D.Cur.( Psychiatric Nursing Science) / Please refer to full text to view abstract

published_or_final_version / Social Work / Master / Master of Social Work

M.A. / A child's life-threatening illness has severe implications for the family. Changes in lifestyle which result from an illness of this nature influence the child-patient's own life, as well as the lives of people who are in close contact with him, i.e. his parents and healthy siblings. Literature on the subject suggests that the healthy siblings suffer due to the illness and that their needs are not addressed during the illness. They often become the victims of emotional neglect, due to the lack of meaningful contact with their parents. Literature also suggests that parents often judge their healthy children to he handling the situation of one child's lifethreatening illness far more successfully than they actually are. Healthy siblings may also develop death anxiety due to this experience. Due to these, and various other reasons, the healthy siblings of children with life-threatening illnesses constitute a population which is at risk of developing moderate and severe personal, social and psychological problems. The aim of this study was to investigate how healthy siblings experience a child's lifethreatening illness and how this experience influences the healthy siblings. The study also aimed to determine the effect of a child's life-threatening illness on healthy siblings' levels of death anxiety. These aims were achieved by conducting interviews with healthy siblings, as well as their parents. The three families which were included in this study were contacted through a local state hospital. In all three families one child had been diagnosed with a life-threatening illness. All the healthy siblings who were interviewed were between the ages of nine and 16. Both qualitative and quantitative data analyses were incorporated by this study. The qualitative data for the study was gathered by means of open-ended interviews with healthy siblings and their parents. These interviews were then analysed according to the phenomenological research method. The quantitative data for the study was gathered by means of the Death Anxiety Questionnaire for Children (Malan, 1996) which was constructed far the study. The results of the qualitative data of all the participants of the study were combined in the final analysis, to determine how healthy siblings experience a child's life-threatening illness and what effect this experience has on them. The quantitative results of the study were analysed and interpreted in association with the qualitative results. The findings of this study suggest that a child's life-threatening illness constitutes a traumatic and emotional experience for the child's healthy siblings. Various conclusions were drawn as to the effects which this experience may have on the healthy siblings. The study also determined that a child's life-threatening illness influences healthy siblings' levels of death anxiety. According to these findings hypotheses may be set for future research. The results of this study is of value to the fields of psychology, social work and medicine. In the .fields of counselling and child psychology, the results serve to improve the understanding of families, and especially , children, who are experiencing the life-threatening disease of a family member. In the fields of social work and medicine the results serve to improve the relations between professionals and families of child-patients with life-threatening illnesses.

published_or_final_version / Nursing Studies / Master / Master of Nursing in Advanced Practice

Thesis (M. (Nursing)) -- University of Limpopo, 2022 / Caring for terminally ill cancer patients is considered stressful and heartbreaking. Oncology nurses often consider leaving the nursing profession because of the high levels of stress experienced by these health care professionals. The aim of this study was to investigate the experiences and the practices of nurses who care for terminally ill cancer patients in the Pietersburg Provincial Hospital in the Capricorn District of the Limpopo Province. The objectives of this study were to explore and describe the experiences and practices of nurses who care for terminally ill cancer patients and further to describe the relationship between certain demographic variables and nurses’ experiences of death. An additional objective was to develop recommendations and strategies that might assist management of the Pietersburg Provincial Hospital with the development of appropriate skills and the implementation of emotional support that could assist nurses who care for dying cancer patients in the oncology wards. The study followed a phenomenological, descriptive, exploratory and contextual research design, which assisted the researcher to describe and explore the experience and practices of nurses caring for terminally ill cancer patients. Semi-structured interview method was used to collect data, making use of an interview guide, was used because it is a more free-flowing approach, with its structure being limited only by focusing on the research. Field notes were captured during the data collection session by the researcher. A voice recorder was used to capture all the interview sessions. The initial data analysis started with the researcher listening to the recordings and transcribing verbatim all statements made by the participants. Tesch’s open coding data analysis method was used by following the proposed eight steps to analyse qualitative data as outlined in Creswell (2013). Ethical standards as set in Babbie (2013) were adhered to by the researcher. The researcher requested permission to conduct the study from the Limpopo Department of Health Ethics Research Committee and informed consent was obtained from the participants before collecting data. Privacy of the participants was ensured as participants were never called by their names. In the study participants shared different views with respect to caring for dying cancer patients. Some participants regarded caring for cancer patients as stressful and heartbreaking. Other oncology nurses blamed the management for not providing them with courses to assist them with caring for dying cancer patient, nor providing debriefing sessions for them. On the other hand, some oncology nurses believed that relocating to other wards was a better solution. The participants suggested the following improvements for caring for dying cancer patients; oncology nurses should be offered short courses to assist them with the challenges that they come across with regard to caring for dying cancer patients. Oncology nurses need support from the management and colleagues in order to cope with the workload. Oncology nurses need psychological assistance to help them with the psychological stressors they experience. Family members and patients need health education on how to deal anticipatory grief. / University of Limpopo

This survey examined anticipatory grief as a process of grieving that occurs when a loved-one has been diagnosed with a life-threatening illness. The inevitability of loss creates certain needs and feelings for the survivor. The study examined these needs, the extent to which these needs were satisfied, and the feelings. Finally, the relationship between dissatisfaction of important needs and certain feelings was observed. Findings show that certain needs, such as the need to gain knowledge about illness and to feel emotional support from family members rate as extremely important by the greatest number of respondents. These needs were not, however, rated as highly satisfied. It was also found that feelings such as anger, loneliness, and frustration were rated as occurring frequently when prognosis of death was within a year. Lastly, there was found to be a positive relationship between dissatisfaction of needs and these feelings.

No description available.

O presente estudo teve por objetivo compreender as vivências emocionais de filhos adultos de genitor (pai ou mãe) acometido por câncer em progressão. Sabe-se que o câncer atualmente é uma das principais causas de morte na vida adulta e que, a despeito dos avanços diagnósticos e terapêuticos, alguns tipos de câncer têm aumentado em incidência ou permanecem entre aqueles cuja letalidade é alta. A gravidade da doença, somada a maior expectativa de vida da população em diversos países, impõe a filhos adultos a experiência de acompanharem o processo de agravamento que culmina na morte do genitor. Diante desse fato, a literatura científica situada no campo do luto tem se voltado para esse grupo, que, segundo alguns autores, ainda é negligenciado, sob a alegação de que a maturidade favorece naturalmente um melhor enfrentamento de perdas e que, por isso, pesquisas acadêmicas e serviços de saúde devem zelar apenas pelas necessidades de crianças e adolescentes confrontados com o luto filial. Outro fator que contribui com a desatenção à situação de filhos adultos de genitor com câncer avançado é a causa da morte, já que, não se tratando de morte acidental, violenta ou súbita, aparenta menor poder de impactar psiquicamente o enlutado. O que desafia essas noções é o incremento de livros autobiográficos e/ou de autoajuda que, junto a estudos científicos, apontam para a vulnerabilidade emocional gerada pela perda de pais. Esses trabalhos fortalecem e disseminam particularmente dois conceitos: luto antecipatório e orfandade adulta. Utilizamos como referência metodológica o Método Clínico-Qualitativo, entrevistando participantes que, em sua maioria, voluntariaram-se para participar após lerem cartaz-convite em salas de espera de uma clínica oncológica. Um participante foi diretamente convidado pela pesquisadora e outros dois decidiram participar após sugestão de um familiar que soube do estudo. As entrevistas semidirigidas foram gravadas, transcritas e categorizadas, oferecendo elementos para uma discussão compreensiva da situação investigada. Os trechos selecionados foram compondo o que, ao todo, são cinco categorias: o filho desamparado, o filho culpado o filho impotente, o filho criativo, o filho onipotente. Em uma análise detida de cada categoria, destacamos trechos mais representativos e buscamos discuti-los sustentados, em especial, por contribuições de Freud e Klein. A frequente referência a essas vivências emocionais desamparo, culpa e impotência ajuda a entender a necessidade desses filhos empregarem uma variedade de defesas psíquicas, algumas (chamadas aqui de embates contra a morte) utilizadas para a veemente negação da realidade imposta pela doença e outras, mais criativas (esforços pela vida), utilizadas para reparar danos imaginariamente causados à figura perdida, para preservá-la internamente como uma companhia perenizada e, também, para ligar-se a novas experiências que reduzam a dependência em relação a quem está morrendo. A multiplicidade de angústias relatadas por cada entrevistado sugere que o luto filial na vida adulta é um tema relevante de estudo e aplicação para profissionais de saúde mental, demandando um espaço de elaboração que ultrapassa ao largo o que um estudo acadêmico oferece a entrevistados / The aim of this study was to understand the emotional experiences of adult children of parents (father or mother) affected by cancer in advanced stages. It is known that cancer is currently one of the leading causes of death in adults. Despite diagnostic and therapeutic advances, some types of cancer have increased in incidence or remained among those with high mortality rates. The severity of the disease, coupled with longer life expectancy of the population in various countries, imposes on adult children the experience of accompanying the degeneration process that ends with the death of the parent. Scientific literature in the field of grief, which historically has concentrated on children and adolescents, is now focusing on this group that, according to some authors, is still neglected due to the assumption that maturity favors better coping with loss. Another factor that contributes to the disregard of adult children of parents with advanced cancer is the cause of death, given that accidental, violent or sudden deaths seem more likely to impact the mourner psychologically. What challenges these misconceptions is the increase of autobiographical or self-help books as well as scientific studies that point to the emotional vulnerability generated by the loss of parents. These readings strengthen two concepts: anticipatory grief and adult orphanhood. The Clinical-Qualitative Method was used as a methodological reference, by interviewing participants who volunteered after reading a poster-invitation in the waiting room of an oncology clinic. One participant was directly invited by the researcher and two others decided to participate upon the recommendation of a relative who had heard about the study. The semi-structured interviews were taped, transcribed and categorized, providing elements for a comprehensive discussion of the circumstances investigated. The excerpts were arranged into five categories: the desolate child, the guilty child, the powerless child, the creative child, the omnipotent child. The analysis of each category highlighted the most representative sections of the interview and sought to discuss them based on Freud and Klein. The recurrent reference to these emotional experiences vulnerability, guilt and helplessness helps explain the need of these adult children to make use of several psychological defenses, such as vehement denial of the new reality imposed by the disease (battles against death), or the more creative attempt to: repair imaginary damage caused to the lost figure, internally preserve an eternal companion and reduce reliance on the dying person (struggle for life). The myriad of sorrows reported by each participant suggests that filial grief in adult life is a relevant topic of study and practice for mental health professionals, demanding an elaborate work that exceeds the possibilities of what an academic study may offer the interviewed subjects

Introdução: O processo de morrer é uma experiência vinculada a considerações significativas para a existência do ser, principalmente quando sobrevêm no contexto familiar. Objetivo: compreender a experiência do familiar de pacientes em fase terminal de vida, que enfrentam o processo de morrer no mundo do hospital. Método: Com esta proposta, optei por realizar uma pesquisa qualitativa, norteada pela Fenomenologia existencial de Martin Heidegger. Os sujeitos do estudo foram 15 familiares que estavam acompanhando seus pacientes adultos, em fase terminal de vida, que enfrentavam o processo de morrer em um hospital universitário de Maceió, Alagoas. Os depoimentos foram obtidos por meio de entrevista, no período de fevereiro a maio de 2013, a partir da seguinte questão norteadora: Conte-me como é para você vivenciar a situação do seu familiar atualmente. Resultados: Da análise dos depoimentos dos familiares emergiram três estruturas, denominadas unificações ontológicas: Manifestação de Angústia dos familiares, que envolve a possibilidade do ser assumir-se como um ser-para-a-morte; Manifestação do Cuidado e da Solicitude, que compreende o momento de cuidar como algo significativo na existência; e Ser-aí no mundo do hospital, que compreende o ser lançado no mundo onde o limite entre a vida e a morte é tão estreito. Conclusões: A compreensão do fenômeno vivido por esses familiares permitiu apreender a dimensão do sofrimento relativo à condição de estar-no-mundo cuidando no processo de morrer. Aponta a relevância do tema MORTE na formação dos profissionais de saúde, sinalizando importância da reflexão dessa temática, para desenvolver uma assistência que seja compatível com a situação vivenciada pelos familiares diante da terminalidade. / Introduction: The death process is an experience linked to significant considerations to the existence of the being, mainly when they take place in the family context. Objective: To understand the experience of family members of terminal patients, who face the death process in the hospital setting. Method: A qualitative study was developed, in light of the existential phenomenology of Martin Heidegger. Study subjects were 15 family members who were accompanying adult terminal patients, who faced the death process at a teaching hospital in Maceió, Alagoas. The statements were obtained by means of interviews, between February and May of 2013, based on the following guiding question: What is it like for you to experience the current situation of your relative? Results: The analysis of the statements of the family members generated three structures, named ontological unifications: Manifestation of anxiety by the family members, involving the possibility of the individual assuming her/himself as a being-to-death; Manifestation of the care and concern, which comprehends the moment of caring as a meaning in the existence; and Dasein in the hospital setting, which comprehends the being inserted in a world with a narrow limit between life and death. Conclusion: The understanding of the phenomenon experienced by these family members allowed to apprehend the dimension of the suffering regarding the condition of being-in-the-world providing care in the death process. This study points to the relevance of the death theme in the education of health professionals and the need for reflecting on this issue so as to develop a compatible care to the situation experienced by families in face of this terminal situation.

Made available in DSpace on 2016-07-27T14:19:53Z (GMT). No. of bitstreams: 1 LAURA MENESES VINHAL.pdf: 679036 bytes, checksum: b3a974fc1a50a1fd7a2292f33a734d46 (MD5) Previous issue date: 2012-04-16 / This study aimed to identify, describe and analyse the psychological aspects of mothers of children with cancer, while experiencing the process of illness treatment and terminal. The sample consisted of six mothers (22-30 years) of children ages between 3 and 12 years, who were in cancer treatment. We used a Statement of Informed Consent (IC), a social-demographic questionnaire, the habits of family and personal and clinical data of the patient, Inventory of coping strategies by Folkman and Lazarus, a range of internal dynamics of the family and a roadmap for semi-structured interview. The first chapter provides a literature review related to the themes: family, dynamics, cancer, diagnosis, cancer treatment, and psychological impact of childhood cancer, death, grief and coping. In Chapter 2, is displayed on the actual field research, conducted with mothers of children in cancer treatment. In this chapter we used the guidelines for publication of the journal Psychology: Reflection and criticism." In general, it was realized that the way mothers experience the experience of having an infant son, strickenwith cancer, is different in each situation, considering the history of life, relationships and bonds prior to the illness and the structure for available coping resources. / O presente estudo objetivou identificar, descrever e analisar os aspectos psicológicos de mães de crianças com câncer, quando vivenciando o processo de enfermidade, de tratamento e de terminalidade. A amostra foi constituída de seis mães (22 a 30 anos) de crianças com idades entre 3 e 12 anos, que encontravam-se em tratamento oncológico. Foram utilizados um Termo de Consentimento Livre e Esclarecido (TCLE), um questionário sócio-demográfico, de hábitos de vida do familiar e dados pessoais e clínicos do paciente, Inventário de estratégias de coping de Folkman e Lazarus, uma Escala da dinâmica interna da família e um Roteiro de entrevista semiestruturada. O primeiro capítulo oferece uma revisão de literatura relacionada aos temas: dinâmica familiar, diagnóstico de câncer, tratamento oncológico, câncer infantil e impacto psicológico, morte, luto e coping. No Capítulo 2, é apresentado o texto referente à pesquisa de campo propriamente dita, realizada junto às mães de crianças em tratamento oncológico. Neste capítulo foram utilizadas as diretrizes de publicação da Revista Psicologia: Reflexão e Crítica . Em geral, percebeu-se que a forma com que as mães vivenciam a experiência de ter um filho ainda criança, acometido pelo câncer, é diferenciada em cada situação, considerando a história de vida, as relações e vínculos anteriores ao adoecimento e à estrutura para disponibilizar recursos de enfrentamento.