The death of one�s parents, irrespective of the age at which it occurs, is generally regarded as a life experience of considerable significance. The last few years of an elderly person�s life are often characterized by increasing frailty, declining health and loss of independence. Responsibility for the spiritual and physical care of parents during that period is undertaken by many adult children. Current research in this area is generally informed by the requirements of social policy, which, by identifying and addressing the inherent difficulties in this so-called informal caring, is designed to support carers in the community. The research reported in this thesis represents a departure from this mode of inquiry and seeks, rather, to explore the existential aspects of caring in this particular situation, from the carer�s perspective. To achieve this objective, an existential phenomenological approach informed principally by the philosophies of Heidegger and Merleau-Ponty, and the adaptation of these philosophies by Schutz, Giorgi and van Manen to social science research, was developed to suit the particular requirements of the topic. In addition to the author�s autobiographic material, primary sources include conversations with five people who had been principal carers for their parents during their final illnesses. In all cases caring had ended with the parent�s death at least one year before the conversations took place. The principal secondary sources are Simone de Beauvoir�s memoir, A Very Easy Death, and Philip Roth�s account of his father�s illness and death, Patrimony: A True Story. In addition, the argument is supported throughout by reference to other literary works. From these sources a number of major existential themes, including temporality, hope, suffering, and knowing the body, have been explored in depth, in conjunction with relevant existential theories. Synthesis of these topics suggests that in this particular circumstance, for the people involved in the study, the phenomenon of caring can be understood as an unconditional engagement with the life and concerns of their parent at the end of life, and can be interpreted within an existential framework as representing an authentic way of Being.

Diss. (sammanfattning) Uppsala : Univ., 2003. / Härtill 4 uppsatser.

Thesis (Ph. D.)--University of Missouri--Columbia, 2002. / "May 2002." Typescript. Vita. Includes bibliographical references (leaves 76-81).

Considerando-se que a Teoria de Orem é objeto de estudo dos enfermeiros, indaga-se como estes dela se apropriam e a aplicam em sua prática de cuidado, ensino e pesquisa. Trata-se de pesquisa exploratória, descritiva por meio de revisão sistemática com objetivo de analisar publicações científicas de Enfermagem brasileira com aplicação da Teoria do autocuidado de Orem. Para investigar essa aplicação, buscaram-se publicações, disponíveis em bases de dados Cochrane, Bireme e PeriEnf. A revisão sistemática incluiu 75 pesquisas de Enfermagem publicadas de 1985 a 2006. A análise das publicações fundamentou-se na abordagem de pesquisa qualitativa, sendo que a caracterização de autores e de artigos foi apresentada mediante estatística descritiva simples. Constatou-se que os estudos sobre a Teoria de Orem foram publicados mais freqüentemente na Revista Brasileira de Enfermagem e se intensificaram após 2000, relevando-se uma média de dois anos e seis meses (DP=1,48) entre o ano da realização do estudo e sua publicação. Predominam os estudos procedentes da região sudeste (45,5%) e nordeste (32,5%), destacando-se os estados de São Paulo e Ceará. Dentre as palavras-chave utilizadas, pelos autores, sobreleva-se a freqüência (n=47) para autocuidado. Identificou-se 21% da produção originária de teses, dissertações e monografias. Referente aos autores, a maioria é enfermeiro (84,3%) e docente (70,7%). Quanto aos desenhos de pesquisa, 58,4% é qualitativo, 31,2% quantitativo e 10,4% quantitativo-qualitativo. Predominam estudos com adultos (50,6%), no cenário ambulatorial (50,6%), associado à patologias (63,2%), sobressaindo aqueles relacionados ao autocuidado de clientes com diabetes mellitus (33,3%). A análise por categorização foi aplicada para analisar as modalidades de aplicação da teoria de Orem, tendo-se delimitado três categorias temáticas: aplicação na sistematização da assistência de Enfermagem, aplicação como estratégia de ensino para desenvolver o autocuidado e aplicação como referencial teórico. Considerando os critérios para categorização, verificou-se que os artigos revelando maior aplicação da Teoria de Orem foram os que a aplicaram no processo de Enfermagem (44,1%), pois utilizaram os três construtos teóricos. Seguem-se os que revelam análise do contexto dos clientes para determinar estratégias a serem realizadas (36,4%) e os artigos utilizando o conceito de autocuidado como referencial para as discussões e reflexões sobre o cuidar (19,5%). Conclui-se que a apropriação da Teoria de Orem está presente na aplicação do conceito de autocuidado como referencial na prática e na fundamentação teórica, na identificação dos déficits de autocuidado e na utilização do sistema de apoio-educação como instrumento do cuidar. Portanto, o modelo teórico de Orem constitui uma abordagem sistemática e lógica, capaz de ajudar o enfermeiro a oferecer e promover autocuidado. Analisando as comunicações científicas, delineou-se um perfil da produção sobre a Teoria do autocuidado, demonstrando-se sua aplicação por enfermeiros brasileiros. / Considering the Orem Theory as a subject of nursing studies, it is posed a question on authors have usedit and applied to nursing care practices, research. It is a descriptive research through systematic review was designed aiming to analyse brazilian publications that used Orem Self-care Theory. In order to investigate the evidences of this appropriation, publications were assessed, available in Cochrane, Bireme and PeriEnf data bases. The systematic review included 75 nursing research published from 1985 to 2006. The publication assessment was based on quantitative and qualitative approaches. The quantitative one was used to analyse variables related to authors and articles characteristics. It was found that studies about Orem Theory were published more recently on Revista Brasileira de Enfermagem and became intensified after 2000, with an average of two years and six months (DP-1,48) between the making of the study and its publication. The majority of the studies comes from the southeast region (45,5%), and northeast (32,5%), with an emphasis to São Paulo and Ceará states. Among the keywords used by the authors, it is important to highlight the frequency (n=47) for self-care. Only 21% of the thesis, monographs and dissertations original production were identified. Concerning the authorship, the majority are nurses (84,3%) and professor of nursing lectures (70,7%). Concerning the research design: qualitative (58,4%), quantitative (31,2%), and quantitative/qualitative (10,4%). The predominance indicated studies with adults (50,6%), in the clinic scenario (50,6%), associated to patology (63,2%), being distinguishable the studies related to patients self-care with diabetes mellitus (33,3%). The analysis for categorization was applied in order to assess the ways of Orem Theory application, being possible to delimitate three thematic categories which reflect the following appropriation: the use of the theory in the systematization of nursing attendance, applying of the nurse clinical judgement concerning the development of self-care and application as theoretical reference. Considering the evaluation criteria to identify such appropriation, it was confirmmed that the articles revealing more appropriation concerning the Orem Theory were the ones that applied it in the nursing process (44,1%), for they used the three theoretical constructs. Next, the articles revealing clients context analysis to determine strategies to be taken (36,4%), and the articles that use the concept of self-care as a reference to discussions and reflections about caring (19,5%). In conclusion, the ways that Orem Theory appropriation are present in the application of the self-care concept are as a reference towards practice and as a theoretical framework, in the assessement of self-care deficit, and in the utilization of the support-education system as a means of caring. This theoretical model constitutes a logical and systematic approach, that helps nursing in the provision and promotion of self-care to clients. By assessing the scientific communication, it was possible to outline a prodution profile concerning the self-care Orem Theory and it became clear the evidences pertaining the appropriation of such theory by the Brazilian nurses.

Considerando-se que a Teoria de Orem é objeto de estudo dos enfermeiros, indaga-se como estes dela se apropriam e a aplicam em sua prática de cuidado, ensino e pesquisa. Trata-se de pesquisa exploratória, descritiva por meio de revisão sistemática com objetivo de analisar publicações científicas de Enfermagem brasileira com aplicação da Teoria do autocuidado de Orem. Para investigar essa aplicação, buscaram-se publicações, disponíveis em bases de dados Cochrane, Bireme e PeriEnf. A revisão sistemática incluiu 75 pesquisas de Enfermagem publicadas de 1985 a 2006. A análise das publicações fundamentou-se na abordagem de pesquisa qualitativa, sendo que a caracterização de autores e de artigos foi apresentada mediante estatística descritiva simples. Constatou-se que os estudos sobre a Teoria de Orem foram publicados mais freqüentemente na Revista Brasileira de Enfermagem e se intensificaram após 2000, relevando-se uma média de dois anos e seis meses (DP=1,48) entre o ano da realização do estudo e sua publicação. Predominam os estudos procedentes da região sudeste (45,5%) e nordeste (32,5%), destacando-se os estados de São Paulo e Ceará. Dentre as palavras-chave utilizadas, pelos autores, sobreleva-se a freqüência (n=47) para autocuidado. Identificou-se 21% da produção originária de teses, dissertações e monografias. Referente aos autores, a maioria é enfermeiro (84,3%) e docente (70,7%). Quanto aos desenhos de pesquisa, 58,4% é qualitativo, 31,2% quantitativo e 10,4% quantitativo-qualitativo. Predominam estudos com adultos (50,6%), no cenário ambulatorial (50,6%), associado à patologias (63,2%), sobressaindo aqueles relacionados ao autocuidado de clientes com diabetes mellitus (33,3%). A análise por categorização foi aplicada para analisar as modalidades de aplicação da teoria de Orem, tendo-se delimitado três categorias temáticas: aplicação na sistematização da assistência de Enfermagem, aplicação como estratégia de ensino para desenvolver o autocuidado e aplicação como referencial teórico. Considerando os critérios para categorização, verificou-se que os artigos revelando maior aplicação da Teoria de Orem foram os que a aplicaram no processo de Enfermagem (44,1%), pois utilizaram os três construtos teóricos. Seguem-se os que revelam análise do contexto dos clientes para determinar estratégias a serem realizadas (36,4%) e os artigos utilizando o conceito de autocuidado como referencial para as discussões e reflexões sobre o cuidar (19,5%). Conclui-se que a apropriação da Teoria de Orem está presente na aplicação do conceito de autocuidado como referencial na prática e na fundamentação teórica, na identificação dos déficits de autocuidado e na utilização do sistema de apoio-educação como instrumento do cuidar. Portanto, o modelo teórico de Orem constitui uma abordagem sistemática e lógica, capaz de ajudar o enfermeiro a oferecer e promover autocuidado. Analisando as comunicações científicas, delineou-se um perfil da produção sobre a Teoria do autocuidado, demonstrando-se sua aplicação por enfermeiros brasileiros. / Considering the Orem Theory as a subject of nursing studies, it is posed a question on authors have usedit and applied to nursing care practices, research. It is a descriptive research through systematic review was designed aiming to analyse brazilian publications that used Orem Self-care Theory. In order to investigate the evidences of this appropriation, publications were assessed, available in Cochrane, Bireme and PeriEnf data bases. The systematic review included 75 nursing research published from 1985 to 2006. The publication assessment was based on quantitative and qualitative approaches. The quantitative one was used to analyse variables related to authors and articles characteristics. It was found that studies about Orem Theory were published more recently on Revista Brasileira de Enfermagem and became intensified after 2000, with an average of two years and six months (DP-1,48) between the making of the study and its publication. The majority of the studies comes from the southeast region (45,5%), and northeast (32,5%), with an emphasis to São Paulo and Ceará states. Among the keywords used by the authors, it is important to highlight the frequency (n=47) for self-care. Only 21% of the thesis, monographs and dissertations original production were identified. Concerning the authorship, the majority are nurses (84,3%) and professor of nursing lectures (70,7%). Concerning the research design: qualitative (58,4%), quantitative (31,2%), and quantitative/qualitative (10,4%). The predominance indicated studies with adults (50,6%), in the clinic scenario (50,6%), associated to patology (63,2%), being distinguishable the studies related to patients self-care with diabetes mellitus (33,3%). The analysis for categorization was applied in order to assess the ways of Orem Theory application, being possible to delimitate three thematic categories which reflect the following appropriation: the use of the theory in the systematization of nursing attendance, applying of the nurse clinical judgement concerning the development of self-care and application as theoretical reference. Considering the evaluation criteria to identify such appropriation, it was confirmmed that the articles revealing more appropriation concerning the Orem Theory were the ones that applied it in the nursing process (44,1%), for they used the three theoretical constructs. Next, the articles revealing clients context analysis to determine strategies to be taken (36,4%), and the articles that use the concept of self-care as a reference to discussions and reflections about caring (19,5%). In conclusion, the ways that Orem Theory appropriation are present in the application of the self-care concept are as a reference towards practice and as a theoretical framework, in the assessement of self-care deficit, and in the utilization of the support-education system as a means of caring. This theoretical model constitutes a logical and systematic approach, that helps nursing in the provision and promotion of self-care to clients. By assessing the scientific communication, it was possible to outline a prodution profile concerning the self-care Orem Theory and it became clear the evidences pertaining the appropriation of such theory by the Brazilian nurses.

The column is an interview with one of the Neuman trustees. Dr. Lois Lowry shared her experience with the Neuman systems model in curriculum development and evaluation in this dialogue. She shared insights from the development of the international Neuman conference in Holland in June.

Human beings with unmet needs related to their health and illnesses are the central focus of the domain of nursing. It is proposed in this column that nurses who conduct their practice from a nursing theory base, while assisting individuals and families to meet their health needs, are more likely to provide comprehensive, individualized care that exemplifies best practices. The Neuman systems model has been widely acclaimed to guide practice, yet specific examples are few in the published literature. The purpose of this column is to present two case studies based upon Neuman systems model; one case is directed toward family care, and the other demonstrates care with an individual. Theory-based exemplars serve as teaching tools for students and practicing nurses. These case studies illustrate how nurses' actions, directed by Neuman's wholistic principles, integrate evidence-based practice and generate high quality care.

Each year in Canada there are nearly 13,000 infants born to women under the age of 20 years (Statistics Canada, 2016). Infants born to adolescent mothers are at an increased risk for preterm birth, low birth weight, and congenital anomalies, making these infants more likely to require hospitalization in a neonatal intensive care unit (NICU) shortly after birth (DeMarco et al., 2021; Fleming et al., 2013; Shrim et al., 2011). Admission of their infant to the NICU creates an increasingly complex situation, as adolescent mothers and their children often already experience multiple social, psychological, and economic difficulties (Fleming et al., 2015). Additionally, adolescents are still developing important cognitive functions, such as advanced reasoning and decision-making, thus making their ability to navigate complex systems such as the NICU particularly challenging (Blakemore & Choudhury, 2006). However, the unique experience of the adolescent mother within the context of the NICU and their transition-home following discharge is poorly understood. Therefore, the overall purpose of this thesis was to explore the issue of transition-home from NICU for adolescent mothers with infants admitted to the NICU. Three overarching goals guided this thesis work, these goals were to: (a) understand the transition experiences of adolescent mothers with infants in the NICU from a theoretical perspective; (b) understand how to best collect rich qualitative data among study participants experiencing marginalization or stigma; and (c) conduct research to further understand the phenomena and how to begin to address transition-related issues. Findings related to each of these goals are presented in four manuscripts that make up this sandwich thesis, including a critical review of theory, an exploration of methods, and an interpretive description study exploring NICU-to-Home transitions. The work presented in this thesis emphasizes the complexity of the NICU-to-home transition for adolescent mothers. Findings highlight the need for strategies within the NICU to mitigate the negative influence of this experience and opportunities for more integrated models of care within the NICU and extending into the community. Implications for research, policy, and nursing education and practice are discussed. / Thesis / Doctor of Philosophy (PhD) / Pregnancy and parenting during adolescence and care transitions from neonatal intensive care unit (NICU) to home are relatively complex experiences. While each have been explored separately, very little is known about when these experiences intersect. This thesis examines theory and methods related to this complex intersection and describes findings of research exploring NICU-to-home care transitions for adolescent parents.

No description available.

En vårdrelations uppbyggnad är en komplex process där hinder och möjligheter finns. Vårdrelationen är central i den personcentrerade vården och kan vara både vårdande och icke-vårdande. Syftet med litteraturstudien var att beskriva vårdrelationens hinder och möjligheter ur patienters perspektiv. Litteraturstudiens resultat baseras på tio vetenskapliga artiklar som har bearbetats med ett deduktivt förhållningssätt utifrån Halldórsdóttirs omvårdnadsteori. Hinder som framkom i resultatet var att vårdare ofta var för upptagna för sina patienter eller visade ovilja till sitt arbete. Det gjorde att patienterna drog sig tillbaka och kände sig ensamma. Resultatet visade att patienterna beskriver respekt och bekräftelse som två möjligheter i uppbyggnaden av en vårdrelation. Detta resulterade i att patienterna kunde tala fritt om sina behov för vårdarna. Både hinder och möjligheter kan överensstämma med Halldórsdóttirs omvårdnadsteori, där väggen står för hinder och bron står för möjligheter. Genom denna litteraturstudie framkom att det finns begränsad forskning kring ämnet därför skulle det vara av intresse att forskningen i framtiden fortsätter undersöka vårdrelationen ur patienters perspektiv. / A nurse-patient relations contexture is a complex process in which there are both barriers and facilitators. The nurse-patient relations is central to the person centered care and can be both caring and uncaring. The aim of this study was to describe the nurse-patient relations barriers and facilitators from the patients' perspective. The literature study results are based on ten scientific articles and are analyzed with a deductive approach by Halldórsdóttirs nursing theory. Barriers that emerged in the result is that nurses were often too busy for their patients or showed reluctance to work. This meant that patients withdrew and felt lonely. The result showed that patients described respect and comfirmation as two facilitators in the contexture of a nurse-patient relations. This resulted in that patients were able to speak freely about their needs for caregivers. Both barriers and facilitators could apply with Halldórsdóttirs nursing theory where the wall represent barriers and the bridge represent facilitators. Through this study it revealed that there is limited research on the topic so it would be of interest that research will continue examining the nurse-patient relations from the patients' perspective.