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Mellan hopp och förtvivlan - patienters erfarenheter av att vänta på en lungtransplantation: En litteraturöversikt
Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
2017 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesisAlternative title
Between hope and despair - Patients' experience of waiting for a lung transplant : A literature review (English)
Abstract [sv]

Bakgrund: Vid livshotande lungsjukdomar såsom vid kronisk obstruktiv lungsjukdom, cystisk fibros, interstitiella lungsjukdomar och pulmonell arteriell hypertension finns möjligheten till förlängt liv vid en lungtransplantation. En lungtransplantation är endast möjlig om en donator eller donatorns anhöriga sagt ja till att donera organ vid konstaterad hjärndöd. När patienter är uppsatta på väntelistan finns risken att de hinner avlida innan det kommer passande lungor att tillgå. Sjukvården behöver tillhandahålla en avancerad medicinsk vård och en palliativ vård parallellt.

Syfte: Syftet med denna litteraturöversikt var att undersöka hur patienter med allvarliga lungsjukdomar erfar att vänta på lungtransplantation.

Metod: En litteraturöversikt har utförts enligt inspiration av Forsberg & Wengström och Polit & Becks "niostegsmodell". Sökning efter resultatartiklar till litteraturöversikten gjordes i PubMed, CINAHL, PsycINFO och Google Scholar. Tretton vetenskapliga artiklar inkluderades, tolv kvalitativa och en mixad metod. Alla inkluderade artiklar kvalitetsgranskades enligt en granskningsmall av Willman, Stoltz & Bahtsevani.

Resultat: I resultat framträdde tre huvudkategorier: utmaningar, trygghet och begränsningar i vardagen, därtill även subkategorier. Rädsla och osäkerhet varierade under väntetiden parallellt med tacksamhet och hopp om att fortsätta leva. Stöd från närstående, vänner, transplanterade och sjukvården var betydelsefullt under vänteprocessen.

Diskussion: Litteraturöversiktens huvudfynd diskuterades utifrån bakgrund, tidigare forskning och begreppen lidande, mening och hopp i Travelbees omvårdnadsteori. Därtill diskuterades stödet från sjukvården i väntan på en lungtransplantation och dess svårigheter i att avgöra om och när palliativ vård skall sättas in till patienter som väntade på lungtransplantation.

Abstract [en]

Background: With life threatening lung diseases such as chronic obstructive pulmonary disease, cystic fibrosis, interstitial lung disease and primary pulmonary hypertension patients can live longer with a lung transplant. Lung transplantation is only possible if the donor is confirmed brain dead. A prerequisite is that consent has been given by the donor or their next of kin. There is, therefore, a risk that patients on the transplant waiting list die waiting for suitable lungs. Thus, it is necessary to provide medical care and palliative care simultaneously for these patients.

Aim: The aim of this literature review was to investigate what experiences patients with serious respiratory diseases have while waiting for a lung transplantation.

Method: A literature review has been completed using models developed by Forsberg & Wengstrom as well as the Polit & Becks "Nine-Stage Model". The literature search was done using PubMed, CINAHL, PsycINFO and Google Scholar. Thirteen articles are included, of these twelve are qualitative and one uses a mixed method. All articles included were quality reviewed according to a template of Willman, Stoltz & Bahtsevani.

Results: The results highlight three main categories: challenges, sense of security and limitations of daily life, as well as sub- categories. While waiting for transplant, the feelings of fear and uncertainty varied but ran in parallel with gratefulness and the hope of survival. Support from relatives, friends, other who had received transplants and health care professionals was meaningful during this time.

Discussion: The key findings of this present literature review were discussed in the relation to prior research, and the light of Travelbees, three concepts of suffering, hope and meaning. Additionally, health care personnel’s support was deliberated, as well as the difficulties in deciding if and when to initiate palliative care for these patients.

Place, publisher, year, edition, pages
2017. , 48 p.
Keyword [sv]
Lungtransplantation, väntelista, palliativ vård, hopp, mening
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-6385OAI: oai:DiVA.org:esh-6385DiVA: diva2:1146188
Educational program
Postgraduate Diploma in Specialist Nursing - Palliative Care 60 ECTS
Uppsok
Medicine
Supervisors
Examiners
Available from: 2017-10-02 Created: 2017-10-02 Last updated: 2017-10-09Bibliographically approved

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