Dilemmas in thanatology in the 21st century In the thesis "Dilemmas in thanatology in the 21st century" I focused on the definition of the contradictory questions about the end of human life. I found that most of the respondents of different age groups, who were involved in the care process and responded to the questionnaire, are acquainted with the issue of thanatology. They assess this issue as emotionally challenging, difficult and professionally untreated. In addition, I investigated the needs of helping professions in the issue of communication barriers in the topic of death and dying. I came to the conclusion that communication on this subject is displaced, missing training and there is a lack of the literature on this topic. Due to the unrepresentativeness of the survey I assess the result obtained only as the orientation indicator according to the issue under the investigation. This result rather opens up further contradictory questions in the thanatology.

Nursing moral philosophy in the care of the terminally ill Abstract The aim of the work The aim of the research part of the diploma thesis was to fid out what ethical dilemmas the medical staff recognizes in the care of the terminally ill and what role it occupies in accompanying the dying. The method to reach the goal To achieve the goal, we chose a qualitative research solution using a semi-structured interview, which ethical dilemmas of the non-medical healthcare staff recognizes and what roles it takes to make decisions at the end of the patient's life. The research group was consisted of 10 nurses who are part of palliative teams in selected health care institutions. The interviews which were provided, were rewritten, and using of coding techniques "paper-pencil", the data was organized into each categories. The gained knowledge and the conclusion The research which we have conducted reveals what ethical dilemmas we see as a non-medical healthcare professionals in their practice and which attitudes and roles we hold to the terminally ill, dying patients and their families. The patients with an incurable illness at the end of their lives find themselves in a very difficult situation. It is very important to improve the quality of the care and to be close to these patients. The medical staff member should be aware that any decision can become an ethical dilemma that we should recognize to find the best solution to meet the needs of the patient, respect his desire with maintain one´s dignity. Only that palliative care can be characterized as a first-rate care, focused on the patient's individuality and uniqueness

This diploma thesis looks into the issues of death and dying. Based on a chosen work of fiction, it endeavours to remit the topic of fear of dying and concerns on the possibilities of how to deal with it from points of view of a dying person as well as that of an accompanying one. By using and connecting approaches used in sociology of literature and social work, it aims to appraise the benefit of reading fiction on the given topic for social workers in their professional as well as personal life. The work of fiction therefore serves as an alternative receptive material. By its interpretation, a social worker or layman can gain a more profound knowledge of current social issues, which the last matters of a human unquestionably belong to.

Made available in DSpace on 2016-04-04T18:28:07Z (GMT). No. of bitstreams: 1 CLEBER JOSE ALO DE MORAES.pdf: 2634763 bytes, checksum: 00f21e97451a3045afdec187b0e4421e (MD5) Previous issue date: 2012-12-18 / A professional nurse who works in an Intensive Care Unit (ICU) is daily confronted with the truth of death. Such process is usually followed by ambivalent feelings which, once overlooked or denied by the team itself, results in damages regarding the comforting of the patient s suffering, bringing on to the professional a psychical suffering. This study aims to investigate the imaginative expressions of an ICU nursing team who looks after adult patients, in search of the fields of affective-emotional meaning that sustain their imaginative constructions in the face of impending death. We have adopted the psychoanalytic methodology, which permeate our journey from the moment of an interactive narrative elaboration, to be presented as a dialogic procedure that entails an imaginative creation of the participants of this research, pervading the interviews that followed the interactive narratives, until the analysis of the obtained material. The interactive narratives and the transferencial narratives, both considered record documents that compile this study, unveil, among other findings, the field we have called Death Inevitability, being this one compound by three subfields: impotence, indifference and the assimilated absence. All three subfields are inextricably interwoven, sometimes appearing simultaneously in several narratives. The subfield of impotence is characterized by feelings and beliefs of defeat or failure, whenever the nursing team faces death without being able to subdue it. The subfield of indifference expresses itself predominantly through intellectualized reactions, where the emotional detachment and the rationalization predominate as defenses against the impact of death. On the other hand, the subfield called assimilated absence reveals the possibility of integration between the relative or limited power to the available resources and the experience of pain of the separation, which results in the iv acceptance of death as part of living. The emotional range that is woven by the participants through narratives reveals a fertile field of research on professional suffering, aging processes, palliative care, as well as psicossocial studies about the contemporary way of dealing with death and dying. / O profissional de enfermagem que trabalha no ambiente de UTI ? diariamente confrontado com a realidade da morte. Tal processo ? usualmente acompanhado de sentimentos ambivalentes que, ao serem menosprezados ou negados pela pr?pria equipe, trazem preju?zos no que se refere ao acolhimento do sofrimento do paciente, ocasionando o sofrimento ps?quico do profissional. Este estudo tem por objetivo investigar as produ??es imaginativas de uma equipe de enfermagem de Unidade de Terapia Intensiva que cuida de pacientes adultos, em busca dos campos de sentido afetivo-emocional que sustentam suas constru??es imaginativas diante da imin?ncia da morte. Adotamos o m?todo psicanal?tico, que permeia nosso percurso desde a elabora??o de uma narrativa interativa, a ser apresentada como procedimento dial?gico que enseja a cria??o imaginativa dos participantes desta pesquisa, perpassando as entrevistas que se seguiram ?s narrativas interativas, at? a an?lise interpretativa do material obtido. As narrativas interativas e as narrativas transferenciais, como os dois documentos de registro que comp?em este estudo, desvelam, entre outros achados, o campo de sentido o qual denominamos Inevitabilidade da Morte, sendo este composto por tr?s subcampos: a impot?ncia, a indiferen?a e a aus?ncia assimilada. Os tr?s subcampos se encontram intimamente imbricados, por vezes surgindo ao mesmo tempo nas diversas narrativas. O subcampo da impot?ncia ? caracterizado por sentimentos e cren?as ligadas ao sentimento de derrota ou fracasso da equipe de enfermagem ao enfrentar a morte sem conseguir subjug?-la. O subcampo da indiferen?a se expressa por rea??es predominantemente intelectualizadas, onde o distanciamento emocional e a racionaliza??o predominam como defesa contra o impacto emocional da morte. No subcampo chamado de aus?ncia assimilada, encontramos a integra??o ii entre a pot?ncia relativa ou limitada aos recursos dispon?veis e a viv?ncia da dor da separa??o, o que vem resultar na aceita??o da morte como parte integrante do viver. A gama emocional tecida em narrativas pelos participantes revela um campo f?rtil para a pesquisa do sofrimento profissional, dos processos de envelhecimento, dos cuidados paliativos, al?m de estudos psicossociais sobre o modo contempor?neo de lidar com a morte.

Poimenické aspekty komunikace na pomezí individuální eschatologie The poimenical aspects of communication at the interface with individual echatology Jiří Flam The present thesis responds to a question, whether there is a way of communication that can be used by churches to address the world, and that is not sufficiently used by the churches today. The thesis thus presents a specific means of communication, which is the law. The law is described as a communication process, and different methods how one can enter into such a communication process are presented. The success of a communication process depends on willingness of participants of such a process to communicate with each other. For this reason, the thesis also deals with the question, whether churches should seek the use of means of communication addressing the society as a whole, while the alternative might be the creation of closed theological elites. The answer to this question is sought through the Christological meaning of communication. The last part of the thesis focuses on research that would provide a partial answer to the question, whether the Czech society is actually interested in communication with churches, with special emphasis on communication concerning selected topics from the field of individual eschatology. Thus, the...

The shift in health care and nursing philosophy and practice from a holistic approach to a highly technological, cure-oriented approach has been attributed to effective pharmaceuticals made to prolong life. Recently medical professionals have shifted their focus to a combination of spiritual healing and medicine. Hospice care in particular have taken a key interest in integrating spirituality within their health care. The problem is that due to the complications in defining spirituality and appropriate training and education of spirituality within nursing curriculum, assessing patients' spiritual distress may be difficult for many hospice nurses which may be at a loss when attempting to integrate spirituality within their practice. This study used a phenomenological approach to explore the infusion of spirituality in nursing practice and the hospice nurses perceptions of assessing spiritual distress needs of terminally ill patients. Frankl's existential theory and Kubler- Ross's stages of grief theory framed the study. Participants included 8 hospice nurses working in a Pacific Northwestern state. Face-to-face interviews were conducted to explore the essence of the experience of integrating spirituality as well as their views and concerns regarding assessment instruments used to assess spiritual distress. Data was analyzed for content themes. The study found that spiritual courses were merged into hospice nursing as a teaching unity making it difficult for hospice nurses in a Pacific Northwestern State to fully grasp the concept of spirituality. Further findings suggested that only a handful of schools had spiritual nursing as an independent course. The study may impact social change by informing the advancement of hospice nurses and hospice administrators in the practice of including spirituality within healthcare and integrating extensive existential support training within nurses' curriculum.

In humour studies research, there have been few attempts to elucidate why black humour was such a prevalent, powerful force in late twentieth century culture and why it continues to make a profound impression in the new millennium. As Dana Polan (1991) laments: ???Rarely have there been attempts to offer material, historically specific explanations of particular manifestations of the comic???.1 This thesis offers an interdisciplinary analysis of black humour in the late twentieth century. I contend that the experience of black humour emerges from the intricacies of human beliefs and behaviours surrounding death and through the diverse rituals that shape experiences of loss. I suggest that black humour is an attempt to articulate the tension between the haunting absence and disturbing presence of death in contemporary society. Chapter 1 of this thesis offers an historical and etymological perspective on black humour. In Chapter 2, I argue that the increasing privatisation and medicalisation of death, along with the overt mediatisation of death, creates a problematic juxtaposition. I contend that these unique social conditions created, and continue to foster, an ideal environment for the creation and proliferation of black humour. In Chapters 3 and 4, I examine the structures and functions of black humour through three key theories of humour: incongruity, catharsis and superiority. Chapter 5 looks at ways in which the experience of black humour creates resolutions and forces dissonances for people entwined with loss. In this final chapter, I also consider how black humour may help people make meaning from issues surrounding death. Throughout this theoretical discussion, I interweave the analysis of a range of scenes from contemporary black comic texts (i.e. plays, screenplays and television scripts). On the whole, this thesis works towards a more complex, specific understanding of the phenomenon of black humour within a social context.

Bakgrund. Vård av döende barn kan vara psykiskt påfrestande för många sjuksköterskor som arbetar på neonatala intensivvårdsavdelningar. Internationella studier visar på att de främsta faktorerna är; brist på utbildning inom neonatal palliativ vård och brist på kommunikation. Syfte. Syftet med studien var att beskriva samband mellan sjuksköterskors attityder till att vårda döende barn på en neonatal intensivvårdsavdelning och arbetslivserfarenhet samt utbildningsnivå. Metod: Studien genomfördes med en webbaserad enkät på de neonatala intensivvårdsavdelningarna vid Norrlands Universitetssjukhus i Umeå samt Akademiska sjukhuset i Uppsala. Studien inkluderade 72 sjuksköterskor med erfarenhet av att vårda minst ett döende barn. Studien är en empirisk kvantitativ tvärsnittsstudie med deskriptiv design. Resultat. Alla sjuksköterskor med kort arbetslivserfarenhet ansåg att det var psykiskt påfrestande att vårda döende barn jämfört med 61% av de med lång erfarenhet. Mer än hälften (59%) av de utan vidareutbildning jämfört med de med vidareutbildning (16%) ville  undvika situationer där de behövde vårda döende barn. Av alla deltagarna önskade 85% mer utbildning än vad de fick i nuläget om vård av döende barn. Konklusion. Brist på vidareutbildning, kort arbetslivserfarenhet och hög tjänstgöringsgrad i konkret omvårdnadsarbete ökar risken för negativa attityder och uppfattningar bland sjuksköterskor i vården av döende barn. / Background. It can be a challenge for nurses to care for dying children in a neonatal intensive care unit. International studies show that the main factors are; lack of training in neonatal palliative care and lack of communication within the health care team. Objectives. The aim of this study was to describe the correlation between nurses' attitudes of caring for dying children in a neonatal intensive care unit and work experience and level of education. Method. The study was conducted using a web-based survey in the neonatal intensive care units at Norrland University Hospital in Umeå and Uppsala University Hospital. The study included 72 nurses with experience of caring for at least one dying child. The study is an empirical quantitative cross-sectional study with descriptive design. Results. All nurses with short work experience felt that it was psychologically stressful to care for dying children , compared with 61 % of those with long work experience. More than half (59%) of those without further education compared to those with further education ( 16%) wanted to avoid situations where they have to care for dying children. Of all the participants 85% wanted more education about caring for dying children. Conclusion. Lack of education, brief work experience and a high degree of service in the real nursing work increases the risk of negative attitudes and perception in the care of dying children among nurses.

The overall aim of this thesis was to describe how people with very severe obstructive pulmonary disease (COPD) experienced their every day lives and created meaning, with focus on end-of-life. A second aim was to describe how death and dying can be viewed from the perspective of relatives to people with COPD. In study I, eight patients were interviewed about how COPD affected their everyday lives. A phenomenological method was used. In study II, four people with COPD who lived alone were interviewed over time, to illuminate how the illness influenced their everyday life and their existential thoughts about life and death. In study III, four couples of whom one partner in each couple had COPD were interviewed several times to illuminate the affect the illness had on the spousal relationship, their self-expressed needs, and their existential thoughts, from the perspective of two people living together. A phenomenological-hermeneutic method was used for the analyses in studies IIand III. Study IV aimed at studying patients’ last six months of life with focuson dying and death, and in this study content analysis was used.The studies (I-IV) revealed that suffering from very severe COPD can be a daily struggle to survive as well as to maintain the self-image. The studies also explicate experiences of a shrinking life space, and questions of meaning were being challenged (I). Study II showed that living alone provided feelings of independency. However the bodily losses reminded the patients’ about death and raised fears about death of being painful, as they did not want to face death alone. For the couples in study III living with COPD meant living in a changed pace with uncertainty, changed intimate relationship and finding new ways of living together. Study IV outlined the trajectory of illness to be irregular and characterized by periods of sudden deterioration, making it difficult to plan for the future. Death was experienced as an unexpected experience and was described by all as peaceful. The results in this thesis have outlined important insight into the existential challenges of living with COPD as experienced by the ill persons themselves and their next of relatives. / Birgitta Andershed is also affiliated to Enheten för forskning i palliativ vård, Ersta Sköndal Högskola, Stockholm och Institutionen för omvårdnad, Gjøvik universitet, Norge.Eva Sahlberg-Blom is also affiliated to Enheten för forskning i palliativ vård, Ersta Sköndal Högskola, Stockholm

This practicum focuses on end-of-life care for older adults in rural Canada. Specifically, it addresses links between domesticity and terminal illness amongst adults within the building typology of hospice. The objective of the practicum is the creation of a model for hospice design in rural Manitoba. The hospice will be supported in pre-fabricated housing. The practicum will address contemporary issues arising from publicly-funded healthcare, the aging Canadian population, and cultural issues surrounding dying, death, and grieving. The main goals to be achieved with this project were the creation of care facilities that encourage dialogue, education, and wellbeing for all users. Additionally, the facilities will be designed as multi-sensory environments where all human senses can be stimulated, expanding beyond typical visual stimuli.