Qualitative observation in a clinical setting: Challenges at end of life

Family caregivers provide the majority of home care of people with Alzheimer's disease. In this study, we discuss family caregivers' life orientation and changes in life orientation during the first year after the diagnosis of Alzheimer's disease. Family caregivers' unstructured diaries (n = 83), of the first six months after diagnosis (years 2002-2004), were analyzed using qualitative content analysis. Two core themes emerged from the data analysis: the meaning of the onset of Alzheimer's disease for the lives of family caregivers, and restructuring life in its entirety. Family caregivers face challenges in their life orientation after the onset of their family members' Alzheimer's disease. Their personal milieu, familial cohesion, and conception of the future consequentially change. They face multiple challenges in the process of becoming caregivers. In this study, it was revealed that the process starts before the diagnosis of Alzheimer's disease and has an impact on their future. We conclude that family caregivers' well-being should be assessed at the time of the diagnosis of Alzheimer's disease.

Section: Methodsmentioning

confidence: 99%

Life orientation in Finnish family caregivers' of persons with Alzheimer's disease: A diary study

Välimäki

Vehviläinen‐Julkunen

Pietilä

et al. 2012

“…This inappropriate outlook is manifested by attitudes of reflection, avoidance, and insecurity, among others, and by having to face one's own fears of death (Maza Cabrera, Zavala Gutiérrez, & Merino Escobar, ). In contrast, other authors have reported that professionals who are in contact with death experience a greater personal growth and acceptance of their own death (Bloomer, Cross, Endacott, O'Connor, & Moss, ; Lester & Abdel‐Khalek, ; Reid et al, ).…”

Section: Discussionmentioning

confidence: 84%

Comparative study among Spanish students of health sciences degrees: Facing death

Cruz

Luengo

2018

The purpose of this study was to explore the perceptions and attitudes of students of health sciences faculties (medicine, nursing, and physiotherapy) regarding specific issues related to death and end of life in both professional and personal realms. A descriptive, cross-sectional, and multi-center approach was used. The modified Bugen Scale for facing death was used. The study population (411 students) encompassed three distinct groups: students from the degrees of medicine, nursing, and physiotherapy. In total, 12 items showed significant differences between the three groups. The sample presented a moderate level of perceived competency in the ability to face death. We found significant differences in the scores obtained by the three groups regarding their ability to face the death of people who are emotionally close. Furthermore, the sample demonstrated a good level of self-efficacy when facing death, with nursing students displaying the greatest emotional involvement when compared to their colleagues studying medicine and physiotherapy. It is therefore recommended that study curricula of future health professionals contain specific training in end-of-life care.

“…Several strategies were employed to ensure the rigor of the study. Credibility was ensured by researcher reflexivity, and the use of reflective journaling (Koch, 2006;Bloomer et al, 2012). Dependability and transferability of the research was ensured through the use of an audit trail detailing research design, data collection, and analysis (Holloway & Freshwater, 2007).…”

Section: Discussionmentioning

confidence: 99%

Australian nursing students' stories of end‐of‐life care simulation

Gillan

Riet

Jeong

2016

Because nurses are at the forefront of end-of-life care, it is imperative that nursing students are prepared for this role upon graduation. Research suggests that many nursing students are unprepared to deliver compassionate and quality end-of-life care. There have been many attempts to address this need; one emerging method is end-of-life care simulation. This paper explores the experiences of 18 undergraduate nursing students of end-of-life care simulation. Participants' stories were obtained via observation during end-of-life care simulation, audio-recorded post simulation debriefing, and semi-structured interviews. Using Clandinin and Connolly's three dimensions of Narrative Inquiry (temporality, spatiality, and sociality) participants' stories reflected convergence of time, place, and person. Findings revealed three distinct plotlines along a time continuum, specifically surrounding time of death: (i) "The privilege of end-of-life care;" (ii) "Witnessing death as surreal;" and (iii) "The honor of providing after-death care." Participants' narratives suggest that end-of-life care simulation is an important means of preparing students for clinical end-of-life care experiences. This has implications for nursing educators wishing to consider simulation in end-of-life care education.