Betekenisgeving en rituelen bij persisterende en traumatische rouw

Verlies van dierbaren confronteert nabestaanden met fundamentele vragen over de zin van het leven. Betekenisgeving kan bijdragen aan het ervaren van onder meer coherentie, verbondenheid en transcendentie. Rituelen en symbolische expressies van rouw kunnen betekenisgeving na verlies ondersteunen. In dit artikel gaat het over de rol van betekenisgeving en rituelen bij de behandeling van persisterende en traumatische rouw

Moral distress among healthcare professionals in long-term care settings:a scoping review

AIM: To explore the body of knowledge available regarding the moral distress of healthcare professionals in long-term care settings, focusing on influencing factors and strategies to cope with moral distress.DESIGN: Scoping review.METHODS: This scoping review follows the guidelines of the PRISMA-ScR protocol (Tricco et al. 2018) Searches were done using a strategy that included MeSH terms and free text terms.DATA SOURCES: Data sources were PubMed, CINAHL, Psychinfo and Embase. Searches were done in October 2023 without any date restrictions.RESULTS: Eight articles were included in this review. Moral distress can impact the wellbeing of healthcare professionals. Influencing factors of moral distress of health care professionals appeared to be lack of resources, lack of communication and incongruence with colleagues. Strategies to cope with moral distress were talking about ethical issues with others, receiving support from colleagues and managers, and seeking support from outside the team or organization. Individual healthcare professionals relied on their personal characteristics or their professional identity and used rationalization, distancing themselves or acceptance of the situation to cope with their moral distress.CONCLUSION: Moral distress of healthcare professionals in long-term care settings appears not differently experienced than moral distress among healthcare professionals in other healthcare settings. This can be beneficial in learning from each other, but also raises the question whether moral distress is too broadly defined.IMPACT: This review addressed the scope and experiences of moral distress in long-term care settings. Future research can contribute to further insight into if and how specific features of long-term care are of influence on moral distress and formulate tailored strategies to lessen moral distress.REPORTING METHOD: PRISMA-ScR.</p

Reanimatieverklaring

In dit artikel wordt ingegaan op de casus van meneer Graas, 80 jaar. Hij wordt met de ziekte van Parkinson opgenomen in een zorginstelling voor langdurige zorg. Tijdens de intake komt het gesprek op het onderwerp wel of niet reanimeren. Meneer Graas en ook zijn zoon twijfelen. Hoe en wie moet dit gesprek met de cliënt en zijn naasten aangaan

Afsluiten achterdeur in thuissituatie

In dit artikel wordt ingegaan op de casus van meneer De Vries, 87 jaar. Meneer De Vries woont thuis en krijgt hulp van een thuiszorgmedewerker. Hij wil graag dat de medewerker de achterdeur op slot draait bij vertrek en de sleutel in het sleutelkastje opbergt. De thuiszorgmedewerker doet dit niet, omdat dit volgens haar niet zomaar mag. Hoe zit dit precies en wat zegt de Wet zorg en dwang hierover

The spiritual care intervention “In dialogue with your life story”: Results of a longitudinal study on palliative clients’ spiritual wellbeing

Background: Spiritual care is important for palliative care, but the evidence base for spiritual care provision is low.Aim:To investigate the course over time of clients’ spiritual wellbeing who participated in the spiritual care intervention “In dialogue with your life story.”Design: The intervention consisted of six individual sessions between client and chaplain of various faiths. A longitudinal study was conducted pre- and post-intervention, and a follow-up approximately 10 weeks after post-intervention. Spiritual wellbeing was measured using the EORTC QLQ-SWB32 and NEIS, and symptoms of anxiety and depression as secondary outcome measure using the HADS. Latent growth modeling was used to investigate changes in outcome measures over time.Setting/Participants: Adult clients receiving home-based, palliative care were eligible to participate in this study.Results: A total of 75 clients and 33 chaplains participated. On the four EORTC QLQ-SWQ32-subscales, a significant increase was found over time on “relationship with self,” “relationship with others,” and ‘“existential wellbeing” (linear trends). “Relationship with someone or something greater” significantly increased over time but decreased 10 weeks post-intervention (quadratic trend). On the two NEIS-subscales, ego-integrity significantly increased over time (linear trend), while despair significantly decreased (quadratic trend). On the two HADS-subscales, symptoms of anxiety significantly decreased over time (linear trend). No significant change was found for depressive symptoms.Conclusions: We provided first empirical evidence for an increase in clients’ spiritual wellbeing after enrollment in the spiritual care intervention “In dialogue with your life story.” Future research using control conditions is needed to investigate its causal effect