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Identification and documentation of persons being in palliative phase regardless of age, diagnosis and place of care, and their use of sitting service at the end of life
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0003-3702-3831
School of Human Sciences, Linnaeus University, Kalmar, Sweden; Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden.
Department of Nursing, Gjövik University College, Gjövik, Norge; School of Human Sciences, Linnaeus University, Kalmar, Sweden; Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden.
2012 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 3, p. 561-568Article in journal (Refereed) Published
Abstract [en]

Background: Older persons and persons with diseases other than cancer are often discriminated against when applying for palliative care despite growing numbers of both older persons and individuals with chronic diseases. An intention for palliative care in Sweden is that all persons in the final stage of life, irrespective of age, domicile, diagnosis, and care place shall have access to palliative care on equal terms. One way to support these persons in final stage of life and their relatives is to offer sitting service.

Aims: To describe individuals who were identified and documented as being in a palliative phase in a Swedish municipality, with respect to demographics, use of a sitting service, continuity of care in the last month of life and the place of death. A second aim was to describe and compare the groups who received/did not receive sitting services related to the aforementioned variables.

Method: Retrospective data from nursing records and palliative care identification forms were analyzed with descriptive and analytic statistical methods.

Findings: Among individuals deceased during 2007, 51% were identified and documented as being in palliative phase. The majority was older people (mean 83 years) with a noncancer diagnosis (58%). Twenty-eight individuals (16%) had received a sitting service between 8 and 249 hours (one extreme value = 2211). It is indicated that sitting service significantly increased the possibility of dying at home (p = 0.00004), but did not affect how often the place of care changed during the last month of life.

Limitation: A small sample from a Swedish context must be considered.

Conclusion: These results can be related to an awareness in the municipality that led to adopting the concept of palliative care as not only for those with a cancer diagnosis.

Place, publisher, year, edition, pages
Hoboken, USA: Wiley-Blackwell, 2012. Vol. 26, no 3, p. 561-568
Keywords [en]
Palliative care, sitting service, death place, care continuity, old people, noncancer diagnosis
National Category
Medical and Health Sciences Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:oru:diva-21766DOI: 10.1111/j.1471-6712.2011.00966.xISI: 000307103600018PubMedID: 22276925Scopus ID: 2-s2.0-84864778705OAI: oai:DiVA.org:oru-21766DiVA, id: diva2:505147
Available from: 2012-02-24 Created: 2012-02-23 Last updated: 2018-05-08Bibliographically approved
In thesis
1. Utmaningar, utsatthet och stöd i palliativ vård utanför specialistenheter
Open this publication in new window or tab >>Utmaningar, utsatthet och stöd i palliativ vård utanför specialistenheter
2012 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to study palliative end-of-life care outside specialist palliative care settings, from an organizational perspective and from professionals’ and relatives’ experiences. In Study I 174 individuals were identified retrospectively from nursing records and palliative care identification forms as being in a palliative phase. Data were analyzed with descriptive and analytic statistical methods. In Study II a total of nine nurses working in primary home care, community care, and hospitals were interviewed. Phenomenological methodology was used to analyze data. In Study III 17 enrolled nurses, who worked in community or primary care and in a sitting service organization, participated in four focus group interviews. Data were analyzed with qualitative content analysis. In Study IV seven relatives from four families were interviewed twice. They had each cared in the private home for a dying family member who had received sitting service. Direct interpretation and categorical aggregation were used to analyze data. The results highlight challenges in palliative care, vulnerable situations, and a need of support (I–IV). Individuals’ needs for both palliative care and sitting service were identified, including those of a smaller part of the population who actually received the sitting service. (I). Registered nurses’ responsibilities included care at the same time for individuals in both palliative and curative phases. This created vulnerable situations for the nurses, since their ambitions concerning the care did not correspond to available resources (II). The enrolled nurses’ task was to manage ongoing life and dying in different care settings, to meet individual needs and still provide equivalent care. Despite experiences of vulnerable situations, they felt safe (III). Relatives experienced care situations differently, related to differences in families, the illness trajectory, the need for support, and the support offered. Without sufficient support, vulnerable situations occurred, which made the relatives feel insecure (IV). Thus, care situations in palliative end-of-life care can be experienced in different ways, with different levels of vulnerability. One implication of the research might be to suggest that professional caregivers, to supplement the relatives’ own resources with support tailored to the individual’s and the family’s needs

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2012. p. 88
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 34
Keywords
vulnerability, support, challenges, palliative care, relatives, registered nurses, enrolled nurses, end-of-life care
National Category
Medical and Health Sciences Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-21411 (URN)978-91-7668-860-1 (ISBN)
Public defence
2012-03-16, Örebro universitet, Hörsal P2, Prismahuset, Fakultetsgatan 1, Örebro, 13:00
Opponent
Supervisors
Available from: 2012-01-30 Created: 2012-01-30 Last updated: 2017-10-17Bibliographically approved

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Wallerstedt, BirgittaSahlberg-Blom, Eva

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