Thesis submitted in fulfilment of the requirements for the degree Master of Technology: Nursing In the Faculty of Health and Wellness Sciences At the Cape Peninsula University of Technology, 2013 / The syringe driver is a battery-operated device which accurately delivers a continuous subcutaneous infusion of a combination of medication to alleviate symptoms, such as pain, nausea and vomiting, noisy moist breathing and preterminal restlessness. The researcher who works in a palliative care unit in Cape Town noticed the ambivalence and negative attitudes from family members regarding the use of the syringe driver. This gave rise to distress, conflict and ambivalence in patients and between family members. This study aimed to gain insight into the understanding, perceptions and expectations of families of terminally ill patients commenced on a syringe driver in a palliative care unit. A descriptive, qualitative research method was employed using semi-structured interviews, diaries, observation and documentation as the data collection methods. Data was coded and arranged into themes. Thematic analysis and coding were used to analyse the data during this study. This study found that the lack of education and written information were the two major contributing factors towards negative attitudes causing ambivalence in family members whose relatives were on a syringe driver. This study also highlighted the need for quality improvement control when using the syringe driver in the palliative care unit. The need for continuous education and written information and support for the immediate and extendedfamily members was evident. KEY WORDS: Syringe driver, Symptom control, Family members, Terminally ill, Palliative care unit.

Made available in DSpace on 2017-06-01T18:08:54Z (GMT). No. of bitstreams: 1 margarida_maria_florencio_dantas.pdf: 490570 bytes, checksum: b1f4c5661387baa4bc4812793bd76819 (MD5) Previous issue date: 2015-01-28 / The present work brings a reflection about the deal with the imminence of death before an illness, in the perspective of the people who chose the form of palliation treatment. To that end, the objective of this research is to understand how a subject seriously ill, without possibility of cure, palliation, experiencía as a possibility to experience their illness. Thus, the study focuses on the meanings assigned to palliation, the process of choosing this treatment and the impact of this choice. Five subjects who were interviewed opted for palliation for treatment before a diagnosis of impossibility of curing their illnesses. For the production of research data, the researcher's observations were recorded in a field journal and listening to the sick subjects, through a semidirected interview recorded and transcribed verbatim. The analysis of the narratives and this journal came from a descriptive analysis of inspiration s Foucault. With respect to the results, it is possible to say that every guy who chose the alleviation, made before the established clinical picture. Thus, they occupied with you, look at you, for your needs, expectations, making alleviation a lifestyle. These patients considered the conscience of his finitude, amid the management of death by the health team, and constituted as subject of their actions, considering its priorities: family, work, leisure and quality of life. What made them deal safely and securely with the impacts of this choice, the negation of the relatives towards her, for example. Given this, it is concluded that despite a health team management in favor of palliation, seeing her as the good death, it is possible the subject ill make this choice from its own mode of subjects to subjetive before falling ill, which makes this choice have a singular meaning, particularly, to the guy who considers. / O presente trabalho traz uma reflexão a respeito do lidar com a iminência da morte diante de um adoecimento, na perspectiva das pessoas que escolheram a paliação como forma de tratamento. Para tanto, o objetivo desta pesquisa é a compreensão de como um sujeito gravemente doente, sem possibilidade de cura, experiencía a paliação, como possibilidade de vivenciar sua enfermidade. Assim, o estudo focaliza os sentidos atribuídos à paliação, o processo de escolha deste tratamento e os impactos desta escolha. Foram entrevistados cinco sujeitos que optaram pela paliação como modo de tratamento diante de um diagnóstico de impossibilidade de cura de suas doenças. Para a produção dos dados da pesquisa, foram utilizadas as observações da pesquisadora registradas em um Diário de Campo e a escuta dos sujeitos doentes, através de uma entrevista semidirigida gravada e transcrita literalmente. A análise das narrativas e deste diário se deu a partir de uma análise descritiva de inspiração foucaultiana. Com relação aos resultados, é possível dizer que cada sujeito que escolheu a paliação, o fez diante do quadro clínico estabelecido. Assim, eles se ocuparam consigo, olharam para si, para suas necessidades, expectativas, fazendo da paliação um estilo de vida. Estes pacientes consideraram a consciência de sua finitude, em meio ao gerenciamento da morte pela equipe de saúde, e se constituíram como sujeito de seus atos, considerando suas prioridades: a família, o trabalho, o lazer e a qualidade de vida. O que os fez lidar com segurança e firmeza com os impactos desta escolha, a negação dos familiares com relação a ela, por exemplo. Diante disso, conclui-se que apesar de um gerenciamento da equipe de saúde em favor da paliação, vendo-a como a boa morte, é possível o sujeito doente realizar esta escolha a partir do seu modo próprio de subjetivar-se diante do adoecer, o que faz esta escolha ter um significado singular, particular, para o sujeito que a considera.

This project addressed the continuing education needs of nursing staff and other health care professionals for delivering competent and compassionate palliative or end of life care. The scope of the project included, writing a grant application, training and certification by the end of life Nursing Education Consortium and implementing an education program for staff at the Loma Linda Veterans Affairs medical center.

Introduction: Rustenburg is a fast growing city in the world. This growth influences establishment of new faith based churches which is, in many respects at the expense of mission churches. The HIV/AIDS pandemic and diseases related to stresses results in movement of Christians from one church to the other. Christians are vulnerable when facing life stressors which results into changing allegiance to a particular church. This is a qualitative descriptive/ exploratory study Method: The researcher purposely selected respondents from the black Christian community of Rustenburg. These are those Christians who have moved from one church to join another .From these interviews the themes that emanate are discussed. Leaders of prominent churches were also interviewed . Findings: The qualities of church leaders have an influence on the movement of its members. The media, especially the local radio station has been widely used to attract new members. The availability of a pastor in times of need plays a vital role. Power struggles seem to disappoint some loyal Christians who may reluctantly leave the church. Financial benefits also play an important role in attracting membership. The faith based churches have grown both in numbers and in membership. Women with their healing power are active especially in the Zion churches. The help seeking behaviour of Christians also influences their affiliation to a particular church such as seeking / Christian Spirituality, Church History and Missiology / M. Th. (Missiology)

No description available.

Title: Exploring the lived experiences of nurses caring for the terminally ill patients with AIDS in selected wards in a level one district hospital. Aim: The purpose of this study was to explore and describe the experiences of nurses caring for dying patients with AIDS in the context of palliative care. Methodology: The study explored the meaning of caring and terminal illness and the lived experiences of nurses in the context of AIDS in palliative care. A constructivist paradigm underpinned this study. A qualitative research approach was used and Giorgi’s five steps of analysis were aligned to the Husserlian phenomenology method to make sense of the data. Individual in-depth interviews were conducted with ten of the operational nurses who were caring for patients suffering from AIDS in the palliative care wards of a level one state-aided district hospital. These included professional nurses, enrolled nurses and enrolled nursing assistants. The interviews were audio-taped. Findings: The findings of the study were presented and discussed according to the two categories that emerged during the data analysis, namely, conceptualization of the core concepts of caring and terminal illness and the experiences of caring in the context of palliative care. Each of these categories had themes and sub-themes that were presented and discussed. The conceptualization of the core terms influenced the nurses’ actions, behaviors and opinions as they described their experiences of taking care of terminally ill patients who suffered from AIDS. The nurses’ lived experiences were conceptualized into three main themes: the social networking that enabled the nurses to collaborate with colleagues in the interdisciplinary teams and share knowledge, skills and support within the palliative care team to optimize patient outcomes; factors hindering the nurses abilities to provide quality care to their patients and the internal and external mechanisms that enabled the nurses to provide care within palliative care contexts despite the encountered challenges. Conclusion: Nurses are exposed to increasing work-load in the context of HIV/AIDS, particularly in the care of terminally ill patients suffering from AIDS as they deal with complex emotional aspects of the diseases. Routine exposure to suffering and death accustom the nurses to dealing with death, resulting in situations where they display lack of care and respect for the terminal patients. Therefore, the antecedents that alter the nurses’ level of caring augmented by the emotionally taxing contexts are an agenda that needs to be addressed in order to achieve emotional work through improved nurse-patient relationships. / Thesis (M.N.)-University of KwaZulu-Natal, Durban, 2012.

Introduction: Rustenburg is a fast growing city in the world. This growth influences establishment of new faith based churches which is, in many respects at the expense of mission churches. The HIV/AIDS pandemic and diseases related to stresses results in movement of Christians from one church to the other. Christians are vulnerable when facing life stressors which results into changing allegiance to a particular church. This is a qualitative descriptive/ exploratory study Method: The researcher purposely selected respondents from the black Christian community of Rustenburg. These are those Christians who have moved from one church to join another .From these interviews the themes that emanate are discussed. Leaders of prominent churches were also interviewed . Findings: The qualities of church leaders have an influence on the movement of its members. The media, especially the local radio station has been widely used to attract new members. The availability of a pastor in times of need plays a vital role. Power struggles seem to disappoint some loyal Christians who may reluctantly leave the church. Financial benefits also play an important role in attracting membership. The faith based churches have grown both in numbers and in membership. Women with their healing power are active especially in the Zion churches. The help seeking behaviour of Christians also influences their affiliation to a particular church such as seeking / Christian Spirituality, Church History and Missiology / M. Th. (Missiology)

Com o avanço dos recursos científico-tecnológicos da medicina, a expectativa de vida vem crescendo de forma substancial nas últimas décadas. Doenças, que no passado eram letais, são hoje passíveis de tratamento. Enfermidades que não apresentavam perspectiva de cura tiveram seu curso e evolução alterados assegurando um aumento na sobrevida dos pacientes. A busca pelo prolongamento e manutenção da vida ao longo dos tempos, foi se configurando como esforços de distanciamento e negação da morte, por vezes, através de tratamentos obstinados e fúteis. A ampliação da quantidade de vida passou a ocupar lugar privilegiado na assistência. Diante do aumento de pacientes gravemente enfermos ou fora de possibilidade terapêutica, os embates da comunidade científica acerca da qualidade de vida se voltam para a necessidade de integração de outras dimensões do cuidado ao paciente inserido em programas de cuidados paliativos, além do foco estritamente físico e biomédico. Nesse sentido, a espiritualidade vem sendo apontada como importante aspecto da dimensão existencial, causadora de grandes impactos na saúde física, sobretudo, em doentes no final da vida. Este trabalho tem por objetivo compreender a clínica psicológica e a experiência da espiritualidade de pacientes inseridos em programa de cuidados paliativos em hospital público da cidade do Recife através de pesquisa qualitativa, com recorte de amostra intencional devido às especificidades do tema. Buscou apresentar os princípios dos cuidados paliativos apontando o manejo da equipe de saúde ao paciente fora de possibilidade terapêutica de cura; identificar as reflexões apresentadas pela Psicologia entre a prática psicológica e a experiência de espiritualidade; apresentar contribuições que possibilitem reflexão no cuidado integral oferecido ao paciente gravemente enfermo, tendo em vista a oferta de melhor qualidade de vida / With the advancement of scientific technological resources of medicine, life expectancy has increased substantially in recent decades. Diseases that were once fatal are now treatable. Diseases that had no prospect of cure had changed its course and development ensuring an increase in patient survival. The search for the extension and maintenance of life over time, it was shaping up as efforts of distancing and denial of death, sometimes through obstinate and futile treatments. The expansion of the quantity of life has come to occupy a privileged place on the tour. Given the increase in critically ill patients or out of therapeutic possibilities, the struggles of the scientific community about the quality of life turn to the need to integrate other dimensions of patient care inserted in palliative care programs, and focus strictly physical and biomedical. In this sense, spirituality has been identified as an important aspect of existential dimension, causing great impacts on physical health, especially in patients at the end of life. This work aims to understand the psychological clinic and experience the spirituality of patients enrolled in palliative care program at a public hospital in Recife through qualitative research, purposeful sampling clipping due to the specific theme. Sought to present the principles of palliative care by pointing the management of the health team to the patient without therapeutic possibility of cure; identify the comments made by the practice of psychology and the psychological experience of spirituality; present contributions that enable reflection in the comprehensive care offered to patients seriously patient, in order to offer a better quality of life

Made available in DSpace on 2017-06-01T18:08:41Z (GMT). No. of bitstreams: 1 dissertacao_Waleska_Medeiros.pdf: 1453485 bytes, checksum: 4cc5ac8b2be5d64bac1fa8bc60dfe416 (MD5) Previous issue date: 2012-03-21 / With the advancement of scientific technological resources of medicine, life expectancy has increased substantially in recent decades. Diseases that were once fatal are now treatable. Diseases that had no prospect of cure had changed its course and development ensuring an increase in patient survival. The search for the extension and maintenance of life over time, it was shaping up as efforts of distancing and denial of death, sometimes through obstinate and futile treatments. The expansion of the quantity of life has come to occupy a privileged place on the tour. Given the increase in critically ill patients or out of therapeutic possibilities, the struggles of the scientific community about the quality of life turn to the need to integrate other dimensions of patient care inserted in palliative care programs, and focus strictly physical and biomedical. In this sense, spirituality has been identified as an important aspect of existential dimension, causing great impacts on physical health, especially in patients at the end of life. This work aims to understand the psychological clinic and experience the spirituality of patients enrolled in palliative care program at a public hospital in Recife through qualitative research, purposeful sampling clipping due to the specific theme. Sought to present the principles of palliative care by pointing the management of the health team to the patient without therapeutic possibility of cure; identify the comments made by the practice of psychology and the psychological experience of spirituality; present contributions that enable reflection in the comprehensive care offered to patients seriously patient, in order to offer a better quality of life / Com o avanço dos recursos científico-tecnológicos da medicina, a expectativa de vida vem crescendo de forma substancial nas últimas décadas. Doenças, que no passado eram letais, são hoje passíveis de tratamento. Enfermidades que não apresentavam perspectiva de cura tiveram seu curso e evolução alterados assegurando um aumento na sobrevida dos pacientes. A busca pelo prolongamento e manutenção da vida ao longo dos tempos, foi se configurando como esforços de distanciamento e negação da morte, por vezes, através de tratamentos obstinados e fúteis. A ampliação da quantidade de vida passou a ocupar lugar privilegiado na assistência. Diante do aumento de pacientes gravemente enfermos ou fora de possibilidade terapêutica, os embates da comunidade científica acerca da qualidade de vida se voltam para a necessidade de integração de outras dimensões do cuidado ao paciente inserido em programas de cuidados paliativos, além do foco estritamente físico e biomédico. Nesse sentido, a espiritualidade vem sendo apontada como importante aspecto da dimensão existencial, causadora de grandes impactos na saúde física, sobretudo, em doentes no final da vida. Este trabalho tem por objetivo compreender a clínica psicológica e a experiência da espiritualidade de pacientes inseridos em programa de cuidados paliativos em hospital público da cidade do Recife através de pesquisa qualitativa, com recorte de amostra intencional devido às especificidades do tema. Buscou apresentar os princípios dos cuidados paliativos apontando o manejo da equipe de saúde ao paciente fora de possibilidade terapêutica de cura; identificar as reflexões apresentadas pela Psicologia entre a prática psicológica e a experiência de espiritualidade; apresentar contribuições que possibilitem reflexão no cuidado integral oferecido ao paciente gravemente enfermo, tendo em vista a oferta de melhor qualidade de vida

The marginalisation of palliative and pastoral care practices by conventional approaches to care for terminally ill patients, motivated the research curiosity. The significance of terminal patient's spirituality, their language practices and communities of concern are endorsed as being the major contributing factor to meaningful 'living' with terminal illness. Listening to stories has been the qualitative research practice, revealing meaning-making, quest stories. Feminist theology and post-modern ideas and discourses have assisted me, and the participants, in the deconstruction of power, patriarchy and dualism as the primary contributing factors to marginalisation of people due to illness, race, gender, poverty, culture and education. Pastoral care practices and feminist theology have guided us to emphasise the necessity to recognise the God of Grace as an important part to ensuring holistic patient care. Recognising the 'God-Self, respectful narrative and pastoral care practices paved the way to honour sacred spaces and voice stories of terminal illness. / Practical Theology / M.Th (Specialisation Pastoral Therapy)