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Reflecting on one's own death: the existential questions that nurses face in end-of-life care
University West, Department of Health Sciences, Section for nursing - undergraduate level. Department of Caring Science, Åbo Academy University.ORCID iD: 0000-0003-1981-455X
Åbo Academy University, Department of Caring Science and Faculty of Professional Studies, Nord Universitet, Bodø.
Åbo Academy University, Department of Caring Science.
2017 (English)In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 15, no 2, p. 158-167Article in journal (Refereed) Published
Abstract [en]

When registered nurses care for patients at the end of life, they are often confronted with different issues related to suffering, dying, and death whether working in hospital or community care. Serious existential questions that challenge nurses' identities as human beings can arise as a result of these situations. The aim of our study was to describe and gain a deeper understanding of nurses' existential questions when caring for dying patients. Focus-group interviews with registered nurses who shared similar experiences and backgrounds about experiences in end-of-life care were employed to gain a deeper understanding about this sensitive subject. Focus-group interviews were performed in hospice care, in community care, and in a palliative care unit in western Sweden. A qualitative hermeneutic approach was employed to interpret the data. Nurses' existential questions balanced between responsibility and guilt in relation to their patients, between fear and courage in relation to being professional caregivers and fellow human beings, and between hope and despair in relation to the other's and their own death. Nurses in end-of-life care experience various emotions from patients related to things physical, spatial, and temporal. When nurses encounter these emotions as expressing a patient's suffering, they lead to challenges of balancing between different feelings in relation to patients, as both professional caregivers and fellow human beings. Nurses can experience growth both professionally and as human beings when caring for patients at the end of life.

Place, publisher, year, edition, pages
2017. Vol. 15, no 2, p. 158-167
Keywords [en]
Existential questions, end-of-life care
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-9452DOI: 10.1017/S1478951516000468ISI: 000399394800003OAI: oai:DiVA.org:hv-9452DiVA, id: diva2:942143
Note

Ingår i avhandling

Available from: 2016-06-23 Created: 2016-06-23 Last updated: 2019-05-23Bibliographically 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. p. 110
Keywords
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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