This is a study of the manner in which death is organised in the city of Belfast. It is concerned with the analysis of the principles, practices, and forms of knowledge which serve to organise the dead from the moment at which physical death is pronounced until the moment of disposal. The thesis is presented in two parts. Part One is entitled Public Bodies. It focuses, in the main, upon the discourse through which individual deaths in particular, and mortality patterns in general, are explained, described, and analysed by state agents and agencies. Chapter One examines the principles according to which causes of death are discovered and allocated. Chapter Two switches attention to modes of death, and examines the use of categories of natural and unnatural death. Chapter Three focuses upon the discourse of modern pathology as it operates within the confines of the city mortuary. And, Chapter Four, concentrates upon the General Register Office, and the principles according to which it collects, collates, and produces data on Belfast mortality patterns. The second part of the thesis is entitled Private Death. Here, the point of focus shifts to the examination of the activities and forms of thought which operate outside of, and beyond the official state agencies. Chapter Five presents an investigation of the organisational principles through which death is ordered within the cemetery, the city, and the hospital. Chapter Six, investigates the ways in which sentiments of the bereaved are structured in relation to the dead. Whilst Chapter Seven focuses upon the organisation of body, soul, and social being during the phase of disposal. The final chapter examines the interpenetration of Belfast politics and political ideologies with the social practices which surround the disposal of the dead. The methodological basis of the study is outlined in Appendix A.

Döden anses vara en stressfaktor för hälso- och sjukvårdspersonal och tidigare forskning visar att detta även gäller vårdare vid hospice. Ett antal vanliga copingstrategier fungerar inte i hospicemiljön på grund av att döden är ett oundvikligt inslag där. En studie framhåller dock den låga utbrändhetsgraden bland vårdgivare på hospice och föreslår bland annat att det holistiska perspektivet på omvårdnad kan vara sammankopplat med detta till synes ambivalenta förhållande. Kan hospicefilosofin inverka på synen på döden och döendet bland hospicepersonal? En intervjustudie genomfördes med tre vårdare yrkesverksamma vid ett hospice i Sverige. Det manifesta innehållet som relaterade till syftet med studien identifierades och analyserades med hjälp av kvalitativ innehållsanalys. Resultatet visar att hospicevårdare påverkas av hospicefilosofin inom områden som synen på vård i livets slutskede, döendet och det professionella samarbetet. Deltagarna uttryckte att de trivs med sitt arbetssätt och uttryckte en mängd olika strategier för att hantera svårigheter i sitt arbete. Arbete som bygger på en filosofi som genomsyrar vården verkar också sammansvetsa personalgruppen. Ytterligare forskning på detta område kan vara av intresse. / Death is considered a stressor to all health care personnel and previous research shows that this applies to hospice caregivers as well. In addition, a number of common coping strategies are impossible to use due to the specific environment. One study however points out low burn-out rating among the hospice caregivers and suggests the holistic nursing perspective, among others, as one of the possible reasons for this seemingly ambivalent finding. Can the hospice philosophy influence the view on death among hospice caregivers? An interview based study was conducted among caregivers working in a hospice in Sweden, where three participants took part. The manifest content relating to the purpose of the study was identified and analyzed using qualitative content analysis. The result shows that hospice caregivers indeed are influenced by the hospice philosophy in areas such as the view on end-of-life care, dying and professional cooperation. The participants displayed affection for their work style and a variety of ways in which to cope with the difficulty of their work. Work based on a philosophy that permeates the care of the patients seems to increase the appreciation of each other as co-workers. Further research in this area can be of interest.

Bakgrund Palliativ vård tas vid när kurativ behandling inte längre är ett alternativ. Majoriteten av människorna som dör varje år i Sverige bedöms vara i behov av palliativ vård. Detta behov förväntas öka i takt med en allt åldrande befolkning och en ökad förekomst av kroniska sjukdomar. Den palliativa vårdmodellen syftar till att lindra alla de behov som kan uppstå vid livshotande sjukdom i livets slutskede. För att tillgodose dessa behov utgår modellen ifrån de fyra hörnstenarna och de 6 S:n. Sjuksköterskan har en central roll i den palliativa vården men får ofta en bristfällig utbildning i ämnet. Syfte Syftet med litteraturöversikten var att beskriva vuxna personers attityder kring döden i samband med palliativ vård. Metod Examensarbetet är en strukturerad litteraturöversikt där resultatet är baserat på 14 kvalitativa artiklar publicerade mellan 2013–2023. Resultat Resultatet visar att personerna som är i behov av palliativ vård önskade få denna vård i hemmet och leva ett så normalt liv som möjligt fram till sin död. Närvaron av och relationen med familj, vänner och vårdpersonal var viktig för upplevelsen av trygghet. Ett bevarat självbestämmande och bibehållet oberoende var av största vikt för välbefinnandet. Slutligen var det viktigt att vara fri från smärta och andra former av obehag samt att andliga och existentiella behov var tillgodosedda. Slutsats Sjuksköterskan bör sträva efter att söka kunskap om personens vardag och hur denna kan upprätthållas den sista tiden i livet. Därtill behöver sjuksköterskan arbeta för att skapa förutsättningar för en god död genom att vara lyhörd och visa sig tillgänglig för dialog / Background Palliative care starts when curative treatment is no longer an option. The majority of people who die each year in Sweden are estimated to need palliative care. This need is expected to increase in line with an aging population and an increased incidence of chronic diseases. The palliative care model aims to relieve all the needs that may arise in the event of a life-threatening illness at the end of life. To meet these needs, the model is based on the four cornerstones and the 6 S's. The nurse has a central role in palliative care, but often receives insufficient training in the subject. Aim The aim of the literature review was to describe adults’ attitudes towards death in connection with palliative care. Method This thesis is a structured literature review where the results are based on 14 qualitative articles published between 2013–2023. Results The results show that the people in need of palliative care wanted to receive this care at home and live as normal a life as possible until their death. The presence of and the relationship with family, friends and healthcare staff was important for the experience of security. Preserved self-determination and maintained independence were of paramount importance for well-being. Finally, it was important to be free from pain and other forms of discomfort and that spiritual and existential needs were met. Conclusions The nurse should strive to seek knowledge about the person´s everyday life and how it can be maintained at the end of life. In addition, the nurse needs to work to create conditions for a good death by being responsive and by showing herself available for dialogue.

<p>Den palliativa vårdens mål är att uppnå en god och fridfull död. En god död har dock visat sig vara en individuell och varierande upplevelse varför patienten själv måste få möjlighet att uttala sig om sin förestående död. Forskning har framhållit att det finns olika uppfattningar om vad en god död innebär, utifrån patientens, närståendes och vårdpersonalens perspektiv. Syftet med litteraturstudien var därför att belysa kunskap om uppfattningar om en god död, för att kunna förbättra omvårdnaden i en palliativ kontext. Föreliggande litteraturstudie baseras på 15 vetenskapliga artiklar. Resultatet visade att det finns gemensamma uppfattningar om en god död, men även olikheter som är betydelsefulla ur ett omvårdnadsperspektiv. En god död kan sammanfattas som symptomkontroll, självbestämmande, sociala relationer, självbild, syntes och samtycke. Främst var det samtal kring den existentiella dimensionen som saknades av patienterna, och de närstående önskade mer information om döendeprocessen för att kunna förbereda sig inför sin närståendes död. Palliativ vårdfilosofi syftar till att ge patienterna en helhetsvård där befrämjande av livskvalitet står i fokus, trots att döden är nära förestående. Helhetsvård var också den inriktning som framkom som den viktigaste uppfattningen om en god död ur vårdpersonalens synvinkel. En god död inom en palliativ kontext är ett forskningsområde som behöver undersökas mer, framförallt gällande de olika uppfattningar som framkommit om en god död ur olika perspektiv.</p> / <p>The palliative care aims to achieve a good and peaceful death. A good death has proven to be an unique and varied experience why the patient should have an opportunity to comment on his impending death. Research has pointed out that there are different perceptions of what a good death means, from the patients’, relatives’ and nursing staff perspectives. The purpose of this study was therefore to elucidate knowledge about perceptions of a good death, in order to improve nursing care in a palliative context. This literature review is based on 15 scientific articles. The results showed that there are common perceptions of a good death, but also differences that are important from a nursing perspective. A good death can be summarized as symptom control, autonomy, social relationships, self image, synthesis and consent. Foremost it was conversation about the existential dimension, which was missing from the patients’ perspective. From the relatives’ perspective it was more desirable with information about the dying process in order to prepare for their relatives’ death. Palliative care philosophy aims to give the patients a holistic approach, where the promotion of quality of life is the focus, despite the fact that death is imminent. Holistic care was also the approach which emerged as the main idea of a good death from the nursing staff perspective. A good death in a palliative context is a research area that needs to be investigated further, especially concerning to the different views obtained about a good death from different perspectives.</p>

Den palliativa vårdens mål är att uppnå en god och fridfull död. En god död har dock visat sig vara en individuell och varierande upplevelse varför patienten själv måste få möjlighet att uttala sig om sin förestående död. Forskning har framhållit att det finns olika uppfattningar om vad en god död innebär, utifrån patientens, närståendes och vårdpersonalens perspektiv. Syftet med litteraturstudien var därför att belysa kunskap om uppfattningar om en god död, för att kunna förbättra omvårdnaden i en palliativ kontext. Föreliggande litteraturstudie baseras på 15 vetenskapliga artiklar. Resultatet visade att det finns gemensamma uppfattningar om en god död, men även olikheter som är betydelsefulla ur ett omvårdnadsperspektiv. En god död kan sammanfattas som symptomkontroll, självbestämmande, sociala relationer, självbild, syntes och samtycke. Främst var det samtal kring den existentiella dimensionen som saknades av patienterna, och de närstående önskade mer information om döendeprocessen för att kunna förbereda sig inför sin närståendes död. Palliativ vårdfilosofi syftar till att ge patienterna en helhetsvård där befrämjande av livskvalitet står i fokus, trots att döden är nära förestående. Helhetsvård var också den inriktning som framkom som den viktigaste uppfattningen om en god död ur vårdpersonalens synvinkel. En god död inom en palliativ kontext är ett forskningsområde som behöver undersökas mer, framförallt gällande de olika uppfattningar som framkommit om en god död ur olika perspektiv. / The palliative care aims to achieve a good and peaceful death. A good death has proven to be an unique and varied experience why the patient should have an opportunity to comment on his impending death. Research has pointed out that there are different perceptions of what a good death means, from the patients’, relatives’ and nursing staff perspectives. The purpose of this study was therefore to elucidate knowledge about perceptions of a good death, in order to improve nursing care in a palliative context. This literature review is based on 15 scientific articles. The results showed that there are common perceptions of a good death, but also differences that are important from a nursing perspective. A good death can be summarized as symptom control, autonomy, social relationships, self image, synthesis and consent. Foremost it was conversation about the existential dimension, which was missing from the patients’ perspective. From the relatives’ perspective it was more desirable with information about the dying process in order to prepare for their relatives’ death. Palliative care philosophy aims to give the patients a holistic approach, where the promotion of quality of life is the focus, despite the fact that death is imminent. Holistic care was also the approach which emerged as the main idea of a good death from the nursing staff perspective. A good death in a palliative context is a research area that needs to be investigated further, especially concerning to the different views obtained about a good death from different perspectives.

This study examines the attitudes to, and commemoration of, death in Wales in the period between the end of the thirteenth century and the middle of the sixteenth century by analysis of the poetical work produced during this period. In so doing, this is placed in the wider context of death and commemoration in Europe. Although there are a number of memorial tombs and some evidence of religious visual art in Wales which has survived from the late medieval period, in comparison with that to be found in many other European countries, this is often neither so commonplace nor so imposing. However, the poetry produced during this period very much reflects the visual material that was produced in other parts of Europe. The poetry shows that the Welsh gentry at that time were familiar with many of the themes surrounding death and commemoration so obvious in European visual art such as the macabre and the fate of both the body and the soul after death. With war, famine and disease being so commonplace during the Middle Ages, and the late medieval period witnessing the effects of the Black Death, it is, perhaps, little wonder that macabre imagery and concerns about the fate of the soul were so often produced in European visual art of the time. These concerns are reflected in the Welsh poetry of the period with several poets composing quite vivid poetry describing the fate of the body as a decomposing corpse after death or allusions to the personification of Death appearing to claim its victims. The tension that many felt between the role of God on Judgement Day and God as Redeemer is also apparent in a number of the poems composed at this time. This study shows how important the role of the poet was amongst the gentry in Wales during the late medieval period, a role which ensured that the patrons of the poets were immortalised in words rather than by physical memorials. It also highlights the importance of poetical works of the period as an important primary source for historical research. Many of the poems give a contemporaneous account of important events of the period such as symptoms of plague victims which confirm that the Black Death was indeed the bubonic form of the plague.