Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-10T14:54:16.522Z Has data issue: false hasContentIssue false
  • English
  • Français

Meanings and experiential outcomes of bodily care in a specialist palliative context

Published online by Cambridge University Press:  24 April 2014

Cecilia Håkanson  and
Joakim Öhlén
Cecilia Håkanson*
Affiliation:
Palliative Research Centre, Ersta University College and Ersta Hospital, Stockholm, Sweden Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden
Joakim Öhlén
Affiliation:
Palliative Research Centre, Ersta University College and Ersta Hospital, Stockholm, Sweden Institute of Health and Care Sciences and Centre for Person-Centred Care at the University of Gothenburg, Gothenburg, Sweden
*
Address correspondence and reprint requests to: Cecilia Håkanson, Palliative Research Centre, Ersta University College and Ersta Hospital, P.O. Box 111 89, SE-100 61 Stockholm, Sweden. E-mail: cecilia.hakanson@esh.se
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The objective of this study was to enhance the depth of existing knowledge about meanings and experiential outcomes of bodily care in the context of an inpatient specialist palliative setting.

Method:

Interpretative phenomenology was chosen as the study sought to explore individuals' lived experiences related to bodily care. Nine participants (five women, four men) of various ages and with various metastasized cancers and bodily-care needs, all from one specialist palliative care ward, participated. Data were collected with repeated narrative interviews and supplementary participating observations. Analysis was informed by van Manen's approach.

Results:

The following meanings and experiential outcomes of bodily care were revealed by our study: maintaining and losing body capability, breaching borders of bodily integrity, being comforted and relieved in bodily-care situations, and being left in distress with unmet needs. These meanings overlap and shape the nature of each other and involve comforting and distressing experiences related to what can be described as conditional dimensions: the particular situation, one's own experiences of the body, and healthcare professionals' approaches.

Significance of results:

The results, based on specialist palliative care patients' experiences, outline the meanings and outcomes that relate to the quintessence and complexity of palliative care, deriving from dying persons' blend of both basic and symptom-oriented bodily-care needs. Moreover, the results outline how these two dimensions of care equally influence whether comfort and well-being are facilitated or not. Considering this, specialist palliative care may consider how to best integrate and acknowledge the value of skilled basic nursing care as part of and complementary to expertise in symptom relief during the trajectories of illness and dying.

Keywords

Bodily careBody declineInterpretive phenomenologyNursing carePalliative care
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 3 , June 2015 , pp. 625 - 633
Copyright
Copyright © Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Barnard, A., Hollingum, C. & Hartfiel, B. (2006). Going on a journey: Understanding palliative care nursing. International Journal of Palliative Nursing, 12, 6–12.Google Scholar
Benner, P., Tanner, C. & Cheslea, C. (eds.) (2009). Expert nursing practice: Caring, Clinical judgment and ethics. New York: Springer Publishing Company.Google Scholar
Berndtsson, I., Claesson, S., Friberg, F., et al. (2007). Issues about thinking phenomenologically while doing phenomenology. Journal of Phenomenological Psychology, 38, 256–277.Google Scholar
Broom, A. & Cavenagh, J. (2010). Masculinity, moralities and being cared for: An exploration of experiences of living and dying in a hospice. Social Science and Medicine, 71, 869–876.Google Scholar
Carlander, I. (2011). Me-ness and we-ness in a modified everyday life close to death at home . Doctoral dissertation. Stockholm: Karolinska institutet.Google Scholar
Chochinov, H.M. & Stienstra, D. (2012). Vulnerability and palliative care. Palliative & Supportive Care, 10, 1–2.Google Scholar
Conner, A., Allport, S., Dixon, J., et al. (2008). Patient perspective: What do palliative care patients think about their care? International Journal of Palliative Nursing, 14, 546–552.Google Scholar
Department of Health (2008). End of life care strategy: Promoting high quality care for all adults at their end of life. Stockholm: Department of Health.Google Scholar
Elias, N. (2000). The civilizing process. Malden: Blackwell Publishing.Google Scholar
Eriksson, M. & Andershed, B. (2008). Care dependence: A struggle toward moments of respite. Clinical Nursing Research, 17, 220–236.Google Scholar
Friberg, F. & Öhlén, J. (2010). Reflective exploration of Beekman's participant experience. Qualitative Health Research, 20, 273–280.Google Scholar
Jensen, A.L., Vedelo, T.W. & Lomborg, K. (2013). A patient-centred approach to assisted personal body care for patients hospitalised with chronic obstructive pulmonary disease. Journal of Clinical Nursing, 22, 1005–1015.Google Scholar
Lawler, S. (2006). Behind the screens: Nursing, somology and the problem of the body. Sydney: Sydney University Press.Google Scholar
Lawton, J. (1998). Contemporary hospice care: The sequestration of the unbounded body and “dirty” dying. Sociology of Health & Illness, 20, 121–143.Google Scholar
Lawton, J. (2000). The dying process: Patients' experiences of palliative care. New York: Routledge.Google Scholar
Lindqvist, O., Tishelman, C., Hagelin, C., et al. (2012). Complexity in non-pharmacological caregiving activities at the end of life: An international qualitative study. PLoS Medicine, 9, e1001173.Google Scholar
Lomborg, K. & Kirkevold, M. (2008). Achieving therapeutic clarity in assisted personal body care: Professional challenges in interactions with severely ill COPD patients. Journal of Clinical Nursing, 17, 2155–2163.Google Scholar
Lomborg, K., Bjorn, A., Dahl, R., et al. (2005). Body care experienced by people hospitalized with severe respiratory disease. Journal of Advanced Nursing, 50, 262–271.Google Scholar
Malmsten, K. (1999). Reflective assent in basic care. Doctoral dissertation. Uppsala: Uppsala University.Google Scholar
Martinsen, K. (2006). Care and vulnerability. Oslo: Akribe as.Google Scholar
Merleau-Ponty, M. (2002). Phenomenology of perception. London: Routledge.Google Scholar
Mount, B.M. & Scott, J.F. (1983). Whither hospice evaluation. Journal of Chronic Diseases, 36, 731–736.Google Scholar
National Board of Health and Welfare (2013). National guidelines for good palliative care. Stockholm, Sweden: Socialstyrelsen.Google Scholar
Öhlén, J., Bengtsson, J., Skott, C., et al. (2002). Being in a lived retreat-embodied meaning of alleviated suffering. Cancer Nursing, 25, 318–325.Google Scholar
Pols, J. (2013). Washing the patient: Dignity and aesthetic values in nursing care. Nursing Philosophy, 14, 186–200.Google Scholar
Price, B. (2000). Altered body image: Managing social encounters. International Journal of Palliative Nursing, 6, 179–185.Google Scholar
Probst, S., Arber, A. & Faithfull, S. (2012). Malignant fungating wounds: The meaning of living in an unbounded body. European Journal of Oncology Nursing, 17(1), 38–45.Google Scholar
Rasmussen, B.H. (2000). Striving for becoming at-home in the midst of dying. American Journal of Hospice & Palliative Medicine, 17, 31–43.Google Scholar
Rasmussen, B.H., Tishelman, C. & Lindqvist, O. (2010). Experiences of living with a deteriorating body in late palliative phases of cancer. Current Opinion in Supportive Palliative Care, 4, 153–157.Google Scholar
Schutz, A. (1967). Phenomenology of the social world. Evanston, IL: Northwestern University Press.Google Scholar
Stienstra, D. & Chochinov, H.M. (2006). Vulnerability, disability, and palliative end-of-life care. Journal of Palliative Care, 22, 166–174.Google Scholar
Tishelman, C., Bernhardson, B.M., Blomberg, K., et al. (2004). Complexity in caring for patients with advanced cancer. Journal of Advanced Nursing, 45, 420–429.Google Scholar
van Manen, M. (1997). Researching the lived experience: Human science for an action sensitive pedagogy. Ontario: Althouse Press.Google Scholar
Walker, S. & Read, S. (2011). Accessing vulnerable research populations: An experience with gatekeepers of ethical approval. International Journal of Palliative Nursing, 1, 14–18.Google Scholar
Wilkes, L.M., Boxer, E. & White, K. (2003). The hidden side of nursing: Why caring for patients with malignant malodorous wounds is so difficult. Journal of Wound Care, 12, 76–80.Google Scholar
Zingmark, K., Norberg, A. & Sandman, P.O. (1995). The experience of being at home throughout the life span: Investigation of persons aged from 2 to 102. International Journal of Aging & Human Development, 41, 47–62.Google Scholar