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Att mötas i livets slut: Sjuksköterskors upplevelse av palliativ vård för unga vuxna inom hemsjukvården - en intervjustudie
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
2019 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesisAlternative title
To meet at the end of life : Nurses' experience of palliative care for young adults in home health care - an interview study (English)
Abstract [sv]

Bakgrund: Antalet patienter under 65 år inom hemsjukvården har ökat kraftigt under de senaste åren i Sverige. Inom slutenvården ser många sjuksköterskor svårigheter i att vårda dessa unga döende patienter, men vid litteratursökning har det framkommit att det föreligger en brist på forskning om hur sjuksköterskor inom hemsjukvården upplever detta.

Syfte: Syftet var att belysa sjuksköterskors upplevelser av att vårda unga vuxna i livets slut inom hemsjukvården.

Metod: Studien utformades enligt en kvalitativ forskningsmetod där en semistrukturerad intervjuteknik användes. Studiens deltagare bestod av legitimerade sjuksköterskor med minst ett års erfarenhet av arbete inom hemsjukvårdens verksamhet och som hade vårdat patienter i palliativt skede i ålderskategorin 18-45 år inom hemsjukvården.

Resultat: Innehållsanalysen resulterade i tre huvudkategorier och tretton underkategorier. Huvudkategorierna blev Vårdrelationens innebörd och förhållningssätt, Känslor av varierande karaktär samt Underlättande medel i mötet. Sjuksköterskorna kunde bland annat relatera mycket till sitt eget liv och upplevde att anhörigvård utgjorde en stor del vid vård av unga vuxna i livets slut. Att arbeta med vård som berör bidrog bland annat till ökat behov för bearbetning av sjuksköterskornas egna känslor under vårdförloppets gång.

Slutsats: Studiens resultat visade att sjuksköterskorna upplevde att vårda unga vuxna i livets slut påverkades av att de kunde relatera mycket av patientens situation till sina egna liv. Detta gav en djupare förståelse för patienten och anhörigas lidande. Vid vård av unga vuxna upplevde sjuksköterskorna patienten och dess anhöriga mycket delaktiga i vården vilket sågs som en stor tillgång men även resulterade i ökat behov av anhörigvård. Det stöd som ges till de anhöriga av sjuksköterskorna försvinner däremot plötsligt när patienten avlidit. Detta kan leda till att den positiva känslan av att vårda sin anhörig förgås och det är därför av stor vikt med fortsatt professionellt stöd från hemsjukvården till anhöriga även efter patienten avlidit. Slutsats kunde även dras om att sjuksköterskors erfarenhet var en bidragande faktor till att tillgodose patienternas behov i livets slut. Studien visade slutligen på behov av reflektion i samband med och efter vårdandet av yngre palliativa vuxna för utökad bearbetning för sjuksköterskorna vid och efter vårdandet av denna patientgrupp.

Abstract [en]

Background: In home health care has the number of patients under 65 years increased significantly in recent years in Sweden. In hospitalization many nurses see difficulties in caring for these young dying patients, but a literature search has revealed that there is a lack of research on how nurses in home health care experience this.

Aim: The purpose was to illuminate nurses' experiences of caring for young adults at the end of their lives in home health care.

Method: The study was designed according to a qualitative research method using a semi-structured interview technique. The study participants consisted of legitimate nurses with at least one year of experience working in the home health care and who had cared for patients at palliative stage in the 18-45 age group in home health care.

Result: The content analysis resulted in three main categories and thirteen subcategories. The main categories were The meaning and attitude of the caregiver relationship, Emotions of varying nature and Facilitating means at the meeting. The nurses could, among other things, relate a great deal to their own lives and felt that caregiving for the patients relatives was a major part in the care for young adults at the end of their lives. Working with care that affects contributed to an increased need for processing the nurses' own feelings during the course of care.

Conclusion: The study's result showed that the nurses experienced caring for young adults at the end of their lives was affected by being able to relate much of the patient's situation to their own lives. This provided to a deeper understanding of the patient's and the relatives suffering. When caring for young adults, the nurses experienced the patient and their relatives very involved in the care, which was seen as a great asset but also resulted in an increased need for family care. However, the support given to the relatives by the nurses disappears suddenly when the patient dies. This can lead to the positive feeling of caring for their relatives perishing and it is therefore of great importance with continued professional support from home health care to relatives even after the patient has died. It could also be concluded that nurses 'experience was a contributing factor in meeting patients' needs at the end of their lives. The study finally showed the need for reflection in connection with and after the care of younger palliative adults for extended treatment for the nurses at and after the care of this patient group.

Place, publisher, year, edition, pages
2019. , p. 39
Keywords [en]
Palliative Care, Young adults, Home health care, Nurse, Experiences
Keywords [sv]
Palliativ vård, Unga Vuxna, Hemsjukvård, Sjuksköterska, Upplevelser
National Category
Nursing
Identifiers
URN: urn:nbn:se:lnu:diva-90192OAI: oai:DiVA.org:lnu-90192DiVA, id: diva2:1371801
Subject / course
Vårdvetenskap
Educational program
Specialist Nursing Programme, with Specialism in Primary Health Care, 75 credits
Supervisors
Examiners
Available from: 2019-11-21 Created: 2019-11-20 Last updated: 2019-11-21Bibliographically approved

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