Thesis (M.S.)--University of Michigan, 1994. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1977.

Thesis (M.S.)--University of Michigan, 1977.

Thesis (M.S.)--University of Michigan, 1986. / "A research report submitted in partial fulfillment of the requirements for the degree ..." T.p.

Thesis (M.S.)--University of Michigan, 1986. / "A research report submitted in partial fulfillment of the requirements for the degree ..." T.p.

Thesis (M.S.)--University of Michigan, 1988.

Thesis (M.S.)--University of Michigan, 1975.

Thesis (M.S.)--University of Michigan, 1983.

This research tests and refines a middle range theoretical model about unitary developmental patterns in aging adults and dying adults. The primary aim was to explore the relationships among four unitary patterns of Health (power, personal death awareness, perceived symptoms in transition, and well-being) and three unitary patterns of Spirituality (self-transcendence, spiritual perspective, and meaning and purpose in life and death). A secondary aim was to explore the personal meanings of death for participants. A descriptive, cross-sectional design was used to answer the research questions. The sample was composed of 35 aging adults and 35 dying adults. Descriptive statistics were used to examine relationships among demographic and study variables. Relationships among variables were explored using bivariate and canonical correlational analysis. Content analysis was used to describe the meaning of death paragraphs. Analysis of variance and covariance was used to describe differences between the groups. Dying adults had greater death awareness than aging adults. There were no differences between the two groups for the other three patterns of Health. There were no differences in self-transcendence or meaning and purpose in life and death. Differences in spiritual perspective were gender-related, aging men having less spiritual perspective than aging women, dying men, or dying women. Different patterns of relationships were identified for each group. Greater purpose and self-transcendence were positively associated with greater well-being, more positive and fewer negative symptoms in transition, and more power for aging adults. For dying adults, less purpose, self-transcendence, and spiritual perspective were associated with less well-being, less positive and more negative symptoms, less power and more death awareness. Moderate or high scores were obtained on instruments measuring power, well-being, self-transcendence, spiritual perspective, and purpose in life. Both groups attributed positive evaluations, acceptance, and self-transcendence to meanings of death. This research enhances understanding of the potential for personal transformation and ongoing development in persons facing death. It also provides direction for nursing care in terms of fostering a sense of purpose in life, promoting spiritual expression, and assisting identification of patterns of power, symptoms in transition, and death awareness.

Trata-se de uma pesquisa qualitativa que buscou compreender a vivência dos trabalhadores no universo do Instituto Médico Legal (IML) de Londrina Pr. Teve por objetivos analisar as experiências dos funcionários no IML com morte, identificar os desafios advindos e as percepções sobre a humanização no cotidiano do processo de trabalho em seu ambiente profissional. O referencial teórico adotado foi a Bioética Personalista. Para a coleta de dados optou-se por utilizar a entrevista semiestruturada. A saturação das entrevistas foi atingida com a participação de 12 profissionais do Instituto Médico Legal, incluindo representantes de todos os segmentos funcionais. As entrevistas foram realizadas de abril de 2008 a março de 2009. Para a construção das categorias empíricas foi utilizada a análise de conteúdo proposta por Bardin. Esta análise seguindo um ordenamento conceitual conduziu à definição de três categorias temáticas: (1) o objeto do trabalho no Instituto Médico Legal; (2) a experiência do trabalhador do Instituto Médico Legal com morte e; (3) o cotidiano no processo de trabalho no Instituto Médico Legal. As três categorias versam sobre o processo de trabalho dos funcionários do Instituto Médico Legal de Londrina, cujas atividades laborativas são interdisciplinares. Nela estão incluídas as características do trabalho pericial em cadáveres, a representação do cadáver enquanto objeto de trabalho e os sentimentos vividos pelos funcionários em atuação. O cadáver enquanto objeto de trabalho foi percebido como uma pessoa num corpo calado, resultado de escolhas de vida e como membro de uma família. A família do cadáver também foi percebida como um objeto de trabalho, na perspectiva do atendimento e acolhimento que esta necessita neste momento de morte abrupta, em suas diferentes formas de reação. A segunda categoria versa sobre as percepções do fato da morte em si; seus significados agrupados nas dimensões biológica, religiosa e filosófica e; os sentimentos vivenciados frente ao final da vida. A terceira categoria abrange as características do processo de trabalho pericial e os sentimentos frente a esta prática. Emergem nas características do processo pericial os aspectos legais, o desconhecimento social, a repercussão pública, a ignorância do resultado final, as situações inesperadas e inusitadas, o trabalho em equipe e a carga laborativa. Entre os sentimentos surgem a tristeza, a compaixão, a dor, o medo, a surpresa, a exaustão, a impotência, a realização profissional e o resgate como ser humano. Nesse trabalho insurgiram desafios enquanto pessoas e enquanto profissionais técnicos, no atendimento pericial tanto às vítimas como aos familiares, no momento de morte. Resultados deste estudo evidenciam que os funcionários do IML são impelidos ao resgate de suas crenças e valores enquanto pessoas, desde o momento em que, conceituam morte, recordam-se de suas vivências, trabalham em equipe, relacionam-se com o cadáver e com os familiares deste. / This is a qualitative research that aimed to understand the experience of workers in the universe of the Institute of Forensic Medicine in Londrina-PR. The three objectives were to analyze the experiences of these workers with death, identify the challenges sprung from this work and their perceptions about humanization in their daily work process at the work environment. The Personalistic Bioethics theoretical reference was used. Semi-structured interviews were chosen for data collection. The interviews saturation was reached by the participation of 12 Institute of Forensic Medicine workers, representing all functional sectors. The interviews were conducted from April 2008 to March 2009. The Bardin Content Analysis was used to build empirical categories. By following a conceptual ordering, this analysis led to three thematic categories: (1): the object of work at the Institute of Forensic Medicine; (2) the Institute of Forensic Medicine workers experience with death and; (3) the daily routine in the work process at the Institute of Forensic Medicine. These three categories approach the work process of the Institute of Forensic Medicine workers in Londrina, whose work activities are interdisciplinary. These activities include forensic procedures in corpses, the representation of the corpse as object of work and the feelings expressed by the workers in action. The corpse, as object of work, was acknowledged as a person in a quiet body, the result of choices made in life and as a member of a family. The corpse family was also acknowledged as object of work, regarding reception and acceptance that this family needs in this moment of abrupt death, considering their different reactions towards it. The second category approaches the perceptions about death as a fact; its meanings grouped in the biological, religious and philosophical dimensions; and the feelings experienced towards the end of life. The third category regards the characteristics of forensic work process and the feelings towards this activity. These characteristics include the legal aspects, the social unrecognition, the media repercussion, the ignorance about the final result, the unexpected and peculiar situations, the team work and the work load. Among the feelings there are sadness, compassion, pain, fear, surprise, exhaustion, impotence, professional accomplishment and the recalling as a human being. In this work there were challenges regarding people as human beings and as technical workers, while conducting forensic work in victims or receptioning family members, during the moment of death. The results of this study highlight that the Institute of Forensic Medicine workers are impelled to regain their beliefs and values as people, since they define death, remember their experiences, work as a team, relate to the corpse and to its family members.