Spirituality in Patients at the End of Life—Is It Necessary? A Qualitative Approach to the Protagonists

Spirituality is the most unknown aspect of palliative care despite being the need that is most altered in the last moments of life. Objective. To identify on the one hand the spiritual needs of patients who are at the end of life and on the other hand, the way in which nursing professionals can work to provide effective accompaniment in this process. Method. A qualitative study was conducted which applied different data collection techniques. This was done to describe the phenomenon from a holistic perspective in relation to experts’ perceptions of the competencies required by health professionals and palliative patients’ spiritual needs. Semi-structured interviews were conducted within both populations. In order to analyze the qualitative data collected through interviews, discourse was analyzed according to the Taylor–Bodgan model and processed using Atlas.ti software. Results. Three well-differentiated lines of argument are extracted from the discourse in each of the groups, on the one hand in the group of patients they define the concept of spirituality, system of values and beliefs, and the Factors that influence the spirituality of patients at the end of life (differentiating palliative care areas/other areas) and on the other, the professionals agree with the patients in the line of argument of concept of spirituality although they define more metaphysical categories and the other two lines of argument that result are the spiritual attention in this process and the need for formation in spirituality. Conclusions. The provision of spiritual care gives meaning to the actions of nursing professionals when it comes to providing end-of-life care, achieving holistic care, humanizing death, and promoting a dignified en

How to Manage the Suffering of the Patient and the Family in the Final Stage of Life: A Qualitative Study

Background: The end of life and death have changed from being issues managed within the family, assumed as part of life, to occur within health institutions for the majority of patients. The amount of patients dying at home has decreased, and the roles of families and communities in death and dying have become involuted, threatening related traditions and knowledge. As a result, a need to promote the end of life at home in this new self-serving society has arisen. In that context, the main objective of this study was to find out what patients and their families need during the end-of-life process in order to feel effectively accompanied at this time. Methods: With that objective, a descriptive qualitative study was conducted via the content analysis of data from semi-structured interviews and focus groups. This research adhered to the COREQ guidelines. The sample consisted of 36 informants selected via intentional sampling of family members and patients integrated into the Comprehensive Palliative Care Process (PAI Paliativos). Results: The results suggest the existence of several common needs such as communication and presence, including the conspiracy of silence as an important factor generating suffering for both. However, there are specific needs such as autonomy, dignity, and respect for patients, which must be taken into account. Conclusions: The results of this study will allow us to establish intervention strategies for effective accompaniment of patients’ family members at the end of life and the avoidance of ethnocentrism in this process. This study was retrospectively registered with the (nursrep-1194226) on the (21 April 2023).Departamento de Enfermerí

Approaching Grief And Death In Family Members Of Patients With Covid-19: Narrative Review

Revisión Narrativa para realizar una síntesis de evidencias y establecer recomendaciones para el acompañamiento y duelo al familiar del paciente COVIDObjetivo: Realizar una síntesis de la evidencia disponible para establecer recomendaciones sobre el abordaje del duelo y la muerte en familiares de pacientes Covid19 así como ofrecer recursos sustitutivos de los rituales y procedimientos necesarios con el fin de favorecer duelos funcionales y prevenir duelos complicados. Método: Se realizó búsqueda bibliográfica en bases de datos MEDLINE, EMBASE, SCIENCEDIRECT, WOS, CINAHL y CUIDEN, utilizando términos MeSH, (family, patient, isolation hospitals, grief, death, ceremonial behavior, self care, affects y social networking) con su ecuación boleana correspondiente. Los artículos seleccionados se sometieron a una lectura crítica a través del Critical Apraisal Skill Programme en español (CASPe). Resultados: Se encontraron 560 artículos atingentes, tras aplicar los criterios de selección, 13 estudios se incluyeron en el análisis, de los cuales 8 eran revisiones sistemáticas, 3 estudios cualitativos,1 estudio piloto prospectivo transversal y 1 guía clínica, que permitieron identificar estrategias para el abordaje del duelo y la muerte atendiendo a este momento de excepcionalidad covid19, incidiendo en el manejo competencial de los profesionales sanitarios en apoyo emocional y el acompañamiento así como el seguimiento durante todo el proceso, así como en la comunicación con la familia. Conclusión: En el proceso final de la vida en tiempos de COVID19, los profesionales sanitarios deben trabajar despedidas, los ritos fúnebres alternativos, la atención espiritual y el afrontamiento precoz que permitirán a su vez la prevención del duelo complicad

Effect of Music Therapy as a Non-Pharmacological Measure Applied to Alzheimer’s Disease Patients: A Systematic Review

The objective of this research was to learn about the effects of music as a non-pharmacological therapeutic intervention applied to Alzheimer’s disease. To this aim, we evaluated its results regarding symptomatology and caregiver burden. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. We searched Pubmed/Medline (NLM), Web of Science, Scopus, Cochrane and Google Scholar, including articles from 1 January 2011–20 July 2021, using the keywords “Alzheimer’s disease”, “Music therapy”, “Caregivers overload”, “Amnesia retrograde” and “Clinical evolution”. To select the articles our criteria included complete text availability, quantitative research of an experimental nature and studies which, at least, figured in SJR or in JCR. Results: We found a relationship between the application of music therapy in patients with Alzheimer’s disease and an improvement regarding symptomatology, as it smoothed down the progress of the disease. Using music therapy in Alzheimer’s patients also led to a decrease in caregivers’ burden and an increase in their well-being. Conclusions: Our results showed the benefits of music therapy, as it improved both patients’ symptomatology and caregivers’ burde

Digital Identities of Young People from the South of Spain: An Online Sexual Differentiation

Through a mixed methodological approach, we want to know how adolescents aged between 14 and 16 years from the south of Spain express and identify themselves on social networks, with respect to their sex. As such differences can determine gender inequality, we will analyse differences between females and males regarding the expression of identity on social networks. Analysis of obtained results demonstrates that many relevant attributes still emerge such as the socio-cultural representation of gender as sex in social networks. Differences emerged between the identity expressions of females and males which can generate inequalities favouring females and males. This implies a series of repercussions and, ultimately, defines the so-called digital gender divide. Taking into account these results we could intervene in the population of children to carry out prevention activities focused on social network

Food as Culture among African Women: Exploring Differences between North and South (Morocco-Senegal)

The goal of this exploratory study was to analyze the influence of culture on African women’s diet considering their role as primary caregivers. The analysis differentiated between Moroccan and Senegalese women and identified the key elements that influence their dietary habits and their health. Using a qualitative methodology, we performed a triangulation of data based on a literature review and a panel of experts, all of which served as the basis for the interview script to conduct 14 semi-structured interviews (n = 7 Moroccan and n = 7 Senegalese). This study reflects the substantial relationship between dietary habits, cultural identity, and health that healthcare providers need to acknowledge. It is important for healthcare practitioners to be culturally competent in order to provide holistic and individualized car

Edad, dependencia y consecuencias sociosanitarias

The use of health resources is conditioned by several factors, that are not considered by health system. It is necesary to consider that factors in order to improve the efficiency and effectiveness, prevention, care and population health. This is especially important in a sociological and demographic context in which elderly and very elderly population is getting more and more importance. This fact, and its consequences, raise key issues not only in terms of efficiency and effectiveness of the health system, but also at the level of values and social rights.El uso de recursos sanitarios viene condicionado por una serie de factores que escapan a los tratados directamente por el sistema sanitario, y que es necesario considerar en el avance hacia la eficiencia y eficacia del mismo, así como para mejorar la prevención, la atención y la salud de la población. Esto es especialmente importante en un contexto sociológico y demográfico en el que el sector de población mayor y muy mayor está ganando cada vez más peso específico. Este peso, y sus consecuencias, plantean asuntos clave no sólo en términos de eficiencia y eficacia del sistema sociosanitario, sino también a nivel de valores y derechos sociales

Nursing students' perceptions of spiritual needs at the end of life. A qualitative study

Spirituality is defined as the meaning of life, being the very essence of life made up of all of the aspects inherent to it. During end-of-life processes, this need is shown to be particularly altered in patients and yet it is an aspect that the health professionals accompanying patients in this situation report being least equipped to address, alongside therapies that could help to meet these needs, such as art therapy. An exploratory qualitative study was conducted, adheres to the guidelines of COREQ (41). The study population were final year students undertaking a nursing degree at the University of Huelva, Spain. The sample was selected via intentional sampling using snowball recruitment from the study population. Stratification according to gender was performed due to the feminised nature of the population. Sample size was determined progressively during the research, with recruitment ceasing at 13 informants once information saturation was achieved. Inclusion criteria required that participants were to be final year students enrolled on a nursing degree who had provided consent to participate voluntarily in the research. The analysis Realized was interpretive phenomenological (IPA) as described by Smith (43–45). The present study revealed that students perceive their training on spiritual care to be deficient. Despite them reporting that they possess the skills and tools to provide end-of-life care, this is not enough to provide effective accompaniment, given that this moment brings them into touch with their own insecurities. Students verbalized the need to learn strategies to address this shortcoming regarding final accompaniment, for instance, through art, with creativity being one of the skills with the potential to uncover the meaning of life.Departamento de Enfermerí

Attitudes of nursing degree students towards end of life processes. A cultural approach (Spain-Senegal)

Introduction The concept of death is abstract, complex and has a number of meanings. Thus, its understanding and the approach taken to it depend, to a large extent, on aspects such as age, culture, training and religion. Nursing students have regular contact with the process of death and so it is of great interest to understand the attitudes they have towards it. As we live in a plural society it is even more interesting to not only understand the attitudes of Spanish students but, also, those of students coming from other countries. In the present article, we seek to identify and compare the attitudes held by nursing degree students at Hekima-Santé University (Senegal) and the University of Huelva (Spain) about end of life processes. The study identifies elements that condition attitudes and coping with death, whilst considering curricular differences with regards to specific end of life training. Method A descriptive, cross-sectional and multi-center study was conducted. The overall sample (N = 142) was divided into groups: Hekima-Santé University (Dakar, Senegal) and the University of Huelva (Huelva, Spain). The measurement instruments used were an ad-hoc questionnaire and Bugen´s Coping with Death Scale. Results Statistically significant differences (p = 0.005, 95%CI) were found in relation to overall Bugen Scale scores. We can confirm that specialized end of life training (University of Huelva, Spain) did not lead to better coping when compared with a population whose academic curriculum did not provide specific training and who engaged in more religious practices (Hekima-Santé University, Senegal). Conclusions In cultures where religion not only influences the spiritual dimension of the individual, but acts in the ethical and moral system and consequently in the economic, educational and family sphere, the accompaniment at the end of life transcends the formative plane. Considering the plural society in which we live, the training that integrates the Degree in Nursing with regard to the care of the final process, must be multidimensional in which spirituality and faith are integrated, working emotional and attentional skills, as well as cultural competence strategies in this process

Educational interventions by nurses in caregivers with their elderly patients at home

Introduction: The home is the natural setting for the development of informal care. The work that nurses are required to develop in this context (the carer/the elderly dependent/the home) focuses on training and educational activities to assist these two groups, such as demonstrating care activities to help dependent seniors, instruction in self-care techniques and teaching strategies for the use of human and material resources. Aims: This article analyzes care education interventions performed by nurses, and the factors that facilitate, or limit, health care training. Methodological approach: This is a qualitative, descriptive study designed to be flexible and openly analytical in its approach to the research problem and the dynamic nature of the home environment. Triangulation of the methodological techniques and study subjects was applied. Results: Nursing interventions related to professional attitudes, such as encouraging communication and facilitating teaching; communication interventions in health education and counseling; and technical interventions aimed at improving access to health information and support for the informal carer. Lack of will, the advanced age of the carer, emotional state and work overload are factors that undermine care instruction, which if reversed, would become learning facilitators. The lack of time and resources in the home are the major limiting factors on care teaching, according to nurses. Evidence from our study suggests that care in the home is considered a key primary health care strategy, one in which nurses play a significant role.Funding for open access charge: Universidad de Huelva / CBU