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“The unpredictable death”: The last year of life for patients with advanced COPD: Relatives’ stories
School of Health and Education, University of Skövde, Skövde, Sweden.
Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden; Department of Nursing, Gjøvik University College, Gjøvik, Norway.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0003-3702-3831
Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
2015 (English)In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 5, 1213-1222 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The end stage of chronic obstructive pulmonary disease (COPD) is described as prolonged, and the symptom burden for patients with COPD is often high. It progresses slowly over several years and can be punctuated by abrupt exacerbations that sometimes end in sudden death or a recovery of longer or shorter duration. This makes it difficult to identify the critical junctures in order to prognosticate the progress and time of death. Patients with COPD often express a fear that the dying process is going to be difficult. There is a fear that the dyspnea will worsen and lead to death by suffocation. The present article aimed to retrospectively describe the final year of life for patients with advanced COPD with a focus on death and dying from the perspective of relatives.

Method: Interviews were conducted with the relatives of deceased family members who had advanced COPD. In total, 13 interviews were conducted and analyzed by means of content analysis.

Result: All relatives described the patients as having had a peaceful death that did not correspond with the worry expressed earlier by both the patients and themselves. During the final week of life, two different patterns in the progress of the illness trajectory emerged: a temporary improvement where death was unexpected and a continued deterioration where death was inevitable.

Significance of Results: The patients and their relatives lived with uncertainty up until the time of death. Little support for psychosocial and existential needs was available. It is essential for the nurse to create relationships with patients and relatives that enable them to talk about dying and death on their own terms.

Place, publisher, year, edition, pages
Cambridge University Press, 2015. Vol. 13, no 5, 1213-1222 p.
Keyword [en]
Chronic obstructive pulmonary disease, End of life, Palliative care, Oxygen therapy; Dying and death
National Category
Nursing
Research subject
Caring sciences
Identifiers
URN: urn:nbn:se:oru:diva-37808DOI: 10.1017/S1478951514001151ISI: 000365663900007PubMedID: 25315360Scopus ID: 2-s2.0-84944159938OAI: oai:DiVA.org:oru-37808DiVA: diva2:756261
Available from: 2014-10-16 Created: 2014-10-16 Last updated: 2017-10-18Bibliographically approved

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Andershed, BirgittaSahlberg-Blom, EvaBritt-Marie, Ternestedt

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