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  • 1.
    Forsner, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eriksson, Katarina
    Svedberg, Marianne
    Furingsten, Lovisa
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    When children die: a survey in Sweden about hospital guidelines related to care after death2014Conference paper (Refereed)
  • 2.
    Forsner, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Heimdal, Sara
    Jacobsson, Marlene
    Furingsten, Lovisa
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lûtzén, Kim
    Karolinska Institutet.
    Health care professionals’ experiences of moral stress when children are dying2014Conference paper (Refereed)
  • 3.
    Furingsten, Lovisa
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Sjögren, Reet
    Mälardalen university, Sweden.
    Forsner, Maria
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Caring for dying children in an acute paediatric ward2013Conference paper (Other academic)
    Abstract [en]

    Introduction

    Swedish acute paediatric wards usually focuses on children with urgent and short-time illnesses and the care is not always suited for a dying child. Caring for dying children in this context therefor faces special challenges and needs to be further investigated through research from the health care professionals´ (HCP) perspective.

     

    Purpose

    The aim was to describe caring as presented in professional caregivers’ experiences of caring for dying children in paediatric ward.

     

    Material

    Four HCP in a paediatric ward, which had been caring for at least one dying child during the last five years, participated.

     

    Methods

    A phenomenological approach was chosen using qualitative in-depth interviews, starting with one opening question, continuing with follow-up questions according to responsive listening. Data were analysed following four steps suggested by Giorgi: reading to capture the global sense, constitution of parts into ‘meaning units’, transformation from implicit meaning to explicit constituents and gaining structure.

     

    Results

    The findings are represented in five constituents. Presence is a prerequisite for caring when a child is dying. Self-knowledge and support from others are suggested to help when the HCP is suffering and struggling with the injustice in dying. The essence of caring for dying children is like a musical attuned composition. The moments are vulnerable and could easily be disrupted and turn into disharmony.

     

    Conclusions

    The HCP needs self-knowledge to be true and sensitive in the perceived situation of injustice when caring for dying children and their families. Caring assumes presence; however, caring for dying children is found to mean suffering to HCP and raises the need for support from others.

  • 4.
    Furingsten, Lovisa
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjögren, Reet
    Mälardalen University and Linnaeus University.
    Forsner, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ethical challenges when caring for dying children2015In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 22, no 2, p. 176-187Article in journal (Refereed)
    Abstract [en]

    Background: Caring for dying children presents special challenges, according to the children themselves, their relatives and healthcare professionals. 

    Objective: The aim of this study was to describe caring as represented in healthcare workers' experiences of caring for dying children. 

    Method: A phenomenological approach was chosen, in-depth interviews were carried out and data were analysed in four steps focusing on (a) open reading, (b) meaning units, (c) constituents and (d) essence. 

    Ethical considerations: Four nurses in a general acute paediatric care setting in Sweden participated after providing written informed consent. Voluntary participation and confidentiality were ensured, and the study was ethically approved. 

    Findings: The essence of caring for dying children was likened to a musically attuned composition, comprising five constituents: presence, self-knowledge, injustice in dying, own suffering and in need of others. Presence was found to be a prerequisite for caring when a child is dying. Self-knowledge and support from others can be of help when struggling with emotional pain and injustice. 

    Discussion: Caring for dying children has been found to be a delicate task for healthcare workers all over the world, and the ethical dimension is emphasized in international research. In this study, emotional pain and suffering accompanied caring, but an atmosphere in which it is possible to give and get support from colleagues and to have time to grieve and time to focus on the patient's needs may ease the burden, as can having time to process thoughts about life and death, and a possibility to grow in self-knowledge. 

    Conclusion: Caring in ethically demanding situations may be facilitated through presence, atmosphere, self-knowledge and time. The challenge does not demand highly technological solutions; these assets are readily available, no matter where on earth. However, there is a need to further investigate these prerequisites for caring, particularly when a child is dying.

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