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"The unpredictable death" - The last year of life for patients with advanced COPD: Relatives' stories
University of Skövde, School of Health and Education. University of Skövde, Health and Education. (Äldre och långvariga hälsoproblem, Older Adults and Long-Term Health Problems)ORCID iD: 0000-0001-9257-5087
Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden / Department of Nursing, Gjøvik University College, Gjøvik, Norway.
School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
Department of Palliative Care Research, Ersta Sköndal University College, Stockholm, Sweden / Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
2015 (English)In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 5, 1213-1222 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The end stage of chronic obstructive pulmonary disease (COPD) is described as prolonged and the symptom burden for patients with COPD is often high. It progresses slowly over several years and can be punctuated by abrupt exacerbations that sometimes end in sudden death or recovery of longer or shorter duration. This makes it difficult to identify the critical junctures in order to prognisticate the progress and time for death. patients with COPD often express a fear that the dying process is going to be difficult. There is a fear that the dyspnea will worsen and lead to death by suffocation. The present article aimed to retrospectively describe the final year of life for patients with advanced COPD with focus on death and dying from the perspective of relatives. Method:Interviews were conducted with relatives of deceased family members who had advanced COPD. In total, 13 interviews were conducted and analyzed by menas of content analysis. Result: All relatives described the patients as having had a peacful death that did not correspond with the worry expressed earlier by both the patients and themselves. during the final week of life, two different patterns in the progress of the illness trajectory emerged: a temporary improvement where death was unexpected and a continued deterioration where death was inevitable. Sigificance and Results: The patients and their realtives lived with uncertainty up until the time of death. Little support for psychosocial and existential needs was avaiable. It is essential for the nurse to create relationship with patients and relatives that enable them to talk about dying and death on their own terms.

Place, publisher, year, edition, pages
Cambridge University Press, 2015. Vol. 13, no 5, 1213-1222 p.
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Research subject
Medical sciences
URN: urn:nbn:se:his:diva-10199DOI: 10.1017/S1478951514001151ISI: 000365663900007PubMedID: 25315360ScopusID: 2-s2.0-84944159938OAI: diva2:764043
Available from: 2014-11-18 Created: 2014-11-18 Last updated: 2016-06-01Bibliographically approved

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