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Existential Issues in Palliative Care

Bolmsjö, Ingrid LU (2002)
Abstract
The main purpose of this dissertation is to describe how terminally ill patients experienced their situation, and what their views about the future were. Further, the experiences and attitudes of relatives of such patients, and of health care professionals, were also central. Focus was on existential issues, such as autonomy, meaning, guilt, relations, dignity, and communication. In the first paper, a case based on actual facts was described and analysed. The study showed that in every situation where a decision has to be made, there is often more than one alternative interpretation of the situation and how to act. The studies in the other papers comprised 18 patients in palliative care (diagnosed with advanced cancer and ALS) and 8 close... (More)
The main purpose of this dissertation is to describe how terminally ill patients experienced their situation, and what their views about the future were. Further, the experiences and attitudes of relatives of such patients, and of health care professionals, were also central. Focus was on existential issues, such as autonomy, meaning, guilt, relations, dignity, and communication. In the first paper, a case based on actual facts was described and analysed. The study showed that in every situation where a decision has to be made, there is often more than one alternative interpretation of the situation and how to act. The studies in the other papers comprised 18 patients in palliative care (diagnosed with advanced cancer and ALS) and 8 close relatives of ALS patients. Moreover, 7 caregivers, formal and informal, were interviewed in a focus group. Data were collected from in-depth interviews with patients and relatives and from focus group interviews with caregivers. The results showed that patients experienced a number of problems concerning existential issues and consider these questions important. The patients diagnosed with cancer wished to be able to discuss existential issues with someone. The ALS patients experienced problems particularly in connection with physical inability. Close relatives of ALS patients need more information about the disease and the process of the disease and have to be supported and viewed as individuals with their own preferences. One practical question is: Who's responsibility is it to try to meet existential needs in palliative care? The results of the focus group study indicate that, depending on the circumstances, several different solutions can be sufficiently satisfactory, and possible ways of handling the problems are suggested. (Less)
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author
supervisor
opponent
  • Docent Ternestedt, Britt-Marie, Ersta Stockholm
organization
publishing date
type
Thesis
publication status
published
subject
keywords
experiences, communication, ethics, existential issues, palliative care, medical training, General practice, Allmän medicinsk utövning, medicinsk utbildning
pages
160 pages
publisher
Ingrid Ågren Bolmsjö, Department of Medical Ethics, Stora Gråbrödersgatan 16, 22222 Lund, Sweden,
defense location
BMC
defense date
2002-05-02 10:15:00
language
English
LU publication?
yes
additional info
Article: I. Bolmsjö I, Hermerén G. Challenging assumptions in end-of-life situations. Palliative Medicine, 1998; 12: 451-456.II. Bolmsjö I. Existential issues in palliative care - interviews with cancer patients. Journal of Palliative Care, 2001; 16(2): 20-24.III. Bolmsjö I. Existential issues in palliative care - interviews with ALS patients. Journal of Palliative Medicine, 2001; 4(4): 499-505.IV. Bolmsjö I, Hermerén G. Interviews with patients, family and caregivers in Amyotrophic Lateral Sclerosis: Comparing Needs. Journal of Palliative Care, 2001; 17(4): 236-241.V. Bolmsjö I, Hermerén G. Ethical issues in palliative care - experiences of close relatives of ALS patients. Submitted.VI. Bolmsjö I, Hermerén G, Ingvar Ch. Meeting existential needs in palliative care - Who, When, Why? Submitted. The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Caring Sciences (Closed 2012) (016514020)
id
01043153-e916-4912-a2e6-89d7bff0d4b9 (old id 464528)
date added to LUP
2016-04-04 11:28:41
date last changed
2018-11-21 21:05:07
@phdthesis{01043153-e916-4912-a2e6-89d7bff0d4b9,
  abstract     = {{The main purpose of this dissertation is to describe how terminally ill patients experienced their situation, and what their views about the future were. Further, the experiences and attitudes of relatives of such patients, and of health care professionals, were also central. Focus was on existential issues, such as autonomy, meaning, guilt, relations, dignity, and communication. In the first paper, a case based on actual facts was described and analysed. The study showed that in every situation where a decision has to be made, there is often more than one alternative interpretation of the situation and how to act. The studies in the other papers comprised 18 patients in palliative care (diagnosed with advanced cancer and ALS) and 8 close relatives of ALS patients. Moreover, 7 caregivers, formal and informal, were interviewed in a focus group. Data were collected from in-depth interviews with patients and relatives and from focus group interviews with caregivers. The results showed that patients experienced a number of problems concerning existential issues and consider these questions important. The patients diagnosed with cancer wished to be able to discuss existential issues with someone. The ALS patients experienced problems particularly in connection with physical inability. Close relatives of ALS patients need more information about the disease and the process of the disease and have to be supported and viewed as individuals with their own preferences. One practical question is: Who's responsibility is it to try to meet existential needs in palliative care? The results of the focus group study indicate that, depending on the circumstances, several different solutions can be sufficiently satisfactory, and possible ways of handling the problems are suggested.}},
  author       = {{Bolmsjö, Ingrid}},
  keywords     = {{experiences; communication; ethics; existential issues; palliative care; medical training; General practice; Allmän medicinsk utövning; medicinsk utbildning}},
  language     = {{eng}},
  publisher    = {{Ingrid Ågren Bolmsjö, Department of Medical Ethics, Stora Gråbrödersgatan 16, 22222 Lund, Sweden,}},
  school       = {{Lund University}},
  title        = {{Existential Issues in Palliative Care}},
  year         = {{2002}},
}