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Case managers erfarenheter av att vårda personer med schizofreni och livshotande sjukdom: Emellanåt en överväldigande roll att bära för sjuksköterskan
University West, Department of Health Sciences, Section for nursing - graduate level.
University West, Department of Health Sciences, Section for nursing - graduate level.
2020 (Swedish)Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesisAlternative title
Case managers' experiences of caring for people with schizophrenia and life- threatening illness : Occasionally an overwhelming role to carry for the nurse (English)
Abstract [sv]

Bakgrund: Personer med schizofreni har större risk att dö i samband med allvarliga somatiska sjukdomar. Trots detta erhåller personer med schizofreni bristande palliativ vård, bland annat på grund av bristande kunskap hos vårdpersonal. Därav rekommenderas ett bredare samarbete mellan psykiatri och palliativ vård och specifikt anses case manager kunna ha en viktig roll. Dock saknas studier om case managers erfarenheter att vårda dessa personer. Syfte: Syftet med studien var att beskriva case managers erfarenheter av att vårda personer med schizofreni och livshotande sjukdom. Metod: Kvalitativ intervjustudie, deltagarna bestod av sjuksköterskor med erfarenhet av personer med schizofreni och livshotande sjukdom i sin roll som case manager. Data analyserades enligt kvalitativ innehållsanalys. Resultat: Studiens resultat presenteras i tre kategorier och sju underkategorier. Resultatet visade ett skifte i case managerns roll och arbete med patienter med schizofreni och livshotande sjukdom. Case managernas uppgifter fokuserades på att få patienten att förstå sjukdomen och ta emot vård. Case managerna påverkades känslomässigt och de beskrev känslor av otillräcklighet, misslyckande och hjälplöshet medan patienterna närmade sig livets slut. Arbetet påverkades av kunskapsnivån kring livets slutskede och det underlättade att få stöd från sitt team och handledning. Slutsats: Case managers relation med patient har en viktig och avgörande roll för att patienten ska få en adekvat somatisk vård. En tydligare bild av case managers ansvar, omvårdnadskompetens, tillräcklig kunskap av somatisk och palliativ vård och samtal om livets slut hjälper case managern att klara av den överväldigande uppgiften.

Abstract [en]

Background: Patients with schizophrenia are in a greater risk of dying in connection with severe somatic diseases. Despite this, people with schizophrenia receive inadequate palliative care, partly because of lack of knowledge of the healthcare professionals. Hence a broader collaboration between psychiatry and palliative care is recommended and specifically the case manager is considered to be able to play an important role. However, studies on case managers' experiences of caring for these people are lacking. Aim: The purpose of the study was to describe the case managers' experiences of caring for people with schizophrenia and life-threatening illnesses. Method : Qualitative interview study, the participants consisted of nurses with experience of people with schizophrenia and life-threatening illnesses in their role as case manager. Data was analyzed according to qualitative content analysis. Results: The results are presented in three categories with seven sub-categories. The results showed a shift in the case manager's role and work with patients with schizophrenia and lifethreatening illnesses. The case managers' tasks were focused on getting the patient to understand the disease and receive care. The case managers were emotionally affected, and they described feelings of inadequacy, failure, and helplessness while the patients are approaching the end of their lives. The work was influenced by the level of knowledge around the end stage of life and it facilitated the support of their team and guidance. Conclusion: The case manager's relationship with the patient plays an important and decisive role for the patient to receive adequate somatic care. A clearer picture of case managers' responsibilities, nursing competence, adequate knowledge of somatic and palliative care and conversation about end of life helps the case manager to cope with the overwhelming task.

Place, publisher, year, edition, pages
2020. , p. 24
Keywords [en]
case manager, experiences, life- threatening illness, schizophrenia, nurses
Keywords [sv]
case manager, erfarenheter, livshotande sjukdomar, schizofreni, sjuksköterskor.
National Category
Nursing
Identifiers
URN: urn:nbn:se:hv:diva-15405Local ID: EXS801OAI: oai:DiVA.org:hv-15405DiVA, id: diva2:1453205
Subject / course
Nursing science
Educational program
Specialist nursing programme
Supervisors
Examiners
Available from: 2020-07-22 Created: 2020-07-09 Last updated: 2020-07-22Bibliographically approved

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