scholarly journals Spirituality in Patients at the End of Life—Is It Necessary? A Qualitative Approach to the Protagonists

2021 ◽  
Vol 19 (1) ◽  
pp. 227
Author(s):  
E. Begoña García-Navarro ◽  
Alicia Medina-Ortega ◽  
Sonia García Navarro
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
The Other ◽  
Spiritual Needs ◽  
Structured Interviews ◽  
Values And Beliefs ◽  
Well Differentiated ◽  
The One ◽  
Nursing Professionals ◽  
Process Method

Spirituality is the most unknown aspect of palliative care despite being the need that is most altered in the last moments of life. Objective. To identify on the one hand the spiritual needs of patients who are at the end of life and on the other hand, the way in which nursing professionals can work to provide effective accompaniment in this process. Method. A qualitative study was conducted which applied different data collection techniques. This was done to describe the phenomenon from a holistic perspective in relation to experts’ perceptions of the competencies required by health professionals and palliative patients’ spiritual needs. Semi-structured interviews were conducted within both populations. In order to analyze the qualitative data collected through interviews, discourse was analyzed according to the Taylor–Bodgan model and processed using Atlas.ti software. Results. Three well-differentiated lines of argument are extracted from the discourse in each of the groups, on the one hand in the group of patients they define the concept of spirituality, system of values and beliefs, and the Factors that influence the spirituality of patients at the end of life (differentiating palliative care areas/other areas) and on the other, the professionals agree with the patients in the line of argument of concept of spirituality although they define more metaphysical categories and the other two lines of argument that result are the spiritual attention in this process and the need for formation in spirituality. Conclusions. The provision of spiritual care gives meaning to the actions of nursing professionals when it comes to providing end-of-life care, achieving holistic care, humanizing death, and promoting a dignified end.

Palliative care at the end of life in pediatric oncology: a nursing perspective

2021 ◽  
Vol 42 ◽  
Author(s):  
Tatiana Pifano da Silva ◽  
Liliane Faria da Silva ◽  
Emília Gallindo Cursino ◽  
Juliana Rezende Montenegro Medeiros de Moraes ◽  
Rosane Cordeiro Burla de Aguiar ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Pediatric Oncology ◽  
End Of Life Care ◽  
Professional Training ◽  
Quality Care ◽  
Structured Interviews ◽  
The Family ◽  
Pediatric Inpatient ◽  
Nursing Professionals

ABSTRACT Objectives: To identify the knowledge of nursing professionals about palliative care in pediatric oncology and their needs for end-of-life care. Method: A descriptive study with a qualitative approach, carried out in a federal hospital in Rio de Janeiro specialized in oncology. 29 nursing professionals from the pediatric inpatient sector participated in semi-structured interviews between July and August 2019. Data submitted to textual lexicographic analysis with Iramuteq. Results: Professionals are aware of the use of comprehensive care, centered on the family, aimed at comfort, and dignified death. They highlighted the need for psychological support for the nursing team, in addition to effective communication with a multidisciplinary team and carrying out actions for professional training in pediatric palliative care. Final considerations: A study showed care that is consistent with the precepts of palliative care and points out gaps in training, highlighting the need for professional training with a view to quality care.

The Other Entrepreneurs - Migrant Economies as Spaces for Social Innovation?

2019 ◽  
Vol 16 (2) ◽  
pp. 265-271
Author(s):  
Claudia Lintner
Keyword(s):  
Social Innovation ◽  
Close Relation ◽  
The Other ◽  
Structural Level ◽  
Structured Interviews ◽  
Economic Activities ◽  
Migrant Entrepreneurship ◽  
False Dichotomy ◽  
Migrant Entrepreneurs ◽  
The One

This article analyses the relationship between migrant entrepreneurship, marginalisation and social innovation. It does so, by looking how their ‘otherness’ is used on the one hand to reproduce their marginalised situation in society and on the other to develop new living and working arrangements promoting social innovation in society. The paper is based on a qualitative study, which was carried out from March 2014- 2016. In this period, twenty semi-structured interviews were conducted with migrant entrepreneurs and experts. As the results show, migrant entrepreneurs are characterised by a false dichotomy of “native weakness” in economic self-organisation against the “classical strength” of majority entrepreneurs. It is shown that new possibilities of acting in the context of migrant entrepreneurship are mostly organised in close relation to the lifeworlds and specific needs deriving from this sphere. Social innovation processes initiated by migrant entrepreneurs through their economic activities thus develop on a micro level and are hence less apparent. Supportive networks are missing on a structural level, so it becomes difficult for single innovative initiatives to be long-lasting.

Health and death literacy and cultural diversity: insights from hospital-employed interpreters

2017 ◽  
Vol 10 (1) ◽  
pp. e8-e8 ◽  
Author(s):  
Barbara Hayes ◽  
Anne Marie Fabri ◽  
Maria Coperchini ◽  
Rafatullah Parkar ◽  
Zoe Austin-Crowe
Keyword(s):  
End Of Life ◽  
Qualitative Description ◽  
Cultural Issues ◽  
Structured Interviews ◽  
Individual Values ◽  
Language Groups ◽  
A Value ◽  
Values And Beliefs ◽  
Advance Care ◽  
End Of Life Decision

Objectives001225The aim of this qualitative study is to better understand, through the experiences and insights of hospital interpreters, how people from culturally and linguistic diverse (CALD) communities might respond to advance care planning (ACP) and end-of-life discussions.MethodsHospital interpreters from five Melbourne metropolitan health services were recruited for in-depth semi-structured interviews that explored the question, ‘What can be learnt from hospital interpreters about cultural issues related to ACP and end-of-life decision-making?’ Thirty-nine interpreters, representing 22 language groups, were interviewed. Analysis of the transcribed interviews used qualitative description.ResultsThematic analysis identified three major themes: (1) moral difference; (2) health and death literacy; and (3) diversity within culture.ConclusionA value-based approach to ACP is recommended as a way to capture the person’s individual values and beliefs. Health and death literacy have been identified as areas that may be over-estimated; areas that can be addressed and improved, if recognised. Health and death literacy is a particular area that needs to be assessed and addressed as a pre-requisite to ACP discussions.

Sexuality and Intimacy Needs Within a Hospitalized Palliative Care Population: Results From a Qualitative Study

2021 ◽  
pp. 104990912110369
Author(s):  
Anne Kelemen ◽  
Clara Van Gerven ◽  
Katherine Mullins ◽  
Hunter Groninger
Keyword(s):  
Palliative Care ◽  
Family Relationships ◽  
Comparative Method ◽  
Future Research ◽  
Spiritual Needs ◽  
Structured Interviews ◽  
Course Of Illness ◽  
Serious Illness ◽  
Medical Teams ◽  
The Impact

Background: Palliative care (PC) clinicians are well trained to address physical, psychosocial and spiritual needs of patients who have a serious illness. However, one area that is often overlooked is intimacy and sexuality. Objective: To explore patient concerns regarding intimacy as it relates to illness, family reactions, physician conversations, and coping strategies and challenges. Methods: Eligible subjects (at least 18 years old, capacitated, receiving PC consultation at the lead author’s institution) participated in semi-structured interviews between November and December 2017. Transcripts were open-coded and analyzed using Dedoose 3.5.35 software. A constant comparative method was used to identify patterns in the data. Results: 21 interviews were analyzed and several themes emerged. Participants described the effect of physical and mental/emotional changes on their relationships. Family relationships, romantic relationships, and sexuality were prominent in patients’ experiences of intimacy and how it changed as the illness progressed. Relationships were often noted to strengthen during the course of illness, while sexual activity was frequently reported to be negatively impacted. Patients consistently reported little provider communication on the impact of illness on intimacy beyond instructions about what sexual activities they could or could not engage in. Conclusion: This study underlines the significant impact of serious, progressive illness on relationships, sexuality, and physical and emotional intimacy. It highlights that these topics continue to be priorities for patients with serious illness, and that medical teams frequently fail to address them at all. Future research should further explore these issues across diverse patient populations.

scholarly journals Klubpædagogen mellem demokrati, frihed og markedsgørelse?

2020 ◽  
Vol 4 (2) ◽  
pp. 16
Author(s):  
Lea Ringskou ◽  
Christoffer Vengsgaard ◽  
Caroline Bach
Keyword(s):  
Professional Identity ◽  
Leisure Time ◽  
Final Section ◽  
The Other ◽  
Structured Interviews ◽  
Research Project ◽  
The One

ResuméArtiklen omhandler et toårigt forskningsprojekt på VIA Pædagoguddannelse om klubpædagogisk professionsidentitet. I forskningsprojektet er der udført 11 kvalitative semistrukturerede interviews. Ud fra interviewene konstruerer vi analytisk tre dominerende narrativer: klubpædagogen som demokratisk medborgerskaber, frihedens klubpædagog og klubpædagogen som sælger. Ud fra narrativerne præsenterer vi tre større historisk og kulturelt forankrede nøglefortællinger om klubpædagogisk professionsidentitet. De to første narrativer indeholder nøglefortællinger om demokrati og frihed, der trækker på klassisk reformpædagogik og kritisk frigørende pædagogik. Heroverfor indeholder narrativet pædagogen som sælger en historisk nyere nøglefortælling om markedsgørelse. Vi betragter mødet mellem nøglefortællingerne som en mere overordnet fortælling om klubpædagogisk professionsidentitet mellem tradition og forandring. Afslutningsvis diskuterer vi, hvilke udfordringer og muligheder mødet mellem nøglefortællingerne, nærmere bestemt mødet mellem demokrati og frihed på den ene side og markedsgørelse på den anden, potentielt kan indeholde i forhold til klubpædagogisk professionsidentitet og omverdenens anerkendelse. På den ene side kan markedsgørelsen tolkes som risiko for dekonstruktion af klubpædagogisk professionsidentitet, der vil kunne udhule nøglefortællingerne om demokrati og frihed. På den anden side kan der argumenteres for, at netop nøglefortællingen om markedsgørelsen kan tolkes som mulighed for at styrke de to andre nøglefortællinger og at den sigt vil kunne bidrage til stabilisering og anerkendelse af klubpædagogisk professionsidentitet. AbstractLeisure time pedagogue working in youth clubs: between democracy, freedom and marketing? Three key narratives in professional identity of leisure time pedagogues working in youth clubsIn this article, we present the results of a research project about the professional identity of leisure time pedagogue working in different forms of youth clubs with children and teenagers from 10 to 18+ years of age. We base the analysis on 11 qualitative semi-structured interviews. Through the analysis, we construct three key narratives: a key narrative concerning democracy, a key narrative concerning freedom and a key narrative concerning marketing (sale). We use these three key narratives to illustrate the complexity of the professional identity of the leisure time pedagogue. Both tradition and renewal characterizes the professional identity of the leisure time pedagogues. In the final section, we discuss the encounter between the key narratives of democracy and freedom on the one hand and the key narrative of marketing on the other. What are the possible pitfalls and potentials in this encounter, when the pedagogues strives for the acknowledgement and acceptance of professional identity?

scholarly journals Favouritism: Exploring the ‘uncontrolled’ spaces of the leadership experience

Leadership ◽  
2018 ◽  
Vol 15 (3) ◽  
pp. 381-397 ◽  
Author(s):  
Ofelia A Palermo ◽  
Ana Catarina Carnaz ◽  
Henrique Duarte
Keyword(s):  
Ethical Issues ◽  
Social Process ◽  
The Other ◽  
Structured Interviews ◽  
Organisational Justice ◽  
Other Hand ◽  
The Social ◽  
Leadership Experience ◽  
The One ◽  
The Way

In this paper, we argue that a focus on favouritism magnifies a central ethical ambiguity in leadership, both conceptually and in practice. The social process of favouritism can even go unnoticed, or misrecognised if it does not manifest in a form in which it can be either included or excluded from what is (collectively interpreted as) leadership. The leadership literature presents a tension between what is an embodied and relational account of the ethical, on the one hand, and a more dispassionate organisational ‘justice’ emphasis, on the other hand. We conducted 23 semi-structured interviews in eight consultancy companies, four multinationals and four internationals. There were ethical issues at play in the way interviewees thought about favouritism in leadership episodes. This emerged in the fact that they were concerned with visibility and conduct before engaging in favouritism. Our findings illustrate a bricolage of ethical justifications for favouritism, namely utilitarian, justice, and relational. Such findings suggest the ethical ambiguity that lies at the heart of leadership as a concept and a practice.

scholarly journals Paradigms in Political Science Revisited

1990 ◽  
Vol 7 (1) ◽  
pp. 113-118
Author(s):  
Eric A. Winkel
Keyword(s):  
Social Sciences ◽  
Political Science ◽  
The Self ◽  
The Other ◽  
The Political ◽  
Western Thought ◽  
Values And Beliefs ◽  
The One

We are at a crossroads where the time is ripe for the emerging Muslim thought to once again set the standard for universal participation and debate. My continual argument with Mona Abul-Fadl's concept of kairos in The American Journal of Islamic Social Sciences, Vol. 6, No. 1, (September 1989 supplement) is whether the openness of the discourse realm is a result of what Gai Eaton describes as the process of decomposition releasing explosive gases, where the "ripeness" is putridity, or a beneficial progress of ideas. Does postmodern deconstruction, decentralization, and destruction create a foothold for the remembering of Islam? Or will the Islamic discourse enter the scene to be trivialized and relativized in the encounter? From my perspective, I tie the movements of the paradigms to the political encounter with the other, where the self-described American establishment was forced to recognize the non-white, the non-male, the non-consumer. More sensitive to complexities, calmer in her approach, and without any reductionism or oversimplification, Mona Abul-Fadl recognizes the "mundane" links of ideas, but treats them with respect nevertheless. It is her insight to see in the tanzil, in the physical and already interpreted descent of the Qur'an and Sunnah, the one rope on which we may spin, in shaa Allah, the Islamic discourse for it to achieve grounding and affirmation in a world of chaos and alienation. We are in a time when a metacritique may now become possible, where the crisis in Western thought coincides with a dawning epistemic consciousness among Muslims. "We are living," she notes, "at the threshold of a critical era which is steadily being acknowledged as such. The designation 'post­modernity' indicates the direction of the transition away from the established canon of values and beliefs identified with the European Enlightenment." ...

scholarly journals Assisted Living Administrators' Views of Palliative Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 906-906
Author(s):  
Elise Abken ◽  
Molly Perkins ◽  
Alexis Bender
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Assisted Living ◽  
Spiritual Needs ◽  
Structured Interviews ◽  
Age In Place ◽  
Care Access ◽  
Access And Quality ◽  
Using Data

Abstract As many older adults with progressive chronic conditions choose to age-in-place in assisted living (AL) communities, external healthcare workers (e.g., those who provide palliative care) increasingly support AL staff in caring for residents with complex health needs. Palliative care is a branch of healthcare dedicated to preserving quality of life by attending to the physical, mental, and spiritual needs of individuals with chronic, life-threatening diseases and is well suited to manage AL residents’ progressive medical conditions. However, AL residents and their care partners often face barriers to accessing palliative care. Using data from a larger 5-year NIA-funded study, we examined AL administrator knowledge and use of palliative care in seven AL communities around the Atlanta metropolitan area that were racially, ethnically, and socioeconomically diverse. Findings from thematic analysis of semi-structured interviews with 16 administrators indicated that 15 of 16 administrators were familiar with palliative care. A minority of administrators clearly distinguished palliative care from hospice services and conceptualized it as a “bridge” to hospice services. Administrators emphasized how palliative care assists communities in caring for health concerns in-house rather than having to send residents to the hospital. Despite their positive view of palliative care, administrators described infrequent use of palliative services in their communities. Findings show that although none of the AL communities integrate palliative care with their service offerings, AL administrators see value in palliative care for their residents. We provide recommendations for improving palliative care access and quality of life for AL residents at end of life.

scholarly journals Refractory suffering at the end of life and the assisted dying debate: An interview study with palliative care nurses and doctors

2020 ◽  
pp. 147775092094661
Author(s):  
Kristine Espegren Gustad ◽  
Åsta Askjer ◽  
Per Nortvedt ◽  
Olav Magnus S Fredheim ◽  
Morten Magelssen
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Symptom Control ◽  
Prima Facie ◽  
Assisted Dying ◽  
Analysis Framework ◽  
Structured Interviews ◽  
Care Services ◽  
Palliative Care Services ◽  
Shed Light

Background How often does refractory suffering, which is suffering due to symptoms that cannot be adequately controlled, occur at the end of life in modern palliative care? What are the causes of such refractory suffering? Should euthanasia be offered for refractory suffering at the end of life? We sought to shed light on these questions through interviews with palliative care specialists. Methods Semi-structured interviews with six nurses and six doctors working in palliative care in five Norwegian hospitals. Transcripts were analysed with systematic text condensation, a qualitative analysis framework. Results Informants find that refractory suffering is rare, and that with palliative sedation satisfactory symptom control can nearly always be achieved at the end of life. However, the process of reaching adequate symptom control can be protracted, and there can be significant suffering in the meantime. Both somatic, psychological, social and existential factors can contribute to refractory suffering and potentiate each other. However, informants also place significant weight on factors pertaining to the organization of palliative care services as contributing to insufficient symptom control. Conclusions If refractory suffering is indeed rare, then this arguably weakens a common prima facie argument for the legalization of assisted dying. However, the process of reaching adequate symptom control can be protracted and involve significant suffering. The experiences of palliative care clinicians constitute important empirical premises for the assisted dying debate. The study points to several areas in which palliative care can be improved.

Managing Do Not Attempt Cardiopulmonary Resuscitation conversations in the community

2020 ◽  
Vol 25 (2) ◽  
pp. 58-64 ◽  
Author(s):  
Jennifer M Hadley
Keyword(s):  
Palliative Care ◽  
Cardiopulmonary Resuscitation ◽  
End Of Life ◽  
Communication Strategies ◽  
Structured Interviews ◽  
Clinical Nurse ◽  
Patient Understanding ◽  
Clinical Nurse Specialists ◽  
Impending Death

Clear, sensitive and timely communication with palliative and end-of-life (EoL) patients and their families is important. Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) conversations can help patients accept their impending death and achieve a more dignified death. This research explored the experiences and communication strategies of clinical nurse specialists (CNSs) in palliative care when managing DNACPR conversations in the community. Six semi-structured interviews were conducted with community palliative care CNSs, and the results were summarised using autoethnography. Delays in EoL discussions mean that some community palliative care CNSs are having DNACPR conversations at their first meeting with patients. Balancing being clear and sensitive is challenging, especially when patients and families have previously been informed inappropriately or insensitively about DNACPR decisions. DNACPR discussions should be initiated by exploring patient understanding and preferences while emphasising care continuation and a more dignified death.

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