No description available.

According to the WHO cancer is one of the leading causes of morbidity and mortality in the world. In 2012 there was 14 million of new cases worldwide. A number of new cases is expected to rise in future. An increasing number of cases demanding a new approach from health care systems regarding the staff education, hospital equipment and interprofessional cooperation in order to give full service to the customers (patients). For several years palliative care education is a top priority in the education of nurses due to the fact that there are serious deficiencies in that area (Komaromy et al. 2000, Miller et al. 2004, Goodridge et al. 2005, Hasson et al. 2008). Nurses are the forefront of caring for terminally ill patients and their families approaching the end of life, which does not minimize role of other healthcare professionals, but nurses have main role in this process. Definition and competencies of nurses involved in this process must be precisely identified and measured from time to time in order to improve the process of end of life care and palliative care nursing. Continuous development of guidelines and protocols for palliative care nursing is particularly relevant (Watts, 2013; Gambles et al 2009, Hockey et al 2005, Jack et all 2003). Development of competencies is one of key issues in contemporary education it and can be achieved with development of proper curriculum and education schedule, especially development of a proper instrument for measurement of competencies. This research has identified most important 10 competencies in accordance with WHITE paper for EAPC and WHO. General objective. This research has one general objective and it is creation and validation of new questionnaire about competencies in field of palliative care nursing with aspect of realization of core competences in developed and under developing systems. This questionnaire is a new instrument in field of competence measurement in palliative care nursing. Specific objectives of the research are based on evaluation and comparison of competences among nurses from Bosnia and Herzegovina and Spain (Valencia area). Methodology. Methodology comprises research, cross – section, analytical method of research. Actions taken in this process were literature review, analysis of data available curricula of nursing schools, literature research, development of new instruments for measurement of competences in palliative care nursing, interviews with nurses in Bosnia and Herzegovina, development of online platform for nurses in Spain, translation of instruments to Spain language, data processing, Comparison of results from both group were done by every single item of instrument and by every competences. Results. Results are presented in two different parts: Part I (one) of results is about development of instrument PALCOM and part II (two) is about the data collected from Bosnia and Herzegovina and Spain. All results are shown in proper table and graphs that are reflecting research process. Results show the significant statistical difference between groups in Bosnia and Herzegovina and Spain (Valencia area) in some aspects, while in several aspect there is no difference. Working experience and level of education are in directly linked with self-competence measurement. There is a high statistical difference between groups with different level of education, and working experience, which has a direct impact on development of competence of nurses. Conclusion. Need for measurement of competencies is expressed in the daily development of palliative care, community palliative care, hospice care and subspecialty palliative care. Questionnaire that can measure all competencies does not exist but using general competencies in PALCOM questionnaire can cover this entire field with measurement of various domains and competencies specific to that domains. PALCOM as an instrument for evaluation of competencies in the field of palliative care, is, for the time being, a reliable instrument. With the development of palliative care, improvement can be done in the area of competencies in palliative care nursing. PALCOM is applicable in various health care systems and educational systems and it does not depended on external factors. PALCOM as instrument measures the competence level of nurses and preparedness for work in palliative care settings. First scale measure knowledge, while second scale is self-measurement of competences in accordance with the level of education and work experience. Need for the appropriate instrument for measuring competences in palliative care nursing leads us to this instrument following most economical and reasonable way of developing.

Darbo tikslas - išanalizuoti bendruomenės slaugytojų vaidmenį teikiant paliatyviosios priežiūros paslaugas. Darbo uždaviniai: 1. ištirti bendruomenės slaugytojų požiūrį į jų dalyvavimą nepagydoma liga sunkiai sergančių ligonių priežiūroje; 2. ištirti bendruomenės slaugytojų vaidmenį nepagydoma liga sunkiai sergančio ligonio priežiūroje; 3. ištirti bendruomenės slaugytojų vaidmenį teikiant paramą šeimai nepagydoma liga sunkiai sergančio artimojo priežiūros metu ir netekties atvejais; 4. išsiaiškinti priežastis, turinčias įtaką paliatyviosios pagalbos paslaugų teikimui Lietuvoje. Tyrimo metodika: tyrimas atliktas vienkartinės anoniminės apklausos būdu Kauno miesto atsitiktinės atrankos būdu parinktose 2 pirminės sveikatos priežiūros įstaigose 2008 m. kovo mėnesį. Tyrimo objektas – bendruomenės slaugytojų vaidmuo teikiant paliatyviosios priežiūros paslaugas nepagydoma liga sunkiai sergantiesiems ir jų artimiesiems priežiūros metu ir netekties atveju. Tyrime dalyvavo 64 bendruomenės slaugytojos. Naudota anoniminė anketa, sudaryta pagal literatūros analizę. Tyrimo išvados: 1. Slaugytojų požiūris į dalyvavimo nepagydoma liga sunkiai sergančių ligonių priežiūroje svarbumą priklauso nuo jų pasitenkinimo atliekamu vaidmeniu (p<0,05), tuo tarpu slaugytojų vaidmens lūkesčių atitikimas atliekamo darbo svarbai įtakos neturi (p>0,05). 2. Ištyrus bendruomenės slaugytojų vaidmenį nepagydoma liga sunkiai sergančio ligonio priežiūroje, nustatyta, kad bendruomenės slaugytoja dažniausiai... [toliau žr. visą tekstą] / Aim of study: to traverse community nurses role in lending palliative care assistance. Objectives: 1. To explore attitude of community nurses to rendering palliative care assistance. 2. To explore community nurses role in terminal ill patients care 3. To explore community nurses role in rendering family support during terminal ill patients care and bereavement 4. To find out a factors that have hold on rendering palliative care assistance by community nurses. Methods: the research was performed in the way of onetime anonymous questionnaire at Kaunas primary health institutions, in the march, 2006. The object of research – the community nurses role in rendering palliative care assistance to terminal ill patients and their family providing care and in bereavement. There were 64 community nurses. An anonymous questionnaire was used, which was developed according to literature analysis. Conclusions: 1. The community nurses attitude to importance of participation in terminal ill patient’s care is under influence of satisfaction with job (p<0,05) and is not under influence of nurses expectation of role (p>0,05). 2. After exploring community nurses role in terminal ill patient care, it was set, that nurses render palliative care assistance in a team in large part as family doctors assistant, also as health educator, consultant, render of health care assistance, while leading role is not prevalent. 3. After exploring community nurses role in lending support to terminal ill... [to full text]

Made available in DSpace on 2016-04-27T18:47:19Z (GMT). No. of bitstreams: 1 Dissertacao LUIS AUGUSTO DE MELO.pdf: 442894 bytes, checksum: 07ea39342721b9643560304fbf757477 (MD5) Previous issue date: 2006-06-22 / This study tries to think about the decisions made by the family when having one of its elder members ill without autonomy. lt is about the therapeutic actions and about the professional acting. Thus, its general purpose was to comprehend how the family decides to hospitalize the patient in terminal stage and without autonomy. A research was performed under the qualitative approach with ethnographic interview used to data collecting. The investigation was developed with health professionals and 8 relatives that rescued by an oral life history, their experiences while taking care of iii elders and dependents. The group was made of six women and two men with ages between 46 and 85 years old, in which the majority had a coliege degree. By the testimoniais of the interviewed ones it was possible to realize the recognizing of new family schemes and their implications to the support they offer its members. Referring to the quality of aging it was possible to observe that the way of living differentiate the healthy aging and the iii one. lt was realized that the process hat involves this reality happens in different ways according to values, to conditions and to the characteristics that constitute the paris of each family. lt became evident that there is an affective behavior and obligation and attached cluties to the commitment of taking care of elders that are III and have no autonomy. lt was realized the importance of health services that need to fulfill their purposes and promote ways and social resources so that the families welcome the ilI elder and are able to provide him/her a support web, assuring his/her continuity in the family nucleus and in the proper community / O presente estudo procura fazer uma reflexão a respeito das decisões utilizadas pela família quando possui um dos seus membros idosos doentes sem autonomia diz respeito ás ações terapêuticas e ao agir profissional. Assim, seu objetivo geral foi compreender como a família decide o internar do paciente em fase terminal e sem autonomia. Foi realizada uma pesquisa sob a abordagem qualitativa com entrevista etnográfica utilizada para a coleta de dados. A investigação foi desenvolvida com profissionais da saúde e familiares em número de oito que resgataram por intermédio da história oral de vida, suas experiências ao cuidar de idosos doentes e dependentes. O grupo constou de seis mulheres e dois homens com idades entre 48 e 85 anos, no qual a maioria tinha curso superior. Pelos depoimentos dos entrevistados foi possível perceber o reconhecimento de novos arranjos familiares e suas implicações quanto ao suporte que oferecem a seus membros. No que se refere à qualidade do envelhecimento observou-se que o modo de viver é um delimitador entre o envelhecimento saudável e doente. Percebeu-se que o processo envolve essa realidade ocorre de distintas formas de acordo com os valores, as condições e as características que constituem os elos de cada família. Ficou evidente que existe um comportamento afetivo, a obrigação e o dever embutidos no compromisso do cuidar do idoso doente e sem autonomia. Percebeu-se a importância dos serviços de saúde que precisam dar conta de seus propósitos e promover meios e recursos sociais a fim de que as famílias acolham o idoso doente e possam proporcionar-lhe uma rede de suporte, garantindo sua manutenção no núcleo familiar e na própria comunidade

Submitted by Maike Costa (maiksebas@gmail.com) on 2016-12-01T13:07:49Z No. of bitstreams: 1 arquivototal.pdf: 1466086 bytes, checksum: 1e09a0784d1f4e4b4f096322f2f15d20 (MD5) / Made available in DSpace on 2016-12-01T13:07:49Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1466086 bytes, checksum: 1e09a0784d1f4e4b4f096322f2f15d20 (MD5) Previous issue date: 2016-04-25 / The caring is a action endowed with responsibility, in which we shall consider the different dimensions and real necessities of the human being. It is a peculiar characteristic to all the health professionals, which demand fundamental practices at the life quality and promotion, mainly considering the terminal ill assistance. This study aimed to investigate the health professional experience at a household attention service with the care turned to the terminal patient. Methodology: It is an exploratory-qualitative research, guided by criteria established at the Qualitative Research Reporting. The scenario involved the Household attention service, located in João Pessoa – PB. Twenty professionals from the superior level participated at this study: two doctors, six nurses, Five physiotherapists, two nutritionists, two psychologist, two speech therapist and a social assistant from the multi professionals team at the household attention and from the multi professional support teams. To capture the empirical material, was used the interview technique that followed a script containing guided questions, pertinent to the proposed objective to this study. Data were collected between February and May 2015, after the agreement of the Education Management at Health from the referred city and the Ethics Research Committee of the Health Sciences Center approval, as certificate as CAAE register under the number: 39989514.0.0000.5188. The empirical material was analyzed in a qualitative way, through the Content Analysis Technique proposed by Bardin. . Results: From data collection, emerged two originals manuscripts. To the first was given the name “Professional experience at a household attention service at the terminal patient caring”, from with were identified three categories: “Humanization at the terminal patient assistance: promoting autonomy, dignity and life quality”; “The terminal patient: feelings experienced during the caring promotion”; and “Terminal patient care, personal and professional permanent learning.” And the second, “Therapeutic actions promoted to the terminal patient: professionals experience at a household attention service, which resulted in two categories construction: “Therapeutic actions directed to biological necessities of the terminal ill to comfort and life quality promotion.” And “Therapeutic actions promoted to answer the psycho socials and spirituals terminal patient’s needs” Conclusion: The health professionals experience during the terminal patient caring action, in the household context, is based on a holistic assistance, with Essentials therapeutic to the humanized care, that brings respect and dignity to the patient at the life ending process. / El cuidado es una acción dotada de responsabilidad y corresponsabilidad, en las que se debe tener en cuenta las diferentes dimensiones y las necesidades humanas reales. Es una característica peculiar de todos los profesionales de la salud, de las cuales las prácticas de demanda son basadas en la promoción de la calidad de vida, especialmente teniendo en cuenta la asistencia al paciente con condición de enfermedad terminal. Este estudio tuvo como objetivo investigar la experiencia de los profesionales de la salud de un Servicio de Atención Domiciliaria en el cuidado basado en el paciente de la enfermedad terminal. Metodología: Se trata de una investigación exploratoria, cualitativa, guiada por los criterios establecidos en los informes de investigación cualitativa. El escenario implica Servicio de Cuidados en el hogar, con sede en la ciudad de João Pessoa - PB. En el estudio participaron veinte profesionales de primer nivel: dos médicos, seis enfermeras, cinco fisioterapeutas, dos nutricionistas, dos psicólogos, dos logopedas y un asistente social de equipos multidisciplinares de atención domiciliaria y equipos multidisciplinares de apoyo. Para captar el material empírico, se utilizó la técnica de la entrevista, que siguió una secuencia de comandos que contiene preguntas de orientación pertinentes para el objetivo propuesto para el estudio. Los datos fueron recolectados de febrero a mayo de 2015, tras el acuerdo de la Gestión de la Educación en Salud del municipio y aprobados por el Comité Ético de Investigación del Centro de Ciencias de la Salud, de acuerdo con el certificado con el registro CAAE con el número: 39989514.0.0000.5188. El material empírico se analizó cualitativamente a través de la técnica de análisis de contenido propuesto por Bardin. Resultados: A partir del análisis de datos, surgieron dos manuscritos originales. La primera, titulada "Los profesionales de la experiencia de un servicio de atención a domicilio para el cuidado de pacientes en enfermedad terminal", que se identificaron tres categorías fi cado: "Humanización en la atención al paciente de la enfermedad terminal: la promoción de la independencia, la dignidad y calidad de vida"; "El paciente de la enfermedad terminal: sentimientos experimentados en la promoción de la atención"; y "Atención al Paciente de la enfermedad terminal, el aprendizaje constante y personal profesional". Y el segundo, "acciones terapéuticas promovidos al paciente de la enfermedad terminal: la experiencia de los profesionales de un servicio de atención a domicilio", lo que dio lugar a la construcción de dos categorías: "Las acciones terapéuticas dirigidas a las necesidades biológicas de los enfermos terminales para promover la comodidad y la calidad vida "y" acciones terapéuticas promovidas para satisfacer las necesidades psicosociales y espirituales de los enfermos terminales". Conclusión: La experiencia de los profesionales de la salud en el acto de cuidar al paciente de la enfermedad terminal en el contexto familiar, se basa en una atención integral con terapias esenciales para el cuidado humanizado para lograr el respeto y la dignidad al paciente en la finitud del proceso de la vida. / Cuidar é uma ação dotada de responsabilidade e corresponsabilidade, na qual se devem considerar as diferentes dimensões e reais necessidades do ser humano. É uma característica peculiar a todos os profissionais da saúde, dos quais demanda práticas fundamentadas na promoção da qualidade de vida, principalmente considerando a assistência ao doente em condição de terminalidade. Este estudo teve como objetivo investigar a vivência de profissionais da saúde de um Serviço de Atenção Domiciliar no cuidado voltado para o paciente na terminalidade. Metodologia: Trata-se de uma pesquisa exploratória, de natureza qualitativa, norteada pelos critérios estabelecidos no Relatório Pesquisa Qualitativos – COREQ. O cenário envolveu o Serviço de Atenção Domiciliar, localizado no município de João Pessoa – PB. Participaram do estudo vinte profissionais de nível superior: duas médicas, seis enfermeiras, cinco fisioterapeutas, duas nutricionistas, duas psicólogas, duas fonoaudiólogas e uma assistente social das Equipes Multiprofissionais de Atenção Domiciliar e das Equipes Multiprofissionais de Apoio. Para apreender o material empírico, foi empregada a técnica de entrevista, que seguiu um roteiro contendo questões norteadoras pertinentes ao objetivo proposto para o estudo. Os dados foram coletados no período de fevereiro a maio de 2015, depois da concordância da Gerência de Educação em Saúde do referido município e da aprovação do Comitê de Ética em Pesquisa do Centro de Ciências da Saúde, conforme certidão com registro CAAE, sob o número: 39989514.0.0000.5188. O material empírico foi analisado qualitativamente, por meio da técnica de análise de conteúdo proposta por Bardin. Resultados: A partir da análise dos dados, emergiram dois manuscritos originais. O primeiro, intitulado “Vivência de profissionais de um serviço de atenção domiciliar ao cuidar de pacientes na terminalidade”, do qual foram identificadas três categorias: “Humanização na assistência ao paciente em terminalidade: promovendo autonomia, dignidade e qualidade de vida”; “O paciente em terminalidade: sentimentos vivenciados na promoção do cuidado”; e “Cuidar do paciente na terminalidade: constante aprendizado pessoal e profissional”. E o segundo, “Ações terapêuticas promovidas para o paciente na terminalidade: vivência de profissionais de um serviço de atenção domiciliar”, que resultou na construção de duas categorias: “Ações terapêuticas direcionadas às necessidades biológicas do doente terminal para promoção do conforto e da qualidade de vida” e “Ações terapêuticas promovidas para atender às necessidades psicossociais e espirituais do doente terminal”. Conclusão: A vivência de profissionais de saúde no ato de cuidar do paciente na terminalidade, no contexto domiciliar, fundamenta-se em uma assistência holística, com terapêuticas essenciais para o cuidado humanizado, que promova respeito e dignidade para o paciente em processo de finitude da vida.

Text in German / Forschungsgegenstand dieser Arbeit ist das Bewältigungsverhalten von schwer kranken und sterbenden Menschen, die in einer Gesellschaft ihren bevorstehenden Tod bewältigen müssen, die ambivalent mit dieser Thematik umgeht. Die unterschiedlichen menschlichen Bewältigungsformen können mit den bisher gängigen Zugangswegen über Phasenmodelle nicht immer befriedigend erklärt werden. Hilfreich erscheint hier das aus der Stressforschung stammende Copingmodell von Richard S. Lazarus und seiner Forschungsgruppe, um Menschen verstehen zu lernen. In wieweit dieses Verstehensmodell aus einem säkularen Forschungszweig für die Seelsorgearbeit unterstützend sein kann, soll in dieser Arbeit geklärt werden. Als Grundlage dienen Seelsorgegespräche mit unterschiedlichen Menschen, die eine große Bandbreite an Bewältigungsverhalten demonstrierten. Die Herausforderung lag darin, Menschen in ihrem Sterben umfassend wahrzunehmen, um möglichst viele Impulse zu erkennen, die ihr Bewältigungsverhalten beeinflussten. Aus der Aufarbeitung dieses Verhaltens ergaben sich Perspektiven für die Begleitung sterbender Menschen. Dies hat gleichbedeutend Konsequenzen für den seelsorgerlichen Umgang mit Sterbenden. Das Wissen um das christlich-biblische Menschenbild und die umfassende Kenntnis der Copingforschung können sich durchaus gegenseitig befruchten, denn beide gehen auf die Individualität des Menschen ein und unterstützen ihn seinen eigenen Zugang zu seinem Leben und seinem Tod finden zu lassen. Dies führt letztlich zu einer intensiven Kommunikation zwischen Patient und Seelsorger, der den Mut und das Vertrauen haben darf, dem Sterbenden eigenständig sein Leben bewältigen zu lassen. Die Ansätze der Copingforschung bieten weitreichende Impulse für vielfältige seelsorgerliche Fragestellungen auch außerhalb der Sterbebegleitung. Object of research of this thesis is the specific behaviour of seriously ill and dying humans coping with their impending death and being members of a society having an ambivalent attitude towards death. People's different and individual ways of coping cannot always be sufficiently explained by the current use of phasing models. In this context the "Coping Model" by Richard S. Lazarus and his stress research group seems to be helpful in understanding dying humans. In how far this comprehension model from a secular branch of research can be supportive of pastoral counselling is the objective of this thesis. Counselling dialogues with different persons who show a wide range of coping form the basis of this research. The challenge of this paper was to observe and sense humans in their death experiences from a broader point of view in order to identify as much as possible kinds of impulses crucial to their coping behaviour. Analysing the behaviour of dying humans led to new perspectives on spiritual guidance. Tantamountly, this has its consequences for spiritual dealing with dying humans. The comprehension of the biblical Christian idea of man and a detailed knowledge of coping research can, by all means, be interactive and thus show positive results as both respond to a person's individuality and support them in their own ways of approach to life and death. Finally, this leads to an intensive dialogue between patient and pastor who can have the courage and the confidence in letting the person find his own way of coping. The different kinds of approach of the coping model research offer far-reaching impulses to various pastoral questions going even beyond terminal care. / Philosophy, Practical & Systematic Theology / D.Th. (Practical Theology)

Text in German / Forschungsgegenstand dieser Arbeit ist das Bewältigungsverhalten von schwer kranken und sterbenden Menschen, die in einer Gesellschaft ihren bevorstehenden Tod bewältigen müssen, die ambivalent mit dieser Thematik umgeht. Die unterschiedlichen menschlichen Bewältigungsformen können mit den bisher gängigen Zugangswegen über Phasenmodelle nicht immer befriedigend erklärt werden. Hilfreich erscheint hier das aus der Stressforschung stammende Copingmodell von Richard S. Lazarus und seiner Forschungsgruppe, um Menschen verstehen zu lernen. In wieweit dieses Verstehensmodell aus einem säkularen Forschungszweig für die Seelsorgearbeit unterstützend sein kann, soll in dieser Arbeit geklärt werden. Als Grundlage dienen Seelsorgegespräche mit unterschiedlichen Menschen, die eine große Bandbreite an Bewältigungsverhalten demonstrierten. Die Herausforderung lag darin, Menschen in ihrem Sterben umfassend wahrzunehmen, um möglichst viele Impulse zu erkennen, die ihr Bewältigungsverhalten beeinflussten. Aus der Aufarbeitung dieses Verhaltens ergaben sich Perspektiven für die Begleitung sterbender Menschen. Dies hat gleichbedeutend Konsequenzen für den seelsorgerlichen Umgang mit Sterbenden. Das Wissen um das christlich-biblische Menschenbild und die umfassende Kenntnis der Copingforschung können sich durchaus gegenseitig befruchten, denn beide gehen auf die Individualität des Menschen ein und unterstützen ihn seinen eigenen Zugang zu seinem Leben und seinem Tod finden zu lassen. Dies führt letztlich zu einer intensiven Kommunikation zwischen Patient und Seelsorger, der den Mut und das Vertrauen haben darf, dem Sterbenden eigenständig sein Leben bewältigen zu lassen. Die Ansätze der Copingforschung bieten weitreichende Impulse für vielfältige seelsorgerliche Fragestellungen auch außerhalb der Sterbebegleitung. Object of research of this thesis is the specific behaviour of seriously ill and dying humans coping with their impending death and being members of a society having an ambivalent attitude towards death. People's different and individual ways of coping cannot always be sufficiently explained by the current use of phasing models. In this context the "Coping Model" by Richard S. Lazarus and his stress research group seems to be helpful in understanding dying humans. In how far this comprehension model from a secular branch of research can be supportive of pastoral counselling is the objective of this thesis. Counselling dialogues with different persons who show a wide range of coping form the basis of this research. The challenge of this paper was to observe and sense humans in their death experiences from a broader point of view in order to identify as much as possible kinds of impulses crucial to their coping behaviour. Analysing the behaviour of dying humans led to new perspectives on spiritual guidance. Tantamountly, this has its consequences for spiritual dealing with dying humans. The comprehension of the biblical Christian idea of man and a detailed knowledge of coping research can, by all means, be interactive and thus show positive results as both respond to a person's individuality and support them in their own ways of approach to life and death. Finally, this leads to an intensive dialogue between patient and pastor who can have the courage and the confidence in letting the person find his own way of coping. The different kinds of approach of the coping model research offer far-reaching impulses to various pastoral questions going even beyond terminal care. / Philosophy, Practical and Systematic Theology / D.Th. (Practical Theology)