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Caring for dying patients outside special palliative care settings: experiences from a nursing perspective
Örebro University, Department of Health Sciences.
Örebro University, Department of Health Sciences.
2007 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 1, p. 32-40Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2007. Vol. 21, no 1, p. 32-40
Keywords [en]
Nursing Care, Palliative Care, Sweden, Terminal Care
National Category
Medical and Health Sciences Nursing
Research subject
Nursing Science
Identifiers
URN: urn:nbn:se:oru:diva-4423DOI: 10.1111/j.1471-6712.2007.00430.xPubMedID: 17428212OAI: oai:DiVA.org:oru-4423DiVA, id: diva2:138722
Available from: 2008-03-11 Created: 2008-03-11 Last updated: 2017-12-14Bibliographically 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, BirgittaAndershed, Birgitta

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