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Brytpunktssamtal för äldre personer: en registerstudie i palliativ vård
University West, Department of Health Sciences, Section for nursing - graduate level.
University West, Department of Health Sciences, Section for nursing - graduate level.
2019 (Swedish)Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesisAlternative title
Breakpoint conversation for older people : a registry study in palliative care (English)
Abstract [sv]

Bakgrund: Behovet av palliativ vård kommer att öka i takt med att befolkning blir äldre och lever allt längre. Det kommer bli fler äldre personer med kroniska sjukdomar som har andra sjukdomsförlopp jämfört med cancer. Det är viktigt för kvaliteten av den palliativa vården att brytpunktssamtal erbjuds. Med kvalitet menas bland annat delaktighet, symtomlindring och stöd för närstående. Detta innebär en utmaning för hälso- och sjukvården som måste uppmärksamma när vården ändrar riktning mot vård i livets slutskede. Äldre personer erbjuds i mindre utsträckning brytpunktssamtal än yngre personer. Distriktssköterskan har en betydelsefull roll i den palliativa vården inom den kommunala hemsjukvården och ska främja äldre personers möjlighet att få information samt delta i beslut som rör den egna vården, vilket ett brytpunktssamtal innebär.

Syfte: Syftet med studien var att undersöka samband mellan brytpunktssamtal och andra faktorer, för äldre personer i palliativ vård, vid tillfällen då dödsfallet varit förväntat.

Metod: Detta är en kvantitativ retrospektiv registerstudie med data hämtad från svenska palliativregistret.

Resultat: Det fanns stora skillnader inom gruppen äldre huruvida brytpunktssamtal erbjöds eller inte. Ju äldre personen var desto mindre odds för att brytpunktssamtal erbjöds. Kön eller diagnos påverkade inte. När brytpunktssamtal erbjudits var närstående i högre utsträckning på plats när den äldre personen dog och när brytpunktssamtal inte erbjudits var personal i högre utsträckning de enda närvarande än då brytpunkssamtal erbjudits.

Slutsats: Den palliativa vården är ojämlik och äldre personer riskerar att utsättas för onödigt lidande. Distriktssköterskan i kommunal hemsjukvård bör sätta extra fokus på denna grupp för att uppmärksamma övergång till vård i livets slutskede.

Abstract [en]

Background: The need of palliative care will increase as the population ages and lives longer. There will be more old people with chronic diseases that will have other disease progression than those with cancer. To achieve a high quality in the palliative care it´s important that the physician gives the dying person information about the imminent death a so-called breakpoint conversation. A high-quality means among other things patient participation, symptom relief and support to relatives. This means a challenge for the healthcare workers who must pay attention to when care changes direction towards care in the end of life. Older people are to a lesser extent offered breakpoint conversation than younger people. The district nurse has an important role in the palliative care for older people in municipal health and medical care and are supposed to promote elderly people's opportunity to have information about their disease course that gives them ability to be involved with decisions about their own care planning, which means paying attention to when it´s time to offer a breakpoint conversation.

Aim: The purpose of this study was to examine relations and other factors associated with breakpoint conversation in palliative care for elderly people when death were imminent.

Method: The study is a quantitative retrospective registry study based on data from the Swedish register of palliative care.

Results: There are a significant difference within the group of old people when it comes to being offered a breakpoint conversation, with a negative trend where older people are less likely to get a breakpoint conversation. Gender and diagnosis had no impact. When a breakpoint conversation was offered, relatives were to a greater extent present when death occurred, and staff were more often the only ones present when a breakpoint conversation weren't offered.

Conclusion: The palliative care is unequal and older people risk being exposed to unnecessary suffering. The district nurse in municipal home care should put an extra focus on this group of elderly people were death is imminent.

Place, publisher, year, edition, pages
2019. , p. 26
Keywords [en]
Breakpoint conversation, district nurse, four cornerstones in palliative care, palliative care, elderly people
Keywords [sv]
Brytpunktssamtal, distriktssköterska, fyra hörnstenar i palliativ vård, palliativ vård, äldre personer
National Category
Nursing
Identifiers
URN: urn:nbn:se:hv:diva-14147Local ID: EXD800OAI: oai:DiVA.org:hv-14147DiVA, id: diva2:1338579
Subject / course
Nursing science
Educational program
Specialist nursing programme
Supervisors
Examiners
Available from: 2019-07-23 Created: 2019-07-23 Last updated: 2019-07-23Bibliographically approved

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