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The Influence of Environment in Palliative Care
Supporting or hindering experiences of ‘at-homeness’
Birgit H Rasmussen
Senior Lecturer, Department of Nursing, Umeå University, Umeå, Sweden
David Edvardsson
Postdoctoral Research Fellow, Department of Nursing, Umeå University, Umeå, Sweden; Australian Centre for Evidence-Based Aged Care (ACEBAC), La Trobe University, Melbourne VIC
Abstract
Florence Nightingale stated that the art of nursing is to provide an environment in which the patient is in the best position for nature to act upon, and Martha Rogers, in turn, emphasized that one part in nursing is to pattern the environment into a place where healing conditions are optimal.
This paper presents a preliminary conceptual framework that describes the influence of environment in palliative care. Based on previously published studies, a conceptual framework describing the influence of environments in palliative care was developed consisting of an atmosphere of hospitality; an atmosphere of safety; and, an atmosphere of ‘everydayness’. The framework describes that the atmosphere is created in the meeting between the person’s needs/expectations and the environment, an atmosphere that can influence experiential outcomes of ‘at-homeness’ or homelessness in the palliative care setting.
In conclusion, this preliminary conceptual framework may contribute to nursing practice by providing a conceptual basis for actively reflecting on and evaluating the atmosphere in palliative care settings.
Keywords
Palliative care, environment, conceptual framework, safety, hospitality, everydayness, at-homeness
References
Andershed B and Ternestedt BM (1997) Patterns of care for patients with cancer before and after the establishment of a hospice ward, Scandinavian Journal of Caring Sciences 11(1): 42-50.
Axlagardens Hospice. (2007) Boendet. Accessed 5 June 2007 at http://www.axlagarden.se/subsidor/boende.htm
Bracke Diakoni. (2007) I livets slutskede. Accessed 4 June 2007 at
http://www.brackediakoni.se/index.php?level1=utbud&level2=content
/utbud/slutskede.php
Brilowski GA and Wendler MC (2005) An evolutionary concept analysis of caring. Journal of Advanced Nursing 56(1):641-650.
Bruner JS (1990) Acts of Meaning, Harvard University Press, Cambridge.
Buckingham RW, Lack SA, Mount BM, MacLean LD and Collins JT (1976) Living with the dying: use of the technique of participant observation, Canadian Medical Association Journal 115: 1211-1215.
Cannaerts N, Dierckx de Casterle B and Grypdonck M (2004) Palliative care, care for life: A study of the specificity of residential palliative care, Qualitative Health Research 14(6): 816-835.
Edvardsson D, Rasmussen BH and Riessman CK (2003) Ward atmospheres of horror and healing: A comparative analysis of narrative, Health: An interdisciplinary Journal for the Social Study of Health, Illness and Medicine 7(4): 377-396.
Edvardsson D, Sandman PO and Rasmussen B (2006) Meanings of being in the physical environment of an oncology clinic, Journal of Advanced Nursing 55(2): 188-197.
Edvardsson D, Sandman PO and Rasmussen B (2005) Sensing an atmosphere of ease – a tentative theory of supportive care settings, Scandinavian Journal of Caring Sciences 19(4): 344-353.
Edvardsson D (2005) Atmosphere in Care Settings. Towards a Broader Understanding of the Phenomenon, Umeå University Medical Dissertations, New Series No 941. http://www.diva-portal.org/umu/theses/abstract.xsql?dbid=406
Ersta Diakoni. (2007) Hospiceklinikens vardavdelning. Accessed 4 June 2007 at http://www.erstadiakoni.se/Page501.aspx
Fawcett J (2005) Contemporary Nursing Knowledge. Analysis and Evaluation of Nursing Models and Theories, Davis, Philadelphia.
Gates M (1991) Transcultural comparison of hospital and hospice as caring environments for dying patients, Journal of Transcultural Nursing 2(2): 3-15.
Hospice Gabriel. (2007) Med livet i centrum. Accessed 4 June 2007 at http://www.hospicegabriel.org/
Jeckert K (2003) Antroposofin – en Kritisk Granskning [in Swedish], (Anthroposophy – a Critical Study), Leopard Förlag, Stockholm.
Kim HS (1987) Structuring the nursing knowledge system: a typology of four domains, Scholarly Inquiry for Nursing Practice 1: 99-110.
Kvale S (1996) Interviews: an introduction to qualitative research interviewing, Sage, Thousand Oaks.
Kwok M and O'Brien J (1991) The Elements of Feng Shui, Element Books, Dorset.
Marcel G (1982) Creative Fidelity, The Crossroad Publishing Company, New York.
Meleis AI (1997) Theoretical Nursing. Development and progress, Lippincott-Raven, Philadephia.
Morse JM, Solberg SM, Neander WL, Bottorff JL and Johnson JL (1990) Concepts of caring and caring as a concept, Advances in Nursing Science 13(1): 1-14.
Nightingale F (1969) Notes on Nursing: What it is, and What it is not, Dover Publications, New York.
Ohlén J, Bengtsson J, Skott C and Segesten K (2002) Being in a lived retreat – embodied meaning of alleviated suffering, Cancer Nursing 25: 318-325.
Radley A and Taylor D (2003) Images of recovery: a photo-elicitation study on the hospital ward, Qualitative Health Research 13(1): 77-99.
Rasmussen BH (1999) In Pursuit of a Meaningful Living Amidst Dying: Nursing Practice in a Hospice, Umeå University Medical Dissertation, New Series No 592. http://www.umu.se/omvardnad/forskning/Kappor/BirgitRasmussen.pdf
Rasmussen BH, Jansson L and Norberg A (2000) Striving for becoming at-home in the midst of dying, American Journal of Hospice and Palliative Care 17(1): 31-43.
Rogers ME (1970) An Introduction to the Theoretical Basis of Nursing, Davis, Philadelphia.
Rogers ME (1992) Nursing science and the space age, Nursing Science Quarterly 5: 27-34.
Russell R (2000) Ethical Bodies. In Hancock P, Hughes B, Jagger E, Paterson K, Russel R, Tulle-Winton E and Tyler M (eds) The Body, Culture and Society, Open University Press, Philadelphia.
Simpson JA and Weiner ESC (1989) Oxford English Dictionary, Clarendon Press, Oxford.
Vidarkliniken (2007) Vidarklinikens arkitektur. Accessed 4 June 2007 at http://www.vidarkliniken.se/om_arkitekturen.php
Walker LO and Avant KC (1995) Strategies for Theory Construction in Nursing, Appleton & Lange, Norwalk.
Weiss GL and Lonnquist LE (2000) The Sociology of Health, Healing, and Illness, Prentice Hall, Upper Saddle River.
Williams M (1988) The physical environment and patient care, Annual Review of Nursing Research 7: 61-85.
Zingmark K, Norberg A and Sandman PO (1995) The experience of being at-home throughout the life span. Investigations of persons aged from 2 to 102, International Journal of Aging and Human Development 41: 47-62.
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