Old people receiving municipal care, their experiences of what constitutes a good life in the last phase of life: A qualitative study
TL;DR: This study confirms theories suggesting that the last phase of life in old age meant focusing inwards, reflecting on the entire life as a way of completing it as well as enjoying small things and also viewing oneself in the perspective of contributing to the future.
About: This article is published in International Journal of Nursing Studies.The article was published on 2008-06-01. It has received 99 citations till now. The article focuses on the topics: Palliative care & Quality of life (healthcare).
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TL;DR: QoL can be expressed in a number of domains and related subthemes that are important for older adults living at home, and the results showed that although different domains can be distinguished, these are also strongly connected.
Abstract: Background Consideration of older adults' quality of life (QoL) is becoming increasingly important in the evaluation, quality improvement and allocation of health and social care services. While numerous definitions and theories of QoL have been proposed, an overall synthesis of the perspective of older adults themselves is lacking. Methods Qualitative studies were identified in PubMed, Ebsco/Psycinfo and Ebsco/CINAHL, through a search on 28 November 2018. Articles needed to meet all of the following criteria: (i) focus on perceptions of QoL, (ii) older adults living at home as main participants, (iii) use of qualitative methodology, (iv) conducted in a Western country and (v) published in English (vi) not focused on specific patient groups. A thematic synthesis was conducted of the selected studies, using the complete 'findings/results' sections from the papers. Results We included 48 qualitative studies representing the views of more than 3,400 older adults living at home in 11 Western countries. The QoL aspects identified in the synthesis were categorized into nine QoL domains: Autonomy, role and activity, health perception, relationships, attitude and adaptation, emotional comfort, spirituality, home and neighbourhood, and financial security. The results showed that although different domains can be distinguished, these are also strongly connected. Conclusion QoL can be expressed in a number of domains and related subthemes that are important for older adults living at home. The findings further support that the concept of QoL should be seen as a dynamic web of intertwined domains.
148 citations
Cites background from "Old people receiving municipal care..."
...NR Three themes emerged as important for life satisfaction: activity, independence and adaptation Andersson 2008 [33] (Sweden) 17 older adults (75+) receiving municipal help and care and having a lifethreatening disease or receiving palliative care, purposefully selected by nurses working in…...
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TL;DR: Four core factors currently impeding the application of the dignity of risk principle in residential aged care settings in Victoria, Australia are identified and potential solutions identified include a conceptual shift in approach and consensus between key stakeholders, as well as more tangible solutions such as education and point‐of‐care decision support tools.
Abstract: This discussion paper identifies four core factors currently impeding the application of the dignity of risk principle in residential aged care settings in Victoria, Australia: the fluctuating decision-making ability of residents; multiple participants in decision-making; discordance between espoused values and actions; and confusion and fear around legal responsibilities of care providers. Potential solutions identified include a conceptual shift in approach and consensus between key stakeholders, as well as more tangible solutions such as education and point-of-care decision support tools.
77 citations
TL;DR: Several care actions are identified related to all themes contained within the Dignity Model, except aftermath concerns and will be used to develop a dignity care pathway for end-of-life care, which is currently being evaluated by the authors.
73 citations
Cites background from "Old people receiving municipal care..."
...Furthermore, patients described that life history and memories could still bring values to the person’s life (Andersson et al., 2008)....
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...Being at home was expressed by elderly care-receivers to be a way to ensure that daily routines (Andersson et al., 2008) and independence could be maintained, this was supported by family members and health professionals (Chan and Pang, 2007)....
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...The usefulness of these religious practices was supported by expressions from patients (Andersson et al., 2008; Buxton, 2007; Chio et al., 2008; Grant et al., 2004)....
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...Faith in, for example God, was shown to have a positive influence on their life situation and conveyed a feeling of being calm, safe and secured in the situation (Andersson et al., 2008; Chio et al., 2008)....
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...Patients receiving community care expressed how they kept up the façade of normality by trying to conceal from others how health complaints affected their lives and the severity of the illness, by not complaining to their children and avoiding seeing other people (Andersson et al., 2008)....
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TL;DR: In order to meet patients’ needs, it is an ethical duty for healthcare staff to be able to recognise experiences of EL, that is, to communicate with the patients about these experiences in an appropriate manner, which in turn demands knowledge about existential issues and skills to deal with them.
Abstract: Background:According to ethical guidelines, healthcare professionals should be able to provide care that allows for the patients’ values, customs and beliefs, and the existential issues that are co...
63 citations
TL;DR: Frail older people sustained their well-being through maintaining a sense-of-self, garnering support from carers and community structures, and focusing on living from day to day.
Abstract: The experiences of people with cancer and organ disease have been described across different dimensions of need as they approach death. Such information is lacking for frail older people approaching death, but could highlight how a palliative approach might be relevant for this population. Cognitively intact, community dwelling adults considered to be moderately or severely frail were recruited from a medical day hospital. Those recruited nominated an informal carer and case-linked professional. Qualitative in-depth serial interviews with older people and their informal carers were conducted over an 18 month period, and single interviews with case-linked healthcare professionals. Interviews were recorded, transcribed and narrative analytical techniques were used to compile case studies. Thirty-four participants (13 patients, 13 informal carers and 8 healthcare professionals) completed 40 individual, 14 joint and 8 professional interviews. Five patients died during the study. The analysis highlighted a dynamic balance between losses and adaptations. Three typical patterns of multi-dimensional change emerged. 1) Maintenance of psychological and existential well-being with a gradual social decline mirroring the physical deterioration. 2) a gradual reduction in both psychological and existential well-being. 3) a marked downturn in social, psychological and existential well-being before death. Frail older people sustained their well-being through maintaining a sense-of-self, garnering support from carers and community structures, and focusing on living from day to day. Their well-being lessened when they lost their sense-of-self, feeling alienated from the world, and confused over the cause of their circumstances. Death remained distant and ‘undiagnosed’. Social and community frameworks were essential for supporting their well-being. Multidimensional end-of-life trajectories for frail older people differed from those with other conditions. Alleviating psychological, social and existential distress should be a priority of care as frail older people reach the end of life. The current palliative care model is problematic for this group. Care should address future concerns and not necessarily involve a focus on death or place of death.
63 citations
Cites background from "Old people receiving municipal care..."
...This was especially acute in an institution as their physical limitations denied them the freedom to ‘walk out’ and relates to affronts to dignity at feeling in the control of other people [34, 35]....
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References
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Book•
01 Jan 1980
TL;DR: History Conceptual Foundations Uses and Kinds of Inference The Logic of Content Analysis Designs Unitizing Sampling Recording Data Languages Constructs for Inference Analytical Techniques The Use of Computers Reliability Validity A Practical Guide
Abstract: History Conceptual Foundations Uses and Kinds of Inference The Logic of Content Analysis Designs Unitizing Sampling Recording Data Languages Constructs for Inference Analytical Techniques The Use of Computers Reliability Validity A Practical Guide
25,749 citations
TL;DR: An overview of important concepts related to qualitative content analysis is provided and measures to achieve trustworthiness (credibility, dependability and transferability) throughout the steps of the research procedure are proposed.
16,695 citations
"Old people receiving municipal care..." refers background or result in this paper
...Another aspect of credibility concerns the sufficiency of data to answer the research question (Graneheim and Lundman, 2004)....
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...Hellstrom et al. (2004a) found that decreased functional ability in terms of high amount of help in personal activities in daily living (PADL) was related to low QoL among older people (75+ years) receiving help with activities of daily living....
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...Credibility also concerns the question of judging similarities within and differences between categories (Graneheim and Lundman, 2004), which in this study was increased as three researchers were involved in the analysis....
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...confidence in the truth of the data, participants of various sex, age, living conditions were selected to increase the possibility to shed light on meanings of the experience (Graneheim and Lundman, 2004)....
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Book•
01 Jan 1989
TL;DR: In this article, the authors present a comprehensive review of the literature on content analysis in the field of qualitative research, focusing on the role of focus groups and focus groups in the research process.
Abstract: IN THIS SECTION: 1.) BRIEF 2.) COMPREHENSIVE BRIEF TABLE OF CONTENTS: Chapter 1: Introduction Chapter 2: Designing Qualitative Research Chapter 3: Ethical Issues Chapter 4: A Dramaturgical Look at Interviewing Chapter 5: Focus Group Interviewing Chapter 6: Ethnographic Field Strategies Chapter 7: Action Research Chapter 8: Unobtrusive Measures in Research Chapter 9: Social Historical Research and Oral Traditions Chapter 10: Case Studies Chapter 11: An Introduction to Content Analysis Chapter 12: Writing Research Papers: Sorting the Noodles from the Soup COMPREHENSIVE TABLE OF CONTENTS: Chapter 1: Introduction Quantitative Versus Qualitative Schools of Thought Use of Triangulation in Research Methodology Qualitative Strategies: Defining an Orientation From a Symbolic Interactionist Perspective Why Use Qualitative Methods? A Plan of Presentation Chapter 2: Designing Qualitative Research Theory and Concepts Ideas and Theory Reviewing the Literature Evaluating Web Sites Content versus Use Theory, Reality, and the Social World Framing Research Problems Operationalization and Conceptualization Designing Projects Data Collection and Organization Data Storage, Retrieval, and Analysis Dissemination Trying It Out Chapter 3: Ethical Issues Research Ethics in Historical Perspective From Guidelines to Law: Regulations on the Research Process Institutional Review Boards (IRBs) Ethical Codes Some Common Ethical Concerns in Behavioral Research New Areas for Ethical Concern: Cyberspace Informed Consent and Implied Consent Confidentiality and Anonymity Securing the Data Objectivity and Careful Research Design Trying It Out Chapter 4: A Dramaturgical Look at Interviewing Dramaturgy and Interviewing Types of Interviews The Data Collection Instrument Guideline Development Communicating Effectively A Few Common Problems in Question Formulation Pretesting the Schedule Long Versus Short Interviews Telephone Interviews Computer Assisted Interviewing Conducting an Interview: A Natural or an Unnatural Communication? The Dramaturgical Interview The Interviewer's Repertoire Know Your Audience Analyzing Data Obtained from the Dramaturgical Interview Trying It Out Chapter 5: Focus Group Interviewing What are Focus Groups? Working With a Group The Evolution of Focus Group Interviews Facilitating Focus Group Dynamics: How Focus Groups Work The Moderator's Guide Basic Ingredients in Focus Groups Analyzing Focus Group Data Confidentiality and Focus Group Interviews Recent Trends in Focus Groups: Online Focus Groups Trying It Out Chapter 6: Ethnographic Field Strategies Accessing a Field Setting: Getting In Reflectivity and Ethnography Critical Ethnography Becoming Invisible Other Dangers During Ethnographic Research Watching, Listening, and Learning How to Learn: What to Watch and Listen For Computers and Ethnography OnLine Ethnography Analyzing Ethnographic Data Other Analysis Strategies: Typologies, Sociograms, and Metaphors Disengaging: Getting Out Trying It Out Chapter 7: Action Research The Basics of Action Research Identifying the Research Question(s) Gathering the Information to Answer the Question(s) Analyzing and Interpreting the Information Sharing the Results with the Participants When to Use and When Not to Use Action Research The Action Researcher's Role Types of Action Research Photovoice and Action Research Action Research: A Reiteration Trying It Out Chapter 8: Unobtrusive Measures in Research Archival Strategies Physical Erosion and accretion: Human Traces as Data Sources Trying It Out Chapter 9: Social Historical Research and Oral Traditions What Is Historical Research? Life Histories and Social History What Are the Sources of Data for Historical Researchers? Doing Historiography: Tracing Written History as Data What Are Oral Histories? Trying It Out Chapter 10: Case Studies The Nature of Case Studies Theory and Case Studies The Individual Case Study Intrinsic, Instrumental, and Collective Case Studies Case Study Design Types Designing Case Studies The Scientific Benefit of Case Studies Case Studies of Organizations Case Studies of Communities Trying It Out Chapter 11: An Introduction to Content Analysis What is Content Analysis? Analysis of Qualitative Data Content Analysis as a Technique Content Analysis: Quantitative or Qualitative? Communication Components What to Count: Levels and Units of Analysis Category Development: Building Grounded Theory Discourse Analysis and Content Analysis Open Coding Coding Frames Stages in the Content Analysis Process Strengths and Weaknesses of the Content Analysis Process Computers and Qualitative Analysis Qualitative Research at the Speed of Light Trying It Out Chapter 12: Writing Research Papers: Sorting the Noodles from the Soup Plagiarism: What It Is, Why It's Bad, and How to Avoid It Identifying the Purpose of the Writing: Arranging the Noodles Delineating a Supportive Structure: Visual Signals for the Reader Terms and Conditions Presenting Research Material A Word About the Content of Papers and Articles Write It, Rewrite It, Then Write It Again! A Few Writing Hints A Final Note
14,765 citations
Book•
01 Jan 1978
TL;DR: Part I:The Scientific Research Process Introduction to Nursing Research Overview of the Research Process Research Problems, Research Questions, and Hypotheses Part II:Contexts for Nursing Research The Knowledge Contexts Conceptual and Theoretical Contexts The Ethical Context of Nursing Research.
Abstract: Part I:The Scientific Research Process Introduction to Nursing Research Overview of the Research Process Research Problems, Research Questions, and Hypotheses Part II:Contexts for Nursing Research The Knowledge Context:Literature Reviews Conceptual and Theoretical Contexts The Ethical Context of Nursing Research Part III:Designs for Nursing Research Selecting a Research Design Research Design for Quantitative Studies Research Control in Quantitative Research Qualitative Research Design and Approaches Integration of Qualitative and Quantitative Designs Sampling Designs Part IV:Measurement and Data Collection Designing and Implementing a Data Collection Plan Self-Reports Observational Methods Biophysiologic and Other Data Collection Methods Assessing Data Quality Part IV:The Analysis of Research Data Quantitative Analysis:Descriptive Statistics Inferential Statistics Multivariate Statistical Procedures Designing and Implementing a Quantitative Analysis Strategy The Analysis of Qualitative Data Computers and Nursing Research Part VI:Communication in the Research Process Writing a Research Report Evaluating Research Reports Utilization of Nursing Research Writing a Research Proposal Index
7,017 citations
01 Jan 1981
TL;DR: The ERIC/ECTJ Annual Review Paper as mentioned in this paper was published by the National Institute of Education (NIE), U.S. Department of Education, and was supported by the ERIC (Educational Resources Information Center) Clearinghouse on Information Resources.
Abstract: This is the ninth ERIC/ECTJ Annual Review Paper, preparation of which was supported by the ERIC (Educational Resources Information Center) Clearinghouse on Information Resources, Syracuse University, Syracuse, New York. The material in this article was prepared pursuant to a contract with the National Institute of Education, U.S. Department of Education. Contractors undertaking such projects under government sponsorship are encouraged to express freely their judgment in professional and technical matters. Points of view or opinions do not necessarily represent the official view or opinion of NIE. The author is grateful to David Clark, Larry Havlicek, Robert Heinich, John McLaughlin, Cecil Miskel, and Robert Wolf for their careful critique of an earlier version of this paper, and to his wife, Yvonna Lincoln, from whose joint work with the author in other contexts many of the ideas expressed in this paper emanated.
4,646 citations