hkr.sePublikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Being acknowledged by others and bracketing negative thoughts and feelings: frail older people's narrations of how existential loneliness is eased
Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Malmö University.ORCID-id: 0000-0002-9362-7464
Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.ORCID-id: 0000-0003-0161-4795
Lund University.
Högskolan Kristianstad, Forskningsplattformen för Hälsa i samverkan. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Högskolan Kristianstad, Fakulteten för hälsovetenskap, Forskningsmiljön Människa - Hälsa - Samhälle (MHS). Lund University.ORCID-id: 0000-0002-7790-6906
2019 (Engelska)Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 14, nr 1Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

AIMS AND OBJECTIVES: The aim of this study was to describe how EL was eased, as narrated by frail older people.

BACKGROUND: Existential loneliness (EL) is an unavoidable part of the human condition. It is a complex phenomenon that has been described as disconnection from life. If EL is acknowledged in the care of older people, the experience of EL can be reduced.

DESIGN: In this qualitative study, we used an exploratory and descriptive design.

METHODS: The study was based on 22 narrative interviews with frail older people, 76 to 101 years old, who were receiving long-term care and services. We analysed the data using conventional content analysis.

RESULTS: Being acknowledged by others, that is, being the focus of others' concern, eased the experience of EL, as did encountering intimacy and having meaningful exchanges of thoughts and feelings. Further, EL was pushed into the background and eased when participants could bracket negative thoughts and feelings, that is, when they could adjust and accept the present situation, view life in the rear-view mirror, be in contact with spiritual dimensions and withdraw and distract themselves.

CONCLUSION: Existential loneliness can be eased by experiencing meaningful togetherness with others and oneself when something else comes to the forefront, pushing EL to the background. Frail older peoples' opportunities to ease EL may be facilitated by health care staff (HCS) providing person-centred care and create possibilities for solitary time and meaningful togetherness.

IMPLICATIONS FOR PRACTICE: If frail older people's ongoing processes of adjusting and accepting their situation are understood and confirmed by people in their environment, for example, by nurses, family and friends, the experience of living a meaningful life can be supported, which, in turn, can ease EL.

Ort, förlag, år, upplaga, sidor
2019. Vol. 14, nr 1
Nyckelord [en]
Content analysis, existential loneliness, experiences, frail older people, home care, palliative care, residential care facilities
Nationell ämneskategori
Omvårdnad
Identifikatorer
URN: urn:nbn:se:hkr:diva-18820DOI: 10.1111/opn.12213ISI: 000459481400006PubMedID: 30403002OAI: oai:DiVA.org:hkr-18820DiVA, id: diva2:1262105
Tillgänglig från: 2018-11-09 Skapad: 2018-11-09 Senast uppdaterad: 2022-11-01Bibliografiskt granskad
Ingår i avhandling
1. Existentiell ensamhet hos sköra äldre personer: äldre personers upplevelser samt dokumentation i patientjournalen
Öppna denna publikation i ny flik eller fönster >>Existentiell ensamhet hos sköra äldre personer: äldre personers upplevelser samt dokumentation i patientjournalen
2020 (Svenska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

The overall aim of this thesis was to illuminate the meanings of existential loneliness(EL) and describe how it was eased, as narrated by frail older people, as well as toexamine existential aspects documented in patient records in specialised palliative care.Two of the constituent studies of this thesis were qualitative with an explorative anddescriptive design (i.e., studies I and II), and two studies were based on a retrospectivepatient record review, of which one was quantitative with an exploratory design (StudyIII) and the other was qualitative with a descriptive design (Study IV). The datacollection for studies I and II was based on individual interviews with frail older people75 or more years old. Studies III and IV were based on a randomly selected sample ofpatient records of frail older people who died in specialised palliative care during 2017.The data were collected using a pilot-tested review template to identify aspects of thedocumentation relating to the aims of the studies.The findings of Study I indicated that EL was a negative experience. Four themeswere identified related to meanings of EL: being trapped in a frail and deterioratingbody, being met with indifference, having nobody to share life with, and lacking purposeand meaning. The first theme was considered an overarching theme due to its closeinterrelatedness with the other three themes. The comprehensive understanding of ELamong frail older people was ‘being disconnected from life’, an experience of at leastmomentary abandonment, being left to one’s fate, and living a meaningless life. Study IIshowed that existential loneliness was eased when being acknowledged by others, beingthe focus of others’ concern, encountering intimacy, and having meaningful exchangesof thoughts and feelings. It was further eased when the participants could bracketnegative thoughts and feelings, that is, when they could adjust and accept the presentsituation, view life in the ‘rear-view mirror’, be in contact with spiritual dimensions, andwithdraw and distract themselves. Existential loneliness could be either in the forefront(i.e., feelings of ill-being) (Study I) or in the background (i.e., feelings of well-being)(Study II). The findings of Study III indicated that performed interventions were the14most common subject of documented clinical notes, mostly related to pharmacologicalinterventions. Pain was the most common documented problem, followed by circulatoryproblems, nutrition problems, and anxiety. Clinical notes concerning wishes and wellbeing-related details were documented, but not frequently. Overall symptom assessmenttools, especially multi-dimensional tools, were used to a small extent. More people whoreceived care in palliative in-patient wards died alone than did people who received carein their own homes. Study IV was based on notes extracted from 84 patient records.The results indicated that documented existential aspects had both negative and positiveconnotations and were related to the patients’ loss of freedom and self-determination,loneliness and community, anxiety and inner peace, and despair and hope. The notesconcerning existential aspects were, however, not recorded in a structured way and nocare plans relating to existential aspects were found.According to the studies, both ill-being and well-being were evident, and the livedbody occupied a central position in all studies. The frail body increased the patients’vulnerability and limited their living space. Meaningful activities and meaningfulcommunity and exchange with others eased the existential loneliness. Existentialloneliness remains invisible to others as long as nobody talks about it, and it remainsinvisible in the documentation as long as it is not documented in a structured way.This thesis demonstrates the importance of making existential loneliness and existentialaspects visible in encounters with frail older people and in the clinical documentation.

Ort, förlag, år, upplaga, sidor
Malmö: Malmö universitet, 2020. s. 108
Serie
Malmö University Health and Society Dissertations, ISSN 1653-5383
Nyckelord
Existential loneliness, frail older people, palliative care, experiences, encounter, existential aspects, meaning, interview, retrospective record review, documentation, ill-being, well-being
Nationell ämneskategori
Omvårdnad
Identifikatorer
urn:nbn:se:hkr:diva-21410 (URN)10.24834/isbn.9789178771462 (DOI)978-91-7877-145-5 (ISBN)978-91-7877-146-2 (ISBN)
Disputation
2020-12-17, Zoom, 09:30 (Svenska)
Opponent
Handledare
Tillgänglig från: 2020-12-10 Skapad: 2020-12-10 Senast uppdaterad: 2022-11-01Bibliografiskt granskad

Open Access i DiVA

fulltext(525 kB)552 nedladdningar
Filinformation
Filnamn FULLTEXT01.pdfFilstorlek 525 kBChecksumma SHA-512
3363f1efbec656b99c314f799de8c75614291391ef9be5b3de2bc5e2e30213fb97dcf851337f29913d9e3065c445ee23d5e7ddcf316789321d445f33bec9d5ae
Typ fulltextMimetyp application/pdf

Övriga länkar

Förlagets fulltextPubMed

Person

Sjöberg, MarinaEdberg, Anna-Karin

Sök vidare i DiVA

Av författaren/redaktören
Sjöberg, MarinaEdberg, Anna-KarinBeck, Ingela
Av organisationen
Forskningsplattformen för Hälsa i samverkanAvdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskapForskningsmiljön Människa - Hälsa - Samhälle (MHS)
I samma tidskrift
International Journal of Older People Nursing
Omvårdnad

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 552 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 1395 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf