Bakgrunden betonar vikten av organdonation för att rädda liv och förbättra livskvaliteten för patienter med terminal organsvikt. Trots ökningen av transplantationer globalt finns det fortfarande en betydande brist på tillgängliga organ, vilket leder till hög dödlighet bland väntande patienter. Närstående spelar en central roll i processen genom att ofta fatta beslut om organdonation när den potentiella donatorn inte själv har uttryckt en vilja. Intensivvårdssjuksköterskor har en nyckelroll i att stödja och kommunicera med närstående under denna känsloladdade process. Familjecentrerad vård är avgörande för att ge stöd och vägledning till familjer genom svåra beslut och sorgearbete.  Syftet var att beskriva upplevelsen av donationsprocessen ur ett närståendeperspektiv. Metoden omfattande en strukturerad litteraturöversikt med en kvalitativ ansats. Genom systematiska sökningar i CINAHL och PubMed har relevant litteratur inom området identifieras och analyserats i teman, för att få en djupare förståelse för ämnet. Totalt identifierades 17 artiklar. Dataanalysen genomfördes med hjälp av Braun och Clares metod för tematisk analys.  Resultatet avslöjar tre teman som belyser närståendes upplevelse av donationsprocessen. Det första temat stormens förståelse, symboliserar en tid av kaos och utmaningar där närstående upplevde olika aspekter av information och kommunikation. Samtidigt som de präglades av svårigheter att acceptera den juridiska dödförklaringen. Det andra temat stormens öga avslöjade närståendes erfarenheter av bemötande, stöd och beslutsfattande i samband med donation. Det tredje temat brisen efter stormen, belyser närståendes upplevelser av generositet och känslomässig kontakt med mottagaren. Dessa teman ger insikt i den emotionella resa och de utmaningar som närstående möter under donationsprocessen.  Slutsatsen är att närståendes upplevelse i donationsprocessen har en direkt koppling till familjecentrerad vård. Där en familjecentrerade vård på intensivvårdsavdelningar kan bidra till utvecklingen av framtida vårdstrategier och riktlinjer. / The background emphasises the importance of organ donation to save lives and improve the quality of life for patients with terminal organ failure. Despite the increase in transplants globally, there is a significant shortage of available organs, which results in high mortality among waiting patients. Family members play a central role in the process by often making decisions about organ donation when the potential donor has not expressed their wishes. Intensive care nurses have a pivotal role in providing support and communicating with families and loved ones during this emotionally intense process. Family centred care is crucial in order to support and guide families through difficult decisions and grief work. The aim was to describe the experience of the donation process through the perspective of family members and loved ones.  The method comprised a structured literature review utilising a qualitative approach. Systematic searches were conducted in CINAHL and PubMed to identify and analyse relevant literature within the field, in order to achieve a deeper comprehension of the topic. A total of 17 articles were selected for inclusion. Data analysis was performed using Braun and Clare’s method of thematic analysis.  The results reveal three central themes that highlight the experiences of families in the organ donation process, providing insight into the emotional journey and challenges faced by loved ones. The first theme, ‘Understanding the Storm’, symbolises a time of chaos and challenges where family members experienced different aspects of information and communication, whilst they faced difficulties in accepting the legal declaration of death. The second theme, ‘The Eye of the Storm’, featured the families experiences of treatment, support and decision making in the context of organ donation. The third theme, ‘The Breeze After the Storm’, highlights the families experiences of generosity and emotional connection with the recipient.  The conclusion determines that the experiences of next of kin in the donation process are intricately connected to family centred care. Implementing such care in intensive care units could significantly contribute to the development of future care strategies and guidelines.

Collaborative care is a philosophy which guides the work of interdisciplinary teams and patients and their families internationally. It has been demonstrated to improve quality of care, safety, and patient and staff satisfaction, yet applying this philosophy still requires much investigation. This thesis describes processes of change directed towards a vision to enhance collaborative care relationships with patients and families within one hospital site of a non-acute academic health science centre in Ontario, Canada. By building focused conversations around existing patient and family centred education and using an initial conceptual framework of customer service, healthcare providers, mid- and senior level leaders shared their perspectives, negotiated meanings and created innovations to enhance collaborative relationships within the organization. Based within the critical paradigm, a critical collaborative ethnography was constructed with the use of sequential and mixed research methodologies. The ethnography evolved over three phases in a step-wise and additive design during the three year period of study. Phase 1 examined the perspectives of healthcare providers in an exploratory case study which contributed to mid-level leaders’ discussions in Phase 2. Cumulative findings from Phases 1 and 2 were brought to discussions with senior leaders in Phase 3. Members of a participative action research team assisted with research design and study processes. Shared meanings and innovative change ideas were developed and captured through the use of semi-structured focus groups and interviews, survey, participant observation and inductive analysis. A conceptual framework of ‘partners-in-care’ emerged and was used to assist participants to make sense of the values and factors important in their work with respect to collaborative relationships. The research processes facilitated the development of many innovations to enhance collaborative practice within the hospital. The organization was described by the research as undergoing directed change to enhance collaborative care as evidenced through participant self-reports, observed initiatives and the ethnographic descriptions. / Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2012-06-25 15:06:24.687

Nowadays the parental presence in the pediatric intensive care units (PICU) is quite common. Building a fellowship between parents and health care staff and high quality parents' integration into the care is a very demanding process. First of all, the success of this process largely depends upon the nurse. It is the very nurse who leads, educates, supports and also professionally integrates parents into their child's care. In addition, critically ill child's care in cooperation with parents is complicated by a high parental stress level, child's serious condition and high professional and technical requirements posed to the nurse. The graduation thesis concentrates on the parents' integration into the care of a critically ill child from the nurse's point of view. The goal of this thesis was to describe the general conditions of parents' integration into the critically ill child's care and to map the actual state of the cooperation within the nurse ? parent ? critically ill child relation from the nurse's point of view. Other goals included the analysis of nurse's feeling of readiness for work with parents of critically ill children, and elaboration of a booklet concerning the initial introduction of an intensive care and resuscitation unit for infants and older children for better parents' awareness. In the research part of the thesis a qualitative research was used. The data collection technique was a semi-standardized interview. A research sample was represented by seven nurses working in the sphere of the critically ill children care in four selected hospitals in the Czech Republic. The study took place in the period starting May 2011 till July 2011. The research results revealed that the parental integration conditions are not quite optimal. First of all, in this sphere the nurses pointed to a limited accommodation capacity for parents, lack of supporting services and unsatisfactory site layout of the intensive care units. The nurses expressed their readiness to the closer cooperation with critically ill children's parents in the basic nursing sphere, mostly, thereafter, in the sphere of hygiene care. The parental cooperation in the special-care sphere was accepted rather negatively by the respondents. As the research results show, most of the nurses consider the work with parents psychologically very demanding and during their school education they had never been prepared for it by anybody. Findings flowing from the research results gave birth to the information booklet that is a basic informational and educational material for parents of children admitted to the intensive and resuscitation care unit for older children and infants in Hradec Králové University Teaching Hospital. It also represents a detailed instruction for a similar material for other facilities of this type and, last but not least, it facilitates the whole process of initial parents' education for nurses. This graduation thesis can also assist in the education of children's nurses, help students and nurses working with critically ill children's parents understand the "Family-centered care" principles and their practical introduction.

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