In this dissertation, I seek to better understand the sensemaking process among surviving family members after a tragic loss of a teenage or young adult child. Using social constructionism (Gergen, 1991) as a theoretical framework, I focused on how meanings of loss are constructed through the use of language and other symbols. I specifically looked at the role of family stories and rituals in making sense of the sudden loss as well as how a survivor's role as a sibling or parent may impact the grieving process. The participants in my research were all members of families in which a child had died unexpectedly in adolescence or young adulthood. I combined multiple in-depth interviews with parents and siblings in each family with episodes of participant-observation. Then I used inductive thematic analysis to examine the patterns of ritualizing in each family, and a process of narrative analysis focusing on the accounts of three siblings and two parents in order to explore how survivors structure their experience in stories. I found that rituals and artifacts play a significant role in assisting family members in coping with bereavement. Even though previous family rituals and traditions are disrupted by the death, families find ways of creating and enacting new rituals. The invention and adoption of new rituals seems to serve an important role in "successful" grieving as a way of sustaining bonds with lost loved ones. I also found that survivors, in sharing with me the stories of sudden loss, worked to construct storylines that tie events together by showing how they are meaningfully, and sometimes causally, connected. In addition, the stories showed how survivors "find benefit" by reframing painful events as positive and growthful. Throughout my analysis of rituals and stories, I looked for similarities or differences between the siblings' and parents' experiences. One insight to emerge from the study was that bereavement is a very individual event, and the resulting differences in expressions and degrees of grief among different family members can put a strain on the family system. Another key theme that emerged was the protective stance taken by surviving siblings towards their parents after the death of a brother or sister, which sometimes involved minimizing the display of their own emotions. In this sense, the siblings seem to have experienced what the literature has called "prohibited mourning," By contrast. parental grief seems to be more socially acknowledged. This study holds potential benefits for those scholars interested in bereavement as a meaning-making process as well as the effects on the family system. Therapists who treat families might find the insights these participants contribute to be helpful in creating ways to communicate with their clients.

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Bakgrund: Att drabbas av ALS är traumatiskt för den drabbade människan och leder vanligtvis till en drastisk förkortning av livet. Att inte försonas med sitt öde kan innebära att den sista tiden i den döende människans liv innefattar förtvivlan och dödsångest. Därför är det viktigt med kunskap om försoning hos vårdpersonal. Syfte: Studien syftar till att undersöka om och i så fall hur människor med diagnosen ALS ger uttryck för försoning med sin dödliga och snabbt progressiva sjukdom. Metod: Analysen utfördes inspirerat av Lundmans och Hällgren Graneheims (2008) metod för kvalitativ innehållsanalys för att undersöka de latenta uttrycken för begreppet försoning. Analysen utfördes på fyra självbiografier. Resultat: Stunder av försoning kan uttryckas som uthärdligt lidande, stunder med upplevelser av tillfredsställelse samt skapande av upplevelser av trygghet genom existentiella funderingar. Faktorer som kan möjliggöra stunder av försoning kan vara utvecklande av nya perspektiv, tröst som resulterar i frånvaro av rädsla och genom meningsskapande av livssituationen. Slutsats: Upplevelser av försoning kan komma till uttryck på många olika sätt utifrån individuella faktorer, som social kontext och värderingar. Upplevelser av försoning kan inträffa under korta och pendlade perioder och är inget konstant tillstånd. / Background: To suffer from amyotrophic lateral sclerosis is traumatic for the affected individual and usually leads to a drastic shortening of life. The absence of reconciliation towards the dying person´s destiny may lead to that the remaining part of life comprises despair and agony. Therefore, it is important for care givers to have knowledge about meaning of reconciliation.  Aim: The study aims to examine whether, and if so, persons diagnosed with amyotrophic lateral sclerosis express reconciliation with their deadly and rapidly progressive disease. Methods: The analysis performed was inspired by Lundman´s and Hällgren Graneheim´s (2008) method of qualitative content analysis to examine the latent expressions of the concept of reconciliation. The analysis is based on four autobiographies. Results: Moments of reconciliation can be expressed as bearable suffering, experiences of satisfaction and experiences of safety through existential thoughts. Factors that could enable moments of reconciliation may be the development of new perspectives, comfort which results in the absence of fear and through creation of a meaning of life situation. Conclusion: Experiences of reconciliation can be expressed in many different ways based on individual factors such as social context and values. Moments of reconciliation can occur over short periods and are not a constant condition.

I shall argue in this thesis that Zakes Mda's novels Ways of Dying (l995a) and She Plays with the Darkness (1995b) are magic realist texts that are representative of the hybrid nature of this literary mode. Furthermore I shall demonstrate that Ways of Dying (l995a) and She Plays with the Darkness (1995b) share common elements with a variety of magic realist texts. Mda's own creative and literary consciousness has been shaped by an intellectual background stemming from tertiary education at Ph.D level, his teaching positions at various international universities, and his knowledge of African folk-culture. The seemingly contesting streams of Western education and African mysticism are not presented as sources of conflict in Mda's novels, but rather as syncretic forces of potential transformative power. Mda displays in his project as a novelist, the continuing concerns of black writers who saw the novel as a tool for socio-political change. My thesis therefore also investigates the extent to which Mda's use of magic realism in the novels mentioned above, signals a radical shift in literary representation by South African black writers who wrote in English. Mda's novels transcend Black Consciousness-inspired protest that characterised black literature in the 1970's and 1980's. His use of tropes associated with magic realism, African folk-culture, the apocalyptic and carnivalesque has enabled him to create a discursive space for South African black writers on the international stage, and foregrounds a movement towards literature that offers opposition to being classified as merely ''black writing". The death of the old order in South Africa and the birth of a new one, invites questioning and analysis of the position of the self during a period of cataclysmic change. That the apocalypse brings with it both death and renewal could be seen within the context of post modernist visions of the erosion of the self and death as the ultimate reality. Mda's novels, Ways of Dying (l995a) and She Plays with the Darkness (1995b), are the first English narratives by a South Afiican black author that can claim affinities with postcolonial writers such as Carpentier, Marquez, Okri and Rushdie. These writers reflect in their narratives, the infinite possibilities of magic realism in reclaiming the self submerged by the colonial experience. I shall attempt, in Chapter One, a survey of specific theoretical assumptions relevant to magic realism. Chapter Two will provide biographical details of Zakes Mda the playwright, poet, theatre practitioner, film producer and novelist and the importance of magic realism in his writings. Chapter Three is an analysis of Mda's published plays and points to the early uses of elements consistent with magic realism in his work. Chapters Four and Five are investigations into Mda's use of magic realism in Ways of Dying (1995) and She Plays with the Darkness (1995), respectively. / Thesis (Ph.D.)-University of Durban-Westville, 1998.

Bakgrund: Palliativ vård är en aktiv holistisk vård som utgår från den enskilde patientens livssituation. WHO definierar palliativ vård som ett förhållningssätt som syftar till att förbättra livskvaliteten för patienter och deras närstående som drabbats av livshotande sjukdom. Sjuksköterskans roll i denna vårdkontext kan beskrivas som relationsskapande, stödjande, kommunikativ och koordinerande. Patienten i palliativ vård befinner sig i en utsatt situation och dennes behov består i att upprätthålla god livskvalitet genom smärtlindring och existentiellt stöd. Denna situation ställer krav på sjuksköterskor att ständigt skapa och upprätthålla vårdrelationer med patienter som senare dör, vilket kan vara en utmaning för sjuksköterskan. Syfte: Syftet var att beskriva sjuksköterskors erfarenheter av att vårda patienter i palliativ vård. Metod: Litteraturöversikt baserad på åtta vetenskapliga kvalitativa artiklar hämtade från databaserna CINAHL och MEDLINE. Artiklarna har analyserats enligt Fribergs analysmetod. Benner och Wrubels omsorgsteori har använts som teoretisk utgångspunkt för att diskutera resultaten. Resultat: De erfarenheter av palliativt vårdarbete som sjuksköterskorna beskrev i denna litteraturöversikt fångas i fyra centrala teman; Sjuksköterskans relation till patient och dennes familj i palliativ vård, Hur palliativ vård påverkar sjuksköterskans egen person och liv, En vårdande inställning samt Utmaningar i det palliativa vårdarbetet. Diskussion: Resultatet ger en bild av ett komplext vårdområde där ett holistiskt förhållningssätt är nödvändigt. Sjuksköterskan följer med patient och närstående på en resa i livets slutskede som kräver närhet och påverkar hen emotionellt. Utmaningarna och de negativa aspekterna i vården uppvägs av stimulans, tacksamhet och strategier att bemästra de svåra situationerna. / Background: Palliative care is an active, holistic care which is based on the individual patient's life situation. WHO defines palliative care as an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness. The role of the nurse in this context can be described as relationship-building, supporting, communicative and coordinating. The patient in a palliative care context is put in a vulnerable situation and is in need of maintaining a good quality of life through pain management and existential support. This situation puts demands on nurses to constantly create and maintain care relationships with patients whom will later die, which can be a challenge for the nurse. Aim: The aim was to describe nurses' experiences of caring for patients in palliative care. Method: Literature review based on eight scientific qualitative articles retrieved from the databases CINAHL and MEDLINE. The articles have been analysed according to Friberg's method of analysis. Benner and Wrubel's theory of caring has been used as a theoretical starting point to discuss the results. Results: The nurses' experiences of working in palliative care in this literature review were described in fourcentral themes; The nurse's relation to the patient and her family in palliative care, How palliative care affects the nurse's own person and life, A caring attitude and Challenges in the palliative nursing care. Discussions: The result shows a complex nursing field where a holistic approach is essential. The nurse follows the patient and family on a journey at the end of life which requires closeness and affects her emotionally. The challenges and the negative aspects are balanced by satisfaction, gratitude and strategies to cope with the difficult situations.

Tyrimo tikslas – atskleisti artimųjų, slaugiusių sunkiai sergantį šeimos narį iki jo/jos mirties namuose, patirtį. Tiriamas reiškinys – slaugymas iki mirties namuose. Tyrimo klausimai. 1) Kokia yra artimųjų slaugymo namuose sunkiai sergantį šeimos narį patirtis? 2) Kokia yra artimųjų budėjimo namuose šalia mirštančio šeimos nario patirtis? Tyrimo metodai. Kokybinis tyrimas, taikant aprašomosios fenomenologijos strategiją, pagal P. Colaizzi metodą. Duomenys rinkti taikant individualųjį giluminį interviu. Tyrimo dalyviai. 5 artimieji (1 vyras, 4 moterys). Atranka – tikslinė. Atrankos kriterijai: a) artimieji, slaugę sunkiai sergantį suaugusį šeimos narį ir budėję jo/jos mirties momentu namuose; b) artimieji, slaugę šeimos narį ir budėję jo/jos mirties momentu namuose, ne anksčiau nei praėjus vieneriems metams po mirties. Tyrimo rezultatai. Tyrime išryškėjusios temos, kurios atskleidė patirčių esmę – tiriamą reiškinį: 1) Šeimos narys: nesvarbu koks, svarbu, kad tik būtų kartu?; 2) Slaugos namuose motyvai: „namai lieka namais“; 3) Artimųjų palaikymas ir pagalba – „pats svarbiausias dalykas“; 4) Pokyčiai gyvenime: nuo momentinės pagalbos iki priežiūros 24 valandas per parą; 5) Susitaikymas ir „paleidimas“; 6) Mirties akimirka: nuo „visiška ramybė“ iki „blogiausias momentas“; 7) Sveikatos priežiūros specialistai – padedantys arba apsunkinantys esamą situaciją; 8) Sugrįžimas į gyvenimą „be artimųjų slaugymo“. Išvados. Artimieji nusprendę slaugyti sunkiai sergantį šeimos narį... [toliau žr. visą tekstą] / Reseach purpose – to reveal the family caregivers’ experience of caring a seriously ill family member till his/her death at home. Studied phenomenon – caring a seriously ill family member till his/her death at home. Research questions. 1) What kind of experience have the family caregivers got of caring a seriously ill family member till his/her death at home? 2) What kind of experience have family caregivers got while caring a dying family member? Research methods. Qualitative research, with applied descriptive phenomenology strategy, on the base of P. Colaizzi method. Data has been collected by in-depth interviewing, asking two research questions. Research participants. 5 family caregivers (1 male, 4 female). Selection – target, selection criteria: a) family caregivers who took care of a seriously ill adult family member till his/her death at home; b) family caregivers who took care of a seriously ill adult family member at home, no earlier than a year after he/she had passed. Research results. The following themes have emerged: 1) Family Member: no matter how he or she is, it is important to have one beside; 2) Home care motivation: “home is home”; 3) Family members’ assistance and support – “the most important thing”; 4) Changes in care needs: from instant help to care 24 hours a day; 5) Reconciliation and acknowledging the full reality of the loss; 6) The moment of death: from “total peace” to the “worst moment”; 7) Health care professionals – whether they help or hinder... [to full text]

国立情報学研究所で電子化したコンテンツを使用している。

This doctoral study, composed of four films and an exegesis, configures a new conceptualisation of death in and through film, assembling an intricate theorisation of ‘the mediated I’ and ‘the unmediated I’ of the witness. This thesis focuses on the consciousness of the witness, through locating a position and expression in reflective, reflexive, experiential, critical and artistic practice. My research questions the witness’s attempt to ‘manage’ the experience and tracks the self reflective process of thought s/he undertakes in the face of death, dying, coma and suffering. In probing the subjective experiences of the witness, the knowledge of disaster and the absent Other gives way to a moment of distinction between the spectator and the witness. The actual movement being proposed between the two is through the ways in which they both are activated through the reality of death. Critical and creative practice encourages a recognition of - and identification with - the possible meditations and negotiations of the witness. It aims to infuse a configuration of the witness by way of reflection in consciousness and artistic formulation. This thesis proposes a conceptual diagnosis as the original contribution to knowledge. I identify apathy as an anti-choice and unrecognised necessity of consciousness in the face of death, dying, coma and suffering. The research offers a new insight into the existential encounter of the witness. The aim of the practice component is to re-present and re-vision everyday encounters on television and in media alongside metaphors, possible meditations and negotiations to the subjective experience in and through filmic gaze. The visual propositions complement the written text by means of displaying the fear and anguish of the witness, and the attitude towards the Other, disaster and the irrecoverable death. The aim in turning this subject matter into an academic study has been to align two different perceptions: visual and theoretical practice. These two conceptual terms have offered distinct ways of handling the unsettling encounter from not only a witness’s point of view but also from the perspective of a researcher and the film-maker. Together, the visual and theoretical strategy reveal the workings of consciousness and creative meditation of the witness to identify the struggles against internal and external terror in being a witness. The research is interdisciplinary, deploying philosophy, literary and artistic theory. Yet it is not a contribution to the specialised discipline of philosophy, sociology or psychoanalysis of death, dying and suffering, but offers a critical and creative matrix combining inventive and reflexive approaches. This practice-based doctoral study challenges the artist and practitioner to create and then raise awareness through a dynamic, reflexive and interpretative discourse. It fuses genres, including autobiography, literary studies and visual arts. The relationship between the exegesis and films provide an innovative pathway through creative meditation and negotiation of the witness by integrating filmic presentations as an integral loop in the research. Every chapter frames a dialogue between already existing theories of death, dying and grief and filmic texts to transform experience into visuality through constructing a descriptive insight and artistic expression.

Thesis (M.A.)--Miami University, Dept. of Theatre, 2007. / Title from first page of PDF document. Includes bibliographical references (p. 74-78).