| 1. |
- Carlsson, Maria, 1958-, et al.
(författare)
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Bereaved spouses' adjustment after the patients' death in palliative care
- 2007
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Ingår i: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 5:4, s. 397-404
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To improve the support to bereaved spouses during the year after the patient’s death,a project was started consisting of three visits by a nurse (after 1, 3, and 13 months) withconversations about the patient’s death and the spouse’s life situation. The aim of this study wasto describe the bereaved spouse’s situation and adaptation during the first year after the loss. Methods: Spouses of patients cared for by The Advanced Home Care Team (APHCT) inUppsala, Sweden, were invited to participate in the project. Each participant was encouraged totalk freely about his or her situation, but enough direction was given to ensure that all itemslisted on a standardized questionnaire were covered. Results: Fifty-one spouses met the inclusion criteria and were invited to participate and 45accepted. The subjects felt quite healthy but were tired and suffered from sleep disturbance.The grief reactions had initially been high but showed a significant decline from 1 to 13 months( p , .01). Forty-nine percent had experienced postbereavement hallucinations. Significance of results: This study showed that the bereaved spouses felt quite healthy andadjusted quite well to their new life situation, after the patient’s death in a palliative care setting.The grief reactions had initially been high but showed a significant decline during the year.
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| 2. |
- Carlsson, Maria E., 1958-
(författare)
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Fatigue in relatives of palliative patients.
- 2009
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Ingår i: Palliative & Supportive Care. - 1478-9515 .- 1478-9523. ; 7:2, s. 207-211
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The relatives’ burdens in palliative care are considerable and may cause fatigue. The overall aim of this study was to gain a greater understanding of fatigue in relatives of patients cared for in palliative care settings. Methods This study has a descriptive, comparative, and cross-sectional design. The sample consisted of relatives of all patients cared for in palliative care settings in Uppsala County during a specific day. Relatives completed a questionnaire consisting of the Multidimensional Fatique Inventory (MFI-20) and questions from the Karolinska Sleepiness Scale (KSS) and Karolinska Sleep questionnaire (KSQ). Results Relatives (n ¼ 56) scored high on every dimension on the MFI-20 scale. Two significant negative correlations were found to exist between age and fatigue, with younger relatives reportingmoremental fatigue ( p , .01) and more reduced activity ( p , .01) than older relatives. Relatives of patients in institutional care had higher values concerning mental fatigue ( p , .01) and reduced motivation ( p , .05). Relatives of mostly bedridden patients were significantly more tired but did not have significantly less motivation than relatives of mostly ambulatory patients. Significance of results The findings imply that fatigue is highly prevalent in relatives of patients in palliative care. The sample in this study scored higher in comparison with norm values and also in comparison with relatives of patients with end-stage renal disease. Their scores were similar to those of cancer patients undergoing radiotherapy.
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| 3. |
- Dehlin, Lena, et al.
(författare)
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Adolescents’ experiences of a parent’s serious illness
- 2009
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Ingår i: Palliative and Supportive Care. - Cambridge : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 7:1, s. 13-25
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Adolescence is characterized by increasing liberation from parents as the young person evolves into an independent individual. Experiencing the serious illness and death of a parent during this phase implies great stress. Serious illness involves uncertainty, worry, and hope at the same time that it is necessary for everyday life to function. This study sought to describe adolescents’ experiences in the serious illness and death of a parent. Methods: The study was carried out using a qualitative method. Data were collected in interviews with five adolescents who were 14–17 years of age when one of their parents died. Results: The results show that the parent’s illness was a strong threat, as the adolescents understood that their own and the family’s lives would be greatly changed by the illness/death. The incomprehensibility of the parent’s serious illness and deathwas a threatening condition on its own. The adolescents strived to make the inconceivable more conceivable to understand what was happening. They also described the necessity of finding different ways of relating to and managing the threat, such as restoring order, seeking closeness, adapting, gaining control, avoiding talking about the illness, not accepting and counting the parent out. The adolescents described feelings of being alone and alienated, even though they were close to family and friends and they did not actively seek support. The lives of the adolescentswere changed by their experiences, beyond their bereavement over the parent. They felt that they had become more mature than their friends and that there had been a change in their thinking about life, changes in values, and changes in their views of relationships with other people. Significance of results: The results of the present study can form a basis for developing a support program whose purpose would be to prevent effects on health.
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| 4. |
- Egberg Thyme, Karin, 1943-, et al.
(författare)
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Individual brief art therapy can be helpful for women with breast cancer : A randomized controlled clinical study
- 2009
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Ingår i: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 7:1, s. 87-95
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Recent research shows that almost every second woman with breast cancer is depressed or has anxiety; the risk for younger women is even higher. Moreover, research shows that women are at risk for developing depression, also a threat for women with breast cancer. The aim of this randomized controlled clinical trial was to study the outcome of five sessions of art therapy given at a 5-week period of postoperative radiotherapy.Methods: The participants were between 37 and 69 years old; six participants in each group were below 50 years of age. Half of the participants (n = 20) received art therapy and the other half (n = 21) were assigned to a control group. At the first measurement, at least 17% (n = 7) of the participants medicated with antidepressants. Data were collected before and after art therapy and at a 4-month follow-up using self-rating scales that measure self-image (the Structural Analysis of Social Behaviour) and psychiatric symptoms (the Symptom Check List–90).Results: At follow-up, significant lower ratings of depression, anxiety, and somatic symptoms and less general symptoms were reported for the art therapy group compared to the control group. The regression analysis showed that art therapy relates to lower ratings of depression, anxiety, and general symptoms; chemotherapeutic treatment predicts lower depressive symptoms; in contrast to axilliary surgery and hormonal treatment as well as being a parent predicts higher ratings of anxiety and general symptoms.Significance of results: The conclusion suggests that art therapy has a long-term effect on the crisis following the breast cancer and its consequences.
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| 5. |
- Iranmanesh, Sedigheh, et al.
(författare)
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Attitudes of Iranian nurses toward caring for dying patients
- 2008
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Ingår i: Palliative & Supportive Care. - 1478-9515 .- 1478-9523. ; 6:4, s. 363-369
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the attitudes of Iranian nurses toward caring for dying patients.Methods: Nurses' attitudes toward death and caring for dying patients were examined by using two types of questionnaires: the Death Attitude Profile-Revised (DAP-R) and Frommelt's Attitude towards Caring for Dying Patients (FATCOD), both with a demographic survey.Results: The results showed that most respondents are likely to view death as a natural part of life and also as a gateway to the afterlife. The majority reported that they are likely to provide care and emotional support for the people who are dying and their families, but they were unlikely to talk with them or even educate them about death. They had a tendency not to accept patients and their families as the authoritative decision makers or involve families in patient care. Nurses' personal views on death, as well as personal experiences, affected their attitudes toward care of the dying.Significance of results: Lack of education and experience, as well as cultural and professional limitations, may have contributed to the negative attitude toward some aspects of the care for people who are dying among the nurses surveyed. Creating a reflective narrative environment in which nurses can express their own feelings about death and dying seems to be a potentially effective approach to identify the factors influencing their interaction with the dying. Continuing education may be required for Iranian palliative care nurses in order to improve the patients quality of care at the end of life.
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| 6. |
- la Cour, K, et al.
(författare)
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Experiences of engagement in creative activity at a palliative care facility
- 2007
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Ingår i: Palliative & supportive care. - : Cambridge University Press (CUP). - 1478-9515 .- 1478-9523. ; 5:3, s. 241-50
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the meanings that people with advanced cancer ascribe to engaging in creative activity in palliative occupational therapy.Methods: Sixteen interviews were conducted with eight participants over a period of 8–12 months. Participants were asked to narrate about their engagement in creative activities at a palliative intervention program. Transcribed interviews were analyzed with a phenomenological method.Results: Engagement in creative activities was found to ease life in proximity to death for persons with advanced cancer and limited survival time. For the participants, creativity meant that some of the consequences of incurable cancer could be confronted and alternative potentials could be explored and acknowledged. This occurred in an ongoing process of creating alternative ways to deal with life.Significance of results: Creative activity is a means for participants to develop ways to adapt and cope with declining physical abilities and existential concerns through working with their hands and bodies. This complements the often negative focus in palliative phases of cancer with an understanding of how enriching aspects of life can be maintained. The results highlight how people in palliative care experience their engagement in creative activity in the form of crafts, and how such engagements may be a significant tool for finding alternative ways to handle challenges in ongoing life.
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| 7. |
- Melin Johansson, Titti, et al.
(författare)
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The meaning of quality of life: narrations by patients with incurable cancer in palliative home care
- 2008
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Ingår i: Palliative & Supportive Care. - 1478-9515 .- 1478-9523. ; 6:3, s. 231-238
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The objective of this qualitative study was to elucidate the meaning of quality of life as narrated by patients with incurable cancer approaching death in palliative home care in Sweden. METHODS: To gain a deeper understanding of what quality of life means for dying patients, data were collected from narrative interviews with eight patients in their homes in 2004-2006. Qualitative content analysis was used to interpret the meaning regarding quality of life. RESULTS: Three main themes were found: being in intense suffering, having breathing space in suffering, and being at home. Living with incurable cancer at the end of life was experienced as living in physical distress as the body became incapacitated by unexpected physical complications. This incapacity had consequences on patients' psychological, social, and existential well-being. As the complication phase abated, the patients experienced that they regained hopefulness and had time to reflect on existential issues. Patients were provided affirmative care at home from family caregivers and the palliative home care team. SIGNIFICANCE OF RESULTS: This study shows that it is feasible to perform individual interviews with patients approaching death and elucidate the meaning of patients' quality of life in palliative home care. Patients oscillate between being in intense suffering and having breathing space in this suffering, which somewhat opposes the traditional picture of a continuous linear deterioration. Being cared for at home by family caregivers and health care professionals provided a sense of independency and security. Being at home safeguards patients' entire life situation and increases quality of life.
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| 8. |
- Rydé, Kerstin, et al.
(författare)
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Crying : A force to balance emotions among cancer patients in palliative home care
- 2007
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Ingår i: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 5:1, s. 51-59
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Crying is a common but seldom studied phenomenon in palliative care. The aim of this study was to explore the significance of patients crying in a palliative care context.Methods: Tape-recorded interviews with 14 cancer patients in palliative home care were carried out. To gain deeper understanding, a hermeneutic analysis and interpretation was used.Results: Crying was described in different dimensions: (1) intense and despondent crying as a way of ventilating urgent needs, (2) gentle, sorrowful crying as a conscious release of emotions, and (3) quiet, tearless crying as a protection strategy. Crying seems to be an expression for an inner emotional force, provoked by different factors, which cause changes in the present balance. To cry openly but also to cry on the inside meant being able to achieve or maintain balance. Crying may be something useful, which could create release and help reduce tension, but it may also have a negative impact as it consumes energy and creates feelings of shame.Significance of results: Professionals need to understand the different levels of crying. In such situations sometimes comforting the patient may not be the best solution, as some may need privacy.
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| 9. |
- Rydé, K, et al.
(författare)
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Crying: a force to balance emotions among cancer patients in palliative home care
- 2007
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Ingår i: Palliative & supportive care. - : Cambridge University Press (CUP). - 1478-9515 .- 1478-9523. ; 5:1, s. 51-9
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Crying is a common but seldom studied phenomenon in palliative care. The aim of this study was to explore the significance of patients crying in a palliative care context.Methods: Tape-recorded interviews with 14 cancer patients in palliative home care were carried out. To gain deeper understanding, a hermeneutic analysis and interpretation was used.Results: Crying was described in different dimensions: (1) intense and despondent crying as a way of ventilating urgent needs, (2) gentle, sorrowful crying as a conscious release of emotions, and (3) quiet, tearless crying as a protection strategy. Crying seems to be an expression for an inner emotional force, provoked by different factors, which cause changes in the present balance. To cry openly but also to cry on the inside meant being able to achieve or maintain balance. Crying may be something useful, which could create release and help reduce tension, but it may also have a negative impact as it consumes energy and creates feelings of shame.Significance of results: Professionals need to understand the different levels of crying. In such situations sometimes comforting the patient may not be the best solution, as some may need privacy.
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| 10. |
- Seiger Cronfalk, Berit, et al.
(författare)
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A one-day education in soft tissue massage : Experiences and opinions as evaluated by nursing staff in palliative care
- 2008
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Ingår i: Palliative & Supportive Care. - 1478-9515 .- 1478-9523. ; 6:2, s. 141-148
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Increasing awareness of well-being aspects of physical touch has spurred the appreciation for soft tissue massage (STM) as part of palliative care. Educational programs are available but with no specific focus on utilization for this kind of care. The aim was to study the feasibility of a 1-day course in STM in clarifying nursing staff's experiences and opinions, but also to shed light on their motivation and ability to employ STM in the care of dying cancer patients. Method: In all, 135 nursing staff participated. The course consisted of theory and hands-on training (hand-foot-, back massage). Focus-groups with 30/135 randomly chosen participants were conducted 4 weeks after the intervention. This study engaged a qualitative approach using content analysis. Results: The overall opinion of the 1-day course was positive. The majority experienced the contents of the course to be adequate and sufficient for clinical care. They emphasized the pedagogical expertise as valuable for the learning process. The majority of nurses shared the opinion that their extended knowledge clarified their attitudes on STM as a complement in palliative care. Still, a few found it to be too basic and/or intimate. Three categories emerged during the analysis: experiences of and attitudes toward the education, experiences of implementing the skills in every-day care situations, and attitudes to the physical body in nursing care. Significance of results: The approach to learning and the pedagogical skills of the teacher proved to be of importance for how new knowledge was perceived among nurses. The findings may encourage hospital organizations to introduce short courses in STM as an alternative to more extensive education. Copyright © 2008 Cambridge University Press 2008.
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