Background: Nurses continuously meets and cares for dying patients, which can be perceived as both rewarding and stressful. To manage death and dying patients adequately, nurses need to reflect on what death means and her/his own perception of death and dying. Research showed that many nurses felt that they had a lack of knowledge and practical skills regarding end of life care. Objective: The purpose of this study was to illuminate nurses’ experiences of caring for patients in end-of-life care. Method: A literature-based study was used, based on analysis of qualitative data. Thirteen articles were analysed according to Friberg´s five-step model. The analysis resulted in four themes and eight subthemes. Results: Four main themes emerged from the analysis: 1) Deficient environment and organization 2) Deficient knowledge and practical skills 3) Support is an important factor 4) Response to end-of-life care. Conslusion: Education and training in end-of-life care was important. This should be implemented more, both in nursing education and in clinical practice. Support from management and colleagues was highly valued by nurses and should occur to a greater extent, as a way of preventing negative effects, such as burnout, and as a way of improving the care of dying patients and their relatives.

There is a question: what can happen to person in the society, which tends to ignore or to avoid death? What kind of factors increase (and do they increase) concern felt about death? What should be constantly changing medicine like: a human, respectable job or a new kind of science, which does not pay attention to person and does not try reduce his pains, but to prolong his life? Purpose of this final master work – to estimate the view of a dying person of the students of the Nursing faculty. Tasks of the research: · to estimate the studies’ view of the most frequent physiological, psychological, social, spiritual problems of a dying patient in the palliative care; · to compare the differences of the view of a dying person between the students of the Nursing faculty of KMU of different study programs in the first and the fourth course; · to estimate the need of the knowledge about a dying person in the students’ opinion; · to prepare a booklet about dying people’s conception for the students. The agreement of the bioethical Committee of KMU was received to do this research, the research was confidential. 125 students of the 1st and 4th course of the Nursing faculty of KMU were researched. They were given the questionnaire with question about palliative care and problems of bad ill and dying patients. The received results were estimated by using of a statistical analysis. After analyzing the received answers the view of the main care problems of dying people was estimated. The... [to full text]

The goal of this thesis, "Psychological and social aspects of healthcare personnel's work with a dying patient", is to examine the socially unattractive issue of dying. Despite the fact that dying is a natural process, we often treat it with contempt and concern. We inspect this topic through a prism of healthcare personnel view, who is in contact with dying and death on a daily basis. In the theoretical part, we have first described the concept of death from historical point of view and afterwards we have narrowed it down to psychological-medical view of dying. Next, we have introduced the area of lenitive care for a dying patient, which is closely related to the topic of euthanasia. Of course, in relation to euthanasia, we then talked about medical ethics. This way we have circled around the relationship between a medic and his patient, the specifics of their communication, and finally we have described the psychological stress of healthcare personnel, possible coping strategies and eventual defensive mechanisms. Bibliography also features current research, both domestic and foreign. In the empirical part, we have attempted to map and describe psychosocial aspects relevant to working with a dying patient, with emphasis on identifying stress factors and strategies for healthcare personnel to cope...

Inledning: Psykoterapi och psykoanalys är påfallande frånvarande i studier när det gäller palliativ vård och död. Syftet med denna undersökning är att undersöka hur psykoterapeuter arbetar i terapi med döende patienter. Frågeställning: Hur arbetar psykoterapeuter med psykodynamisk inriktning med döden i terapirummet? Metod: Studien baseras på halvstrukturerade intervjuer med fem legitimerade psykoterapeuter med psykodynamisk inriktning med erfarenhet av terapi med döende patienter. Materialet analyserades med hjälp av tematisk analys. Resultat: Resultatet beskriver psykoterapeuters arbete med döende patienter. Fyra teman framträder. Det första belyser att döden är ramen i terapin. Det andra visar på den livsviktiga alliansen. Det tredje beskriver närmare den terapeutiska praktiken och innehållet i terapin. Det fjärde beskriver de särskilda utmaningar som terapeuten möter i terapi med döende patienter. Diskussion: I studien framkommer att döden återverkar på hela terapiförloppet. Döden blir ramen i terapi med döende patienter. När det gäller alliansen ser den ut att komma snabbare i terapier med döende patienter. Själva innehållet i terapin blir också något annorlunda, det blir ett annat fokus. Livsfrågor får ett stort utrymme. Många starka känslor väcks i terapin, såväl hos patient som hos terapeut. Teoribildningens betydelse betonas för att kunna förstå dessa känslor i termer av överföring/motöverföring och projektion/identifikation. Bland det mest utmanande i terapier med döende patienter är de starka känslor som väcks hos terapeuten. Studiens resultat är i linje med tidigare forskning som främst består av kliniska rapporter. / Introduction: Psychotherapy and psychoanalysis are strikingly absent in studies of palliative care and death. The purpose of this study is to explore how psychotherapists work in therapy with dying patients. Research question: How do psychotherapists with psychodynamic orientation work with death in the therapy room? Method: The study is based on semi-structured interviews with five licensed psychotherapists with psychodynamic orientation and with experience of therapy with dying patients. The material was analyzed using thematic analysis. Results: The result describes psychotherapists' work with dying patients. Four themes emerge. The first theme is that death becomes the framework of the therapy. The second theme shows the vital alliance. The third theme describes the therapeutic practice and the content of the therapy. The fourth theme describes the specific challenges that the therapist faces in therapy with dying patients. Discussion: The study reveals that death affects the entire therapy. Death becomes the framework in therapy with dying patients. Alliance seems to come faster in therapies with dying patients. The content of the therapy will have a different focus. Life issues are given a lot of space. Many strong feelings are aroused in the therapy, both in the patient and in the therapist. The importance of theory formation is emphasized in order to understand these feelings in terms of transference/countertransference and projection/identification. The strong feelings aroused by the therapist is among the most challenging issues in therapies with dying patients. The results of the study are in line with previous research, which mainly consists of clinical reports.

Nursing moral philosophy in the care of the terminally ill Abstract The aim of the work The aim of the research part of the diploma thesis was to fid out what ethical dilemmas the medical staff recognizes in the care of the terminally ill and what role it occupies in accompanying the dying. The method to reach the goal To achieve the goal, we chose a qualitative research solution using a semi-structured interview, which ethical dilemmas of the non-medical healthcare staff recognizes and what roles it takes to make decisions at the end of the patient's life. The research group was consisted of 10 nurses who are part of palliative teams in selected health care institutions. The interviews which were provided, were rewritten, and using of coding techniques "paper-pencil", the data was organized into each categories. The gained knowledge and the conclusion The research which we have conducted reveals what ethical dilemmas we see as a non-medical healthcare professionals in their practice and which attitudes and roles we hold to the terminally ill, dying patients and their families. The patients with an incurable illness at the end of their lives find themselves in a very difficult situation. It is very important to improve the quality of the care and to be close to these patients. The medical staff member should be aware that any decision can become an ethical dilemma that we should recognize to find the best solution to meet the needs of the patient, respect his desire with maintain one´s dignity. Only that palliative care can be characterized as a first-rate care, focused on the patient's individuality and uniqueness

This diploma thesis describes Opportunities of Social Work in paliative care in Slovak republic and compares seleccted aspects with Czech republic. Main goal of this work was describe system of paliative care in Slovak republic and compare selected aspekts with Czech republic. Empirical part of this work is focused on blind spaces in paliative care and system of paliative care which was mapped especially by literature and ilustrative intriview with one respondent. Work poits to the need to provide social servoces in paliative care.