O presente estudo teve como objetivos conhecer os conflitos éticos relativos a pacientes terminais identificados por enfermeiros das clinicas médica, cirúrgica e pronto socorro adulto de um hospital público e geral; compreender como os enfermeiros tomam as decisões frente a conflitos éticos referentes a esses pacientes e conhecer o que é levado em consideração, pelos enfermeiros, para a tomada de decisão frente a conflitos éticos relacionados a pacientes terminais. Foi feito um estudo exploratório, descritivo e de abordagem qualitativa. Para análise dos dados foi utilizada a análise de conteúdo proposta por Bardin. Foram entrevistados dez enfermeiros de um hospital público e geral do Município de São Paulo. Após a análise, emergiram três categorias e quinze sub-categorias: Categoria 1- A vivência dos enfermeiros em relação ao paciente terminal. Subcategorias: Cuidados como condição essencial para assistência aos pacientes terminais; Postura da família frente ao paciente terminal; Conseqüências da vivência profissional com pacientes terminais; e Postura profissional frente aos pacientes terminais. Categoria 2- Fatores geradores de conflitos éticos em relação ao paciente terminal. Subcategorias: Obstinação terapêutica; Situações administrativas; A quebra do sigilo e desrespeito à privacidade do paciente terminal; Despreparo profissional; e Falta de autonomia do enfermeiro. Categoria 3- Fatores considerados para a tomada de decisão em relação aos conflitos éticos frente ao paciente terminal. Subcategorias: Os aspectos ético-legais; O uso do conhecimento científico; A participação das equipes multiprofissional e de enfermagem; O respeito à autonomia do paciente e da família; A importância do esclarecimento de pacientes e familiares; e A multifatorialidade concorrendo para a tomada de decisão. O estudo evidenciou que os conflitos éticos relativos aos pacientes terminais, vivenciados pelos enfermeiros, emergem de seu cotidiano e são decorrentes de diversos fatores relacionados à assistência, ao gerenciamento e à capacitação dos profissionais. Foi evidenciado, ainda, que os enfermeiros apontam fatores que devem ser levados em consideração no processo de tomada de decisão, mas revelam sua pouca participação nesse processo frente aos conflitos éticos relativos a pacientes terminais. / The present study aims to identify and understand the ethical conflicts related to terminal patients experienced by nurses and are what considered for decision making to cope with these conflicts. The methodology adopted was the qualitative strand, using the content analysis proposed by Bardin. Ten nurses were interviewed in a general hospital in Sao Paulo. After the analysis emerged three categories and fifteen sub-categories: Category 1 - The experience of nurses in relation to the patient terminal. Subcategories: care as an essential condition for assistance to terminally ill patients; Posture family towards the patient terminal; Consequences of professional experience with terminal patients, and professional attitude to patients facing terminal. Category 2 - Factors generators to ethical conflicts in respect to the terminal patient. Subcategory: Therapeutic futility; Situations administrative on generating of conflict; The breaking secrecy and privacy disrespect of the patient terminal; A lack of professional preparation; and lack of autonomy of nurses. Category 3 - Factors considered in the decision-making in relation to the conflicts ethic facing the terminally ill patient. Subcategories: ethical and legal aspects; The use of scientific knowledge; The participation of multidisciplinary teams and nursing staff; The Respect for patient autonomy and family; The importance of clarifying patients and families, and, The multifactorial competing to decision-making. The study showed that ethical conflicts related to the patients, experienced by nurses, emerge from their everyday and are caused by several factors related to assistance, to management and capacitation professional. It was evidenced, also, that the nurses point to factors that must be taken account in decision-making process, but they reveal their little participation in this process front to the ethical conflicts related to terminally ill patients.

D.Ed. / The goal of this research was to generate and describe an acquiescent approach for the educational psychologist to utilise with a family with a terminally ill child. It appears that family units with a terminally ill child have a tendency to withdraw and this isolation leads to problems in mental health. Their mental health is, amongst others, characterised by anger, frustration, unrest and depression. A tendency with psychologists, clergy and helpers from other professions is to act as ideal experts on the lives of saddened people. From painful personal experience this does not seem to enable acquiescence. In their efforts to provide consultation to the grief stricken families, these professionals often overlook the family's real needs and forge their own views upon them. In this way they only further damage their mental condition. This led me to ask the following questions: • What does the world of the family with a terminally ill child comprise of? • Which approach could be described in order to lead the family with a terminally ill child to acquiescence? A qualitative, explorative, descriptive and contextual research design was followed. v The research was conducted in two phases as follows : The experiences of four families with terminally ill children were explored and described in phase one. This was done using phenomenological, unstructured, in-depth interviews. In phase two, a description for educational psychologists for families with a terminally ill child was done, which is based on the results from phase one. After data was gathered in phase one, I came to the conclusion that the family with a terminally ill child goes through a painful process which could last for years. As they go through the process they gain insight into certain life-skills. The aim of the support was then to facilitate a context for the family with a terminally ill child in order for them to internalise these lifeskills. The central statement of this research was thus supported and can be read as follows: An understanding of the world of the family with a terminally ill child will provide the educational psychologist with the data to describe a acquiescent approach.

In In 1999 the South African Law Reform Commission proposed a draft bill on End of Life Decisions and tabled the Bill before Parliament. To date the Bill is still yet to be put up for discussion perhaps due to the sensitive nature of the subject. This mini-dissertation will examine South African people’s perception and awareness of passive euthanasia and whether the procedure should be regulated. The research will look at the current position in South Africa, arguments for and against passive euthanasia, and the factors influencing society’s reactions to this growing phenomenon.1999 the South African Law Reform Commission proposed a draft bill on End of Life Decisions and tabled the Bill before Parliament. To date the Bill is still yet to be put up for discussion perhaps due to the sensitive nature of the subject. This mini-dissertation will examine South African people’s perception and awareness of passive euthanasia and whether the procedure should be regulated. The research will look at the current position in South Africa, arguments for and against passive euthanasia, and the factors influencing society’s reactions to this growing phenomenon.

The purpose of this study was to explore spiritual and psychological issues as experienced by persons who know they have a terminal illness. An existentialphenomenological method was chosen to understand and articulate the structure and meaning underlying the experience of living with the knowledge that one has a terminal illness. The study had its genesis at the bedside(s) of people who were dying, yet living or living, yet dying. The experience of knowing one has a terminal illness serves to bring life and consciousness to those who may have otherwise continued to live unconsciously, to exist in a potentially weary and dormant state, oblivious to the fact that life was passing them by. The evidence of experience of knowing what it means to have a terminal illness exists in the words and expressions of the twenty-one people who graciously participated in this study as co-researchers. They have given testimony of their own experience to those of us who seek to understand that experience, to understand what it means to have a terminal illness, to confront one's end to life as it is known, to embrace life or to prepare to die. For some it was a single in-depth interview, for others there were numerous indepth interviews over the course of two to eleven months. Eight of the twenty-one coresearcher narratives were presented in this study. Each interview was recorded by audio and video tape, the former being used for transcription. Subsequently, transcriptions were reviewed for accuracy. As a measure of trustworthiness, themes were identified by the principal investigator and presented in the context of the narrative to the coresearchers who confirmed the data and validated the themes. Implications based on the themes identified in this study are presented under theory development, professional practice and future research. One of the strongest implications pertains to clinical practice in that the results could serve as the framework for a palliative care program which models palliative care as defined by the World Health Organization. The co-researchers were eager to tell their stories and to speak their truth with the hope that the care of persons with terminal illness would some day include care of people as whole persons—physical, psychological and spiritual. / Graduate and Postdoctoral Studies / Graduate

No description available.

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Thesis (M.S.W.)--University of Hong Kong, 1987.

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Thesis (Ph. D.)--University of Texas at Austin, 2004. / Supervisors: Larry Browning and Rajiv Rimal. Vita. Includes bibliographical references.

Bakgrund: Under år 2016 upptäcktes 64 000 maligna tumörer i Sverige. Cancer uppstår när det blir en rubbning i celldelningen och cellerna börjar dela sig okontrollerat. När det inte finns någon chans att en kurativ behandling skulle lyckas går man in i en palliativ behandling. Denna fokuserar på symtomlindring och stöd till både patientenoch närstående. Det är viktigt för sjuksköterskan att vara medveten om hur patienter med obotlig cancer upplever sin situation för att kunna ge en så god omvårdnad som möjligt. Syfte: Att beskriva vuxna personers upplevelser av att leva med obotlig cancer samt beskriva vilka datainsamlingsmetoder som använts i de valda artiklarna. Metod: En deskriptiv litteraturstudie som inkluderade tolv vetenskapliga artiklar, varav nio artiklar av kvalitativ ansats och tre av kvantitativ ansats. Sökningarna skedde i PubMed och Cinahl. De valda artiklarna analyserades sedan objektivt. Huvudresultat: Trötthet var ett av de vanligaste upplevda symtomen hos terminalt sjuka cancerpatienter. Rädsla för framtiden samt rädsla inför döden var vanligt upplevda känslor. Känsla av hopp ansågs viktig, likaså relationen till nära och kära. Kontakten med sjukvården kunde upplevas som frustrerande, dock beskrev många att de var tacksamma över den hjälp de fick. Slutsats: Att leva med en obotlig cancer påverkar personerna i både den fysiska, psykiska, sociala och existentiella delen av livet. En rädsla inför framtiden och döden beskrevs. För att minska personens lidande är det viktigt att vården fungerar och att sjuksköterskan kan bemöta den drabbade på dennes nivå. / Background: In 2016, 64,000 malignant tumors were discovered in Sweden. Cancer occurs when there is an abnormal cell growth and the cells start to divide uncontrollably. When there is no chance that a curative treatment would succeed the palliative treatment takes place. It focuses on symptom relief and support for both the patient and his/her relatives. It is important for the nurse to be aware of how patients with incurable cancer experience their situation in order to provide as good care as possible. Aim: To describe adult experiences of living with incurable cancer as well as to describe the data collection methods used in the selected articles. Method: A descriptive literature study, which included twelve scientific articles. Nine articles of qualitative approach, and three of quantitative approach. The searches took place in PubMed and Cinahl. The selected articles were then objectively analyzed. Key Findings: Fatigue was one of the most commonly experienced symptoms in terminally ill cancer patients. Fear of the future as well as fear of death were common feelings. Feeling of hope was considered important, as well as the relationship to loved ones. The contact with health care could be perceived as frustrating, however, many described that they were grateful for the help they received. Conclusion: Living with an incurable cancer affects the people in both the physical, mental, social and existential part of life. A fear of the future and death is described. In order to reduce the person's suffering it is important that the health care works and that the nurse can respond to the patient at his level.