Finding ways to carry on : stories of vulnerability in chronic illness

Purpose: In this study, we explore the lived experiences of chronic illness in four groups of patients; children with asthma, adolescents with diabetes, young adults with depression, and adult patients with chronic, obstructive pulmonary disease (COPD). Persons living with chronic illness are often designated as vulnerable. This study builds on the assumption that being vulnerable belongs to being human, and that vulnerability also might entail strength and possibilities for growth. Methods: A narrative analysis was undertaken to illuminate how experiences of vulnerability were narrated across the four patient groups, presenting four individual stories, one from each of the patient groups. Results/conclusion: The stories illuminate how living with a chronic illness implies differing capabilities and capacities dependent on the specific condition. At the same time the stories point to how various abilities and challenges in living with chronic illness can be alleviated or seen as resources. Considered together, the stories underscore how ´finding ways to carry on´ in chronic illness requires interpretational work. By calling upon resources among significant others, in the surroundings and in oneself, the narrator can find ways of interpreting living with chronic illness that might open towards a hopeful future

Interaction with potential donors' families: The professionals' community of concern—a phenomenological study

The aim of this paper was to explore the health professionals' experiences and gain a deeper understanding of interaction with families of critically ill or traumatized patients with severe brain injuries. The methodological approach was qualitative and phenomenological. Data were collected through participant observation and in-depth interviews with nurses, physicians, and chaplains working in two ICUs in a Norwegian university hospital. A thematic analysis was used for analyzing data. Two main themes emerged from analysis: Patient oriented even when present and Family oriented even when absent. Each main theme is divided into two sub-themes. The themes appeared as phases in an interaction process. In the two first phases the interaction may be characterized as Alternating between being absent and present and Following up and withholding information and in the two last phases as Turning point and changing focus and Partly present when waiting for death. The findings are in the discussion illuminated by the phenomenological concept of concern. Concern is visible as care, and the distinction in care between “leaps in” and “leaps ahead” and “ready-to-hand” and “unready-to-hand” are topics in the discussion. Because of the complexity of caring for both patient and family, the situation demands efforts to relieve nurses in particular, during the most demanding phases of the process

Norwegian nurses' attitudes toward assisted dying : a cross-sectional study

Purpose: The purpose was to investigate: (a) Norwegian nurses’ attitudes toward assisted dying, and (b) how much nurses receive requests from terminally ill patients for help in dying. Participants and Methods: A quantitative explorative study was conducted using a web-based cross-sectional survey to collect data. The survey was sent to a total of 734 eligible participants, and 205 clinical nurses participated by completing the survey. Data were analyzed using bivariate statistics and multivariate ordinal regression. Results: The study revealed that 56% of the participating nurses agreed with the statement that physician-assisted suicide should be allowed, and 48% supported legalization of euthanasia. Nurses in pulmonary wards were more positive about the legalization of physician-assisted suicide (OR = 2.98, CI = 1.34– 6.66, p = 0.008) and euthanasia (OR = 3.51, CI = 1.58– 7.81, p = 0.002) than nurses in oncological wards. Nurses over 30 years old held more negative attitudes about physician-assisted suicide than younger nurses (OR = 0.16, CI = 0.07– 0.39, ppublishedVersio

Norwegian nurses' perceptions of assisted dying requests from terminally ill patients : a qualitative interview study

This study explores the perceptions of Norwegian nurses who have receivedassisted dying requests from terminally ill patients. Assisted dying is illegal inNorway, while in some countries, it is an option. Nurses caring for terminally illpatients may experience ethical challenges by receiving requests for euthanasia andassisted suicide. We applied a qualitative research design with a phenomenologicalhermeneutic approach using open individual interviews. A total of 15 registerednurses employed in pulmonary and oncology wards of three university hospitals andhome care in one municipality were recruited. Four themes emerged from theanalysis: (1) unprepared for the request; (2) meeting direct, indirect, and nonverbalrequests; (3) working in a gray zone, and (4) feeling alone and powerless. The studyfound that nurses were unsure how to handle such requests due to professionaluncertainty about assisted dying. Working in an environment where the topic istaboo made nurses morally uncertain, and some perceived this as moral distress. Thehospital chaplain played a significant role in providing support to these nurses. Keywords: assisted dying requests, ethical challenge, interviews, moral distress, moral uncertainty, nurses'experiences, phenomenological hermeneutic designpublishedVersio

Finding ways to carry on : stories of vulnerability in chronic illness

Purpose: In this study, we explore the lived experiences of chronic illness in four groups of patients; children with asthma, adolescents with diabetes, young adults with depression, and adult patients with chronic, obstructive pulmonary disease (COPD). Persons living with chronic illness are often designated as vulnerable. This study builds on the assumption that being vulnerable belongs to being human, and that vulnerability also might entail strength and possibilities for growth. Methods: A narrative analysis was undertaken to illuminate how experiences of vulnerability were narrated across the four patient groups, presenting four individual stories, one from each of the patient groups. Results/conclusion: The stories illuminate how living with a chronic illness implies differing capabilities and capacities dependent on the specific condition. At the same time the stories point to how various abilities and challenges in living with chronic illness can be alleviated or seen as resources. Considered together, the stories underscore how ´finding ways to carry on´ in chronic illness requires interpretational work. By calling upon resources among significant others, in the surroundings and in oneself, the narrator can find ways of interpreting living with chronic illness that might open towards a hopeful future