published_or_final_version / Architecture / Master / Master of Landscape Architecture

published_or_final_version / Gerontology / Master / Master of Social Sciences

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

This qualitative study of eight First Nation participants and five First Nation Elders is to help understand how First Nation people view spirituality and how it is practiced when one has a terminal illness. Spirituality is often so abstract and practiced in various ways that it requires clarity and understanding from the people around them. Health care professionals could improve health care by understanding some of the spiritual aspects practiced when people are within their health care system. The First Nation people's perspectives aim to banish some of the mystery or unawareness that looms around spirituality in order to improve health services. Social workers have little or no information about First Nation beliefs and practices around spirituality when they have a terminal illness. The study is to help health care professionals and people with a terminal illness understand spiritual practices through specific beliefs and examples of how spirituality is practiced.

The primary purpose of this study was to examine nurses including student nurses perceptions of death education in southern Alberta as one way of improving futrue nursing curricula. Five nurse subgroups were included, as follows: college and university students, hospital nurses, community nurses, and nurse educators. A questionnaire was developed and piloted prior to distribution to 450 nurses in six locations, including two urban and four rural sites, in southern Alberta. Completed, useable returns numbered 373 (83%). Descriptive statistics, ANOVA, and t-tests were used to analyze the data from scaled questionnaire items; content analysis was used to interpret written response items. Theoretical and conceptual frameworks were developed and utilized to guide the interpretation of findings. Generally, nurses perceived that existing death education remains inadequate as preparation for sound clinical nursing practice. Several statistically significant findings related to the provision of professional terminal care were reported amon the five nurse subgroups. Nurses identified concerns and deficits within existing nursing death educaiton and offered several specific suggestions for improvement. The improvement of death education for nurses will most likely result in the delivery of safe, effective, quality nursing care practice to the dying person and family. / xi, 160 leaves : ill., charts ; 28 cm.

It is generally accepted that spirituality can play an important role in the end stage of the life of a person. Spirituality can provide a source of comfort and guidance and in so doing be a coping strategy. Social workers should take into account this spiritual component of their work particularly with clients who use spirituality as a form of social support. This thesis provides a theoretical understanding of spiritual based practice. It identifies the principles and competencies central to this practice, including the need for worker self awareness. It then illustrates how certain social work students have applied these principles in their practice with dying clients. / The author's own identification as an individual from a religiously oriented Muslim country is used to illustrate the importance of understanding and working from the world view of clients. The author concludes that spirituality should not be ignored by social workers in their practice.

This thesis explores home-based care volunteer (HBCV) identity and how it is shaped by context in rural KwaZulu-Natal, South Africa. The literature on home-based care in Africa is dominated by the "burden of care narrative" which is supported by the themes of "women as caregivers", "poverty" and "stigma". The literature presents government and stakeholder collaboration as the general solution to alleviating the burden of care on women caregivers. A wider scope for research within the themes is necessary to discover alternative solutions to the problem of the burden of care. This study ventured to expand the scope of current research by exploring the area of HIV and AIDS home-based care volunteer (HBCV) identity and participation in care and support. Fifteen HBCVs were interviewed about their work and personal life stories and interviewed reflexively using narrative interviewing. Findings indicate that the women's stories were dominated by narratives of gender, poverty and sociopolitical factors (social field narratives). Meta-narratives influencing the women's lives were stories of communal motherhood, aspirations to service-oriented work and religious beliefs and commitment. The women's personal life stories revealed that they saw themselves as distinctively caring. Connections between the different aspects of identity and context revealed that the women made sense of their community participation through their personal identities as strong and loving mothers and the association with the group identity of community mothering. Home-based-care volunteerism was explored as a form of agency in response to a lack of recognition, support and acknowledgement for AIDS caregivers and their patients. Researcher reflexivity through autoethnography and poetry contributed to achieving depth in the study and to the understanding that HBCVs strive for space recognition, acknowledgement and validation for their work. In a resource strained context a balance must be found between material compensation and respect and recognition which can be effective in sustaining community initiated volunteerism. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2013.

Att ett barn vårdas palliativt är en svår och komplex situation för barnets föräldrar. Föräldrarna kan känna sig hjälplösa samtidigt som de tar stor del i barnets vård. Syftet med litteraturstudien var att belysa föräldrars upplevelser av att vårda sitt barn palliativt. Elva artiklar valdes ut som sedan analyserades. I resultatet framkommer fyra olika teman: att fungera som förälder och familj efter det tuffa beskedet, att bibehålla föräldrarollen i barnets vård, att skydda barnet och att vara förälder när barnets död närmar sig. Temana beskrev bland annat föräldrarnas svårighet i att hantera sin egen sorg, samtidigt som vardagslivet fortsatte efter beskedet om barnets obotliga sjukdom. Föräldrarna ville ha kvar föräldrarollen samtidigt som de blev barnets vårdgivare, vilket ledde till att föräldrarna tvingades ta svåra beslut som ibland stred mot barnets vilja. Föräldrarna ville göra allt för barnet, inklusive att stötta, skydda och informera sitt barn. Föräldrarna hade också förhoppningar i samband med barnets död, till exempel att barnet skulle vara smärtfritt och vara bekvämt, dock beskrev föräldrarna att dessa önskningar ofta inte gick att uppfylla. Fortsatt forskning behövs för att sjuksköterskor ska kunna sätta sig in i familjens situation och för att kunna ge den bästa möjliga vården.

Nurses in dual caregiving roles are at high risk for stress and burnout, which may influence nurses’ decisions to leave the nursing profession. This exploratory, descriptive, qualitative study explored registered nurses’ experience of caring for a dying family member. Fourteen nurses were recruited and rich descriptions of their experiences were gained through individual face-to-face interviews. Three important themes were identified through data analysis: knowing the ropes which captures the assets nurses brought to their family caregiving experience from their professional knowledge and association with the health care system; caught in the middle, which highlights tensions the nurses faced as they negotiated their professional and personal boundaries; and gaining insights, which describes nurses’ insights about themselves and their practice gleaned from caring for a dying family member. The findings suggest that lack of support from the formal health care system may compound the stress of caregiving for nurses and may lead to health problems. Therefore, it behooves HCPs, health organizations and policy makers to individualize interventions and design palliative programs to address the unique needs of nurses caring for a dying family member.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2006. / Härtill 4 uppsatser.