Policy Narratives on Palliative Care in Sweden 1974–2018

Ågren, Axel; Krevers, Barbro; Cedersund, Elisabet; Nedlund, Ann-Charlotte

doi:10.1007/s10728-022-00449-1

Cited by 8 publications

(4 citation statements)

References 29 publications

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“…O país discute narrativas políticas de cuidados paliativos desde a década de 1970, e estabeleceu nos últimos anos propostas que se concentram em direção a uma universalização desse tipo de cuidado. (30) Considerando que a Suécia apresenta um sistema de saúde pública, as últimas discussões circularam em torno de indicadores de qualidade. Um estudo (31) publicado no ano de 2015, que avaliou a qualidade da morte em 80 países, classificou a Suécia como décima sexta.…”

Section: Discussionunclassified

“…A arguição procurou avaliar os países quanto à disponibilização de cuidados paliativos, ambientes de saúde, recursos humanos e profissionais, qualidade de cuidados e participação da comunidade. (30) E embora algumas narrativas se concentrem acerca de questões como: medicalização, rotinização e burocratização, que se opõem ao que a filosofia dos cuidados paliativos indica. É possível avaliar que essas narrativas não são lineares e se modificam conforme as necessidades encontradas pelas populações.…”

Section: Discussionunclassified

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Estrategias de autoayuda para pacientes de cuidados paliativos y sus familias: una revisión integrativa

Marques,

Blumentritt,

Cordeiro

2024

Enfermeria (Montev.)

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Objetivo: Identificar as estratégias disponíveis na literatura internacional que forneça métodos de autoajuda para pacientes em cuidados paliativos e seus familiares. Método: Trata-se de uma revisão integrativa da literatura, realizada entre abril e maio de 2022, utilizando as bases de dados e bibliotecas online Medline, Scielo, Scopus, CINAHL e Web of Science. Os estudos foram selecionados de forma rigorosa, através da utilização de diferentes combinações dos MESH’s e palavras chaves self-help, groups, palliative care, medicine in literature, literature, health, disease com o operador booleano AND. Foi utilizado um aplicativo online de gerenciamento de revisões, Rayyan - Intelligent Systematic Review, sendo realizada a dupla verificação cega. Na busca primária foram encontrados 3259 estudos, após a aplicação dos critérios de exclusão 16 artigos compuseram o corpus de análise que usou como forma de apreciação a metodologia descritiva. Resultados: Obteve-se como principais achados a utilização de grupos de autoajuda como uma importante estratégia para auxiliar pacientes e familiares em situações desafiadoras que cernem o final de vida, outras estratégias foram vislumbradas como o uso de cartilhas, espaços e programas, que tendem a auxiliar nos momentos em que é necessário a comunicação de más notícias ou passar por situações de perda antecipatória e luto. Houve a predominância de estudos de abordagem qualitativa, e em maioria realizados na Suécia. Conclusão: Evidenciou-se que a estratégia dominante foi os grupos de autoajuda, que demonstraram ser um espaço de troca de conhecimento e experiências pessoais, entre os indivíduos participantes.

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Section: Discussionunclassified

Estrategias de autoayuda para pacientes de cuidados paliativos y sus familias: una revisión integrativa

Marques,

Blumentritt,

Cordeiro

2024

Enfermeria (Montev.)

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“…Therefore, for some, an altered home with a hospital-like environment may be alienating and too demanding. In many countries, including Norway, 5 , 53 , 54 home death is a political matter. Those in favour of it state that people who want to die at home should have the option to do so.…”

Section: Discussionmentioning

confidence: 99%

‘It’s not just about me’: a qualitative study of couples’ narratives about home death when one of the partners is dying of cancer

Aurén-Møkleby,

Thoresen,

Mengshoel

et al. 2023

Palliat�Care

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Background: Most cancer patients state a preference for home death. Care and support from primary caregivers are important to enable dying at home. A preference for home death from the perspective of couples has rarely been investigated. Objectives: To explore how a preference for home death is understood and enacted in couples where one of the partners is dying of cancer. Design: A qualitative interview research design with a narrative approach was used. Methods: Five couples participated in dyad interviews. During the analysis, two interviews that particularly illuminated couples’ shared and individual views were chosen as the primary cases. Results: The interviews show, in two highly different ways, how a preference for home death is a significant relational matter. The interviews are presented as two cases: ‘Struggles in an Unknown Terrain’ and ‘Reliance at the Kitchen Table’. They show how a preference for home death can be understood and enacted as a struggle or as reliance based on the couple’s shared biography and the partner’s ability to care for the partner during the end-of-life phase. The analysis highlighted the negotiations that underpin a preference for home death. In these negotiations, the couples drew on idealised understandings of home death. These ideas were supported by cultural values related to autonomy and independence as well as participation and citizenship. Thus, in the negotiations about being cared for and caring, legitimate dependency and the maintenance of a reciprocal relationship were balanced. The presence of healthcare professionals and medical devices in the home had to be balanced with the need to maintain a sense of self and an authentic home. Conclusion: A relational perspective on a preference for home death made us attentive to couples’ negotiations. These negotiations give couples the opportunity to re-evaluate and reconfirm individual and mutual needs in the end-of-life phase.

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“…Worldwide Palliative Care Alliance (WHPCA) betonar tillsammans med Världshälsoorganisationen (WHO) att det är ett globalt etiskt ansvar att erbjuda alla människor som är i behov, ett palliativt förhållningsätt för att lindra lidande orsakat av allvarlig och obotlig sjukdom (47,48). Utvecklingen av den palliativa vården har gått framåt de senaste decennierna, och är ett prioriterat ämne globalt (49,50). Trots framsteg står palliativ vård fortsatt inför utmaningar.…”

Section: Palliativ Vårdunclassified

Samtal vid allvarlig sjukdom - Kronobergsmodellen

Granat

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Aim: The overall aim of this thesis was to explore clinicians’ perceptions and self-efficacy regarding the use of the ‘Serious illness conversation’ structured workflow, and to explore their self-efficacy in caring for patients with palliative care needs. Methods: This thesis is comprised of four studies: two qualitative studies, one methodological study, and one quantitative study. In studies I and II, observations of clinic meetings and training sessions were undertaken with clinicians. Interviews were performed and a thematic analysis was conducted. In study III, the Self-Efficacy in Palliative Care scale (SEPC) was translated, adapted, and validated. In study IV, the SEPC-SE was completed by nurses and physicians. Factor analysis and Cronbach's alpha were calculated, and the Mann-Whitney U test was used to compare self-efficacy. Multiple linear regression was used to explore associated factors. Results: In study I, clinicians expressed that working with serious illness conversations was vital, but the conversations were also considered in terms of risks. The conversation training sessions created feelings of exposure but were perceived to be rewarding due to an increase in self-awareness. Obstacles in practice were identified as barriers to change. Study II showed that positive experiences and the group’s level of support, consensus, and behaviour was important for self-efficacy. Some clinicians were affected by perceived high demands, failures, anxiety, stress, when working with serious illness conversations. Study III showed that the SEPC-SE needed improvements in understandability and clarity. In study IV, the SEPC-SE reported high reliability. Physicians reported higher self-efficacy than nurses. Education at work and experience in advanced homecare had the strongest associations with self-efficacy. Conclusions: Implementing serious illness conversations can increase clinicians’ awareness about the importance of engaging in serious illness conversations and thus contribute to increased motivation through behavioural and attitudinal changes. However, building a support system for clinicians within the organisation seems essential for improving self-efficacy. The SEPC-SE was found to be valid and reliable. Clinicians’ estimation of their perceived self-efficacy indicates that healthcare organisations should prioritise work-related education and experience to improve self-efficacy in providing palliative care.

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Policy Narratives on Palliative Care in Sweden 1974–2018

Cited by 8 publications

References 29 publications

Estrategias de autoayuda para pacientes de cuidados paliativos y sus familias: una revisión integrativa

Estrategias de autoayuda para pacientes de cuidados paliativos y sus familias: una revisión integrativa

‘It’s not just about me’: a qualitative study of couples’ narratives about home death when one of the partners is dying of cancer

Samtal vid allvarlig sjukdom - Kronobergsmodellen

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