| 1. |
- Andershed, Birgitta
(författare)
-
Att vara nära anhörig i livets slut : Delaktighet i ljuset - delaktighet i mörkret
- 1998
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aims of the present dissertation were: 1. To describe how the establishment of an inpatient hospice ward affected dying cancer patients' utilisation of care at a Medical Centre Hospital; 2. To analyse the involvement of the relative in the care of gravely ill cancer patients in different care cultures; 3. To analyse obstacles to and possibilities for relatives' involvement: 4. To develop a theoretical framework of understanding concerning the involvement of relatives. For the first aim, data was collected via register studies. The basic research design for the other aims was the hermeneutic method.The results show that during the first three years 315 patients died at the newly opened hospice ward. The year before the ward opened 82% of the cancer patients died in acute care compared with 59% during the third year of the hospice ward.The involvement of relatives in the patients' care was categorised into three main categories: "to know", " to be" and "to do". The studies show that the involvement can be described either as involvement in the light or involvement in the dark. Involvement in the light and in the dark illustrates relatives' understanding of the situation, their possibilities for involvement, and the attitude of the staff toward the relatives. Factors that promoted involvement in the light were a humanistic attitude of the staff, a stronger sense of coherence of relatives, an appropriate course of illness, and other available resources such as other relatives and one's own health.A surprising result was that the time between diagnosis and death was three months or less for 49% of 67 patients. In those cases where the course of illness was short there was no time to lose, and it was important that caring delays were avoided.The results from the substudies were summarised in five statements, which together form a theoretical framework of understanding for the involvement of relatives.
|
|
| 2. |
|
|
| 3. |
- Andershed, Birgitta, et al.
(författare)
-
Involvement of relatives in care of the dying in different care cultures : development of a theoretical understanding
- 1999
-
Ingår i: Nursing Science Quarterly. - : SAGE Publications. - 0894-3184 .- 1552-7409. ; 12:1, s. 45-51
-
Tidskriftsartikel (refereegranskat)abstract
- A prerequisite for the staff to be able to guide relatives through the dying trajectory is that the staff members know what the relative wants and can do. The aim of this study was threefold: (a) to identify and categorize family members' involvement in the care of a dying relative, (b) to develop a theoretical understanding of their involvement, and (c) to discuss the congruence or incongruence between the empirical results and key concepts in Swanson's and Watson's theories of caring. The results show that the relatives' involvement could be classified into three categories: to know, to be, and to do. Good correspondence was found between these three categories and key concepts in Swanson's and Watson's theories of caring.
|
|
| 4. |
- Andershed, Birgitta, et al.
(författare)
-
Involvement of relatives in the care of the dying in different care cultures : involvement in the dark or in the light?
- 1998
-
Ingår i: Cancer Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0162-220X .- 1538-9804. ; 21:2, s. 106-111
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this prospective study was to increase existing knowledge about the involvement of relatives in care of the dying and to shed light on the relatives' sense of coherence. Six relatives were followed via qualitative interviews during the patients' final period of life and after their deaths. The patients died in different forms of care: surgical department, nursing home, inpatient hospice ward, and at home. What the relatives had in common was that they had, in different ways, followed the patient from the first symptoms, through different forms of care, up until death. Some participated very actively in the care. Relatives' involvement in care can be described as involvement in the light or involvement in the dark. Involvement in the light is based on a trusting relationship between the family and the staff. Involvement in the dark is based on insufficient interplay and collaboration, in which the relatives are not seen or acknowledged by the staff, but instead must grope around in the dark when they try to support the patient. Rapid course of illness can be a risk factor for involvement in the dark. It seems that the relatives' sense of coherence was an important factor enabling them to be involved in the light. Humanistic care can constitute a buffer, thereby increasing the possibilities for relatives to be involved in the light.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
|
|
| 8. |
- Andershed, Birgitta, et al.
(författare)
-
Patterns of care for patients with cancer before and after the establishment of a hospice ward
- 1997
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 11:1, s. 42-50
-
Tidskriftsartikel (refereegranskat)abstract
- A majority of people die in acute hospital care, in a culture of quickness primary aimed at curing. There are indications that hospice care in various forms will spread during the present decade in Sweden. The hospice philosophy contributes to a culture of slowness, where the patient is not only allowed but is encouraged to live at his own pace. As a first step in establishing for whom hospice inpatient care is the best alternative, patient flow to a newly started hospice ward was studied. All patients (n = 1464) who died at the Medical Centre Hospital with a primary diagnosis of cancer during the period of study were compared regarding place of death, diagnosis, gender, age and length of the last period of care. The year before the ward was established, 82% of patients died in acute hospital care compared with 59% during the hospice ward's third year of operation. A total of 315 patients (22%) died in the hospice ward during the study period. The percentage of these patients over the age of 80 was significantly higher (p = 0.0001), and they also had a longer continuous final period of care. More women (57%) than men (43%) were cared for at the hospice ward. The hospice ward has in this way influenced the pattern of care in the hospital.
|
|
| 9. |
- Andershed, Birgitta, et al.
(författare)
-
The illness trajectory : for patients with cancer who died in two different cultures of care
- 1998
-
Ingår i: Omega. - 0030-2228 .- 1541-3764. ; 37:4, s. 251-272
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study has been to retrospectively examine the illness trajectory for a consecutive group of sixty-seven patients with cancer who died at a surgical department or were referred from there to an inpatient hospice ward where they died. Relatives of fifty-two patients were interviewed after the patient's death and all sixty-seven medical records were studied. The data was analyzed with support of Glaser and Strauss' concept of a dying trajectory. A surprising result was that as many as forty-four patients had a short trajectory, and nineteen of these had one month or less between diagnosis and death. Patients at surgical wards followed a faster trajectory and were in a somewhat poorer state of health when compared to patients at the inpatient hospice ward. In the case of trajectories within three months, there is no time to lose, and it is important that caring delay are avoided.
|
|
| 10. |
|
|
