Relatives' experiences of palliative care : A qualitative literature review

Bakgrund: Målet med palliativ vård i livets slutskede är att främja välbefinnandet, lindra lidandet och att trygga livskvaliteten. Anhöriga och dess närstående ska ges stöd utifrån en helhetssyn där fysiska, psykiska, sociala och andliga behov säkerställs med hjälp av ett multiprofessionellt vårdteam. Anhöriga kan bidra med kunskap som är viktig i vården och samtidigt få stöd från vårdpersonalen för att kunna stödja sina närstående. Faktorer som påverkar kvaliteten vid palliativ vård är vårdpersonalens tro, attityd och erfarenhet. Syfte: Att belysa anhörigas upplevelse av palliativ vård. Metod: Studien är kvalitativ och baseras på 15 vetenskapliga artiklar. Artiklarna har inhämtats från databaserna CINAHL, PubMed och Medline. Resultat: Visar att anhöriga upplever rädsla, stress och otillräcklighet i samband med att deras anhöriga är i livets slutskede. Anhöriga talar om vikten av delaktighet i den närståendes vård, olika typer av stöd och kommunikationen med sjuksköterskor som faktorer som underlättar för de anhöriga att acceptera situationen. Konklusion: Anhöriga kan känna sig begränsade i sin vardag på grund av den förändring i familjesituationen som blir till följd av den närståendes långvariga sjukdom. För att hantera den nya situationen som de anhöriga inte är vana vid är det viktigt att vårdpersonalen inkluderar dem i ett brytpunktssamtal. Sjuksköterskor behöver evidensbaserad utbildning om kommunikations- och samarbetsförmåga för att kunna stödja anhöriga.Background: Care at the end of life aims to promote well-being, relieve suffering and to keep up the quality of life. Family members and their loved ones must be supported because of a holistic view where physical, mental, social, and spiritual needs are provided with the help of a multi-professional care team. Family members can contribute with knowledge that is important in care, at the same time they may need support from healthcare professionals to be able to support their loved ones. Factors that affect the quality of palliative care are the healthcare professionals' beliefs, attitudes, and experiences. Objectives: To highlight the relatives’ experience of palliative care. Method: The study was conducted as a qualitative literature review based on 15 scientific articles. The articles were obtained from the databases CINAHL, PubMed and Medline. Results: Results from this study show that family members experience fear, stress, and inadequacy for their loved ones in the final stages of life. Family members emphasize that participation in the patient's care, various support and communication with nurses make it easier for them to accept the situation. Conclusion: Family members may feel limited in their daily lives due to change in the family situation because of the long-term illness of their loved one. To handle the new situation that the family members are not used to, it is important that the healthcare professionals include them in the meeting, which is called a breakpoint conversation. Nurses require evidence-based training on families' conference communication and collaboration skills to be able to support family members

Assessing Potentials of Rainfed Lands and Optimum Water Allocation between Irrigated and Rainfed Lands (Case Study: Qazvin Plain)

In this study, water allocation managements between irrigation and rainfed lands were surveyed in different climate conditions. Objective function was maximizing the net benefit. It is supposed that the cropped area of irrigation and rainfed lands have been kept unchanged and deficit irrigation has been only applied to a part of irrigation lands while supplementary irrigation has been applied to a part of rainfed lands. Also the total available water in each decade in initial management is allocated in the same decade or until 4 decades later to the irrigation of same crops in deficit irrigation conditions and in supplementary irrigation conditions for rainfed crops. The optimization model results in the Qazvin Plain indicated net benefit increased under new water allocation management in case of water conveyance from 2000, 4000, 6000, 8000 and 10000 meters in a climatically normal year to be 11.1, 13.5, 19.2, 16.6 and 15.8 percent, respectively, while in a wet year 9.0, 10.9, 17.0, 15.9 and 13.4 and in a dry year 8.05, 12.5, 16.1, 19.1 and 19.9, respectively. Also barley was the best choice for deficit irrigation in three climate conditions. Depths of deficit irrigation were 20, 25 and 30 mm in the first decade of November and 50, 50 and 60 mm in the second decade of May in normal, wet and dry conditions. Also lentil was the first choice for supplementary irrigation. The best treatments for supplementary irrigation in lentil rainfed fields were 75 mm in the third decade of May in normal years, 75 mm in the second decade of May in wet years and 100 in the second decade of May in dry years. With these treatments, the yield of lentil increased from 1000, 1300 and 0 to 3000, 3000 and 2000 kg/ha in normal, wet and dry years, respectively