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Etični vidik prehranjevanja in pitja ob koncu življenja : magistrsko delo
Novak, Brigita (Avtor), Kovač, Edvard (Mentor) Več o mentorju... Povezava se odpre v novem oknu, Pandel Mikuš, Ruža (Komentor)

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Izvleček
Uvod: Smrt je najbolj gotovo dejstvo v življenju. Nekoč je bilo umiranje življenjski dogodek, naši predniki so umirali doma, naravne smrti, danes sta se umiranje in smrt preselila v zdravstvene institucije. Umiranje ni dogodek, temveč eksistencialni fenomen. Človeška bit je kot bit-do-sebe obenem tudi bit-k-smrti. Zdravstveni delavci se v okviru svojega poklicnega delovanja pogosto srečujemo z umiranjem in s smrtjo bolnikov. Namen: Namen magistrskega dela je s pomočjo pregleda in analize strokovne in znanstvene literature predstaviti glavne značilnosti temeljne življenjske aktivnosti prehranjevanja in pitja ob koncu življenja z etičnega vidika. S pomočjo polstrukturiranih intervjujev smo ugotavljali, s kakšnimi težavami se srečujejo pri prehranjevanju in pitju zdravstveni delavci pri delu z bolniki, in predstavili stiske in dileme zdravstvenih delavcev pri izvajanju paliativne oskrbe, posebej pri izvajanju hranjenja in pitja. Metode: Za predstavitev teoretičnih osnov in opis raziskovalnega problema smo uporabili deskriptivno metodo dela s pregledom domače in tuje literature ter dosedanjih raziskav na tem področju. V empiričnem delu je uporabljena metoda polstrukturiranega intervjuja, ki je potekal po 9 kategorijah. V raziskavi je sodelovalo 15 zdravstvenih delavcev, ki izvajajo paliativno zdravstveno oskrbo na vseh treh ravneh zdravstvenega varstva (za analizo teh različnih virov istega problema smo uporabili tehniko triangulacije). Besedila intervjujev smo analizirali z odprtim kodiranjem. Rezultati: Večina intervjuvancev smatra življenje kot proces, ki se zaključi s smrtjo in pomeni konec življenja. Umiranje je eden najtežjih trenutkov, najtežji del v poklicu medicinske sestre in naj bi bilo dostojno in mirno ter brez bolečin. Zmanjšan vnos hrane in šibkost bolnikov so naravni znaki odhoda, s hrano poskusimo, dokler ima smisel, na koncu nadomeščamo samo tekočino, vse drugo je podaljševanje trpljenja, kar ni smiselno in ni kakovostno. Intervjuvanci so mnenja, da so poslušanje, upoštevanje mnenj, želja, vrednot, hidracija, lajšanje bolečin in kontrola dihanja najpomembnejše stvari. Bolnik potrebuje maksimalno kakovostno obravnavo, pomanjkanje časa ter osebja tega ne sme ovirati. Večina intervjuvanih zdravstvenih delavcev se najlažje pogovori s sodelavci, saj so si najbližje in so v isti situaciji, lahko se pogovorijo tudi z nadrejenimi. Nekateri pogrešajo strokovne pogovore, supervizije, izobraževanja, ki bi jim koristila, drugi se samoiniciativno pogovorijo s psihologom, psihiatrom. Zavedajo se, da je treba probleme predelati sproti, komunikacija mora biti prilagojena glede na situacijo. Včasih nekateri svojci sploh ne vedo, v kakšnem stanju je bolnik, drugi sodelujejo in imajo strategijo ob poslabšanju. Razprava in zaključek: Večini intervjuvancev soočanje z umirajočimi predstavlja psihično obremenitev, nekateri poiščejo strokovno pomoč, drugi ne. Za delo z umirajočimi so potrebna posebna znanja s področja paliativne zdravstvene nege, etike in komunikacije. Z osvajanjem teh novih znanj postaja delo z umirajočimi in z njihovimi svojci lažje in manj stresno, sodelovanje med različnimi ravnmi zdravstvenega varstva pa poteka enostavneje. Z uvajanjem supervizije v klinično okolje bi se zdravstveno osebje lažje soočalo z dilemami, ki nastajajo pri njihovem delu, z dejansko uvedbo strokovnih kompetenc in standardov zdravstvene nege tudi na tem področju pa bi lažje delovali. Z raziskavo smo pridobili vpogled, s kakšnimi težavami se soočajo zdravstveni delavci pri delu z umirajočimi bolniki. Področje paliativne oskrbe ponuja še veliko možnosti in priložnosti za izboljšave, razvoj in raziskovanje ob prisotnem sodelovanju in medsebojnem podpiranju vseh sodelujočih, ki delujejo na tem področju.

Jezik:Slovenski jezik
Ključne besede:etična odgovornost, etični vidik prehranjevanja in pitja, paliativna oskrba, paliativna zdravstvena nega, vloga medicinske sestre
Vrsta gradiva:Magistrsko delo/naloga (mb22)
Organizacija:ZF - Zdravstvena fakulteta
Leto izida:2019
COBISS.SI-ID:5655147 Povezava se odpre v novem oknu
Število ogledov:64
Število prenosov:31
Metapodatki:XML RDF-CHPDL DC-XML DC-RDF
 
Skupna ocena:(0 glasov)
Vaša ocena:Ocenjevanje je dovoljeno samo prijavljenim uporabnikom.
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Sekundarni jezik

Jezik:Angleški jezik
Naslov:Ethical aspects of eating and drinking at the end of life : master thesis
Izvleček:
Introduction: Death is the most certain fact in life. Dying used to be a life event – our ancestors were dying at home, of natural causes. Today, dying and death have moved into health institutions. Dying is not an event, but an existential phenomenon. The human beings are both beings-to-themselves and beings-towards-death. As part of their profession, health professionals often face dying and death of their patients. Purpose: The purpose of the master’s thesis is to explore the main characteristics of the basic life activity of eating and drinking at the end of life from an ethical point of view by examining and analysing specialized and scientific literature. Using semi-structured interviews, we discussed eating and drinking problems encountered by health professionals when working with patients, as well as distress and dilemmas faced by health professionals when providing palliative care, especially feeding and drinking. Methods: As far as it concerns the theoretical basis and description of the research problem, we used the descriptive method, examining Slovenian and foreign literature and previous research in this field. In the empirical part, we used the method of a semi-structured interview divided into 9 categories. The research involved 15 health professionals that provide palliative care at all three levels of healthcare (we analysed these different sources of the same problem using triangulation). The interview texts were analysed using open coding. Results: Most interviewees see life as a process that ends with death. Dying is one of the most difficult moments, the hardest part of nursing profession; it should be decent, calm and painless. Reduced food intake and weakness are natural signs of departure. We try to feed patients as long as it makes sense. At the end, we only replace fluids – everything else is an unreasonable and non-quality extension of suffering. The interviewees believe that listening, taking into account patient’s opinions, desires and values, hydration, pain relief and breathing control are most important. Patients need treatment of maximum quality, despite the lack of time and staff. The majority of interviewed health professionals are most likely to talk to their co-workers because they are closest to them and in the same situation, while they can also talk to their superiors. Some of them miss professional conversations, supervision and useful training, while others talk to a psychologist or psychiatrist on their own initiative. They understand that any problem should be tackled promptly and that communication should be adjusted to a particular situation. Some relatives are not even aware of patient’s condition, while others cooperate and have a strategy in case of a deterioration. Discussion and conclusion: When faced with dying patients, most interviewees take on a psychological burden; some of them seek professional help and some of them do not. Working with dying patients requires a special set of skills at palliative nursing care, ethics, and communication. After acquiring these new skills, working with dying people and their relatives becomes easier and less stressful, while cooperation between different levels of healthcare becomes smoother. By introducing supervision into a clinical environment, health professionals would find it easier to face work dilemmas, while the actual introduction of professional competencies and healthcare standards in this field would facilitate their work. The research gave us insight into the problems encountered by health professionals when working with dying patients. The field of palliative care offers many possibilities and opportunities for improvements, development and research in the presence of cooperation and mutual support of all those working in this field.

Ključne besede:ethical responsibility, ethical aspect of eating and drinking, palliative care, palliative nursing care, nurse’s role

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