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Att samtala med närstående inom specialiserad palliativ hemsjukvård: sjuksköterskans erfarenheter
Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
2018 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesisAlternative title
Conversations with family caregivers in specialized palliative home care : nurse´s experiences (English)
Abstract [sv]

BakgrundPalliativ vård ska tillgodose behoven hos patienter med livshotande (icke botbara) sjukdomar på alla vårdnivåer i Sverige. Studier har visat att närstående till patienter i specialiserad palliativ hemsjukvård inte alltid har bemötts korrekt eller tagits på allvar vilket har resulterat i att de har slitit hårt ofta i skymundan. Att inte få rätt stöd har visat sig kunna leda till både fysiska, psykiska och psykosociala påfrestningar. Det har till exempel rapporterats om nedstämdhet, koncentrationssvårigheter och fatigue. Centralt i arbetet som sjuksköterska i specialiserad palliativ hemsjukvård är stöd till närstående då de ofta är en förutsättning för att patienten ska kunna vistas den sista tiden i livet i hemmet. Stödet bestod till stor del av samtal. Genom att bekräfta och ta närståendes oro och funderingar på allvar ökade deras välbefinnande.

Syfte: Att beskriva sjuksköterskornas erfarenheter av att stödja närstående genom samtal inom specialiserad palliativ hemsjukvård.

Metod: Designen var en empirisk studie med induktiv beskrivande ansats. Datainsamling skedde genom kvalitativa forskningsintervjuer.

Resultat: Efter analysen framträdde svaret på de två frågeställningarna: Hur gjorde sjuksköteskorna för att etablera en god kontakt med närstående? Hur kunde sjuksköterskorna stötta närstående?   Det framkom fyra subkategorier till varje fråga. Resultatet visade att samtalet i specialiserad palliativ hemsjukvård var en stor del av det befintliga arbetet men att det inte alltid skedde under strukturerade och medvetna former. Erfarenheter av strukturerade närståendesamtal var uteslutande positiva.

Diskussion: Resultatet diskuterades mot valda delar av Watson´s tio karitativa faktorer. Känslighet gentemot självet och andra, Mänsklig omsorgsrelation, Att ge uttryck för positiva och negativa känslor, Kreativ, problemlösande omsorgsprocess.

Abstract [en]

Background: Palliative care is intended to cater for the needs of patients with life threatening, non-curable, diseases at all levels of medical care in Sweden. Studies have shown that family and loved ones of patients receiving specialized palliative care in the home have not always been taken seriously or otherwise considered appropriately. This has led to them struggling under the pressure, often without acknowledgment. Not receiving the appropriate support has been shown to be a factor causing physical, psychological as well as psychosocial distresses. For example, depression, difficulties to concentrate and fatigue have been reported. Central to the work as a nurse in specialized palliative home care is to provide support to family and loved ones as it is often a necessity enabling the patient to be at home towards the end of life. The support in this case consisted largely of dialogue. By acknowledging and considering the thoughts and worries of the family, their wellbeing was increased.

Aim: Describing the experiences of nurses supporting family and loved ones through dialogue within specialized palliative home care.

Method: The study was by design inductive and data were collected via qualitative research interviews.

Results: Following the analysis, the answer to the two questions emerged: How did nurses do to establish a good relationship with family and loved ones? How could nurses support family and loved ones? There were four subcategories for each question. The result showed that the conversation in specialized palliative home care was a major part of the existing work, but it did not always happen in structured and conscious forms. The experience of structured conversations with relatives was exclusively positive.

Discussion: The result was discussed against selected parts of Watson's ten carative factors. Sensitivity to self and others, Human care relationship, To express positive and negative feelings, Creative, problem-solving care process.

Place, publisher, year, edition, pages
2018. , p. 36
Keywords [en]
Dialogue, Loved ones, Nurse, Palliative care, Specialized home care
Keywords [sv]
Närstående, Palliativ vård, Samtal, Sjuksköterska, Specialiserad hemsjukvård
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-6840OAI: oai:DiVA.org:esh-6840DiVA, id: diva2:1221132
Educational program
Postgraduate Diploma in Specialist Nursing - Palliative Care 60 ECTS
Presentation
2018-06-01, 09:00
Uppsok
Medicine
Supervisors
Examiners
Available from: 2018-06-20 Created: 2018-06-19 Last updated: 2018-06-20Bibliographically approved

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