Where to die? That is the question: A study of cancer patients in Israel

2014 ◽  
Vol 13 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Frida Barak ◽  
Sofia Livshits ◽  
Haana Kaufer ◽  
Ruth Netanel ◽  
Nava Siegelmann-Danieli ◽  
...  

AbstractObjective:Most patients prefer to die at home, but barely 30% do so. This study examines the variables contributing to dying at home.Methods:The participants were 326 cancer patients, of both genders, with a mean age of 63.25 years, who died from 2000 to 2008 and were treated by the palliative care unit of the Barzilai Hospital. Some 65.7% died at home and 33.4% in a hospital. The data were extracted from patient files. The examined variables were demographic (e.g., age, gender, marital status, ethnic background, number of years in Israel until death), medical (e.g., age at diagnosis, diagnosis, nature of last treatment, patient received nursing care, patient given the care of a social worker, patient had care of a psychologist, family received care of a social worker, patient had a special caregiver), and sociological (e.g., having insurance, having worked in Israel, living alone or with family, living with one's children, living in self-owned or rented house, family members working).Results:The findings indicate that the chances of dying at home are higher if the patient is non-Ashkenazi, the family got social worker care, the patient lived in a self-owned house, the patient lived with his family, the family members worked, and the patient's stay in Israel since immigration was longer. Logistic regression showed that all the predictors together yielded a significant model accounting for 10.9–12.3% of the variance.Significance of results:The findings suggest that dying at home requires maintaining continued care for the patient and family in a community context.

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
ERWIN Erwin ◽  
ELLY Nurachmah ◽  
TUTI Herawati

Abstract Funding Acknowledgements Type of funding sources: None. Background The client"s condition for heart failure requires environmental support to be able to be confident and able to carry out activities according to the directions given while the patient is undergoing treatment in the hospital, but sometimes in the client"s time period at home there will be situations where patients may experience complaints or changes in conditions that can affect his cardiovascular status. Purpose this study is conducted to identify psychological and social problems and needs of heart failure clients with a qualitative approach of observation, invite individuals or families to participate, motivate individuals to develop the potential to maintain optimal health. In addition, this study was conducted to assess the need and effectiveness of the practice of consulting for heart failure nursing in hospital outpatients Method qualitative observation approach in nursing consulting practice using steps of the nursing process consisting of an assessment of physical, psychological and social conditions and client needs, formulating problems, making plans and taking care of actions in accordance with the problems that exist by nurses in the outpatient clinic at home sick. Results Clients who came to the outpatient clinic had various  psychological and social problems. From the observations and interviews it was found that psychological and social problems were the most common causes. Psychosocial problems arise due to the client himself, life companion (husband or wife) and family members who live together. So that the family system to support clients with heart failure is not awakened. Health education and promotion to clients, life companions, and family members of heart failure clients who live at home are needed when the client controls health to maintain the client"s health support system while at home. All clients and families in this study stated that the practice of nursing consultations in hospital outpatients is very helpful for clients and families to improve the situation they face. Conclusion the practice of nursing consultations can identify the problems and needs of clients and families. Strengthening the client support system for heart failure at home is needed so that psychological and social problems can be reduced when the client is in the family environment. Nursing consultation practices at outpatient hospitals are needed to help motivate clients and families in maintaining and increasing care and support for clients who suffer from heart failure while at home. Psychosocial problems The client felt anxious, lack of attention, complained sleeping difficulty, often forgot taking medicine, and forgot managing fluid intakeThe client,while at home, was fastidious and wanted to many, was difficult to be told or managed, was always suspicious with their spouse"s activity easily got angry or temperamental, the client"s child felt annoyed because the client acted annoying, the client"s spouse felt annoyed because the client was impatient and temperamentalPsychological, and social problems in heart failure patients


2020 ◽  
pp. 096973302094575
Author(s):  
Ni Gong ◽  
Qianqian Du ◽  
Hongyu Lou ◽  
Yiheng Zhang ◽  
Hengying Fang ◽  
...  

Background: Independent decision-making is one of the basic rights of patients. However, in clinical practice, most older cancer patients’ treatment decisions are made by family members. Objective: This study attempted to analyze the treatment decision-making process and formation mechanism for older cancer patients within the special cultural context of Chinese medical practice. Method: A qualitative study was conducted. With the sample saturation principle, data collected by in-depth interviews with 17 family members and 12 patients were subjected to thematic analysis. Ethical considerations: The study was approved by the ethics committees of Sun Yat-sen University. All participants provided verbal informed consent after being told their rights of confidentiality, anonymity, and voluntary participation. They had the right to refuse to answer questions and could withdraw at any time. Results: Three themes emerged: (1) complex process; (2) transformation of family decision-making power; and (3) individual compromise. Family members inevitably had different opinions during the long process of treatment decision-making for older cancer patients. The direction of this process could be regarded as an extension of the family power relationship. The patient usually compromised the decision to survive, which was made by family members. Conclusion: This study describes the treatment decision-making process of older cancer patients in the context of Chinese culture. The reasons underlying this process are related to the views on life and death and family values. An individual is a part of the family, which is often seen as the minimal interpersonal unit in Chinese society. It is significant that while emphasizing patient autonomy in the decision-making process, health professionals should also pay attention to the important roles of culture and family.


2010 ◽  
Vol 28 (1) ◽  
pp. 142-148 ◽  
Author(s):  
Takuya Shinjo ◽  
Tatsuya Morita ◽  
Kei Hirai ◽  
Mitsunori Miyashita ◽  
Kazuki Sato ◽  
...  

Purpose The aim of this study was to clarify the level of emotional distress experienced by bereaved family members and the perceived necessity for improvement in the care for imminently dying patients and to explore possible causes of distress and alleviating measures. Methods A cross-sectional nationwide survey was performed in 2007 of bereaved families of cancer patients at 95 palliative care units across Japan. Results Questionnaires were sent to 670 families, and 76% responded. Families reported their experiences as very distressing in 45% of cases. Regarding care, 1.2% of respondents believed that a lot of improvement was needed, compared with 58% who believed no improvement was needed. Determinants of high-level distress were a younger patient age, being a spouse, and overhearing conversations between the medical staff outside the room at the time of the patient's death; those reporting high-level necessity of improvement were less likely to have encountered attempts to ensure the patient's comfort, received less family coaching on how to care for the patient, and felt that insufficient time was allowed for the family to grieve after the patient's death. Conclusion A considerable number of families experienced severe emotional distress when their family member died. Thus, we propose that a desirable care concept for imminently dying cancer patients should include relief of patient suffering, family advisement on how to care for the patient, allowance of enough time for the family to grieve, and ensuring that family members cannot overhear medical staff conversations at the time of the patient's death.


Cancer ◽  
2016 ◽  
Vol 122 (9) ◽  
pp. 1453-1460 ◽  
Author(s):  
Jun Hamano ◽  
Takashi Yamaguchi ◽  
Isseki Maeda ◽  
Akihiko Suga ◽  
Takayuki Hisanaga ◽  
...  

2019 ◽  
Vol 7 (1) ◽  
pp. 674-684
Author(s):  
Idauli Simbolon ◽  
Christine Sacha ◽  
Evelyn Hemme ◽  
Sapti Heru Widyarti

Introduction: Previous phenomenological studies explain that family member faced many consequences in caring for family members with Alzheimer’s Dementia at home. The consequences are in the form of the impact of financial, social and psychological pressure. Considering such consequences, families especially in Eastern cultures will continue to care for their elderly at home for reasons of compassion or retribution toward parents even though they feel frustrated and burdened. The purpose of this study is to describe the life experience of Seventh-day Adventist church member in caring for their parent who suffer from Alzheimer’s Dementia. Method: This qualitative study is using phenomenological design. There are 3 participants are selected who are fit with the inclusion criterions: immediate family member, seventh-day Adventist church member, live together with their Alzheimer’s Dementia parent who suffer at least 2 years of dementia, and agree to sign inform consent after the full explanation of the study. Data are gathered using semi structured face to face interview in participant’s home setting. Data than transcribed in to world document and analysed using Cresswel step by step content analysis. Result: There are five negative categories of family member experiences in taking care of their Alzheimer’s Dementia parent: 1) physical abuse, 2) psychological abuse, 3) social limitation, 4) spiritual distress, and 5) knowledge deficit. It also found that there are several coping mechanism or adaptation made by family member in caring their Alzheimer Dementia parent: 1) family members are motivated to learn more about Alzheimer Dementia, 2) spiritual growth that they pray more often and surrendered to God, 3) increase understanding toward elderly. Discussion:  Based on the result of the study, all the informants experienced pressures in all holistic aspects of life. If they are not able to cope with the pressure, illness may be arrived and made the family situation become worse. Therefore, professional health care must provide support to the family who take care of their Alzheimer Dementia family, Introduction: Previous phenomenological studies explain that family member faced many consequences in caring for family members with Alzheimer’s Dementia at home. The consequences are in the form of the impact of financial, social and psychological pressure. Considering such consequences, families especially in Eastern cultures will continue to care for their elderly at home for reasons of compassion or retribution toward parents even though they feel frustrated and burdened. The purpose of this study is to describe the life experience of Seventh-day Adventist church member in caring for their parent who suffer from Alzheimer’s Dementia. Method: This qualitative study is using phenomenological design. There are 3 participants are selected who are fit with the inclusion criterions: immediate family member, seventh-day Adventist church member, live together with their Alzheimer’s Dementia parent who suffer at least 2 years of dementia, and agree to sign inform consent after the full explanation of the study. Data are gathered using semi structured face to face interview in participant’s home setting. Data than transcribed in to world document and analysed using Cresswel step by step content analysis. Result: There are five negative categories of family member experiences in taking care of their Alzheimer’s Dementia parent: 1) physical abuse, 2) psychological abuse, 3) social limitation, 4) spiritual distress, and 5) knowledge deficit. It also found that there are several coping mechanism or adaptation made by family member in caring their Alzheimer Dementia parent: 1) family members are motivated to learn more about Alzheimer Dementia, 2) spiritual growth that they pray more often and surrendered to God, 3) increase understanding toward elderly. Discussion:  Based on the result of the study, all the informants experienced pressures in all holistic aspects of life. If they are not able to cope with the pressure, illness may be arrived and made the family situation become worse. Therefore, professional health care must provide support to the family who take care of their Alzheimer Dementia family,


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shobhit Srivastava ◽  
Pradeep Kumar ◽  
Rashmi ◽  
Ronak Paul ◽  
Preeti Dhillon

Abstract Background Substance use among adolescents is risky behavior that had emerged as a concern in both developed and developing countries. Evidence revealed that substance use is more frequent among those adolescents whose immediate family members (parents, siblings and grandparents) also indulge in such consumption; however, scarce literature is present in the Indian context. Therefore, the present study examined whether substance use among family members and in the community is associated with the substance use behavior of adolescent boys in Uttar Pradesh and Bihar. Method We used the data for 5969 adolescent boys aged 10–19 years from the Understanding the Lives of Adolescents and Young Adults (UDAYA) survey conducted in 2016. A three-level random intercept logit model was utilized to understand the association of adolescent substance use behavior with familial and community context. Results We found that 16% of adolescent boys were using any substance (tobacco or alcohol or drug). The substance use was significantly higher among adolescent boys who were school dropouts (40%) than those who were currently in school. The prevalence of substance use is also high among those who were working (35%). Moreover, 19, 24 and 28% of the adolescents come from families where at least one of the family members consumed tobacco, alcohol and drugs, respectively. The odds of substance use were 2.13 times [CI:1.44–3.17] higher among those adolescent boys whose family members also indulged in substance use. Moreover, the likelihood of substance use was 1.24 times [CI:1.01–1.68] higher among the adolescent boys who come from a community with high substance use. Additionally, the risk of substance use is more likely among adolescent boys belonging to the same household of the same community. Conclusion It is evident that exposure to substance use in the family and community increases the likelihood of substance use among adolescent boys. There is a need for household- and community-level programmatic interventions to alleviate the risk of substance use among adolescents.


2016 ◽  
Vol 6 (3) ◽  
pp. 1008-1017
Author(s):  
Prof. Bader S. Dweik ◽  
Sara N. Al-Rahal

The purpose of this study is to investigate the domains of use of the Turkmen language and Arabic in Baghdad and to explore attitudes towards Turkmen and Arabic. A sample, comprising (100) subjects from the Turkmen of Baghdad, is selected purposefully to fill out a sociolinguistic questionnaire to solicit information about the participants' demographic background, language use in different contexts and language attitudes towards the ethnic language, Turkmen and the mainstream language, Arabic. The results have revealed that the Turkmen of Baghdad use their ethnic language in different domains especially at home and among the family members. Also, they use both languages (their ethnic language and Arabic) in different social domains such as neighborhood, place of work, schools, media and other public places and have displayed positive attitudes towards Turkmen and Arabic alike.


2018 ◽  
Vol 12 (3) ◽  
pp. 599
Author(s):  
Fernanda Misawa ◽  
Rafaely De Cássia Nogueira Sanches ◽  
Anderson Da Silva Rêgo ◽  
Cremilde Aparecida Trindade Radovanovic

RESUMOObjetivo: compreender a vivência dos familiares no cuidado domiciliar após a alta hospitalar de um familiar acometido por Acidente Vascular Encefálico. Método: estudo qualitativo, descritivo, do tipo convergente assistencial, com quatro famílias. O cenário do estudo foi o domicílio, com média de 16 visitas por família, uma vez por semana ou quando houvesse necessidade de assistência. Para a análise dos dados, utilizou-se a técnica de Análise de Conteúdo, na modalidade Análise Temática. Resultados: evidenciou-se que a experiência de cuidar no domicílio levou os membros da família a lidarem com sentimentos como o medo, a tristeza, a angústia e a fragilidade e os membros adoecidos relataram ansiedade, desânimo, frustração e revolta por estarem adoecidos. Conclusão: o estudo permitiu a compreensão da experiência de cuidar no domicílio e a vivência das famílias de familiar acometido por Acidente Vascular Encefálico oportunizando que a prática assistencial e a pesquisa ocorressem ao mesmo tempo e, assim, proporcionou a oportunidade de interação e criação de vínculo com os participantes do estudo e a compreensão da experiência e a repercussão do cuidado no domicílio entre os familiares. Descritores: Acidente Vascular Encefálico; Família; Assistência Domiciliar; Cuidados De Enfermagem; Enfermagem; Doenças Crônicas.ABSTRACT Objective: to understand the experience of family members in home care after hospital discharge from a family member affected by stroke. Method: qualitative, descriptive, convergent type study with four families. The study scenario was the household, with an average of 16 visits per family, once a week or when there was a need for assistance. For the analysis of the data, the technique of Content Analysis was used in the Thematic Analysis modality. Results: It was evidenced that the experience of caring at home led family members to deal with feelings such as fear, sadness, anguish and frailty, and the sick members reported anxiety, discouragement, frustration and revolt at being sick. Conclusion: the study allowed the understanding of the home care experience and the family life of the family members affected by stroke, allowing care practice and research to occur at the same time and, thus, provided the opportunity for interaction and bonding with study participants and the understanding of the experience and the repercussion of care at home among the family members. Descritores: Cerebrovascular Accident; Family; Home Care; Nursing Care; Nursing; Chronic Disease.RESUMEN Objetivo: comprender la vivencia de los familiares en el cuidado domiciliar después del alta hospitalaria de un familiar acometido por Accidente Vascular Encefálico. Método: estudio cualitativo, descriptivo, del tipo convergente asistencial, con cuatro familias. El escenario del estudio fue el domicilio, con promedio de 16 visitas por familia, una vez por semana o cuando hubiera necesidad de asistencia. Para el análisis de los datos, se utilizó la técnica de Análisis de Contenido, en la modalidad Análisis Temático. Resultados: se evidenció que la experiencia de cuidar en el domicilio llevó a los miembros de la familia a lidiar con sentimientos como el miedo, la tristeza, la angustia y la fragilidad y los miembros enfermos relataron ansiedad, desánimo, frustración y revuelta por estar enfermos. Conclusión: el estudio permitió la comprensión de la experiencia de cuidar en el domicilio y la vivencia de las familias de familiar acometido por Accidente Vascular Encefálico, posibilitando que la práctica asistencial y la investigación ocurrieran al mismo tiempo, y así, proporcionó la oportunidad de interacción y creación de vínculo con los participantes del estudio y la comprensión de la experiencia y la repercusión del cuidado en el domicilio entre los familiares. Descritores: Accidente Vascular Encefálico; Familia; Asistencia Domiciliar; Atención de Enfermería; Enfermería; Enfermedad Crónica.


2017 ◽  
Vol 2 (1) ◽  
pp. 11
Author(s):  
Rita Sari

Immobilization is a problem faced by patients with chronic illness, the patients is very weak and paralyzed patients in a long time. This study have purpose  to gain a deep understanding of the experience of families in caring for family members is immobilized with pressure sores at home. This study used qualitative methods. Participants are families who care for patients at home who are immobilized with pressure sores. Collecting data with in-depth interviews by means of instrument is the researcher's own self, written questions as an interview, used recording devices and used field notes.  Criterion sampling by taking 6 participants. Analysis of data used a phenomenological approach. The results showed that the family had a positive experience; Can be more patient, and assume that caring for a sick family member has its own challenges, being able to be with other families in caring for patients, being able to give affection and obligation as a child to parents can help take care of it. There was also an unpleasant (negative) family experience during the care of sick family members, the family felt tired, not strong and bored during patient care. The conclusion of the study is that families have positive and negative experiences in caring for family members with decubitus


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