“Dying With Dignity”: A Qualitative Study With Caregivers on the Care of Individuals With Terminal Cancer

2020 ◽  
pp. 003022282093013
Author(s):  
Lucy Hayden ◽  
Simon Dunne
Keyword(s):  
Terminal Illness ◽  
Terminal Cancer ◽  
Religion And Spirituality ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Loved One ◽  
Experience Of Care ◽  
Dying With Dignity ◽  
Study Support ◽  
Role Of Religion

This study aimed to examine family members’ attitudes and perceptions regarding their choice of care in the event of terminal illness, based on their experience in a caregiver’s role, while a loved one was terminally ill. All participants ( N = 10) had cared for an immediate family member with terminal cancer. Snowball sampling was used. Qualitative data were collected through in-depth, semi-structured interviews. The data were transcribed verbatim and analyzed using thematic analysis. Five themes were identified from the data. These included two themes relating to participants’ experience of care, two themes in relation to participants’ attitudes toward the type of care they experienced and a final theme related to the role of religion and spirituality in dealing with loss. The findings of this study support the integration of multidisciplinary healthcare teams and the introduction of holistic care as early as possible within hospitals for individuals with terminal cancer, using the biopsychosocial–spiritual model.

scholarly journals PERCEPTION OF NURSING PROFESSIONALS ABOUT PATIENT CARE OF THE TERMINALLY ILL IN THE HOSPITAL ENVIRONMENT

2016 ◽  
Vol 25 (3) ◽  
Author(s):  
Tânia Cristina Schäfer Vasques ◽  
Valéria Lerch Lunardi ◽  
Priscila Arruda da Silva ◽  
Karen Knopp de Carvalho ◽  
Wilson Danilo Lunardi Filho ◽  
...  
Keyword(s):  
Exploratory Study ◽  
Terminal Illness ◽  
Qualitative Approach ◽  
University Hospital ◽  
Hospital Environment ◽  
Southern Brazil ◽  
Structured Interviews ◽  
Family Presence ◽  
Loved One ◽  
Nursing Professionals

ABSTRACT This study aimed to understand how nursing professionals perceive the care provided to patients with terminal illness in the hospital environment. This was an exploratory study with a qualitative approach, conducted with 23 professionals in the ambulatory service of a university hospital in southern Brazil. Semi-structured interviews were used for data collection, in 2011. Using discursive textual analysis, dialogue was shown to be a fundamental instrument in caring for patients in terminal illness, enabling the facilitation of the difficulties experienced by these patients and their families. The importance of family presence for these patients was identified, making it indispensable for caring for their loved one. Continuous education of the staff is necessary, using problematization of the difficulties experienced in the workplace, humanizing and qualifying the nursing care, ensuring dignity and comfort to patients and their families.

Cytisine as an alternative smoking cessation product for Pacific smokers in New Zealand

2018 ◽  
Vol 21 (2) ◽  
pp. 89-95
Author(s):  
Vili Nosa ◽  
Kotalo Leau ◽  
Natalie Walker
Keyword(s):  
Smoking Cessation ◽  
New Zealand ◽  
Nicotinic Acetylcholine Receptors ◽  
Cultural Practices ◽  
Partial Agonist ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Liquid Form ◽  
Pacific People ◽  
The Pacific

ABSTRACT Introduction: Pacific people in New Zealand have one of the highest rates of smoking.  Cytisine is a plant-based alkaloid that has proven efficacy, effectiveness and safety compared to a placebo and nicotine replacement therapy (NRT) for smoking cessation.  Cytisine, like varenicline, is a partial agonist of nicotinic acetylcholine receptors, and blocks the rewarding effects of nicotine. Cytisine is naturally found in some plants in the Pacific region, and so may appeal to Pacific smokers wanting to quit. This paper investigates the acceptability of cytisine as a smoking cessation product for Pacific smokers in New Zealand, using a qualitative study design. Methods: In December 2015, advertisements and snowball sampling was used to recruit four Pacific smokers and three Pacific smoking cessation specialists in Auckland, New Zealand. Semi-structured interviews where undertaken, whereby participants were asked about motivations to quit and their views on smoking cessation products, including cytisine (which is currently unavailable in New Zealand). Interviews were recorded and transcribed verbatim, with thematic analysis conducted manually. Findings: Pacific smokers reported wanting to quit for loved ones and family, but did not find currently available smoking cessation products effective. Almost all participants had not previously heard of cytisine, but many of the Pacific smokers were keen to try it. Participants identified with cytisine on a cultural basis (given its natural status), but noted that their use would be determined by the efficacy of the medicine, its cost, side-effects, and accessibility. They were particularly interested in cytisine being made available in liquid form, which could be added to a “smoothie” or drunk as a “traditional tea”.  Participants thought cytisine should be promoted in a culturally-appropriate way, with packaging and advertising designed to appeal to Pacific smokers. Conclusions: Cytisine is more acceptable to Pacific smokers than other smoking cessation products, because of their cultural practices of traditional medicine and the natural product status of cytisine.

Mentalizing Imagery Therapy mobile application for family dementia caregivers: feasibility and effects on mood and caregiving

2018 ◽  
Author(s):  
Abu Sikder ◽  
Francis Yang ◽  
Rhiana Schafer ◽  
Glenna A. Dowling ◽  
Lara Traeger ◽  
...  
Keyword(s):  
Family Caregivers ◽  
Mobile Application ◽  
Self Regulation ◽  
Pilot Trial ◽  
Depression Symptom ◽  
Structured Interviews ◽  
Physical Strain ◽  
Dementia Caregivers ◽  
Loved One ◽  
People With Dementia

Objectives: Due to psychological and physical strain, family caregivers of patients with Alzheimer’s disease and related dementias are at high risk for depression and stress related disorders. We investigated the feasibility of a mobile application (App) intervention delivering Mentalizing Imagery Therapy (MIT), which incorporates guided imagery and mindfulness, to facilitate self-regulation and increase perspective on the mental life of self and others. Method: A 4-week pilot trial of an MIT App for family caregivers of people with dementia was conducted to assess feasibility of use, mood and depression symptom benefit, and relationship changes. Semi-structured interviews were conducted at the study’s conclusion to characterize participants’ perceived benefits. Results: 80% of 21 consented participants downloaded the App, utilized it at least once, and were further analyzed. Of these participants, average usage of audio recordings was 14 ± 10 (SD) days out of 28 possible, and 29 ± 28 individual sessions. Acute improvement in mood from before to after completion of exercises was uniformly observed (p < .001), and after four weeks there was a significant increase in positive affect and a reduction in negative affect. Participants with severe levels of depression (n=3) at baseline exhibited an improvement in symptoms at 4 weeks averaging 30% (p < .05). Semi-structured interviews revealed an increase in the ability to remain “centered" despite caregiving challenges, take the perspective of the loved one, and positively reframe the caregiver experience.Conclusion: App delivery of MIT is feasible for family dementia caregivers. Results showed moderate to high usage of the app for a majority of the users, and promising improvements in mood and depression. These data provide justification for larger, controlled trials.

Ethical Issues in Private Practice: A Phenomenological Investigation of Music Therapy Business Owners

2021 ◽  
Author(s):  
Kyle Wilhelm ◽  
Lindsey Wilhelm
Keyword(s):  
Music Therapy ◽  
Private Practice ◽  
Phenomenological Study ◽  
Ethical Issues ◽  
Ethical Dilemmas ◽  
The United States ◽  
Business Owners ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Music Therapists

Abstract As a music therapy private practice is both a business and a healthcare service, it should adhere to ethical standards from both disciplines. However, this topic has rarely been examined in the music therapy literature. The purpose of this phenomenological study was to explore ethical dilemmas experienced by music therapy business owners (MTBOs) in their private practice and how MTBOs avoid or address ethical dilemmas. Utilizing convenience and snowball sampling techniques, 21 MTBOs in the United States were interviewed using semi-structured interviews. To answer the two areas of inquiry, we identified three themes and 12 subthemes: (1) Ethical issues related to client welfare, (2) Ethical issues related to business relationships and operation, and (3) Strategies to address or avoid ethical dilemmas. MTBOs also shared how they ensure ethical behavior in themselves, with their employees or independent contractors, and when interacting with professionals outside the private practice. These findings provide a better understanding of MTBOs’ lived experiences of ethics in their private practice and may benefit other music therapists who are in private practice or are wanting to go into private practice. Limitations and recommendations for further research are provided.

Adolescent Experience With Parental Cancer and Involvement With Medical Professionals: A Heuristic Phenomenological Inquiry

2021 ◽  
pp. 074355842098544
Author(s):  
Vaida Kazlauskaite ◽  
Stephen T. Fife
Keyword(s):  
Mental Health Professionals ◽  
Health Care Professionals ◽  
Terminal Illness ◽  
Hospital Setting ◽  
Heuristic Inquiry ◽  
Medical Professionals ◽  
Medical Setting ◽  
Parental Cancer ◽  
Phenomenological Inquiry ◽  
Loved One

Experiencing the death of a loved one can be a difficult occurrence. Adolescents, in particular, experience death in a unique way. Yet there is relatively little research on adolescents’ experience with parental death and their involvement in the medical setting during a parent’s terminal illness. This qualitative study utilized heuristic inquiry, a type of phenomenological research, to investigate adolescents’ involvement in the hospital setting during parental terminal illness. Qualitative analysis of participants’ experiences resulted in two primary categories associated with adolescents’ involvement with medical professionals during parental illness: factors influencing hospital involvement and experience with health care professionals. The findings have implications for medical and mental health professionals who work with adolescent family members of terminally ill patients.

Complicated grief knowledge and practice: a qualitative study of general practitioners in Ireland

2021 ◽  
pp. 1-6
Author(s):  
Abiola Muhammed ◽  
Anne Dodd ◽  
Suzanne Guerin ◽  
Susan Delaney ◽  
Philip Dodd
Keyword(s):  
Qualitative Study ◽  
General Practitioners ◽  
Current Knowledge ◽  
Complicated Grief ◽  
Phenomenological Approach ◽  
Structured Interviews ◽  
Relevant Research ◽  
Loved One ◽  
Knowledge And Practice ◽  
Purposive Sample

Objective: Complicated grief is a debilitating condition that individuals may experience after losing a loved one. General practitioners (GPs) are well positioned to provide patients with support for grief-related issues. Traditionally, Irish GPs play an important role in providing patients with emotional support regarding bereavement. However, GPs have commonly reported not being aptly trained to respond to bereavement-related issues. This study explores GPs’ current knowledge of and practice regarding complicated grief. Methods: A qualitative study adopting a phenomenological approach to explore the experiences of GPs on this issue. Semi-structured interviews were carried out with a purposive sample of nine GPs (five men and four women) in Ireland. Potential participants were contacted via email and phone. Interviews were audio-recorded, transcribed and analysed using Braun & Clarke’s (2006) model of thematic analysis. Results: GPs had limited awareness of the concept of complicated grief and were unfamiliar with relevant research. They also reported that their training was either non-existent or outdated. GPs formed their own knowledge of grief-related issues based on their intuition and experiences. For these reasons, there was not one agreed method of how to respond to grief-related issues reported by patients, though participants recognised the need for intervention, onward referral and review. Conclusions: The research highlighted that GPs felt they required training in complicated grief so that they would be better able to identify and respond to complicated grief.

scholarly journals Designing Age-Friendly Communities: Exploring Qualitative Perspectives on Urban Green Spaces and Ageing in Two Indian Megacities

2021 ◽  
Vol 18 (4) ◽  
pp. 1491
Author(s):  
Deepti Adlakha ◽  
Mina Chandra ◽  
Murali Krishna ◽  
Lee Smith ◽  
Mark A. Tully
Keyword(s):  
Older Adults ◽  
Low Income ◽  
Later Life ◽  
Healthy Ageing ◽  
World Health ◽  
Social Resilience ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Urban Green ◽  
Activity Promotion

The World Health Organization and the United Nations have increasingly acknowledged the importance of urban green space (UGS) for healthy ageing. However, low- and middle-income countries (LMICs) like India with exponential ageing populations have inadequate UGS. This qualitative study examined the relationships between UGS and healthy ageing in two megacities in India. Participants were recruited using snowball sampling in New Delhi and Chennai and semi-structured interviews were conducted with consenting participants (N = 60, female = 51%; age > 60 years; fluent in English, Hindi, or Tamil). Interviews were recorded, transcribed, translated, and analysed using inductive and thematic analysis. Benefits of UGS included community building and social capital, improved health and social resilience, physical activity promotion, reduced exposure to noise, air pollution, and heat. Poorly maintained UGS and lack of safe, age-friendly pedestrian infrastructure were identified as barriers to health promotion in later life. Neighbourhood disorder and crime constrained older adults’ use of UGS in low-income neighbourhoods. This study underscores the role of UGS in the design of age-friendly communities in India. The findings highlight the benefits of UGS for older adults, particularly those living in socially disadvantaged or underserved communities, which often have least access to high-quality parks and green areas.

Discordance between the perceptions of clinicians and families about end-of-life trajectories in hospitalized dementia patients

2021 ◽  
pp. 1-8
Author(s):  
Felicity Moon ◽  
David W. Kissane ◽  
Fiona McDermott
Keyword(s):  
End Of Life ◽  
General Medicine ◽  
Terminal Condition ◽  
Life Transitions ◽  
Social Constructionist ◽  
Structured Interviews ◽  
Loved One ◽  
Life Trajectories ◽  
People With Dementia ◽  
Illness Progression

Abstract Background Due to the unpredictable dementia trajectory, it is challenging to recognize illness progression and the appropriateness of a palliative approach. Further confusion occurs during hospitalization where the presence of comorbid conditions complicates prognostication. This research examined clinicians and families' perceptions of dementia as a terminal condition in relation to end-of-life admissions. Context The study was based in the General Medicine units of one Australian public hospital. Medical, nursing, and social work clinicians were recruited to reflect multidisciplinary perspectives. Bereaved caregivers of deceased patients with dementia were interviewed 3 months following death. Methods Qualitative research underpinned by a social constructionist epistemology and framed through complex systems theory. Semi-structured interviews generated data that illuminated perceptions of deterioration observed toward the end of life. Results Although participants anticipated general cognitive and physical deterioration associated with dementia, the emergence of comorbid illness made it difficult to predict the onset of the end of life. During a hospital admission, clinicians attributed the end of life to the advanced outcomes of dementia, whereas families described new medical crises. End-of-life admissions illuminated intersections between dementia and comorbidities rather than illness progression. In contrast with the perception that people with dementia lose awareness at the end of life, families drew attention to evidence that their loved one was present during the dying phase. Significance of results Our findings challenge the dominant understanding of dementia trajectories. Bifurcations between clinicians and families' views demonstrate the difficulties in recognizing end-of-life transitions. Implications for the integration of palliative care are considered.

Models for Integrating Medical Acupuncture into Practice: An Exploratory Qualitative Study of Physicians— Experiences

2016 ◽  
Vol 34 (4) ◽  
pp. 280-289 ◽  
Author(s):  
Ellen T Crumley
Keyword(s):  
Qualitative Study ◽  
General Practitioners ◽  
Full Time ◽  
Snowball Sampling ◽  
Core Concept ◽  
Structured Interviews ◽  
The Core ◽  
Individual Physician ◽  
Part Time ◽  
Medical Acupuncture

Background Internationally, physicians are integrating medical acupuncture into their practice. Although there are some informative surveys and reviews, there are few international, exploratory studies detailing how physicians have accommodated medical acupuncture (eg, by modifying schedules, space and processes). Objective To examine how physicians integrate medical acupuncture into their practice. Methods Semi-structured interviews and participant observations of physicians practising medical acupuncture were conducted using convenience and snowball sampling. Data were analysed in NVivo and themes were developed. Despite variation, three principal models were developed to summarise the different ways that physicians integrated medical acupuncture into their practice, using the core concept of ‘helping’. Quotes were used to illustrate each model and its corresponding themes. Results There were 25 participants from 11 countries: 21 agreed to be interviewed and four engaged in participant observations. Seventy-two per cent were general practitioners. The three models were: (1) appointments (44%); (2) clinics (44%); and (3) full-time practice (24%). Some physicians held both appointments and regular clinics (models 1 and 2). Most full-time physicians initially tried appointments and/or clinics. Some physicians charged to offset administration costs or compensate for their time. Discussion Despite variation within each category, the three models encapsulated how physicians described their integration of medical acupuncture. Physicians varied in how often they administered medical acupuncture and the amount of time they spent with patients. Although 24% of physicians surveyed administered medical acupuncture full-time, most practised it part-time. Each individual physician incorporated medical acupuncture in the way that worked best for their practice.

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