| 1. |
- Cronfalk, Berit, et al.
(författare)
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Inner power, physical strength and existential well-being in daily life: relatives' experiences of receiving soft tissue massage in palliative home care
- 2009
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 18:15, s. 2225-2233
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Tidskriftsartikel (refereegranskat)abstract
- Aim and objectives. This article explores relatives' experiences of receiving soft tissue massage as a support supplement while caring for a dying family member at home. Background. In palliative home care, relatives play an important role as carers to seriously ill and dying family members. To improve their quality of life, different support strategies are of importance. Complementary methods, such as soft tissue massage have become an appreciated supplement for these patients. However, only few studies focus on relatives experiences of receiving soft tissue massage as a supplemental support. Design. Qualitative design Method. Nineteen relatives received soft tissue massage (hand or foot) nine times (25 minutes) in their homes. Open-ended semi-structured tape-recorded interviews were conducted once per relative after the nine times of massage, using qualitative content analysis. Results. Soft tissue massage gave the relatives' feelings of 'being cared for', 'body vitality' and 'peace of mind'. For a while, they put worries of daily life aside as they just experienced 'being'. During massage, it became apparent that body and mind is constituted of an indestructible completeness. The overarching theme was 'inner power, physical strength and existential well-being in their daily lives'. Conclusion. All relatives experienced soft tissue massage positively, although they were under considerable stress. Soft tissue massage could be an option to comfort and support relatives in palliative home care. Relevance to clinical practice. In palliative nursing care, soft tissue massage could present a worthy supplement in supporting caring relatives.
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| 2. |
- Cronfalk, Berit, et al.
(författare)
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The existential experiences of receiving soft tissue massage in palliative home care-an intervention
- 2009
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 17:9, s. 1203-1211
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Tidskriftsartikel (refereegranskat)abstract
- Background Soft tissue massage is currently used in palliative care for the relief of anxiety and pain. Only few studies have focused on patients' deeper experience of receiving the massage. Aim The purpose of this study was to explore how patients with cancer in palliative home care experienced soft tissue massage. Materials and methods Twenty-two patients received soft tissue massage (hand or foot) nine times over a period of 2 weeks. Each session lasted for 25 min. Following the last massage session, a qualitative interview was conducted. The analysis was performed using a hermeneutic approach. Findings Soft tissue massage generated feelings of existential respite with perceptions of being released from illness for a while. Two categories constituted the basis of the experiences: (1) "an experience of thoughtful attention" and (2) "a sensation of complete tranquility" resulting in the overarching theme "A time of existential respite." Conclusion The patients experienced the massage to give meaning and to be important as it generated feelings of an inner respite. Relevance to clinical practice Soft tissue massage appears to be an appreciated source of support to dying patients in palliative home care. The method is easy to comprehend and relatively short (25 min) which may imply that it is a suitable complement in nursing care for this patient group.
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| 3. |
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| 4. |
- Fröjd, Camilla, 1967-
(författare)
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Cancer Patients’ Satisfaction with Doctors’ Care : Consequences and Contributing Conditions
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The main aims were to: explore whether there is a relation between doctors’ ability to identify patients’ worry and wish for information and self-efficacy with regard to communicating with patients about difficult matters; describe which cues doctors consider when estimating patients’ worry and wish for information, and investigate whether there is a relation between patients’ satisfaction with doctors’ care and patients’ psychosocial function. Eleven doctors and 69 patients (of which 36 patients participated in the longitudinal study) with carcinoid tumours participated. Doctors’ self-efficacy, and ability to identify patients’ worry/wish for information were investigated at patients’ first admission. Doctors were interviewed about which cues they considered when estimating patients worry/wish for information. Patients’ satisfaction with care (CASC SF 4.0) and psychosocial function (EORTC QLQ-C30, HADS) were measured longitudinally, during the first year after diagnosis. Doctors reported higher self-efficacy when showing good ability to identify patients’ wish for information, than when showing less good ability, overestimated patients’ worry and underestimated patients’ wish for information. Doctors considered patients’ verbal behaviour and body language together with knowledge and experience when estimating patients worry and wish for information. Patients who met doctors showing good ability to identify their wish for information, reported a higher cognitive function than patients who met doctors showing less good ability. At all assessments patients expressed high satisfaction with doctor’ care and patients’ satisfaction did not change over time. Patients’ satisfaction with doctors’ care were related to their psychosocial function shortly after the first three admissions to specialist care. Patients with carcinoid tumours in some respects reported a worse HRQoL than the general Swedish population. Fatigue, diarrhoea, limited possibilities to work/pursue daily activities, and worry that the illness will get worse were among the most prevalent, and worst, aspects of disease- and treatment related distress.
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| 5. |
- Karlsson, Marit, et al.
(författare)
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Attitudes toward euthanasia among Swedish medical students
- 2007
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Ingår i: Palliative Medicine. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 21:7, s. 615-22
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Tidskriftsartikel (refereegranskat)abstract
- Attitudes toward euthanasia differ between individuals and populations, and in many studies the medical profession is more reluctant than the general public. Our goal was to explore medical students' attitude toward euthanasia. A questionnaire containing open-ended questions was answered anonymously by 165 first- and fifth-year medical students. Data were analysed using qualitative content analysis with no predetermined categories. The students' arguments opposing euthanasia were based on opinions of 1. euthanasia being morally wrong, 2. fear of possible negative effects on society, 3. euthanasia causing strain on physicians and 4. doubts about the true meaning of requests of euthanasia from patients. Arguments supporting euthanasia were based on 1. patients' autonomy and 2. the relief of suffering, which could be caused by severe illnesses, reduced integrity, hopelessness, social factors and old age. There are several contradictions in the students' arguments and the results indicate a possible need for education focusing on the possibility of symptom control in palliative care and patients' perceived quality of life. Palliative Medicine 2007; 21 : 615—622
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| 6. |
- Karlsson, Marit, et al.
(författare)
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Dying with dignity according to Swedish medical students
- 2006
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 14:4, s. 334-339
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Tidskriftsartikel (refereegranskat)abstract
- Goal of work: To die with dignity is an important but ambiguous concept, and it is used in contradictory contexts, both for the promotion of palliative care and as an argument for euthanasia. Our goal was to explore medical students' definition of a dignified death. Patients and methods: A questionnaire containing open-ended questions was answered anonymously by 165 first-and fifth-year medical students. The data were analysed using qualitative content analysis with no predetermined categories. Main results: The students' descriptions of a dignified death resulted in five categories of death: (1) without suffering, (2) with limited medical interventions, (3) with a sense of security, which implied a safe environment nursed by professional staff, (4) with autonomy, respect for the individual and empowerment to the patient and (5) with acceptance. These findings show similarity to the established concepts of a good death, as well as the view of a dignified death by terminally ill patients. Conclusions: The data suggest that the students perceive that the medical system is over-treating patients and sometimes causing harm to dying patients. The results reveal a potential misunderstanding and contradiction relating to death without suffering and the use of necessary palliative interventions. These findings are important when planning education as regards palliative care and dignified death. © Springer-Verlag 2005.
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| 7. |
- Lundstrom, Staffan, et al.
(författare)
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The existential impact of starting corticosteroid treatment as symptom control in advanced metastatic cancer
- 2009
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Ingår i: Palliative Medicine. - : SAGE Publications. - 0269-2163 .- 1477-030X. ; 23:2, s. 165-170
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Tidskriftsartikel (refereegranskat)abstract
- Treatment with corticosteroids often results in increased appetite, reduced nausea and improved well-being in patients with advanced metastatic cancer. Therefore, we have studied the existential impact of starting corticosteroid treatment as symptom control in this patient group using qualitative content analysis with both a descriptive and an interpretative focus. Ten patients were interviewed before and after 1 week of treatment with 4 mg betamethasone. Prior to treatment, patients reported distressing symptoms, deterioration and diminished autonomy, symbolising threat and death. Corticosteroid treatment produced symptom relief in the majority of the patients. They reported enhanced physical abilities and experienced feelings of a more normalized life and strengthened autonomy, symbolising health and hope. This transfer from threat to hope has important existential consequences in end-of-life care and should be addressed when communicating goals of treatment and care with the patient and family.
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| 8. |
- Milberg, Anna, 1966-, et al.
(författare)
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What to do when 'there is nothing more to do'? A study within a salutogenic framework of family members' experience of palliative home care staff
- 2007
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Ingår i: Psycho-Oncology. - : Wiley. - 1057-9249 .- 1099-1611. ; 16:8, s. 741-51
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to develop a theoretical framework of family members' experience of palliative home care staff based on a secondary analysis of four previous studies. A salutogenic framework was used, i.e. with the origin of health in focus. Data had been collected (semi-structured tape-recorded interviews and postal questionnaires with open-ended questions) from 469 family members of mainly cancer patients referred to advanced palliative home care. Walker and Avant's strategies for theory construction were used. The secondary analysis generated three theoretical blocks: (1) general components of staff input (including five generalized resistance resources (GRRs): competence, support, spectrum of services, continuity, and accessibility); (2) specific interactions with staff (including two GRRs: being in the centre and sharing caring); (3) emotional and existential consequences of staff support (including six health-disease continuums: security-insecurity, hope-hopelessness, congruent inner reality-chaos, togetherness-isolation, self-transcendence-feelings of insufficiency and retained everyday life-disrupted everyday life). It seems important that all three aspects of family members' experience of palliative care staff are to be considered in evaluations of palliative care, in goal-setting and in teaching role models. The study is specific to the Swedish model of palliative home care and replication of the work in other countries is recommended.
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| 9. |
- 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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| 10. |
- Rydé, Kerstin, et al.
(författare)
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Crying in solitude or with someone for support and consolation - experiences from family members in palliative home care
- 2008
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Ingår i: Cancer Nursing. - 0162-220X .- 1538-9804. ; 31:5, s. 345-353
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Tidskriftsartikel (refereegranskat)abstract
- Crying has not been studied from the perspective of family members of patients in palliative care. The aim of this study was to explore the significance of family members crying in a palliative care context with special reference to factors that influence crying. Interviews were carried out with 14 family members of patients admitted to palliative care. A hermeneutic approach according to Gadamer was used. Three main categories emerged. (1) Before the start of crying, some prerequisites for crying had to be fulfilled, such as an allowing attitude and courage, time, feeling secure, honesty, and trusting relationships. These prerequisites did not cause crying themselves; rather crying emerged when triggering factors occurred. (2) Triggers for crying were circumstances that created uncertainty and turbulence (bad news), exhaustion due to lack of own time, and sympathy from others. (3) Family members tried to do the best possible by adopting or hiding their crying, to ease the patient's burden and to create a positive counterbalance to suffering and grief. As an interpretation of the whole, crying could be expressed as being shared with someone for support and consolation or escape to solitude for integrity and respite. As a conclusion, crying may be an efficient strategy for family members in palliative care to express their suffering and to gain new energy to continue.
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