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Between the patient and the next of kin in end-of-life care: A critical study based on feminist theory.

https://arctichealth.org/en/permalink/ahliterature299960
Source
Nurs Ethics. 2019 Feb; 26(1):201-211
Publication Type
Journal Article
Date
Feb-2019
Author
Ellen Ramvi
Venke Irene Ueland
Author Affiliation
University of Stavanger, Norway.
Source
Nurs Ethics. 2019 Feb; 26(1):201-211
Date
Feb-2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Family - psychology
Female
Feminism
Focus Groups
Humans
Male
Middle Aged
Norway
Nurse-Patient Relations
Oncology Nursing - methods
Qualitative Research
Terminal Care - psychology - standards
Abstract
For the experience of end-of-life care to be 'good' many ethical challenges in various relationships have to be resolved. In this article, we focus on challenges in the nurse-next of kin relationship. Little is known about difficulties in this relationship, when the next of kin are seen as separate from the patient.
From the perspective of nurses: What are the ethical challenges in relation to next of kin in end-of-life care?
A critical qualitative approach was used, based on four focus group interviews.
A total of 22 registered nurses enrolled on an Oncology nursing specialisation programme with experience from end-of-life care from various practice areas participated.
The study was approved by the Norwegian Social Science Data Service, Bergen, Norway, project number 41109, and signed informed consent obtained from the participants before the focus groups began.
Two descriptive themes emerged from the inductive analysis: 'A feeling of mistrust, control and rejection' and 'Being between hope and denial of next of kin and the desire of the patient to die when the time is up'. Deductive reinterpretation of data (in the light of moral distress from a Feminist ethics perspective) has made visible the constraints that certain relations with next of kin in end-of-life care lay upon the nurses' moral identity, the relationship and their responsibility. We discuss how these constraints have political and societal dimensions, as well as personal and relational ones.
There is complex moral distress related to the nurse-next of kin relationship which calls for ethical reflections regarding these relationships within end-of-life care.
PubMed ID
28116964 View in PubMed
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Experiences of women who have a vaginal birth after requesting a Cesarean section due to a fear of birth: A biographical, narrative, interpretative study.

https://arctichealth.org/en/permalink/ahliterature101642
Source
Nurs Health Sci. 2011 Jun 22;
Publication Type
Article
Date
Jun-22-2011
Author
Ellen Ramvi
Margrethe Tangerud
Author Affiliation
Department of Health Studies, Faculty of Social Sciences, The University of Stavanger Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway.
Source
Nurs Health Sci. 2011 Jun 22;
Date
Jun-22-2011
Language
English
Publication Type
Article
Abstract
A fear of childbirth is a reason for a Cesarean section on request without a medical indication. The law for patients' rights in Norway does not give women the opportunity to choose a Cesarean section, only the potential to participate in the decision-making process. This requires cooperation between health professionals and patients. The present study explores the experience of women who had a vaginal birth after requesting a Cesarean section due to a fear of birth. A biographical, narrative, interpretative method was used. Through five women's stories, it is evident that the practice of decision-making constitutes a challenge for both the women and the health professionals. The importance of a woman's right to be taken seriously, even if she does not want to understand the reason behind her fear of birth, is emphasized. An open mind from midwives and physicians is required, although this seems difficult to achieve.
PubMed ID
21696529 View in PubMed
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