| 1. |
- Coelho, Adriana, et al.
(författare)
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The Effects of Guided Imagery on Comfort in Palliative Care
- 2018
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Ingår i: Journal of Hospice and Palliative Nursing. - : Lippincott Williams & Wilkins. - 1522-2179 .- 1539-0705. ; 20:4, s. 392-399
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Tidskriftsartikel (refereegranskat)abstract
- Guided imagery (GI) is a nonpharmacological intervention that is increasingly implemented in different clinical contexts. However, there have been no studies on the effect of GI on the comfort of inpatients of palliative care (PC) units. Therefore, the aim of this study was to evaluate the effects of GI on the comfort of patients in PC. A 1-group, pretest-posttest, pre-experimental design was used to measure differences in heart rate, respiratory rate, pain, and comfort in patients (n = 26) before and after a 2-session GI program. The intervention featuring GI increased comfort, measured by an Abbreviated Holistic Comfort Scale and the visual analog comfort scale (P < .001), and decreased heart rate (P < .001), respiratory rate (P < .001), and pain, as measured by the (numerical) visual analog pain scale (P < .001). This study demonstrates that the use of an intervention featuring GI increases the comfort of oncology patients admitted to a PC unit. The use of GI by nurses is inexpensive, straightforward to implement, and readily available and may result in the provision of comfort care.
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| 2. |
- Hjelm, Eva, et al.
(författare)
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An inevitable journey by train : Nurses' narratives about palliative care
- 2007
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Ingår i: Journal of Hospice and Palliative Nursing. - 1522-2179 .- 1539-0705. ; 9:4, s. 206-211
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this article is to explore the meaning of palliative care in the context of the caring relationship described by nurses providing such care in the home. Eleven nurses were interviewed, and the transcripts were analyzed using the hermeneutic narrativism method. The study found that the nurses'' narrative account of a caring relationship can be represented by a metaphor: an inevitable journey by train, characterized by the three themes of transit points, time, and guidance. Each journey passes through the same four points in chronological order. Time always moves forward, but the duration of the journey can be either long or short. Having more time creates better conditions for developing a caring relationship. The nurse provides guidance through a journey that she has made before, although each journey is unique. A caring relationship signifies commitment and involvement. © 2007 Lippincott Williams & Wilkins, Inc.
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| 3. |
- Hjelmfors, Lisa, et al.
(författare)
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Simulation to Teach Nursing Students About End-of-Life Care
- 2016
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Ingår i: Journal of Hospice and Palliative Nursing. - : Lippincott Williams & Wilkins. - 1522-2179 .- 1539-0705. ; 18:6, s. 512-518
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Tidskriftsartikel (refereegranskat)abstract
- There is minimal education on death and dying in undergraduate nursing programs, leaving the students unprepared to provide sufficient care to dying patients and their families. This article describes a teaching innovation on how end-of-life care simulation can provide a successful and appreciated learning situation for nursing students, teaching them communication skills in challenging situations. Modifications in the setup of the simulation might help the students to focus more on communication and existential issues instead of mostly practical ones.
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| 4. |
- Kaup, Jaana, et al.
(författare)
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Care for Dying Patients at Midlife Experiences of Nurses in Specialized Palliative Home Care
- 2016
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Ingår i: Journal of Hospice and Palliative Nursing. - 1522-2179 .- 1539-0705. ; 18:6, s. 564-571
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to highlight nurses' experiences of caring for patients in palliative care at midlife, and describe their coping strategies. This study used a qualitative methodology with an inductive and an abductive approach. The analysis started with systematic text condensation. Later in the analysis, an abductive profile inspired by the concepts of a "tentative coping model for nurses in cancer care" was used. Fourteen participants, from 3 specialized palliative home care teams, were interviewed in 3 focus groups. Three themes and 9 codes represented the participants' experiences and coping strategies: experiences of significances: participants felt admiration for the patients, they became invigorated by their encounters with their patients, and they got confirmation that they did well; stress: participants described how they were affected by external influences, psychological stress, and stress-related symptoms; and coping: participants described the various individual-, group-, and organizational-level coping strategies they used in their daily work and the formal and informal support they received. Based on their descriptions, palliative care nursing was stressful for the nurses. They had various coping strategies and significances that helped them care for the families in the most difficult situations. The study also revealed how important formal support was to the nurses.
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| 5. |
- Källström Karlsson, Inga-Lill, 1947-, et al.
(författare)
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Five nurses' experiences of hospice care in a long-term perspective
- 2008
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Ingår i: Journal of Hospice and Palliative Nursing. - Philadelphia, PA : Lippincott Williams & Wilkins. - 1522-2179 .- 1539-0705. ; 10:4, s. 224-232
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Tidskriftsartikel (refereegranskat)abstract
- In this study, five nurses’ experiences of regularly having to face the incurable illness and death of dying patients were explored. Qualitative interviews were conducted on two occasions with an interval of 11 years. An interpretive method was used to discern the nurses’ thoughts, feelings, and attitudes over the years toward death and dying. The main finding was that working in hospice care and facing the dying and death of many patients had an impact both on daily work and private life. Narrations from the first occasion were conceptualized as the theme “Death as an Agent of Change.” Eleven years later the presence of death took a less dominant place in the nurses’ lives and the theme became “Death as a Companion in Life“. In the long term nurses emphasized that their professional and personal growth was fostered by their relationship with the dying patients.
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| 6. |
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| 7. |
- Munck, Berit, et al.
(författare)
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Patients’ understanding of medical technology in palliative home care; a qualitative analysis
- 2012
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Ingår i: Journal of Hospice and Palliative Nursing. - 1522-2179 .- 1539-0705. ; 14:3, s. 191-198
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Tidskriftsartikel (refereegranskat)abstract
- Healthcare reforms and reductions in the number of hospital beds are leading to an increasing amount of medical technology moving from hospitals into home care, affecting the daily lives of patients. The aim of this study was therefore to describe the ways patients understand medical technology in palliative home care. With use of a phenomenographic approach, 15 patients with medical technology were interviewed, and data were analyzed in a 7-step process. Three ways of understanding the phenomenon emerged: a masterful patient, an adjustable patient, and a restricted patient. Masterful patients took control over the medical technology and were mostly independent of assistance from personnel. Adjustable patients accepted and adapted their lives to the medical technology and were satisfied with assistance from the personnel. Restricted patients were reminded daily of the medical technology and dependent on assistance from personnel. Depending on the patients' health conditions, the support from the personnel, and the impact of medical technology, a transfer between the different ways of understanding occurred with a simultaneous movement between independence and dependence. The patient exhibited various ways of understanding, although one way of understanding was more dominant.
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| 8. |
- Möller, Ulrika Olsson, et al.
(författare)
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Using Cards to Facilitate Conversations About Wishes and Priorities of Patients in Palliative Care
- 2020
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Ingår i: Journal of Hospice and Palliative Nursing. - : Lippincott Williams and Wilkins Ltd.. - 1522-2179 .- 1539-0705. ; 22:1, s. 33-39
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Tidskriftsartikel (refereegranskat)abstract
- To avoid discomfort, health care professionals may hesitate to pursue conversations about end of life with patients. Certain tools have the potential to facilitate smoother conversations in this matter. The objective was to explore the experiences of patients in palliative care in using statement cards to talk about their wishes and priorities. Forty-six cards with statements of wishes and priorities were developed and tested for feasibility with 40 participants, who chose the 10 most important cards and shared their thoughts about the statements and conversation. Data from individual interviews and field notes were analyzed using content analysis. One category describes practical aspects of using the cards including the relevance of the content and the process of sorting the cards. The second category describes the significance of using the cards including becoming aware of what is important, sharing wishes and priorities, and reflecting on whether wishes and priorities change closer to death. The cards helped raise awareness and verbalize wishes and priorities. All statements were considered relevant. The conversations focused not only on death and dying, but also on challenges in the participants' current life situation. For the most ill and frail participants, the number of cards needs to be reduced.
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| 9. |
- Möllerberg, Marie-Louise, et al.
(författare)
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Familial Interaction Patterns During the Palliative Phase of a Family Member Living With Cancer
- 2017
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Ingår i: Journal of Hospice and Palliative Nursing. - : Hospice & Palliative Nurses Association. - 1522-2179 .- 1539-0705. ; 19:1, s. 67-74
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to illuminate aspects of familial interactions when 1 member is in the palliative phase of his/her cancer course. An individual cancer diagnosis influences the entire family, often requiring daily life changes for all members. Current research has examined individual family member perspectives; family system nursing studies are warranted. Narrative family interviews were conducted on 13 families living with cancer. The interviews were transcribed and analyzed according to a hermeneutic method. Analyses revealed the following: Family interaction patterns were adjusted in response to changes in family life, which encompassed 3 different, but interrelated, patterns: (1) power dynamics in the family, (2) the "secret game" in the family, and (3) multifaceted closeness and distance in the family. It is crucial to adopt a family perspective during palliative care to meet each unique family's needs. Health care facilitators should be aware of the complex dynamics and challenges that these families encounter. This will help obtain a greater understanding of factors underlying effective palliative care.
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| 10. |
- Möllerberg, Marie-Louise, et al.
(författare)
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Familial Interaction Patterns During the Palliative Phase of a Family Member Living With Cancer
- 2017
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Ingår i: Journal of Hospice and Palliative Nursing. - : Lippincott Williams & Wilkins. - 1522-2179 .- 1539-0705. ; 19:1, s. 67-74
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to illuminate aspects of familial interactions when 1 member is in the palliative phase of his/her cancer course. An individual cancer diagnosis influences the entire family, often requiring daily life changes for all members. Current research has examined individual family member perspectives; family system nursing studies are warranted. Narrative family interviews were conducted on 13 families living with cancer. The interviews were transcribed and analyzed according to a hermeneutic method. Analyses revealed the following: Family interaction patterns were adjusted in response to changes in family life, which encompassed 3 different, but interrelated, patterns: (1) power dynamics in the family, (2) the “secret game” in the family, and (3) multifaceted closeness and distance in the family. It is crucial to adopt a family perspective during palliative care to meet each unique family's needs. Health care facilitators should be aware of the complex dynamics and challenges that these families encounter. This will help obtain a greater understanding of factors underlying effective palliative care.
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| 11. |
- Olsson Möller, Ulrika, et al.
(författare)
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A Reduced Deck of Conversation Cards of Wishes and Priorities of Patients in Palliative Care
- 2022
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Ingår i: Journal of Hospice and Palliative Nursing. - : Lippincott Williams and Wilkins Ltd.. - 1522-2179 .- 1539-0705. ; 24:3, s. 175-180
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Tidskriftsartikel (refereegranskat)abstract
- The individual wishes and priorities of patients with advanced disease are too often neglected, making a deck of cards with statements reflecting potential wishes and priorities a useful conversation tool. However, in the most ill patients, the card selection and sorting process may be too strenuous. The aims of this study were to explore the wishes and priorities of patients receiving palliative care and to reduce a deck of statement cards to be clinically useable even for the most ill patients. In interviews, participants selected their top 10 from a deck of 46 statement cards. Descriptive and analytical statistics were used. Thirty-nine patients from 5 specialized palliative care units in Sweden participated. Six participants died within 1 month of the interviews. "To be free from pain"was ranked as the highest priority by the majority, and "To have staff I feel comfortable with"was ranked highest by the 6 most ill participants. A deck of cards with the 20 statements most chosen by patients receiving palliative care was created. The cards cover physical, psychological, social, existential, and practical aspects and are helpful for formulating goals of care for patients and informing the development of a core outcome set for palliative care.
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| 12. |
- Parola, Vitor, et al.
(författare)
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Burnout in Palliative Care Settings Compared With Other Settings : A Systematic Review
- 2017
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Ingår i: Journal of Hospice and Palliative Nursing. - : Lippincott Williams & Wilkins. - 1522-2179 .- 1539-0705. ; 19:5, s. 442-451
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Tidskriftsartikel (refereegranskat)abstract
- A systematic review, using the guideline of the Joanna Briggs Institute, was conducted to explore the effect of working in palliative care settings, compared with other settings, on burnout among health care professionals. Multiple databases were searched-CINAHL, PubMed, Scopus, and SciELOV-as well as gray literature for studies published since 1975 that compared health professionals caring for patients older than 18 years in specialized palliative care settings (palliative care units, home care, or hospices) with health professionals working in other settings. Of the 539 studies retrieved, 7 cross-sectional studies were included in this review. Of these, six were conducted with nurses, and six used the Maslach Burnout Inventory. Working in palliative care (palliative care unit or hospices) was associated with lower levels of emotional exhaustion and depersonalization, as well as higher levels of personal accomplishment, compared with working in other settings. Evidence indicates that burnout levels seem to be lower among professionals working in palliative care compared with professionals working in other settings. Further research is needed to explore the strategies used by nurses working in palliative care that help them deal with burnout and to apply these same strategies to professionals working in other settings.
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| 13. |
- Parola, Vitor, et al.
(författare)
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Caring in Palliative Care : A Phenomenological Study of Nurses' Lived Experiences
- 2018
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Ingår i: Journal of Hospice and Palliative Nursing. - : Lippincott Williams & Wilkins. - 1522-2179 .- 1539-0705. ; 20:2, s. 180-186
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Tidskriftsartikel (refereegranskat)abstract
- Providing palliative care involves serious challenges for nurses, such as end-of-life decisions, contact with people's suffering and dying, and increased risk of burnout. However, studies have revealed that the burnout level of health professionals working in palliative care is lower than that of health professionals working in other settings. This study aimed to describe the lived experiences of nurses caring in a palliative care unit. A phenomenological descriptive study was undertaken. Nine nurses were recruited from a palliative care unit in Portugal. Data were collected using individual interviews and analyzed following the method of Giorgi. Five themes reflect the essence of the lived experience: (1) experience centered on the relationship with the other (ie, the patient and the family), (2) experience centered on the relationship with one's own self, (3) exhausting experience, (4) rewarding experience, and (5) the team as a pillar. These findings can be valuable for understanding the challenges and strategies experienced by nurses caring in palliative care and for designing interventions that focus on reducing the risk of burnout among nursesnot only those working in palliative care but also those working in other contexts who experience regular contact with suffering and death.
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| 14. |
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| 15. |
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| 16. |
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| 17. |
- Ternestedt, Britt-Marie, et al.
(författare)
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A good death - Development of a nursing model of care
- 2002
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Ingår i: Journal of Hospice and Palliative Nursing. - 1522-2179 .- 1539-0705. ; 4:3, s. 153-160
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the ongoing process at a Swedish hospice to further develop a model for care planning, documentation, and evaluation of the quality of death. The model was adapted to a nursing context by means of concept derivation. The core of the model is the patient as a person, in which that person’s experiences and need for control in his or her life are acknowledged. Six key words have been used as guidelines in this process: symptom control, self-determination, social relations, self-image, synthesis, and surrender. In a retrospective analysis of patient deaths it was found that of 35 patients, 15 had a very good death, 17 a good death, and 3 a bad death. Use of the 6 S key words provided the staff with continual opportunities for reflection, which was described as increasing their awareness concerning the needs of individual patients and concerning individualized nursing care.
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| 18. |
- Werkander Harstäde, Carina, et al.
(författare)
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Feelings of guilt - Experiences of next-of-kin in end-of-life care
- 2013
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Ingår i: Journal of Hospice and Palliative Nursing. - Philadelphia : Wolters Kluwer. - 1522-2179 .- 1539-0705. ; 15:1, s. 33-40
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to gain a greater understanding of the experiences of guilt of the next-of-kin in end-of-life care. Seventeen next-of-kin who had lost a loved one were interviewed with a focus on possible experiences of guilt. A Gadamerian-based hermeneutic approach to interpret these experiences was used. The interpretation showed that next-of-kin’s experiences of guilt emanated from a situation where the next-of-kin had a moral view on what was the right thing to do, it could also originate from a wish to do the best possible for the dying person out of love for this person. The situation could also involve both these aspects. The way in which the situation was handled, could, if the next-of-kin felt that s/he did not fulfill her/his commitments, omitted or neglected the dying person or was the cause of something, lead to experiences of guilt. The situation of being next-of-kin in end-of-life care is complex and demanding, something that health professionals are and should be aware of. Acknowledgement of experiences of guilt can help the next-of-kin in their adaptation to the end-of-life situation as a whole and maybe also give useful tools to support next-of-kin through bereavement.
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| 19. |
- Werkander Harstäde, Carina, et al.
(författare)
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Good palliative care : how and where?: the patients’ opinions
- 2004
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Ingår i: Journal of Hospice and Palliative Nursing. - : Wolters Kluwer. - 1522-2179 .- 1539-0705. ; 6:1, s. 27-35
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe what patients with cancer who are in the final stage of life consider to be good palliative end-of-life care and where they think such care should be carried out. Nine patients receiving palliative end-of-life care were interviewed and the material was analyzed using Grounded Theory. Three main categories (and 7 subcategories) emerged during the analysis: safety, participation, and trust. They were conceptualized metaphorically as a wheel that rolls along smoothly as long as the care is good and all 3 categories are present. The concepts of safety, participation, and trust were interwoven with the patients’ beliefs about where this care should be carried out. The majority said that they wanted to be cared for in the hospital.
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| 20. |
- Werkander-Harstäde, Carina, et al.
(författare)
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Good palliative care - How and where?
- 2004
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Ingår i: Journal of Hospice and Palliative Nursing. - 1522-2179 .- 1539-0705. ; 6:1, s. 27-35
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Tidskriftsartikel (refereegranskat)
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| 21. |
- Werkander-Harstäde, Carina, et al.
(författare)
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Good palliative care - Who and where?
- 2004
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Ingår i: Journal of Hospice and Palliative Nursing. - 1522-2179 .- 1539-0705. ; 6:1, s. 27-35
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe what patients with cancer who are in the final stage of life consider to be good palliative end-of-life care and where they think such care should be carried out. Nine patients receiving palliative end-of-life care were interviewed and the material was analyzed using Grounded Theory. Three main categories (and 7 subcategories) emerged during the analysis: safety, participation, and trust. They were conceptualized metaphorically as a wheel that rolls along smoothly as long as the care is good and all 3 categories are present. The concepts of safety, participation, and trust were interwoven with the patients' beliefs about where this care should be carried out. The majority said that they wanted to be cared for in the hospital.
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| 22. |
- Werkander Harstäde, Carina, et al.
(författare)
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Next of Kin's Experiences of Shame in End-of-Life Care
- 2014
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Ingår i: Journal of Hospice and Palliative Nursing. - Philadelphia, PA : Lippincott Williams & Wilkins. - 1522-2179 .- 1539-0705. ; 16:2, s. 86-92
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to gain a greater understanding of the experiences of shame of next of kin in end-of-life care. Seventeen next of kin who had lost a family member were interviewed. A method inspired by Gadamer's hermeneutic approach was used to interpret possible experiences of shame and to discuss these interpretations. The result showed that next of kin's experiences of shame are linked to their perception of the remaining time and are guided by views on morality and what is right and wrong. Shame can occur when the next of kin are involved and actually cause harm to the family member as well as in situations that are beyond their control. Shame can also involve actions that have nothing to do with what they have actually done but is instead a shame that is placed on them by others, for example, health professionals or relatives. Shame is interpreted as experiences of ignominy, humiliation, and disgrace. Second-order shame is also found. It is important that health professionals are aware of these experiences of unhealthy shame when they meet and support next of kin in end-of-life care.
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| 23. |
- Ångström-Brännström, Charlotte, et al.
(författare)
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Victor and the Dragon. : A Young Child's Experiences of Discomfort and Comfort, From Diagnosis Until Death
- 2013
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Ingår i: Journal of Hospice and Palliative Nursing. - : Lippincott Williams & Wilkins. - 1522-2179 .- 1539-0705. ; 15:8, s. 464-470
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Tidskriftsartikel (refereegranskat)abstract
- Children with progressive cancer often suffer during treatment and at the end of their life, and they need comfort. This study's aim was to describe a child's experiences of being cared for until death, with a focus on discomfort and comfort. Conversations, field notes, drawings, and interviews with the child and his mother and nurse were content analyzed. The themes enduring unbearable situations, expressing emotional suffering, and finding comfort were constructed. The children's parents and other family members are often a significant source of help for the children to endure discomfort and find comfort. Emotional suffering can be expressed in drawing and crying, but sometimes, a child is inconsolable and must endure discomfort. Comfort for a dying child is enhanced by having the family close, experiencing normal daily activities such as drawing and playing, and feeling at home in life despite approaching death.
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