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Meanings of eating deficiencies for people admitted to palliative home care
Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.ORCID iD: 0000-0001-6019-4335
Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.ORCID iD: 0000-0001-8245-5479
Karolinska institutet.
Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.ORCID iD: 0000-0003-3660-6306
2015 (English)In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 13, no 05, p. 1231-1239Article in journal (Refereed) Published
Abstract [en]

Food and eating are embedded in people's everyday social lives: at home with family members and as part of social interactions. For people with progressive life-limiting conditions, however, eating is often obstructed. The objective of the present study was to explore the meanings of living with eating deficiencies at the end of life among people admitted to specialist palliative home care.

This qualitative inductive study employed an interpretive descriptive approach. A dozen persons, with various diagnoses and eating deficiencies, admitted to two specialist palliative home care units, participated. Data were collected through individual repeated interviews. Data collection and analysis were guided by the interpretive description method.

The results reveal that eating deficiencies among people with progressive life-limiting conditions are existentially loaded markers of impending death. Finding ways to overcome declined food intake and hampered eating enabled our participants to feel able to influence their own well-being and remain hopeful. The results also showed that the eating deficiencies influenced participants' relationships and social interactions in ways that hampered their possibilities of sharing valuable moments together with friends and family members during the final period of life.

Efforts to minimize the distress that people experience in relation to the challenges they face with eating deficiencies are important for well-being at the end of life. Person-centered approaches to acknowledge and support individuals' own ways of experiencing and dealing with their eating deficiencies are recommended that include a multidimensional perspective on food and eating.

Place, publisher, year, edition, pages
2015. Vol. 13, no 05, p. 1231-1239
Keywords [en]
Eating deficiencies, Existential, Food intake, Interpretive description, Palliative care
National Category
Health Sciences Nursing
Identifiers
URN: urn:nbn:se:esh:diva-4903DOI: 10.1017/S1478951514001199PubMedID: 25335943OAI: oai:DiVA.org:esh-4903DiVA, id: diva2:867229
Note

Publication status in dissertation: Published online october 22

Available from: 2015-11-05 Created: 2015-11-05 Last updated: 2023-02-16Bibliographically approved
In thesis
1. Mat och måltider vid livets slut: Patienter och närståendes erfarenheter av ätsvårigheter
Open this publication in new window or tab >>Mat och måltider vid livets slut: Patienter och närståendes erfarenheter av ätsvårigheter
2015 (Swedish)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Food and meals are embedded in people’s everyday social life. For people with progressive life-limiting conditions eating is often obstructed. When a dying person is cared for at home, family members often take responsibility for the provision of food and mealtimes. Previous research has shown that the situation around mealtimes can be stressful for patients and their partners. The overall aim of this thesis was to to explore meanings of eating deficiencies at the end of life, from a patient and partner perspective Methods: Interpretive descriptive design was chosen as the study sought to explore experiences related to eating deficiencies. Data was based on repeated individual interviews with dying persons (study I) and retrospective individual interviews with partners 3-6 months after the death of ill persons (study II). Data collection and analysis were guided by the interpretive description method. Findings: The results from the two studies showed that eating deficiencies among people with progressive life-limiting conditions and their partners are existentially loaded markers of impending death (I, II). The results also show that eating deficiencies can influence relationships and social interaction in ways that may hamper the possibility of sharing moments together with friends and family members that are valuable during the last period of life (I). Conclusion: Efforts to minimize the distress people with eating deficiencies and progressive life-limiting conditions and their partners may experience are important for well-being. Person-centered approaches to acknowledge and support individuals’ own ways of experiencing and dealing with eating deficiencies are recommended that include a holistic perspective on food and eating.

Place, publisher, year, edition, pages
Stockholm: Karolinska institutet, 2015. p. 38
National Category
Nursing
Identifiers
urn:nbn:se:esh:diva-5779 (URN)9789175497587 (ISBN)
Presentation
2015-02-06, Aulan, Stigbergsgatan 30, Stockholm, 13:00
Supervisors
Available from: 2017-02-15 Created: 2017-02-15 Last updated: 2023-02-16Bibliographically approved
2. Mealtimes in palliative care contexts: Perspectives of patients, partners, and registered nurses
Open this publication in new window or tab >>Mealtimes in palliative care contexts: Perspectives of patients, partners, and registered nurses
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim was to explore patients’, partners’, and registered nurses’ (RNs)experiences of mealtimes in palliative care contexts. Qualitative (studies I, II, IVand V) and quantitative (study IV) study designs were used to explore the experiences of mealtimes in palliative care from various perspectives. Three interview studies (studies I, II, V), a mixed-method systematic review (study III),and a cross-sectional study (study IV), were conducted. The findings showed that patient’s appreciated support that resembled their needs and wishes during hampered eating. Being encouraged to eat could both reduce and induce distress and well-being, social life was affected. Food and eating had existential loading (I, III). The partners described how they tried to support their dying partner by striving to maintain ordinariness around food and mealtimes, as well as finding new ways to support eating (II). RNs highlighted that food and mealtimes in palliative care cause psychosocial distress for patients and their families. Exploration implies that RNs perceptions align with patients’and families’, indicating awareness of the challenges that patients and families face (IV). RNs in palliative care are well prepared to support patients with eating challenges related to physical problems, but might be less prepared to support existential, psychological, and social needs (V).In conclusion, efforts to minimize the distress that patients and families experience in relation to mealtimes in palliative care are required. An area in need of further development is how to support RNs in communicating about food and mealtimes in palliative care to support patients’, partners’, and families’ well-being at the patient’s end-of-life.

Place, publisher, year, edition, pages
Stockholm: Marie Cederschiöld University, 2022. p. 110
Series
Avhandlingsserie inom området Människan i välfärdssamhället, ISSN 2003-3699 ; 14
Keywords
End-of-life, Family, Food, Mealtimes, Nursing, Nutrition, Palliative care, Partner, Patient perspectives, Registered nurses
National Category
Nursing
Research subject
The Individual in the Welfare Society, Palliative Care
Identifiers
urn:nbn:se:esh:diva-9425 (URN)978-91-985806-3-1 (ISBN)
Public defence
2022-04-08, 09:00
Opponent
Supervisors
Available from: 2022-03-11 Created: 2022-02-24 Last updated: 2023-09-22

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Wallin, ViktoriaCarlander (Goliath), IdaHåkanson, Cecilia

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