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A family's beliefs about cancer, dying, and death in the end of life
Örebro University, Department of Health Sciences.
Örebro University, Department of Health Sciences.
Örebro University, Department of Health Sciences.
2007 (English)In: Journal of Family Nursing, ISSN 1074-8407, E-ISSN 1552-549X, Vol. 13, no 2, p. 226-252Article in journal (Refereed) Published
Abstract [en]

The purpose of this case study was to describe the beliefs over time of a Swedish family and individual family members about cancer and death and how these beliefs affected their daily lives. Data were collected over 10 months using interviews, conversations, and diary notations. The beliefs were aggregated into eight main beliefs and four themes: Cancer is a deadly threat/death is a liberator, death can be held at bay/death can be lived near, dying is done alone/dying should not be done alone, and life has an end/life is endless. These beliefs appear to oscillate between seemingly contrasting poles. Some beliefs were shared by all family members, whereas others were described by only one or more members of the family. The complexity of daily life in families experiencing life-shortening illness underscores the need of individualized nursing care with openness to difference and collaboration as guiding principles.

Place, publisher, year, edition, pages
2007. Vol. 13, no 2, p. 226-252
Keywords [en]
Adult, Aged, Attitude to Death, Decision Making, Family/*psychology, Female, Gastrointestinal Neoplasms/*psychology, Humans, Interviews as Topic, Middle Aged, Sweden, Terminal Care
National Category
Medical and Health Sciences Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:oru:diva-4422DOI: 10.1177/1074840707300849PubMedID: 17452604OAI: oai:DiVA.org:oru-4422DiVA, id: diva2:138721
Available from: 2008-03-11 Created: 2008-03-11 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Bakom rutinerna: kunskap och omvårdnadspraxis i mänskliga gränssituationer
Open this publication in new window or tab >>Bakom rutinerna: kunskap och omvårdnadspraxis i mänskliga gränssituationer
2010 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to study how family members, next of kin, and healthcare professionals construct and use knowledge in nursing praxis in human boundarysituations.The study was carried out on a surgical ward at a university hospital in Sweden.Methodology: Study I: A case study; data concerning a family with six familymembers were collected over 10 months using interviews, conversations, and diary notations.Study II: A hermeneutic approach; interviews with 27 family carers were conductedsix to eight months after a family member’s death. Studies III, IV: a combinedethnographic and hermeneutic approach; participant observations (285 hours), informalconversations (190), and interviews (25) were conducted with 25 nurses and 18 assistant nurses.

The main findings were: (I) The family members used beliefs to explain and understandcancer, dying and death. The beliefs were aggregated into eight main beliefs and fourthemes: cancer is a deadly threat/death is a liberator; death can be held at bay/death canbe lived near; dying is done alone/dying should not be done alone; and life has anend/life is endless. These beliefs appear to oscillate between seemingly contrastingpoles. (II) The family carers made their own assessment of their loved one’s conditionand situation. Their actions were characterized by struggling to get treatment, being leftbehind, being partners, keeping the illness at a distance, hovering beside their loved one,waiting for death, and being experts and protectors. The family carers used practicalwisdom, phronesis, regarding what care was the best, or least harmful, for their lovedone in the encounter with professional care. (III) The nurses constructed knowledgethrough greeting the patient, and reading the patient. By being sensitive, using humor,and emotional involvement, understanding was deepened. By being suspicious and selfcritical,interaction was sought with nurse colleagues, the patient, relatives, and the doctor,and additional knowledge was obtained. They strived to be one step ahead in theirefforts to attain an understanding of the patient´s situation. The knowledge nurses makeuse of can be related to the intertwined and embodied forms of theoretical knowledge,i.e., episteme, practical professional knowledge, i.e., techne, and practical wisdom i.e.,phronesis. (IV) The nurses created and used emotional knowing that could be interpretedin relation to various rooms of emotions, thoughts and actions. They strived to dothings correctly in the normative room; created a safe, secure milieu for patients andnext of kin in the safety-security room; and questioned their actions in the critical room.They created an affinity for co-operation that was of benefit in encounters with patientsin the nurses’ affinity room. And they demonstrated compassion for patients and next ofkin; this compassion was particularly evident in the closeness room.Conclusion: In praxis, construction and use of knowledge occurs that often takes placebehind the routines. This knowledge constitutes an important content in nursing. Thehermeneutic spiral can serve a pedagogic purpose in elucidating nursing and its differentforms of knowledge.

Place, publisher, year, edition, pages
Örebro: Örebro universitet, 2010. p. 104
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 27
National Category
Nursing
Research subject
Nursing Science
Identifiers
urn:nbn:se:oru:diva-9542 (URN)978-91-7668-711-6 (ISBN)
Public defence
2010-01-22, Hörsal P2, Örebro universitet, Örebro, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2010-02-02 Created: 2010-02-02 Last updated: 2017-10-18Bibliographically approved

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James, IngerAndershed, BirgittaTernestedt, Britt-Marie

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