The main purpose of this study was to develop Inventory of Concepts of Good Death to explore the concepts of good death and the relationships among fear of death and concepts of good death in adolescents. This study used Inventory of Concepts of Good Death and The Multidimensional Fear of Death Scale to investigate the Junior high school students within the Taipei and Kaohsiung County , 600 copies of the questionnaire were distributed to the subjects who were chosen. 495 of the 600 subjects were available.The data gathered from questuonnaires were analyzed by statistical methods such as descriptive analysis, t-test, one-way ANOVA, point-biserial correlation, Pearson¡¦s correlation and interaction regression analysis.The main findings in this study were as follows: The concepts of good death included Physical, Perceptive, Affective, Spiritual and Socie-Cultural levels. Adolescents¡¦ fear of death and concepts of good death were up to the median. They showed the highest fear of death on Fear for Significant Others, and the best concepts of good death on Spiritual level. Adolescents who were females, personal religion was Chinese or western religious belief, parental religion was Chinese religious belief, being aware of good physical mental condition held better concepts of good death. Adolescents who talked about death publicly at home, had experienced the death of pets, were exposed to impressive death experience through the mass media like broadcasting and TV, have more death-relevant experience and held better concepts of good death. The fear of death in adolescents was higher and the concepts of good death were better. The fear of death could predict the concepts of good death when adolescents had less death-relevant experience. Based on the findings, some suggestions were proposed for teachers, counselor, parents, school, educational authorities and future studies.

Esse trabalho discute a performance ritual e musical durante a Festa da Boa Morte e Glória realizada anualmente na segunda quinzena de agosto na cidade de Cachoeira, Recôncavo da Bahia. Elaborada através de elementos simbólicos, culturais, religiosos e de resistência política e social, a Festa da Boa Morte compreende performances musicais dentro de uma complexa performance ritual que é ao mesmo tempo coletiva e absolutamente restritiva. A Irmandade de Nossa Senhora da Boa Morte é um coletivo de mulheres idosas, todas religiosas enquanto praticantes do candomblé e do catolicismo popular. Como grupo a Irmandade é considerada elite na luta e resistência do negro contra o sofrimento e a escravidão no Brasil. As irmãs foram e são mulheres diferenciadas em vários sentidos: aos olhos da sociedade colonial eram chamadas de negras do partido alto; miticamente transgressoras da ordem masculina são consideradas iamis e organizadas em sacerdócio religioso unindo diferentes nações são donas do axé ou eleyes. As irmãs antigas compraram as alforrias de outros sacerdotes e sacerdotisas africanos, se comprometeram em garantir funerais dignos a si mesmas e aos seus, e mantém uma festa associada aos seus antepassados femininos (eguns) e aos seus orixás durante rituais católicos públicos e do candomblé (secretos). Segundo as irmãs, elas cumprem uma promessa feita pelas mais antigas: se todos os escravos fossem libertos elas cultuariam Maria na vida e na morte. Personagens narrando e encenando repetidamente performances, as irmãs desenvolvem seqüências rituais e musicais que vão da anunciação da morte ao velório de Nossa Senhora no primeiro dia da Festa. No segundo dia é realizado o enterro, e, no terceiro, demonstram sua crença na vida após a morte através da glorificação e assunção de Maria aos céus. Esses são os três principais momentos do ritual público, aos quais se seguem outros três dias de samba de roda que se fundem aos rituais secretos, já em desenvolvimento antes da Festa. O encerramento é marcado pela entrega de um presente às águas, para os orixás femininos Nanã, Iemanjá e Oxum. / This work discusses the musical and ritual performance during the Sisterhood of Good Death Celebration, which occurs in the second half of August in the city of Cachoeira, Recôncavo Area of Bahia. Involving symbolic, cultural, religious, social and political elements, the Sisterhood of Good Death Celebration engages musical performances inside a complex ritual performance that is at the same time collective and absolutely restrictive. The Sisterhood of Good Death is a collective of elderly women, all of them religious while devoted to candomblé and popular Catholicism. As a group, the Sisterhood is considered the elite in the stuggle of black people against oppression and slavery in Brazil. The Sisters were and still are distinguished women in many different ways: during the colonial period, they were called black women from the partido alto; mythically transgressing the dominant masculinity, they are considered iamis and organized in a religious ministry that congregates different candomblé nations. They are also the ones who possess the axé (eleyes). In the past, the sisters bought the manumission of other priests and priestesses, and commited to guaranteeing dignified funerals to themselves and to their people. The Celebration is associated with their female antecessors (eguns) and to their orixás during public catholic rituals and secret candomblé ceremonies. According to the sisters, they are living up to a promise made by their antecessors: If all the slaves were freed, they would all worship Mary in life and in death. Characters narrating and staging repeated performances, the sisters develop ritual and musical sequences which go from the annunciation of the death of the Virgin Mary to her vigil on the first day; on the second she is buried and on the third the Sisters demonstrate their belief in life after death through the glorification and elevation of Mary. These are the three most important moments of the public ritual, followed by three days of samba de roda . The samba takes place parallel to the development of the secret rituals started before the Celebration. On the last day of feast, the sisters deliver a gift to the waters, destinated to the female orixás Nanã, Iemanjá and Oxum.

This qualitative and quantitative study focused on exploring hospice patient’s perceptions of family support. Family support was conceptualized as which family member they expect to receive support from, types of support provided, frequency of support, family communication about medical illness, and type of support that is perceived to be most helpful. Fifteen partcipants between the ages of 70 to 98 were interviewed using purposive sampling. Findings showed that although participants found both physical and emotional support helpful, more than half reported perceiving emotional support as the most helpful. Recommendations for social work practice and research were discussed.

Delirium is a disturbance of consciousness and cognition that affects many terminally ill patients before death. It can manifest as confusion, hallucinations, and restlessness, all of which are known to be distressing to patients, families, and professional caregivers. Underlying the contemporary palliative care movement is a belief in the idea that a good death is possible; that dying can be made better for patients and families through the proper palliation of distressing symptoms and through proper attention to psychological, social, and spiritual issues that affect wellbeing at the end of life. Given that delirium is potentially disruptive to all that the good death assumes, i.e., mental awareness, patient-family communication, peace and comfort, the question was asked: What is the relationship between end-of-life delirium and the good death in hospice care? Ethnographic fieldwork was conducted at a freestanding residential hospice over a period of 15 months in a suburban community in eastern Canada. The research methods included participant observation (320 hours over 80 field visits), interviews with 28 hospice caregivers, and document analysis. The findings of this study provide an in-depth examination of the nature of caregiving relationships with patients and with families in end-of-life care. They illustrate how a commitment toward providing for the good death prevails within the cultural community of hospice, and how the conceptualization, assessment, and management of end-of-life delirium are organized within such a commitment. In this setting, experiences of conscious and cognitive change in dying are woven by hospice caregivers into a coherent system of meaning that is accommodated into prevailing scripts of what it means to die well. At the same time, delirium itself provides a facilitative context whereby processes of supporting families through the patient’s death are enabled. This study highlights the relevance of considering the contextual and cultural features of individual end-of-life care settings that wish to examine, and perhaps improve, the ways in which care of delirious patients and their families is provided.

Delirium is a disturbance of consciousness and cognition that affects many terminally ill patients before death. It can manifest as confusion, hallucinations, and restlessness, all of which are known to be distressing to patients, families, and professional caregivers. Underlying the contemporary palliative care movement is a belief in the idea that a good death is possible; that dying can be made better for patients and families through the proper palliation of distressing symptoms and through proper attention to psychological, social, and spiritual issues that affect wellbeing at the end of life. Given that delirium is potentially disruptive to all that the good death assumes, i.e., mental awareness, patient-family communication, peace and comfort, the question was asked: What is the relationship between end-of-life delirium and the good death in hospice care? Ethnographic fieldwork was conducted at a freestanding residential hospice over a period of 15 months in a suburban community in eastern Canada. The research methods included participant observation (320 hours over 80 field visits), interviews with 28 hospice caregivers, and document analysis. The findings of this study provide an in-depth examination of the nature of caregiving relationships with patients and with families in end-of-life care. They illustrate how a commitment toward providing for the good death prevails within the cultural community of hospice, and how the conceptualization, assessment, and management of end-of-life delirium are organized within such a commitment. In this setting, experiences of conscious and cognitive change in dying are woven by hospice caregivers into a coherent system of meaning that is accommodated into prevailing scripts of what it means to die well. At the same time, delirium itself provides a facilitative context whereby processes of supporting families through the patient’s death are enabled. This study highlights the relevance of considering the contextual and cultural features of individual end-of-life care settings that wish to examine, and perhaps improve, the ways in which care of delirious patients and their families is provided.

Esse trabalho discute a performance ritual e musical durante a Festa da Boa Morte e Glória realizada anualmente na segunda quinzena de agosto na cidade de Cachoeira, Recôncavo da Bahia. Elaborada através de elementos simbólicos, culturais, religiosos e de resistência política e social, a Festa da Boa Morte compreende performances musicais dentro de uma complexa performance ritual que é ao mesmo tempo coletiva e absolutamente restritiva. A Irmandade de Nossa Senhora da Boa Morte é um coletivo de mulheres idosas, todas religiosas enquanto praticantes do candomblé e do catolicismo popular. Como grupo a Irmandade é considerada elite na luta e resistência do negro contra o sofrimento e a escravidão no Brasil. As irmãs foram e são mulheres diferenciadas em vários sentidos: aos olhos da sociedade colonial eram chamadas de negras do partido alto; miticamente transgressoras da ordem masculina são consideradas iamis e organizadas em sacerdócio religioso unindo diferentes nações são donas do axé ou eleyes. As irmãs antigas compraram as alforrias de outros sacerdotes e sacerdotisas africanos, se comprometeram em garantir funerais dignos a si mesmas e aos seus, e mantém uma festa associada aos seus antepassados femininos (eguns) e aos seus orixás durante rituais católicos públicos e do candomblé (secretos). Segundo as irmãs, elas cumprem uma promessa feita pelas mais antigas: se todos os escravos fossem libertos elas cultuariam Maria na vida e na morte. Personagens narrando e encenando repetidamente performances, as irmãs desenvolvem seqüências rituais e musicais que vão da anunciação da morte ao velório de Nossa Senhora no primeiro dia da Festa. No segundo dia é realizado o enterro, e, no terceiro, demonstram sua crença na vida após a morte através da glorificação e assunção de Maria aos céus. Esses são os três principais momentos do ritual público, aos quais se seguem outros três dias de samba de roda que se fundem aos rituais secretos, já em desenvolvimento antes da Festa. O encerramento é marcado pela entrega de um presente às águas, para os orixás femininos Nanã, Iemanjá e Oxum. / This work discusses the musical and ritual performance during the Sisterhood of Good Death Celebration, which occurs in the second half of August in the city of Cachoeira, Recôncavo Area of Bahia. Involving symbolic, cultural, religious, social and political elements, the Sisterhood of Good Death Celebration engages musical performances inside a complex ritual performance that is at the same time collective and absolutely restrictive. The Sisterhood of Good Death is a collective of elderly women, all of them religious while devoted to candomblé and popular Catholicism. As a group, the Sisterhood is considered the elite in the stuggle of black people against oppression and slavery in Brazil. The Sisters were and still are distinguished women in many different ways: during the colonial period, they were called black women from the partido alto; mythically transgressing the dominant masculinity, they are considered iamis and organized in a religious ministry that congregates different candomblé nations. They are also the ones who possess the axé (eleyes). In the past, the sisters bought the manumission of other priests and priestesses, and commited to guaranteeing dignified funerals to themselves and to their people. The Celebration is associated with their female antecessors (eguns) and to their orixás during public catholic rituals and secret candomblé ceremonies. According to the sisters, they are living up to a promise made by their antecessors: If all the slaves were freed, they would all worship Mary in life and in death. Characters narrating and staging repeated performances, the sisters develop ritual and musical sequences which go from the annunciation of the death of the Virgin Mary to her vigil on the first day; on the second she is buried and on the third the Sisters demonstrate their belief in life after death through the glorification and elevation of Mary. These are the three most important moments of the public ritual, followed by three days of samba de roda . The samba takes place parallel to the development of the secret rituals started before the Celebration. On the last day of feast, the sisters deliver a gift to the waters, destinated to the female orixás Nanã, Iemanjá and Oxum.

Delirium is a disturbance of consciousness and cognition that affects many terminally ill patients before death. It can manifest as confusion, hallucinations, and restlessness, all of which are known to be distressing to patients, families, and professional caregivers. Underlying the contemporary palliative care movement is a belief in the idea that a good death is possible; that dying can be made better for patients and families through the proper palliation of distressing symptoms and through proper attention to psychological, social, and spiritual issues that affect wellbeing at the end of life. Given that delirium is potentially disruptive to all that the good death assumes, i.e., mental awareness, patient-family communication, peace and comfort, the question was asked: What is the relationship between end-of-life delirium and the good death in hospice care? Ethnographic fieldwork was conducted at a freestanding residential hospice over a period of 15 months in a suburban community in eastern Canada. The research methods included participant observation (320 hours over 80 field visits), interviews with 28 hospice caregivers, and document analysis. The findings of this study provide an in-depth examination of the nature of caregiving relationships with patients and with families in end-of-life care. They illustrate how a commitment toward providing for the good death prevails within the cultural community of hospice, and how the conceptualization, assessment, and management of end-of-life delirium are organized within such a commitment. In this setting, experiences of conscious and cognitive change in dying are woven by hospice caregivers into a coherent system of meaning that is accommodated into prevailing scripts of what it means to die well. At the same time, delirium itself provides a facilitative context whereby processes of supporting families through the patient’s death are enabled. This study highlights the relevance of considering the contextual and cultural features of individual end-of-life care settings that wish to examine, and perhaps improve, the ways in which care of delirious patients and their families is provided.

No description available.

Livskvalitet är ett etablerat begrepp och är något som endast den enskilde personen kan beskriva, men vad är dödskvalitet? Vetskap om vad ett gott liv består av och innehåller förvärvas genom erfarenhet under hela livet medan döden endast upplevs en gång, fler tillfällen och försök ges inte och ingen tidigare erfarenhet finns att relatera till. Människan lever allt längre, i Sverige förväntas tillväxten i åldersgrupperna mellan 65 - 80 år stå inför en markant ökning under kommande år. Det är vanligt att den äldre personen slutar sina dagar på vård- och omsorgsboenden när kroppen blir skör på grund av en eller fler kroniska sjukdomar och omvårdnadsbehoven inte längre kan tillgodoses i det egna hemmet. Palliativ omvårdnad har målet att ge personen ett väl symtomlindrat liv och en väl symtomlindrad död vid obotlig livshotande sjukdom och omfattar personens fysiska, psykiska, sociala och existentiella behov. Palliativ omvårdnad är ett viktigt område för den allt äldre befolkningen i livets slut på vård- och omsorgsboenden och ska ges under samma förutsättningar och på lika villkor oavsett ålder. Vad en god död består av och rymmer beskrivs ur en mängd olika synvinklar och aspekter inom och utom sjuksköterskans vårdkontext. Konsensus över beskrivningen av en god död råder inte och kommer sannolikt heller aldrig att råda.   Syftet med studien var att belysa hur sköterskor på vård- och omsorgsboenden beskrev en god död i mötet och omvårdnaden av äldre personer.   Metod och datainsamling: Sex sjuksköterskor på vård- och omsorgsboenden i tre kommuner i Mellansverige intervjuades semistrukturerat vid olika tidpunkter under februari månad 2016. Intervjuerna analyserades genom kvalitativ innehållsanalys på manifest nivå med deskriptiv design.   Resultat: I sjuksköterskornas beskrivningar av en god död framkom kategorierna: sjuksköterskans roll, personcentrerad omvårdnad, närstående och transition. De mest centrala symtomen att lindra var smärta och oro för att kunna ge den äldre personen en god död. Resultatet visade också att äldre personer som över tid nått olika faser av acceptans, hunnit göra bokslut och kände sig klara med livet ofta gick en lugn död till mötes.   Slutsats: Sjuksköterskornas beskrivningar av en god död ger förutsättningar att ge en god sådan på vård- och omsorgsboenden med betoning på att ha hela personens skiftande omvårdnadsbehov i fokus. När livet förändras genom ålderdom, sjukdom och vid insikt om den nära förestående döden genomgår personen transitioner mellan olika faser i livet. Att få hjälp vid transitoner innebär att personen kan nå acceptans för att kunna avsluta livet med känslan av att allt är klart. En av sjuksköterskans uppgifter är att hjälpa den äldre personen att våga prata om och beskriva vad som är viktigt för honom eller henne inför livets slut för komma till ro och genom detta ges möjlighet att dö en god död

Introduktion: Trots mycket forskning inom cancer som genererar nya riktlinjer och behandlingsmetoder är ett cancerbesked ofta förknippat med döden. Om cancerns påverkan på kroppen är tillräckligt allvarlig kan inte längre behandling tillgås. Med det övergår individens vård till palliativ vård, vilket betyder symtomlindring, närståendestöd samt kommunikation för att nå en god och värdig död. Sjuksköterskor har rapporterat att de mottagit önskan om dödshjälp av cancerpatienter, i syfte att bestämma själv och avsluta lidandet.  Syfte: Syftet var att undersöka terminala cancerpatienters syn på en god och värdig död samt dödshjälp. Metod: En systematisk litteraturöversikt utfördes med innehåll från tolv kvalitativa originalartiklar. För att få fram artiklar användes PubMed. En tematisk analys användes för att sammanställa teman baserat på studiernas resultat.  Resultat: Deltagare för dödshjälp motiverade sin ståndpunkt med hänvisning till individens autonomi, samt såg det som en möjlighet att få slut på lidande. Deltagare mot dödshjälp ansåg att det var likvärdigt med självmord, risk för bruk i fel syfte, ej överensstämmer med individens tro och att det alltid fanns hopp och mening. Synen på en god död och värdig död delgavs av deltagarna till förberedelser och rätten att få bestämma själv, att finna nya perspektiv och uppnå acceptans för sitt tillstånd. För att nå en god och värdig död behövdes stöd från anhöriga och vårdpersonal. Det ansågs att sjuksköterskan behövde ha en tät dialog med patienten och involverade patienten i beslut för att tillgodose autonomin.  Slutsats: För att en god och värdig död ska tillgodoses krävs det att vårdpersonal tillsammans med anhöriga strävar efter att uppfylla autonomin hos cancerpatienter. / Introduction: Although cancer research has given new methods and treatment guidelines, a cancer diagnosis is still often associated with death. If the impact of the cancer is too major, treatment is no longer an option. With that the treatment transitions to palliative care, focusing on relief of symptoms, support for related and communication working towards a good death. Nurses have reported that they have received a request from cancer patients to obtain euthanasia or physician-assisted suicide (PAS).  Purpose: The purpose of this systematic literature review was to investigate the views of terminal cancer patients regarding a good death as well as euthanasia and PAS.  Method: A literature review has been constructed from twelve qualitative original articles. The search for articles were found using the database - PubMed. A thematic analysis was used to identify themes, based on the studies results.  Result: These generated three central themes; Support for euthanasia and PAS, Opposition towards euthanasia and PAS and lastly A good death with under themes. Participants who supported euthanasia and PAS motivated it with a person's right to decide and a possibility to end suffering. Participants opposed towards euthanasia and PAS viewed it as an act equal to suicide, and saw a risk of it being abused, some also believed euthanasia and PAS to go against their beliefs and that there always is hope and meaning. The participants' view of a good death was preparedness, the right to decide by themselves, finding new perspectives and acceptance for their condition. To reach a good death support from related and healthcare workers, as well as frequent dialogs with the nurse to involve the patient in decisions to cater to their autonomy was of great importance. Conclusion: To reach a good death the autonomy of cancer patients need to be respected by healthcare workers and relatives.