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"Doing good care" - a study of palliative home nursing care
Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work. University of Gothenburg;Kronoberg County Research Centre.ORCID iD: 0000-0002-3155-575x
Kronoberg County Research Centre.
Kronoberg County Research Centre.
Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work. University of Gothenburg.
2007 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 2, p. 227-235, article id 4Article in journal (Refereed) Published
Abstract [en]

Today, more and more people die in own homes and nursing homes, which fundamentally affects community nursing. The aim of this study was to develop a classic grounded theory of palliative home nursing care and we analysed interviews and data related to the behavior of community nurses caring for palliative cancer patients. Doing Good Care emerged as the pattern of behavior through which nurses deal with their main concern, their desire to do good. The theory Doing Good Care involves three caring behaviors; Anticipatory caringMomentary caring and Stagnated caring. In Anticipatory caring, which is the optimal caring behavior, nurses are doing their best or even better than necessary, in Momentary caring nurses are doing best momentarily and in Stagnated caring nurses are doing good but from the perspective of what is expected of them. When nurses fail in doing good, they experience a feeling of letting the patient down, which can lead to frustration and feelings of powerlessness. Depending on the circumstances, nurses can hover between the three different caring behaviors. We suggest that healthcare providers increase the status of palliative care and facilitate for nurses to give Anticipatory care by providing adequate resources and recognition.

Place, publisher, year, edition, pages
Taylor & Francis, 2007. Vol. 2, p. 227-235, article id 4
Keywords [en]
Anticipatory caring, classic grounded theory, community nurses, momentary caring, palliative care, stagnated caring
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:vxu:diva-3007DOI: 10.1080/17482620701650299OAI: oai:DiVA.org:vxu-3007DiVA, id: diva2:202963
Available from: 2008-01-14 Created: 2008-01-14 Last updated: 2019-04-15Bibliographically approved
In thesis
1. Deciphering Unwritten Rules: Patients, relatives and nurses in palliative cancer care
Open this publication in new window or tab >>Deciphering Unwritten Rules: Patients, relatives and nurses in palliative cancer care
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis focuses on palliative cancer care in acute care hospitals and home care settings. The overall aim was to generate a grounded theory explaining the latent patterns of behavior of patients, relatives and nurses. The thesis includes one population-based study with cross-sectional design and four classic grounded theory studies.

Study I was conducted in two acute care hospitals. In this 5-year follow-up study, the proportion of hospitalized palliative cancer patients had decreased. The patients were older with more symptoms and care needs per patient. In both years, the most common symptoms were pain and deterioration and the most common cancer sites were prostate and colorectal. The results showed that associations between symptoms, care needs and cancer site were mostly weak.

In study II, striving for emotional survival emerged as the pattern of behavior through which nurses in acute care hospitals deal with their main concern, the risk of being emotionally overloaded. Striving for emotional survival involves emotional shielding, emotional processing and emotional postponing.

In study III, doing good care emerged as the pattern of behavior through which nurses in home care deal with their main concern, their desire to give good care. Doing good care involves three different caring behaviors: anticipatory caring, momentary caring and stagnated caring.    

In study IV, living on hold emerged as the pattern of behavior through which patients and relatives deal with their main concern, being put on hold. Living on hold involves three modes: fighting, adjusting and surrendering.

The overall theory, deciphering unwritten rules, explains how patients, relatives and nurses are dealing with the uncertainty of how to act and behave.   Deciphering unwritten rules involves figuring out, deliberating, maneuvering and evaluating.

In conclusion, this thesis demonstrates the complexities of palliative cancer care and the importance of knowledge, resources and counseling. Patients should be cared for at the right care level according to their care needs and the care focus should be on treating symptoms irrespective of the diagnosis. The palliative care approach therefore needs to be implemented in all caring contexts with dying people.

Place, publisher, year, edition, pages
Växjö, Kalmar: Linnaeus University Press, 2010
Series
Linnaeus University Dissertations ; 14/2010
Keywords
cancer, deciphering, unwritten rules, grounded theory, nursing, palliative care, patient, relative
National Category
Nursing
Research subject
Health and Caring Sciences, Caring Science
Identifiers
urn:nbn:se:lnu:diva-2502 (URN)978-91-86491-19-2 (ISBN)
Public defence
2010-05-21, Myrdal, Växjö, 10:30 (Swedish)
Opponent
Supervisors
Available from: 2010-04-21 Created: 2010-04-16 Last updated: 2018-05-17Bibliographically approved

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Sandgren, AnnaThulesius, HansFridlund, Bengt

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