hyeon Ok Ju, So Yeon Park, Jaeyoung Lee, Hye-Ryeon Park
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• Nurses’ attitudes and stress related to perinatal bereavement care in Korea: a cross-sectional survey
  Eunhui Kim, Hae Won Kim
  Korean Journal of Women Health Nursing.2022; 28(2): 134.     CrossRef
• Personal and Emotional Factors of Nursing Professionals Related to Coping with End-of-Life Care: A Cross-Sectional Study
  María Povedano-Jiménez, Carmen Ropero-Padilla, Miguel Rodriguez-Arrastia, María Paz García-Caro
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