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Community nurses' experiences of ethical problems in end-of-life care in the patient's own home.
University West, Department of Nursing, Health and Culture, Division of Nursing. (LINA)ORCID iD: 0000-0003-1981-455X
Tallbackens Demenscentrum, Trollhättans stad.
Ansgar College and Theological Seminary, Kristiansand.
University West, Department of Nursing, Health and Culture, Division of Nursing. (LINA)ORCID iD: 0000-0003-0305-8649
Show others and affiliations
2013 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, 831-838 p.Article in journal (Refereed) Published
Abstract [en]

AIM: To gain a deeper understanding of community nurses' experiences of ethical problems in end-of-life care in the patient's own home. METHOD: Ten female nurses from five different communities with experience of end-of-life care were interviewed. A hermeneutic approach inspired by Gadamer was used to analyse the qualitative data from the interviews. FINDINGS: In the first step of interpretation, two themes emerged: Uncomfortable feelings and Lack of cooperation and in the second step, one theme Lack of security emerged. Finally, the overall interpretation revealed the theme Feelings of loss of control in end-of-life care in the patient's own home. CONCLUSION: The nurses exhibited commitment and a desire to do good when caring for patients in the end-of-life phase, even if they sometimes experienced feelings of lack of control. This implies that, when confronted with care-related issues, they have the power to both act and react. This study aimed to increase understanding of ethical problems that arise in end-of-life care in the patient's own home and revealed the need to take the patients', relatives' and nurses' perspectives on health and suffering into consideration to ensure good end-of-life home care.

Place, publisher, year, edition, pages
2013. Vol. 27, no 4, 831-838 p.
Keyword [en]
control, cooperation, end-of-life, ethical problem, Gadamer, hermeneutics, home car, security, nursing
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-4758DOI: 10.1111/j.1471-6712.2012.01087.xISI: 000328140200007PubMedID: 23067002Scopus ID: 2-s2.0-8488659516OAI: oai:DiVA.org:hv-4758DiVA: diva2:562749
Available from: 2012-10-25 Created: 2012-10-22 Last updated: 2016-06-23Bibliographically approved
In thesis
1. Vidrörd av livet i dödens närhet: Att varda som människa och vårdare i vårdandets gemenskap
Open this publication in new window or tab >>Vidrörd av livet i dödens närhet: Att varda som människa och vårdare i vårdandets gemenskap
2016 (Swedish)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[en]
Touched by life in the proximity of death. : Becoming as a human being and health care provider in the caring communion
Abstract [en]

The overall aim of the study is to create a theory model of "becoming" as a human being and health care provider in the caring communion at the end-of-life. The theoretical perspective of the study is caring science as it is developed at Åbo Academy University in Finland outlined in Eriksson's theory of caritative caring with focus on caring ethics. The thesis consists of four sub-studies reported as scientific articles and a summary section. The study has an overarching hermeneutic research approach. The sub-studies I-IV are reinterpreted from viewpoint of the overall question. Empirical assumptions could then be discerned from the substance of the four substudies, which raised questions. The answers to these questions were sought in dialogue with selected texts by Kierkegaard and resulted in a theory model. The theory model results in following theses: 1. To "become" as a human being is to remain in an endless guilt. Guilt is a form of love. It is guilt that give strength and willingness to act in love and mercy when caring for patients at the end-of-life. The guilt as love allows becoming as a human being to be at home in love and mercy. 2. The human being's courage is characterized as the willingness to obtain contact with the life of fellow human beings. This courage develops over time to stand for itself, with a foundation of belief in human beings, and resulting in a selfless, loving way to help the patients grieve and reconcile at the end-of-life. 3. To be "touched" can be illustrated as an inner awakening; an inner movement towards consciousness for the examination of the love for one another, and to love unselfishly. 4. The human being's evolution in its own understanding of life occurs in the care of another human being who is at the end-of-life, as well as to be at home in ethos, love and mercy. Becoming in this context means that the human being evolves to become responsive to the heart's inner voice; an inner strength and joy which opens to the eternal and holy. 5. To overcome external obstacles is characterized as serving human beings in a selfless love; a caring in love that has requirements that need to be expressed by what is true, beautiful and good for patients at the end-of-life. An awareness and understanding of what it means to become as a human being and health care provider in caring community can help health care providers to easily focus on the patient.

Place, publisher, year, edition, pages
Åbo: Åbo Akademi University Press, 2016. 110 p.
Keyword
Caring communion, caring science, caritative theory, end-of-life, health care provider, hermeneutics, becoming as human being, Caritativ teori, hermeneutik, livets slutskede, vårdandets gemenskap, vårdvetenskap, människans vardande
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-9453 (URN)978-952-12-3393-7 (ISBN)978-952-12-3394-4 (ISBN)
Supervisors
Available from: 2016-06-23 Created: 2016-06-23 Last updated: 2016-06-23Bibliographically approved

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