Background: Critical Care Nurses (CCNs) frequently provide end of life (EOL) care in intensive care units (ICUs). Barriers to EOL care in ICUs exist and have been previously published, but qualitative reports from CCNs themselves remain scarce. Qualitative data exploring barriers faced during ICU EOL care may increase awareness of obstacles and help remove them. Objective: Excluding family experiences, what are the major themes recounted by CCNs when asked to share common obstacles experienced in providing ICU EOL care? Methods: Members of the American Association of Critical-Care Nurses were randomly surveyed and responses to a single qualitative question were used. Results: There were 104 participants who provided 146 responses reflecting EOL obstacles which were divided into 11 themes; 6 physician- related obstacles and 5 nursing-and-other related obstacles. Top three EOL ICU barrier themes were inadequate physician communication, physicians giving false hope and nursing-related obstacles. Conclusion: Poor physician communication is the main obstacle noted by CCNs during ICU EOL care followed by physicians giving false hope. Heavy patient workloads were also a major barrier in CCNs providing EOL care.

The purpose of this study was to investigate the use and frequency of euphemisms for die, dying or dead in the American English-language using the Corpus of Contemporary American English. To fulfill the purpose, three research questions were answered. I wanted to know in which genres, of Spoken, Fiction, Magazines, Newspapers, Academic texts, TV/Movies, Blogs and web-gnl, the euphemisms occurred the most. I also wanted to investigate which euphemism, in terms of frequency, of pass away, demise, decease and last breath was the most common one, and how frequent they are compared to the “standard” die, dying or dead. How the frequency of the euphemisms developed over the time span 1990-2019, was also something the study wanted to answer. To answer these questions, studies which defined and discussed taboo, euphemisms, and metonymy were used. The conclusion was that even the least occurring genre in the standard has got a higher frequency than all the euphemisms together. However, demise was the most frequent euphemism and Fiction, TV/Movies and Academic were the genres in which the euphemisms occur the most in. Moreover, although demise was the most frequent euphemism, it was also the one that decreased the most over the period of 30 years. pass away, however, increased the most over time.

In my work I deal with the issue of palliative care, which includes variables such as illness, pain, suffering and dying. The first part is focused on these facts, which the terminally ill meet in several variations over time, they consider the issues that affect the essence of their lives and are confronted with the reality. I tried to enlarge the general view around the patient and of his problems with the Christian view , ie the possibility to browse the desperate hope that exceeds life and death. For Christians this hope means Jesus Christ .For the patient to receive this hope there is the Christian Church. The second part of this work deals with specific help, such as companionship, which is the work of chaplains and other Christians, whether in volunteer work, or experts in any of the religious establishments. In conclusion, I try to approach the issue of euthanasia, which just highlights the need for human and compassionate palliative care.

The thesis aims with discourse rules of dying of a close person. Author works with other theories, especially with Gorer's pornography of death and also comparisons of current situation and history of Ariés and Elias, who considered the current representations of death to be more a taboo than in the past. The practical base of the text is a research combining both in-depth interviews with young people and interpretations of closed groups, such as support group and internet discussion. The analysis identified two approaches in young people's families, focusing either on practical aspects of dying of a relative or on emotional aspects. These two approaches were in opposition against each other especially while both being present in a single family. Also, several conditions changing discourse rules were identified. The death of a young person or by suicide were more tabuized than death of an elder person. Generally, the research shows that people's view on death is not constructed by media as Gorer proposed, since young adult people have their own experience from their families. In this text, death is considered to be a taboo of the society because of strict boundaries of what is appropriate and inaproppriate. Powered by TCPDF (www.tcpdf.org)

Up to 90% of adolescents in the U.S. experience a loss of a family member or friend. However, prior research on loss of a family member has focused predominantly on the adult experience (e.g., loss of a spouse), parental bereavement (loss of a child), or grief counseling as an intervention for dealing with loss. Little is known about the sibling loss experience, particularly from the point of view of the surviving sibling who suffered the loss when they were young. Thus, the purpose of this qualitative study was to explore the narratives of young adults who experienced the loss of a sibling during adolescence, and to understand the role of family, friends, and resources. This research utilized three theoretical models: Erik Erickson's theory of Psychosocial Development, Murray Bowen's theory of Family Systems, and Theresa Rando's 6 R's theory of loss. Eight participants (all female) between 18 and 30 years who lost a sibling between 13 and 18 years were invited through posting in 4 closed sibling loss groups on Facebook. Using Reissman's thematic analysis, data from semi-structured interviews revealed five themes: returning to school (refuge vs. struggle); being there (sources of support); emotional separation (family, friends, and the lost sibling); identification of self/moving forward (turning points following the loss); and family dynamics with departed and surviving (maintaining the lost connection). Future research should intentionally sample other demographics to broaden the understanding of sibling bereavement across age, gender, ethnicity, and religion. Positive social change implications include efforts to promote training and programs sensitive to the unique needs of bereaved young adults in secondary school and college settings.

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In 2016, Gray and Jones adapted the narrative policy framework (NPF) to a qualitative context. In this research, I build from their resulting Qualitative NPF (Q-NPF) method to analyze 300 randomly selected Canadian media articles published between 2007-2017 on the topic of Medical Assistance In Dying (MAID). I begin by explaining how the concrete procedures of MAID are distinct from other end-of-life practices, and introduce the terminology that will be used throughout this research. I then introduce historic and academic literature relevant to the form and content of the contemporary media narratives to be analyzed, especially drawing theoretically from Rose’s (2013) discussion of biomedical personhood discourses and Butler’s theory of unevenly distributed precarity. I then explain the methodology of qualitative narrative policy analysis (Q-NPF), and apply it to Canada’s MAID debate by dividing the policy positions into what I call the Freedom, Protection, and Fence-sitting narrative policy camps. The Freedom camp advocated for MAID legalization; the Protection camp advocated against MAID legalization; and the Fence-sitting camp avoided advocating either for or against baseline legalization of MAID, instead weighing in only on peripheral issues. I discuss the qualitative differences of narrative content specific to these three camps, highlighting the most prominent narrative trends (by frequency of publication) and discussing the ways in which these findings either accord with or contradict the expectations of the literature review. Finally, I update the reader on Canadian legislative developments since 2017 and identify how the data of 2007-2017 anticipated these developments, demonstrating the salience and predictive power of Q-NPF. I conclude by proposing new directions for potential investigation. / Graduate / 2022-12-13

Värdighet var ett centralt temai vård av äldre. Självbild, autonomi och integritet var några viktiga teman och värderas högt i relation till uppfattning av värdighet hos svenska äldre personer. Samtidigt fanns det studier som indikerade att när invandrarpatienter betraktades i vårdsituationen bedömdes ofta deras individuella skillnader inom ramen för deras speciella kultur. Är tolkning av begreppet värdighet detsamma i andra kulturer som den svenska? Kultur hade inte varit ett särskilt utforskat ämne inom svenska vården. Det kan vara avintresse för vården att ha kunskap om och förståelse för patienters olika värderingar och perspektiv i en alltmer globaliserad värld. Syftet var att belysa kulturs betydelse för uppfattning av begreppet värdighet för äldre personer. Metoden var en allmän litteraturstudie som byggde på 18 vetenskapliga artiklar om äldres värdighet från olika världsdelar. Resultatet från europeiska studier stämde väl överens med de svenska, där informanterna lyfte fram identitet, autonomi, oberoende, och integritet somde viktigaste faktorerna för värdighet. Dessa faktorer var också centrala teman enligt informanterna i de asiatiska studierna, dock med mer betoning på respekt från omgivningen och familjen och sociala relations betydelse för ens värdighet. Tankar om döden och acceptans inför smärtan och döden var annat återkommande tema hos de äldre från asiatiska länder. De flesta studier från USA hade jämfört tolkning om värdighet mellan grupper av personer med olika kulturella bakgrunder och fann att människor från olika bakgrunder hade i stort sätt samsyn på värdighet, men de kunde ha olika seder och vanor och därmed handlade olika i konkreta situationer. Slutsatser som drogs från resultatet var att samhälles kultur tjänade som förmedlare och upprättare av samhälletsvärderingar till individen. Kultur hade viss betydelse för människans uppfattning av begreppet värdighet och dess innebörd, vilket var viktigt för vårdpersonal att känna till för att utföra värdighetsbevarande vård för äldre personer med olika kulturella bakgrunder. / Dignity was an essential theme within geriatrics care. Self-image, autonomy and integrity were the underlying elements that the Swedish elderly value highly. In the meantime there were studies that indicated elderly people with immigrant background were often judged by the Swedish health care providers according to their cultural origins rather than their personal attributes. Did the term of dignity mean the same thing in other countries as in Sweden? Culture as a theme had not been particularly explored in the Swedish health care context. It would be interesting for the health care workers to have more knowledge and deeper understanding for patients´ different perspectives and values in an increasingly globalized world. The aim was to explore the cultural significance on the perception of the concept of dignity for the elderly. Method was a general literature review based on 18 research articles from different countries. The results from the European countries were similar to that from the Swedish ones. The participants valued highly independence, identity and integrity and considered these values as the most relevant for dignity. Even the participants from Asian studies shared these points of view, yet with more emphasis on the importance of family and respect from others. Social relationship mattered for dignity. Another topic from the Asian studies were the elderly´s accepting attitude towards pain, suffering and death. Studies from the United States were often based on comparisons on interpretation of concept dignity between groups with different cultural backgrounds. The results indicated that most people shared the same opinion upon the question but people had different customs and habits but could behave in different ways under a certain situation. Conclusions to be drawn from the results were the culture was a society´s agent for promoting its values to its people. Culture mattered for the understanding of the concept dignity. This knowledge could be useful for the health care workers engaged in conserving dignity for the elderly.

IntroductionOver the last decades a positive shift in attitudes towards legalisation of assisted dying (AD) (AD including euthanasia (EUT) and physician-assisted suicide (PAS)) have occurred in western Europe. Physicians are generally more negative than the general public toward legalisation. Medical students’ attitudes, as future practitioners, are important to assess when addressing this ethically complex issue.AimThe aim was to explore the attitudes among medical students at Örebro university, Sweden regarding assisted dying and their stance on the legalisation of assisted dying and to evaluate if religious beliefs, current term of study, gender, and a shift of legal framing would affect medical students´ attitudes.MethodsA cross-sectional online-based anonymous survey containing eight different patient scenarios was distributed to all medical students enlisted at Örebro university Sweden (n=657). Association between demographics and positive attitudes towards AD was tested using logistic regression, and McNemar for difference of proportion in attitudes between various scenario framings.ResultsThirty five percent (n=229) of the medical students responded with completed questionnaires. Sixty percent of the respondents believed PAS for terminally ill patients should be legalized in Sweden. Shifting of legal framing resulted in statistically significant differences of position in all eight scenarios (p<0.05). Strong religious beliefs were associated with decreased likelihood for positive attitudes towards AD in scenario 1-6 (p<0.05).ConclusionsMost respondents in this study believed PAS should be legalised. Held attitudes toward AD were affected by religious beliefs and legal framework. Additional studies to further explore medical students´ attitudes are deemed necessary.

This study examines the level design of the game Dying Light through the lens of player movement. It aims to answer the question: How does the player movement capabilities inform the level design in the game Dying Light? The study analyses the correlation between the player’s movement capabilities and level layout. The research is relevant to game designers wanting to make games centered around movement as a core mechanic, and researchers wanting to use design patterns to study level design through the lens of a core mechanic. The research was conducted through a formal analysis of the actions, components, and goals found in the level, which together form a multitude of level design patterns that support the player’s movement capabilities. These patterns were split into categories based on their goals, followed by these categories being noted down on a designated area of the map. The study indicates that the patterns made with these primitives are a useful tool to tie a specific mechanic like player movement to level- and game design decisions, which is shown in how the level design of Dying Light was built around its movement system to allow for almost unlimited freedom of movement.