Conceptions of mental health care : from the perspective of parents’ of adult children suffering from mental illness

The aim of this study was to describe parents' conceptions of the mental health care provided to adult children suffering from mental illness. Data were collected using qualitative research interviews with a purposive sample of sixteen mothers and ten fathers. Phenomenographic analysis was used to identify conceptions and formulate descriptive categories. The first category, questioning the availability of care, describes mental health care as being unequal in terms of accessibility and lacking in continuity. The second category, disapproval of parental exclusion, illustrates conceptions that mental healthcare professionals disregard parents and do not provide them with adequate information. The third category, questioning the quality of care, encompasses conceptions of lack of trust in the professionals' competence, an unsatisfactory environment as well as inadequate cooperation with other healthcare providers and authorities. Positive aspects, such as being seen and confirmed, were mentioned as valuable by the parents.Accepterad juli 2013.In thesis named "Parents’ conceptions of adult mental health care: aphenomenographic study"</p

"The unpredictable death" - The last year of life for patients with advanced COPD : Relatives' stories

Objective: The end stage of chronic obstructive pulmonary disease (COPD) is described as prolonged and the symptom burden for patients with COPD is often high. It progresses slowly over several years and can be punctuated by abrupt exacerbations that sometimes end in sudden death or recovery of longer or shorter duration. This makes it difficult to identify the critical junctures in order to prognisticate the progress and time for death. patients with COPD often express a fear that the dying process is going to be difficult. There is a fear that the dyspnea will worsen and lead to death by suffocation. The present article aimed to retrospectively describe the final year of life for patients with advanced COPD with focus on death and dying from the perspective of relatives. Method:Interviews were conducted with relatives of deceased family members who had advanced COPD. In total, 13 interviews were conducted and analyzed by menas of content analysis. Result: All relatives described the patients as having had a peacful death that did not correspond with the worry expressed earlier by both the patients and themselves. during the final week of life, two different patterns in the progress of the illness trajectory emerged: a temporary improvement where death was unexpected and a continued deterioration where death was inevitable. Sigificance and Results: The patients and their realtives lived with uncertainty up until the time of death. Little support for psychosocial and existential needs was avaiable. It is essential for the nurse to create relationship with patients and relatives that enable them to talk about dying and death on their own terms

Emotional knowing in nursing practice: In the encounter between life and death

Patients, next of kin and nurses in surgical wards often raise existential questions in the encounter between life and death. Nurses&#x2019; emotional knowing at this encounter is crucial. Consequently, this study&#x0027;s purpose was to analyse and describe nurses&#x2019; emotional knowing to reveal (a) how this knowing is expressed in daily work and (b) what emotions, thoughts and actions this knowing includes. This study used combined ethnographic and hermeneutic methodologies. Data were collected using participant observations, informal conversations and interviews. We found that nurses&#x2019; emotional knowing could be interpreted in relation to various rooms of emotions, thoughts and actions. Nurses&#x2019; judgements formed these rooms. They strived to do things correctly in the normative room; created a safe, secure milieu for patients and next of kin in the safety&#x2013;security room; and questioned their actions in the critical room. They created affinity for co-operation that benefitted encounters with patients in their affinity room. And they demonstrated sensitivity and compassion to patients and next of kin; sensitivity and compassion were particularly evident in the closeness room. In our main interpretation, we found that nurses&#x2019; judgements in various rooms (emotional knowing) constitute an expression of practical wisdom (phronesis) in nursing practice