Thesis (doctoral)--Universität, Kiel, 2003. / Includes bibliographical references (p. xiii-xxxiii).

There is minimal research into families where a person who is receiving palliative care has dependent children. In particular, there is a lack of information about the work that palliative care social workers undertake with such families. This study examines the role of the palliative care social worker in safeguarding and promoting the welfare of children of adults receiving specialist palliative care. This is a qualitative study involving the collection of information from a total of 57 palliative care social workers in three ways: focus groups, survey and semi-structured interviews. The analysis demonstrates that palliative care social workers understand the term 'safeguarding children' to mean more than child protection alone. The analysis also focuses on the process of referral, institutional barriers, supports for their work with children, and inter-agency collaboration. An equally important aspect of the analysis, and one generally neglected in psycho-social studies, relates to the socio-economic context of the palliative care social workers' work, including the effects of the immigration status of families on children. In the main, concerns about the present and future care of children come to the attention of palliative care social workers via members of the multidisciplinary team in which they are based. The numbers are reported to be relatively small in contrast to the total number of referrals received. The extent to which support to children is provided varies considerably; some palliative care agencies do not encourage palliative care social workers to work directly with children prior to bereavement and others restrict direct work with children post-bereavement. The main emphasis for all workers, however, is on support to the parents to help them understand their children's needs during the terminal phase of the illness. The well-being of children at this time of emotional stress is included in the palliative care social workers' definition of 'safeguarding children'. In addition, the wide-ranging examination of the palliative care social workers' involvement with the families illustrates the extent of the dedication involved in an under-resourced and little understood area of their work. Whilst palliative care social workers reported receiving basic training on child protection within their agency, with some themselves providing this training, further training on safeguarding children is not always available or known about. The amount and type of professional supervision and support is also varied, particularly in relation to child-care matters; not all have access to supervision from another social work professional. There are a small number of examples given in the study where children are considered to be at risk in some way. Children cared for by lone parents are recognised as being especially vulnerable, particularly if future care plans are not in place before the death of the parent. Also identified as vulnerable are children of parents whose immigration status is in question as their future location may be in doubt, placing children and the surviving parent under additional stress. One of the major difficulties for palliative care social workers is securing support services from local authority children's services. Whilst there are examples of collaboration and co-operation, the findings in this study echo those of others which examine the relationship between adult and children's services. In this study, palliative care social workers speak of frustration and disappointment in the responses they receive, and they are concerned that the needs of children of dying parents are not understood. This study contributes to the debate about the focus of children in care services for adults and how staff may be supported in their task of safeguarding and promoting the welfare of children. This study also adds to the limited existing knowledge about palliative care social work practice.

published_or_final_version / Nursing Studies / Master / Master of Nursing

Sammanfattning/Abstract Bakgrund: Många patienter väljer i dag att vårdas hemma under sin sista tid i livet istället för som tidigare på sjukhus eller ett boende. Den palliativa hemsjukvården blir därför alltmer utbredd vilket samtidigt innebär att allt större krav ställs på de närstående som då ofta intar en vårdande roll.  Syfte: Syftet är att beskriva hur närstående upplever sin vårdande roll i den palliativa hemsjukvården. Metod: En litteraturstudie baserad på tio resultatartiklar som består av både kvalitativa och kvantitativa studier där vi kom fram till tre teman som handlade om den närståendes upplevelser av den vårdande rollen, närståendes vårdande roll och den sjuke och närståendes vårdande  roll och sjuksköterskan.  Resultat: Många närstående fann både fördelar och nackdelar med den vårdande rollen och att den innebär en stor omställning. Många närstående kände sig mer eller mindre tvingade att ta över den vårdande rollen.Tillräcklig information och en god kommunikation ansågs av de närstående som en mycket viktig faktor.   Diskussion: Att vårda en svårt sjuk anhörig är ofta en belastning. Detta kräver att vårdpersonalen är medvetna om de närståendes svåra situation och upplevelsen av denna. Det är även viktigt att uppmärksamma närståendes behov av information och att ha en bra kommunikation för att vi som sjuksköterskor ska kunna stödja de närstående i deras vårdande roll. Nyckelord: Anhörig vårdare, vårdande roll, palliativ vård, döende patienter, vård i livets slut Keywords: Family caregivers, caring role, palliative care, terminally ill, end of life care

This paper investigates whether or not the experience of survivors of the Holocaust through the dying process follow the stages and tasks of dying as defined in the theoretical literature and the ramifications this has for the social worker serving these individuals and their families. The methodology employed was a library search to overlay the literature on death and dying upon the literature concerning Holocaust survivors. The study concludes that, for the most part, there is little congruence between the theories of dying and the coping mechanisms of the Holocaust survivor and that a different model of death and dying is required for this population. In order to provide a preliminary model and guide workers who might encounter terminally ill survivors and their families as patients and clients, approaches for engagement, assessment, and intervention are proposed and analyzed.

This thesis explores the experience of living with cancer and a terminal prognosis from the dying individual's perspective. It is based on qualitative sociological research. My study group comprised nineteen hospice patients, eighteen women and one man, aged 27 to 67, all of whom had been diagnosed with cancer. Thirty focused interviews were conducted; each respondent was interviewed at least once with a sub-group being interviewed a second or third time dependent upon symptoms, willingness to participate again and the need to explore issues further. My thesis is a sociological account of respndents' views and experiences. Its focus is the management and negotiation of dying and death at an individual level. A central tenet of my thesis is how self-identity is constructed and negotiated in different social encounters, in both the public and the private sphere. With reference to the public sphere I consider respondents' experiences of communicating with health professionals, and the difficulties they encountered. Within this discussion I look at how respondents constructed understandings of their illness within the context of their own biographies. I also discuss individuals' experiences of treatment, and the choices they made about this. In addition, I examine respondents' hopes and fears for their own deaths, and I suggest the notion of a 'good enough' death may be useful in interpreting their views. Repsondents perceived they had a spoiled identity as a result of their cancer and dying status. As a result, they spent a great deal of time and effort engaging in emotional work, in order to reassert their more valued roles. Much has been written about the emotional work of paid and unpaid carers. Here I suggest attention must also be given to the work of dying individuals themselves. However, I do not conceive of this emotional work as selfless, rather I suggest such work has benefits for individuals themselves. Emotional work enabled them to reaffirm or renegotiate more valued self-identities while alive, but in addition, I suggest that it also meant that respondents were able to contribute towards their own 'disembodied' after-death identities.

Bibliography: leaves 238-253. / xviii, 261 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Through a methodological blend of hermeneutics, phenomenology and social constructionism the experiences of donor parents are presented. Using a process of dialogical interpretation the themes of Unprepared, Uncertainty, Waiting, Watching, Waiting and Aloneness have been developed to expand our understanding of donor parents experiences. / Thesis (Ph.D.)--University of Adelaide, Dept. of Clinical Nursing, 1999

Thesis (M. N.) (Hons.) -- University of Western Sydney, 2003. / A thesis submitted in total fulfillment of the requirements for the degree of Master of Nursing (Honours), Faculty of Nursing and Community Health, Department of Nursing, University of Western Sydney, February, 2003. Bibliography : leaves 190-205.

Thesis (D. Min.)--Western Seminary, Portland, OR, 2008. / Abstract. Includes bibliographical references (leaves 195-198).

Thesis (D. Min.)--Nazarene Theological Seminary, 1993. / Abstract. Includes bibliographical references (leaves [221]-231).