| 1. |
- Wallerstedt, Birgitta, et al.
(författare)
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Caring for dying patients outside special palliative care settings : experiences from a nursing perspective
- 2007
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 21:1, s. 32-40
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to describe nurses' experiences in caring for gravely ill and dying patients outside special palliative care settings. Tape-recorded qualitative interviews were conducted with a total of nine nurses in primary home care, community care and hospitals. The interviews were analysed according to phenomenological methodology, which resulted in the three common structures: ambition and dedication, everyday encounters, and satisfaction/dissatisfaction. In the `everyday encounters' structure, the following key constituents emerged: responsibility, cooperation, experience and knowledge, feelings, and time and resources. The results describe the nurses' high ambitions to give dying patients and their relatives high-quality care. Despite this, they experienced greater or lesser degrees of dissatisfaction because of insufficient cooperation, support, time and resources. They experienced satisfaction through contact with patients and relatives, functioning collegial cooperation, and the knowledge, experience and personal growth the care had given them. The results indicate that nurses need the resources such as time, improved methods of communication and cooperation as well as more support in order to give quality palliative care and achieve satisfaction with the outcome. The need for discussion about the conditions for giving palliative care outside the hospices and other special palliative care settings is also elucidated.
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| 2. |
- Andershed, Birgitta, et al.
(författare)
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Next of kin's feelings of guilt and shame in end-of-life care
- 2007
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Ingår i: Contemporary nurse : a journal for the Australian nursing profession. - : Informa UK Limited. - 1037-6178 .- 1839-3535. ; 27:1, s. 61-72
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Tidskriftsartikel (refereegranskat)abstract
- In this study the aim was to explore and describe next of kin's feelings of guilt and shame in end-of-life care via secondary analysis of 47 qualitative interviews. In the analysis categories and subcategories emerged which conveyed how the next of kin experienced guilt; not having done or talked enough, being absent at important events or making errors of judgement. Categories conveying feelings of shame were situations where the next of kin felt inferior, was ashamed on behalf of the dying person and when family conflicts became apparent. Receiving help and support in order to make the remaining period as pleasant as possible can facilitate the next of kin's sense of having fulfilled their duties and responsibilities and therein reduce feelings of guilt and shame. It is apparent that these feelings should be taken into account and the next of kin should receive support to increase their well-being during the remaining time in end-of-life care and the grieving period.
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| 3. |
- Andershed, Birgitta
(författare)
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Relatives in end-of-life care--part 1 : a systematic review of the literature the five last years, January 1999-February 2004
- 2006
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 15:9, s. 1158-1169
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Forskningsöversikt (refereegranskat)abstract
- AIM:To review systematically research conducted during the past five years focusing on the relatives' situation and needs in end-of-life care.BACKGROUND AND AIM:That relatives make a large contribution in the care of the dying is well-known. In this situation, relatives often have to solve many new practical problems in the care as well as dealing with the sorrow of both themselves and the dying person. In recent years, palliative care has been developed in many countries and many new studies have been carried out.METHODS:A systematic search of the literature was performed in the CINAHL and Medline databases. Of the 94 papers analysed, there were 59 qualitative and 35 quantitative studies with differing designs. The studies were carried out in 11 countries and were published in 34 different journals.RESULTS:The results were categorized in two main themes with several subthemes: (1) being a close relative--the situation: (i) exposed position--new responsibility, (ii) balance between burden and capacity and (iii) positive values; (2) being a close relative--needs: (i) good patient care, (ii) being present, (iii) knowing and communicating and (iv) support from and trusting relationship with the professional. The relative's feelings of security and trust in the professional were found to be of great importance.CONCLUSION:More than twice as many studies had a descriptive/explorative design, which is of importance in the assessment of evidence. However, different studies complement one another and in summary, it can be said that analytic evidence is unequivocal: good patient care, communication, information and the attitude of the professional are of decisive importance regarding relatives' situation. These results are also in accord with earlier review studies.RELEVANCE TO CLINICAL PRACTICE:Staff members have a great deal of responsibility for assuring that the patient feels as good as possible, facilitating relatives' involvement based on the family's wishes and limiting the stress and difficulties experienced by the family. The results showed that the relative's satisfaction could depend on the attitude of the professional as well as on good communication, good listening and good information. This can also be viewed as a prerequisite for the professional to get to know the family and to provide 'care in the light'.
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| 4. |
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| 5. |
- Andershed, Birgitta, et al.
(författare)
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Review of research related to Kristen Swanson's middle-range theory of caring
- 2009
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 23:3, s. 598-610
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Forskningsöversikt (refereegranskat)abstract
- The aim of this study was to identify and describe how Kristen Swanson's middle-range theory has been used in nursing practice/research presented in international journals. A total of 120 studies were included in the review and 23 were analysed further. An overview of the studies is presented, followed by four categories of how the theory has been used: referring to the theory (97 papers), applications of the theory to practice/research and/or theoretical discussions (nine papers), relating findings to and/or validation of the theory (eight papers), and development of measurements from and/or testing of the theory (six papers). The use of the theory and conclusions of the studies related to criteria for evaluation of theories were discussed.
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| 6. |
- Bergdahl, Elisabeth, 1962-, et al.
(författare)
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Esthetic abilities : a way to describe abilities of expert nurses in palliative home care
- 2007
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Ingår i: Journal of Clinical Nursing. - : Blackwell Science Ltd.. - 0962-1067 .- 1365-2702. ; 16:4, s. 752-760
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this paper is to focus on the abilities needed to create the caring relation in palliative home care and to find ways to describe these abilities and skills from an esthetic perspective.BACKGROUND: Nurses in Palliative home care have to create a functioning relationship between themselves the patient and the patient's next of kin, this puts special demands on the nurse. A number of abilities, such as creativity, intuition, empathy and self-knowledge are mentioned in literature related to the caring relation. Many nursing theorists have referred to the art and esthetic of nursing when trying to describe these abilities.METHODS: Data were collected using semi-structured interviews with eight expert nurses in palliative home care. The transcribed interviews were analysed using qualitative content analyses.FINDINGS: Three main categories where found: The will to do good, Knowledge and Perceptiveness. Subcategories that can be seen as abilities where found in the main categories knowledge and perceptiveness.CONCLUSIONS: The main categories can be seen as expressions for abilities, personal qualities and skills needed to create the caring relation in palliative home care. We found interesting connections between the three main categories and the concepts of esthetics, ethics and science. We also found that nurses develop in a way, i.e. similar to an artist.RELEVANCE TO CLINICAL PRACTICE: The concepts brought forward in this paper could be used in clinical supervision and education as well as in clinical practice. If nurses think about the three aspects: Knowledge, the will to do good and perceptiveness, the chance for a positive relation between the nurse and the patient, and the patient's next of kin might increase. One could speculate that perceptiveness is a vital ability in order to achieve the expert level of nursing and that this perspective should be taken in consideration when recruiting nurses and in curriculum development.
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| 7. |
- Dwyer, Lise-Lotte, et al.
(författare)
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Dignity as experienced by nursing home staff
- 2009
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Ingår i: International Journal of Older People Nursing. - : John Wiley & Sons. - 1748-3735 .- 1748-3743. ; 4:3, s. 185-193
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. To explore nursing home staff members’ experiences of what dignity in end of life care means to older people and to themselves.Background. Dignity is a concept often used in end-of-life care, but its meaning is rarely clarified.Design. Qualitative descriptive study.Methods. Content analysis. This study is based on interviews with 21 staff members in four different nursing homes in Sweden.Findings. The results show that staff members balanced between providing for the older person’s physical needs while wishing to be able to deliver a ‘deeper’ level of care. The older people’s dignity is presented in the main theme: Feeling trust – Showing respect. The staff members’ dignity is presented in the main theme: Maintaining self-respect – Being shown respect. Threats to dignity are presented in the main theme: conflicts between the ideal and the reality.Conclusions. The results reveal that nursing home staff members deal with a moral conflict between what they are able to deliver and what they would like to provide in the care of older people.Relevance to clinical practice. To promote older people’s dignity, there is a need to take account of staff members’ work situation. Supervision and continuous education could be one way of achieving this.
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| 8. |
- Elmberger, Eva, et al.
(författare)
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Being a mother with cancer : achieving a sense of balance in the transition process
- 2008
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Ingår i: Cancer Nursing. - : Lippincott Williams & Wilkins. - 0162-220X .- 1538-9804. ; 31:1, s. 58-66
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Tidskriftsartikel (refereegranskat)abstract
- For women with cancer and with children living at home, the demands of being a good mother while undergoing treatments and recovering from illness have been described as a difficult life process. The aim of this study was to further examine the transition process with focus on women's experience of their responsibility toward their children. Interviews from 2 previous studies investigating the transition process of women with cancer were gathered and were subjected to a qualitative secondary analysis, an analytic expansion of the transition process. The 3 phases in the transition process were used in an interpretive description: ending an earlier life situation, in-between, and new beginning. A main theme that integrated these phases was constructed: "the desire to manage ones responsibility as a parent," within the context of mothering. The women expressed moral concern about not being able to function as "good" mothers yet attempted to find a balance between experiences of exhaustion and other experiences that made it difficult to maintain their responsibility as parents. All of the women included in this study expressed the need for professional support to help them endure treatment procedures as well as to sustain their moral responsibility as good mothers.
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| 9. |
- Eriksson, Monika, et al.
(författare)
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Care dependence : a struggle toward moments of respite
- 2008
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Ingår i: Clinical Nursing Research. - : SAGE Publications. - 1054-7738 .- 1552-3799. ; 17:3, s. 220-236
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to describe people's experiences of being dependent on others for care in their final stage of life, as well as what they felt made their experience of being dependent easier or more difficult. The phenomenological-hermeneutical method was chosen, where data collection consisted of open-ended interviews with nine people undergoing palliative care at a hospice unit or at home. The meaning of being care dependent is described via the following themes: changed relationship with oneself and with others, striving to adapt oneself to the situation, obstacles, and opportunities along the way while dependent. The result is described as an effort, a journey from independence to moments where it was possible to rest and recuperate while struggling with care dependency. Nursing staff require knowledge and understanding of experiences with care dependency to make life easier for people during increasing dependency in the final stage of life.
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| 10. |
- Ewertzon, Mats, 1956-, et al.
(författare)
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Developing the concept of family involvement and the alienation questionnaire in the context of psychiatric care
- 2008
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Ingår i: International Journal of Mental Health Nursing. - London : Wiley- Blackwell. - 1445-8330 .- 1447-0349. ; 17:6, s. 439-449
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Tidskriftsartikel (refereegranskat)abstract
- Research shows that family members of persons with a mental illness often experience a lack of involvement in the psychiatric care of their relative. An interpretation of the findings of these studies raises the question whether the family members’ experience of not being involved can be conceptualised in terms of alienation towards mental health services from their encounter with psychiatric care. In order to explore this possibility, the Family Involvement and Alienation Questionnaire (FIAQ) was constructed, guided by relevant theoretical frameworks and empirical research. The content validity of the questionnaire was evaluated by two groups of experienced researchers who had sound knowledge of the theoretical frameworks used. Validity based on the response process was evaluated by parents of persons with mental illness. The reliability of the questionnaire was evaluated by a test-retest design, in a group of 15 family members. The data were analysed by a non-parametric statistical method. The results of the validity and reliability evaluations show that of the 46 original items 28 items in the questionnaire would be useful in exploring the concept of family involvement and alienation in the context of psychiatric care. Further, minor modification may make the FIAQ useful in exploring these concepts in other settings.
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