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Sjuksköterskors erfarenheter av palliativ sedering: En litteraturöversikt
Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
2017 (Swedish)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesisAlternative title
Nurses' experiences of palliative sedation : A literature review (English)
Abstract [sv]

Bakgrund: Palliativ sedering avser en avsiktlig sänkning av medvetandegraden hos en patient som befinner sig i livets slutskede och har outhärdliga symtom. Behandlingen ges av ett multiprofessionellt team där sjuksköterskornas uppgift är att iordningställa och administrera ordinerade läkemedel samt utvärdera effekt och upplevelse av behandlingen. Förutom de praktiska kraven som ställs på sjuksköterskorna medför palliativ sedering även krav på förmåga till reflektion och kritiskt såväl som etiskt tänkande.

Syfte: Syftet med denna litteraturöversikt var att undersöka sjuksköterskors erfarenheter av palliativ sedering.

Metod: En litteraturöversikt genomfördes och tio vetenskapliga artiklar valdes ut till analys efter litteratursökningar i databaserna CINAHL Complete och PubMed.

Resultat: Tre teman med underteman identifierades. God palliativ vård inkluderade att ge palliativ sedering för att erbjuda patient, närstående och personal ett fridfullt avslut och för att uppfylla patientens önskningar. Palliativ sedering och eutanasi kunde vara svåra att skilja från varandra och sjuksköterskorna hade en känsla av att palliativ sedering påskyndande patientens död. Att arbeta i team var en viktig faktor för hur sjuksköterskor upplevde arbetet med palliativ sedering. Det underlättade om beslut om sedering togs gemensamt och olika former av stöd från teamet var betydelsefullt för sjuksköterskor under arbetet med palliativ sedering.

Diskussion: Resultaten diskuterades utifrån Jean Watsons omvårdnadsteori om mänsklig omsorg och tre av hennes caritasprocesser Ett kärleksfullt och omsorgsfullt sinnelag, Utrymme för känslor och Hjälpsamma och tillitsfulla omsorgsrelationer.

Abstract [en]

Background: Palliative sedation refers to an intentional lowering of consciousness of a patient in the end of life who is suffering from unbearable symptoms. The care is performed by a multi-professional team where the nurses’ duties are to prepare, administer and evaluate prescribed pharmaceuticals. In addition to the practical skills required by the nurses, this treatment also requires ability to reflect as well as critical and ethical thinking.

Aim: The aim of this literature review was to explore nurses’ experiences of palliative sedation.

Method: A literature review was conducted and ten scientific articles were chosen for analysis. Literature searches were made in the databases CINAHL Complete and PubMed.

Results: Three themes with subthemes were identified. Good palliative care included giving palliative sedation to offer patients, families and the staff a peaceful ending and to meet the patient’s wishes. Palliative sedation and euthanasia could be difficult to separate and there was a sense that palliative sedation hastened the patient’s death. Teamwork was an important factor for how nurses experienced working with palliative sedation. It was easier if the decision to sedate was taken jointly and support within the team was meaningful to nurses during their work with palliative sedation.

Discussion: The results were discussed in relation to Jean Watson’s Theory of Human Caring and the three caritas processes The practice of loving kindness and equanimity, Promotion and acceptance of the expression of positive and negative feelings and Developing and sustaining a helping-trusting caring relationship. 

Place, publisher, year, edition, pages
2017. , p. 38
Keywords [en]
Palliative sedation, Terminal sedation, Palliative care, End of life care, Team, Nurses’ experiences, Jean Watson
Keywords [sv]
Palliativ sedering, Terminal sedering, Palliativ vård, Vård i livets slutskede, Team, Sjuksköterskors erfarenheter, Jean Watson
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-6034OAI: oai:DiVA.org:esh-6034DiVA, id: diva2:1107309
Educational program
Bachelor of Science in Nursing
Uppsok
Medicine
Supervisors
Examiners
Available from: 2017-06-12 Created: 2017-06-09 Last updated: 2017-06-12Bibliographically approved

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